An Ecological Understanding of Caregiver Experiences in Palliative Care

Palliative care is specialized health care to improve quality of life for patients with serious illness and their families through prevention and relief of suffering. A Palliative Care Institute was held in western Washington to capture community voices about diverse needs, strengths, and opportunities for improvement of palliative care. Researchers employed qualitative methods to obtain thematic data, provide real-time analysis, and engage in a multivoting technique to reflect stakeholder interest in individual themes and prioritize larger group interests. Bronfenbrenner’s ecological systems framework was used to explore caregiver experiences. Within the microsystem, caregivers reported difficulties in interactions with medical providers as a key challenge. Within the mesosysytem, interactions between patients and medical providers and the impact on caregivers were explored. Within the exosystem, caregivers reported lack of control over the schedules of personal care staff. Macrosystem influences included impact of local culture on the development of palliative care services. Chronosystem influences include de-medicalization of childbirth and its impact on perceptions of palliative care. Implications include the need for social workers to be proactive in fostering trust and effective communication between care providers and caregivers, and the demand for health care provider training in communication with patients and families.     

Using the Inverse Maximum Ratio-Λ as a Technique to Quantify Surface Uniformity

Techniques used in variability assessment are subsequently used to draw conclusions regarding the “spread”/uniformity of data curves. Due to the limitations of these techniques, they are not adequate for circumstances where data manifest with multiple peaks. Examples of these manifestations (in three-dimensional space) include under-foot pressure distributions recorded for different types of footwear (Becerro-de-Bengoa-Vallejo et al., 2014 Biau, D.J. (2011). In brief: Standard deviation and standard error. Clinical Orthopaedics and Related Research 469(9):2661–2664.[Crossref], [PubMed], [Web of Science ®] , [Google Scholar]; Cibulka et al., 1994 Cibulka, M.T., Sinacore, D.R., Mueller, M.J. (1994). Shin splints and forefoot contact running: A case report. Journal of Orthopaedic &; Sports Physical Therapy 20(2):98–102.[Crossref], [PubMed], [Web of Science ®] , [Google Scholar]; Davies et al., 2003 Davies, M.B., Betts, R.P., Scott, I.R. (2003). Optical plantar pressure analysis following internal fixation for displaced intra-articular os calcis fractures. Foot &; Ankle International 24(11):851–856.[PubMed], [Web of Science ®] , [Google Scholar]), surface textures and interfaces designed to impact friction, and and and molecular surface structures such as viral epitopes (Torras and Garcia-Valls, 2004 Torras, C., Garcia-Valls, R. (2004). Quantification of membrane morphology by interpretation of scanning electron microscopy images. Journal of Membrane Science 233(1–2):119–127.[Crossref], [Web of Science ®] , [Google Scholar]; Pacejka, 1997; Fustaffson, 1997). This article proposes a technique for generating a single variable – Λ that will quantify the uniformity of such surfaces. We define and validate this technique using several mathematical and graphical models.     

Complexity and Self‐Sustainment in Disaster Response Supply Chains

Governmental organizations play a major role in disaster relief operations. Supply chains set up to respond to disasters differ dramatically in many dimensions that affect the cost of relief efforts. One factor that has been described recently is self‐sustainment, which occurs when supplies consumed by intermediate stages of a supply chain must be provided via the chain itself because they are not locally available. This article applies the concept of self‐sustainment to response supply chains. A mathematical model of a self‐sustaining response supply chain is developed. Analysis of this model yields insights about the relationships and interactions among self‐sustainment, speed of disaster onset, dispersion of impact, and the cost of the relief efforts.     

内蒙古城镇化质量评价研究

为了对内蒙古的城镇化质量做出科学地、客观的评价,本文结合内蒙古城镇化的特点,构建了多目标指标模型。首先结合层次分析法与隶属度分析,确定了3个一级指标、6个二级指标、21个三级指标,并且通过德尔菲法确定了各个指标的权重,最后得出城镇化质量评价函数,为各级政府提高城镇化品质提供决策依据。     

Stochastic Optimization for Natural Disaster Asset Prepositioning

A key strategic issue in pre‐disaster planning for humanitarian logistics is the pre‐establishment of adequate capacity and resources that enable efficient relief operations. This paper develops a two‐stage stochastic optimization model to guide the allocation of budget to acquire and position relief assets, decisions that typically need to be made well in advance before a disaster strikes. The optimization focuses on minimizing the expected number of casualties, so our model includes first‐stage decisions to represent the expansion of resources such as warehouses, medical facilities with personnel, ramp spaces, and shelters. Second‐stage decisions concern the logistics of the problem, where allocated resources and contracted transportation assets are deployed to rescue critical population (in need of emergency evacuation), deliver required commodities to stay‐back population, and transport the transfer population displaced by the disaster. Because of the uncertainty of the event's location and severity, these and other parameters are represented as scenarios. Computational results on notional test cases provide guidance on budget allocation and prove the potential benefit of using stochastic optimization.     

Trade openness and manufacturing growth in Malaysia

This study investigates the long-run relationship between trade openness and manufacturing growth and further assesses the causal relationship between these variables. Contrary to some scholars belief that at national level, openness does not contribute to growth in Malaysia, our sector specific analysis suggest otherwise. In this aspect, we believe that in any attempt to establish relationship between openness and growth, the analysis should be sector specific since it is more relevant as well as assures a meaningful insight for policy makers. The results suggest that in the long-run, trade openness is positively related to manufacturing growth in Malaysia. Furthermore, the results also suggest that openness should be viewed as the long term policy initiative for the sector to benefit. Therefore, the policy direction for Malaysian manufacturing sectors should focus on long term trade openness policies. Nevertheless, to ensure sustainability, emphasis should be placed on how (which manufacturing sub-sectors) or when openness is actually important. Importantly, policy makers and scholars should understand that leveraging the benefits of openness also depend on whether the liberalized sector has the comparative advantage.     

Focusing on Customer Time in Field Service: A Normative Approach

Although customer convenience should be rightfully considered a central element in field services, the customer experience suggests that service enterprises rarely take the customer's preferred time into account in making operational and scheduling decisions. In this paper we present the results of our exploratory research into two interrelated topics: the explicit inclusion of customer time in nonemergency field service delivery decisions and the analysis of trade‐off between the customer's convenience and field service provider's cost. Based on prior research in service quality we identify and illustrate two time‐based performance metrics that are particularly appropriate for assessing service quality in nonemergency field services: performance and conformance quality. To determine vehicle routes, we develop a hybrid heuristic derived from the existing and proven heuristic methods. A numerical example closely patterned after real‐life data is generated and used within a computational experiment to investigate alternate policies for promise time windows. Our experiment shows that over a reasonable range of customer cost parameters the policy of shorter promise time windows reduces the combined total cost incurred by the provider and the customers and should be considered a preferred policy by the field service provider. Managerial implications of this result are discussed.     

Exposition Psychological and social aspects of disease: A comparison of traditional and complementary medicine

Some comparisons are made between the treatment of patients by traditional and complementary medicine. Asthma, as an example of psychosomatic disease, is used to present the need for holistic treatment in stress related disease for which the patient's compliance is required.     

Measuring Human,Physical and Structural Capital Efficiency Performance of Insurance Companies

Based on the strategy perspective of intellectual capital, this paper proposes an integrated framework that is practical to estimate the human, physical, and structural capitals (intellectual capital) efficiency performance, at firm level. This paper uses a dynamic network data envelopment analysis model to estimate the intellectual capital efficiency at three levels in the insurance industry over the period of 2005–2012. Within the insurance industry, deficiencies occurred in the human and structural capital stages as opposed to the physical capital stage. A further investigation indicates that total investment is the major concern for the deficiencies. Moreover, the cluster analysis highlights the strengths and weaknesses of the insurers based on their inherently similar efficiencies. Malaysian insurance industry need to translate and promote the existing knowledge-based economy agenda lauded by the government to improve the intellectual capital efficiency, particularly at the human capital level.