Management of the National Medical Stockpile

This audit assessed the effectiveness of the Department of Health’s management of the National Medical Stockpile. Audit objective, criteria and scope The audit objective was to assess the effectiveness of the Department of Health’s management of the National Medical Stockpile. To assist in evaluating the department’s performance in terms of the audit objective, the ANAO developed the following high level criteria: the Department of Health has sound governance arrangements in place for the management of the Stockpile, including an integrated and systematic approach to risk management and performance reporting; the Department of Health’s procurement and contract management arrangements for the Stockpile demonstrate a focus on getting the right outcomes and achieving value for money; the Stockpile’s inventory management system reflects value for money—it provides an assurance that the right items in the correct amount are being purchased, and stored appropriately, until they are either deployed, or they are disposed of on expiry; and the deployment plans and processes provide a high level of assurance that the Stockpile can be reliably deployed within agreed timeframes to agreed locations. The ANAO did not assess processes for the disposal or destruction of expired stock. While the audit examined aspects of the deployment strategy for the Stockpile, it did not seek to assess Australia’s general preparedness to respond to a national health emergency. Nor did the audit assess the clinical efficacy of stockpiled items. An ANAO performance audit in 2007–08 on Australia’s pandemic preparedness concluded that the Stockpile was established without high level planning, assessment of risks and an appropriate management framework. The ANAO recommended a shift from a short term ‘supply and store’ strategy for the Stockpile to a longer term management strategy. The current audit was not intended to assess implementation of all the earlier audit recommendations. However, in the course of the audit the ANAO considered the extent to which the Department of Health has implemented recommendations relating to the Stockpile. Overall conclusion The maintenance of the National Medical Stockpile (the Stockpile) since 2002 represents a significant government investment in the nation’s preparedness for public health emergencies resulting from terrorist activities or natural causes such as pandemics; with over 750 million allocated for the Stockpile in the past decade. In 2012–13 the Stockpile comprised 42 products and over 110 million items, with a reported value of almost 196 million. The effective management of this large strategic reserve, comprising pharmaceuticals and personal protective equipment with a limited shelf life, relies on planning and administrative arrangements geared to: select and procure appropriate items; warehouse and control the stock; and deal with expiring items. Effective deployment arrangements are also required to augment state and territory reserves of items from the Stockpile in a timely manner. Overall, the Department of Health’s management of the National Medical Stockpile has been generally effective in recent years, benefiting from improvements introduced since 2010. There remains scope, however, for improving the department’s strategic framework, operational management and deployment arrangements for the Stockpile. Since 2007, when the ANAO concluded that the department had not developed an appropriate framework for managing the Stockpile, the Department of Health has implemented a more structured management approach, including: the development of strategic and operational risk management plans in 2010; the rationalisation of previously fragmented storage contracts in 2010; the application of an evidence‑based approach for the selection of appropriate stockpile items; and the maintenance of formal deployment arrangements with states and territories. Strategies have also been adopted or examined for the cost‑effective replenishment and disposal of expired stockpile items. However, there remains scope for improving key elements of the department’s management arrangements, including: updating the strategic and operational risk management plans; clarifying aspects of the storage contracts to strengthen reporting and performance monitoring; improving the integrity of data used to manage the stockpile; and planning to test Stockpile deployment arrangements. Key issues relating to the Stockpile’s strategic framework, operational management and deployment are discussed in the following paragraphs. The department adopted a more strategic approach to the Stockpile’s management with the introduction of a strategic plan in 2010, albeit some eight years after the Stockpile was established. While the plan broadly describes the governance, funding and administrative arrangements for the Stockpile, it should be updated to identify objectives, priorities and strategies for the Stockpile’s management—key elements of a strategic plan. High level outcomes for the Stockpile agreed to in 2011 by the then Government should also be reflected in an updated plan. Operational management of the Stockpile benefited from the introduction of an operational risk management plan in 2010, which should be updated to reflect risks identified in the Department of Finance’s 2011 Strategic Review of the Stockpile. Operational management was further improved with the consolidation of warehousing arrangements into two longer‑term contracts with logistics firms, relating to pharmaceutical items and personal protective equipment. However, management reports have not been regularly provided, as required under the contracts, and the department should clarify reporting obligations. Further, there is scope to address weaknesses in some system controls and shortcomings in manual processing, which have contributed to the emergence of data integrity issues such as discrepancies between information held in the Stockpile database and warehouse system records. The department has developed a deployment framework with states and territories, although these arrangements have not been recently tested. To provide assurance that deployment arrangements will be effective in a national health emergency, the department should undertake planning to test deployment arrangements, in consultation with other jurisdictions. While there remains scope for further improvement as indicated above, the department’s work in recent years demonstrates a more active approach to management of the Stockpile, as does the recent focus on the findings of the 2011 Strategic Review. The ANAO has made four recommendations aimed at improving the effectiveness of the department’s management of the Stockpile, by: improving strategic planning and risk management; enhancing performance reporting by contractors; reviewing information management arrangements; and planning to test deployment arrangements

Assessment of Factors Contributing to Medicine Expiry in Rwanda: Case of the Medical Procurement and Production Division

BackgroundRegardless of the significant efforts used and put in place to enhance supply chain performance in Rwanda, there is still poor inventory management and big loss due to expiry of medicines at Medical Procurement and Production Division (MPPD).ObjectiveTo assess the factors that contributes to expiry of medicines at MPPD and formulate recommendations for the improvement of the current situation.MethodsThis is a descriptive cross-sectional study used for 25 respondents. A questionnaire containing closed-ended questions was used focusing on factors contributing to expiries of medicines for each product category managed by MPPD from 2014-2018. Additionally, the researcher reviewed all inventory reports, including expiries for the same period under study. The study focused on targeting respondents working at MPPD as pharmacists both technical and administrative, also other non-pharmacist working in the warehouse were considered as respondents. The hard copy of questionnaire was handed over to 26 respondents and requested to provide filled questionnaire within seven days. Twenty-five respondents were able to return the filled questionnaire on time, giving 96% response rate.ResultsThe study found that in MPPD, medicines are still expiring. During five years (from 2014 up to 2018) the total expired products were valued at RWF 6,046,778,655 for all program categories: HIV commodities had the largest share 53.3%, Essential Medicines 22.5%, Malaria 13%, Maternal Child Health commodities 5.7%, Products used for Community health workers 4.5%, TB products 1% and 0.1% for Family Planning products. The study found that major contributing factors for expiry of health commodities at MPPD, are ranked as follows: Supply chain management 90%, other factors 73%, Poor storage management 68% and Excessive drug supply 67%. ConclusionConsidering the study results, it looks like no significant effect of excessive drug supply and inventory management on the expiration of medicines at MPPD. However, the Supply Chain Management components are the most vulnerable to contribute to the expiration of medicines at MPPD. There are many changes to be done inside the institution to remedy the issue of expiration like working according to the standard operating procedures, improving the Skills of personnel in supply chain management, empowering the procurement unit with skilled personnel and improving the communication with stakeholders to facilitate the smooth and quick replenishment and distribution of the stock. Rwanda J Med Health Sci 2021;4(2): 281-29

A quantitative mirror on the Euribor market using implied probability density functions

This paper presents a set of probability density functions for Euribor outturns in three months’ time, estimated from the prices of options on Euribor futures. It is the first official and freely available dataset to span the complete history of Euribor futures options, thus comprising over ten years of daily data, from 13 January 1999 onwards. Time series of the statistical moments of these option-implied probability density functions are documented until April 2010. Particular attention is given to how these probability density functions, and their associated summary statistics, reacted to the unfolding financial crisis between 2007 and 2009. In doing so, it shows how option-implied probability density functions could be used to contribute to monetary policy and financial stability analysis. JEL Classification: C13, C14, G12, G13financial, financial market, options, probability density functions

The Performance of Chicago Board of Trade Corn, Soybean, and Wheat Futures Contracts after Recent Changes in Speculative Limits

Three attributes of futures contract behavior important for market performanceliquidity, volatility, and convergenceare investigated before and after the 2005 increase in speculative position limits for corn, soybean, and wheat contracts at the Chicago Board of Trade. The analysis of liquidity and market depth reveals a sharp increase in open interest for corn, soybeans and wheat beginning in late 2005. The increase in position limits likely accommodated the increase in speculative interest in corn, soybean and wheat futures, but some of the increase would have occurred without the increase as new market participants received hedge exemptions. The analysis of price volatility revealed no large change in measures of volatility after the change in speculative limits. For corn and soybeans, the picture that unfolds relative to convergence patterns is one of weakness, but not failure. For wheat, the picture that unfolds relative to convergence patterns is not only one of weakness, but failure to accomplish one of the fundamental tasks of a futures market. The persistence and growing magnitude of the delivery location basis in wheat suggests a problem with the contract specifications.corn, futures contract, performance, soybeans, speculation, wheat, Marketing,

A client focused business intelligence & analytics solution for the hospitality sector

Project Work presented as the partial requirement for obtaining a Master's degree in Information Management, specialization in Knowledge Management and Business IntelligenceOne of the greatest needs of today's business is to know the customer or the type of customer it wants to reach, which makes a customer database a strategic weapon and one of the most important investments a company can make. The business world is becoming more competitive every day, we are constantly overwhelmed with advertisements of products we may like, product promotions we usually buy or discounts on the next purchase if we subscribe to the company’s newsletter. All of this creates a client customization, and any company that is not able to do this cannot keep up with its competition. This report details the project developed at Pestana Hotel Group, which consisted of a Business Intelligence solution, more specifically the development of a customer database with the creation of two tabular models using SQL Server tools, one specific for loyal customers and another, more general, with information about all Pestana customers, and two Power BI reports that allow the visualization of the information obtained in an effective and simplified way. This report contains a literature review that situates the reader on the subject addressed in this project, a chapter dedicated to the data modeling used to create the tabular models, and another on the creation of the reports.Uma das maiores necessidades dos negócios atuais é conhecer o seu cliente ou o tipo de cliente que quer atingir, o que torna uma base de dados de cliente uma arma estratégica e um dos mais importantes investimentos. O mundo empresarial está cada dia mais competitivo, somos constantemente assoberbados com anúncios de produtos que podemos gostar, promoções de produtos que costumamos comprar ou descontos na próxima compra caso subscrevamos a newsletter. Tudo isto cria uma personalização para o cliente, e qualquer empresa que não o consiga fazer não conseguirá acompanhar a concorrência. Este relatório detalha o projeto feito no Pestana Hotel Group, que consistiu numa solução de Business Intelligence, mais especificamente na construção de uma base de dados do cliente com a criação de dois modelos tabulares através de ferramentas do SQL Server, um específico para clientes fidelizados e outro mais geral com informação sobre todos os clientes Pestana, e dois relatórios em Power BI que permitem a visualização da informação obtida de uma forma eficaz e simplificada. O relatório contém uma revisão de literatura que situa o leitor sobre os assuntos abordados neste projeto, um capítulo dedicado à modelação dos dados de forma a criar os modelos tabulares e outro sobre a criação dos relatórios

Underdeveloped spot markets and futures trading: The Soya Oil exchange in India

The limited presence of futures exchanges in developing countries where commodity markets fall short of the ideal underscore the importance of understanding the relation between spot and futures markets. The paper examines the exceptional success of the soya oil contract at the National Board of Trade (NBOT) in India. The paper asks whether the NBOT contract exhibits the fundamental features of mature futures markets in terms of its use by hedgers. If the market offers arbitrage opportunities to hedgers and if such activity is significant, then the activities of commercial firms should affect the returns to their hedging portfolio i.e., change in basis. This insight is developed into an examination of the impact of soya oil imports on the basis. Despite the lack of key market institutions such as certified warehouses and centralized spot prices, the NBOT contract compares well with mature exchanges. Soya oil imports exercise a significant impact on the basis and provide enough short-term volatility to make the contract attractive to both hedgers and speculators.hedging, futures markets, spot markets, soya oil

Offline and online power aware resource allocation algorithms with migration and delay constraints

© . This manuscript version is made available under the CC-BY-NC-ND 4.0 license http://creativecommons.org/licenses/by-nc-nd/4.0/In order to handle advanced mobile broadband services and Internet of Things (IoT), future Internet and 5G networks are expected to leverage the use of network virtualization, be much faster, have greater capacities, provide lower latencies, and significantly be power efficient than current mobile technologies. Therefore, this paper proposes three power aware algorithms for offline, online, and migration applications, solving the resource allocation problem within the frameworks of network function virtualization (NFV) environments in fractions of a second. The proposed algorithms target minimizing the total costs and power consumptions in the physical network through sufficiently allocating the least physical resources to host the demands of the virtual network services, and put into saving mode all other not utilized physical components. Simulations and evaluations of the offline algorithm compared to the state-of-art resulted on lower total costs by 32%. In addition to that, the online algorithm was tested through four different experiments, and the results argued that the overall power consumption of the physical network was highly dependent on the demands’ lifetimes, and the strictness of the required end-to-end delay. Regarding migrations during online, the results concluded that the proposed algorithms would be most effective when applied for maintenance and emergency conditions.Peer ReviewedPreprin

Fifty-Sixth Annual Report of the Federal Mediation and Conciliation Service, Fiscal Year 2003

Federal Mediation and Conciliation ServiceFMCSFY2003_Annual_Report.pdf: 385 downloads, before Oct. 1, 2020

Underdeveloped Spot Markets and Futures Trading: The Soya Oil Exchange in India

Abstract The limited presence of futures exchanges in developing countries where commodity markets fall short of the ideal underscore the importance of understanding the relation between spot and futures markets. The paper examines the exceptional success of the soya oil contract at the National Board of Trade (NBOT) in India. The paper asks whether the NBOT contract exhibits the fundamental features of mature futures markets in terms of its use by hedgers. If the market offers arbitrage opportunities to hedgers and if such activity is significant, then the activities of commercial firms should affect the returns to their hedging portfolio i.e., change in basis. This insight is developed into an examination of the impact of soya oil imports on the basis. Despite the lack of key market institutions such as certified warehouses and centralized spot prices, the NBOT contract compares well with mature exchanges. Soya oil imports exercise a significant impact on the basis and provide enough short-term volatility to make the contract attractive to both hedgers and speculators.basis, hedging, futures market, spot markets, soya oil, Marketing, G13, Q13,