A Simulation-Based Evaluation Of Efficiency Strategies For A Primary Care Clinic With Unscheduled Visits

In the health care industry, there are strategies to remove inefficiencies from the health delivery process called efficiency strategies. This dissertation proposed a simulation model to evaluate the impact of the efficiency strategies on a primary care clinic with unscheduled walk-in patient visits. The simulation model captures the complex characteristics of the Orlando Veteran\u27s Affairs Medical Center (VAMC) primary care clinic. This clinic system includes different types of patients, patient paths, and multiple resources that serve them. Added to the problem complexity is the presence of patient no-shows characteristics and unscheduled patient arrivals, a problem which has been until recently, largely neglected. The main objectives of this research were to develop a model that captures the complexities of the Orlando VAMC, evaluate alternative scenarios to work in unscheduled patient visits, and examine the impact of patient flow, appointment scheduling, and capacity management decisions on the performance of the primary care clinic system. The main results show that only a joint policy of appointment scheduling rules and patient flow decisions has a significant impact on the wait time of scheduled patients. It is recommended that in the future the clinic addresses the problem of serving additional walk-in patients from an integrated scheduling and patient flow viewpoint

Job Insecurity and Turnover Intentions among Banking Sector Employees: The Moderating Role of Organizational Support and Ethical Leadership

Purpose - Job insecurity exerts a significant impact on turnover intentions among employees. The association may be partly due to the influence of organizational support and the ethicality of leaders. However, there is a shortage of studies on the ameliorating role of organizational support and ethical leadership in the nexus between job insecurity and turnover intentions. Thus, the purpose of this study is to examine the nexus between job insecurity and turnover intentions among banking sector employees. The moderating role of organizational support and ethical leadership on the underlying relationship was assessed to achieve this. Design/methodology/approach – One hundred and sixty (160) banking sector employees were conveniently selected to participate in the study. The sample consisted of female (n = 92) and male (n = 68) employees, ranging from 23 to 49 years. Standardized measures were used in soliciting respondents' demographic characteristics, perceived job insecurity, ethical leadership, organizational support, and turnover intentions. Data were analyzed using regression analysis. Findings – Results revealed a significant positive correlation between perceived job insecurity and turnover intentions. Organizational support and ethical leadership also moderated the association between job insecurity and turnover intentions. The influence of job insecurity on turnover intentions minimizes when management provides the needed support and favorable climatic conditions. Originality/value – In general, the study highlights the importance of organizational support and ethical leadership in lessening the impact of job insecurity on turnover intentions

Anatomical and chemical characterization of Alstonia boonei for pulp and paper production

Alstonia boonei, an abundant lesser utilized species within the West African Subregion, was evaluated as an alternative raw material for pulp and paper production. The basic density (BD), fibre characteristics [fibre length (FL), fibre diameter (FD), lumen diameter (LD) and wall thickness (WT)], derived anatomical indices [Flexibility Ratio (FR), Slenderness Ratio (SR), Rigidity Coefficient (RC), Luce’s Shape Factor (LSF), Solids Factor (SF) and Runkel Ratio (RR)] and chemical composition (lignin, holocellulose, 1% NaOH solubility and ash contents) of A. boonei were studied to evaluate variation along the trunk (base, middle and top portions) and ascertain its suitability for pulp and paper production. Significant variations were observed in the density and fibre characteristics along the trunk of the tree. Although the FD was large, the observed adequate FL, thin-wall and large LD implied easy beating of fibres and manufacture of dense, smooth and strong papers. The favourable SF, RR, FR, RC, and LSF values obtained for the fibres would produce papers with suitable burst and tearing strengths and folding endurance. Chemically the lower lignin (< 30%), ash and 1% NaOH solubility and the high holocellulose contents of A. boonei, will generate a higher pulp yield. A. boonei although a low-density species, will be desirable for pulp and paper production

Barriers and opportunities in cyber risk and compliance management for data-driven supply chains

© 2022 The Authors. Published by Hawaii International Conference on System Sciences. This is an open access article available under a Creative Commons licence. The published version can be accessed at the following link on the publisher’s website: http://hdl.handle.net/10125/79557In today's highly competitive market, where globalisation, mass production, and specialisation characterise the interconnected industrialised society, integrated Supply Chains (SCs) are more important than ever. Decision-makers rely on precise SC data, and even the smallest interruption in the data flow can have a substantial impact on the quality of the decisions. This dependency has inadvertently driven device connectivity towards an Industrial Internet of Things (IIoT) approach in the complete interconnection paradigm. While interconnectivity between devices has accelerated, IIoT and Industry 4.0 SC security measures have not kept pace. This conflict is exacerbated further by the need to process the data produced by IIoT systems while maintaining data privacy. With personal data being an integral part of the SC paradigm, this paper provides an extensive review of academic sources and consulting reports and presents a comprehensive analysis of the SC management barriers in Industry 4.0, as well as the role that advancements in Blockchain and artificial intelligence (AI) can play in mitigating SC security management risks.Published onlin

Chemical and Mechanical Characterization of Thermally Modified Gmelina arborea Wood

Gmelina arborea (Roxb. ex. Sm.) wood samples were thermally modified at 180 °C, 200 °C and 220 °C for 3 h, by employing a process similar to ThermoWood®. The resulting effects on the basic chemical composition and mechanical properties were determined. The results were analyzed statistically with ANOVA, and Least Square Deviation was used to compare means. Generally, after the thermal modification (TM) process, the cellulose, hemicelluloses and extractives content decreased significantly. By contrast, lignin proportions increased significantly. Untreated wood and samples modified at 180 °C indicated comparable modulus of elasticity (MOE), modulus of rupture (MOR), degree of integrity (I), fine fraction (F) and resistance to impact milling (RIM). Noteworthy reductions however occurred at 200 °C and 220 °C. Significant increases in Brinell hardness (BH) took place at 180 °C, recording a high decrease at 220 °C. Gmelina arborea could be modified suitably at 180 °C for structural and other purposes. To take advantage of other improved properties, modification at 200 °C could be employed for non-structural uses.

PLA/WOOD BIOCOMPOSITES: IMPROVING COMPOSITE STRENGTH BY CHEMICAL TREATMENT OF THE FIBERS

A resol type phenolic resin was prepared for the impregnation of wood particles used for the reinforcement of PLA. A preliminary study showed that the resin penetrates wood with rates depending on the concentration of the solution and on temperature. Treatment with a solution of 1 wt% resin resulted in a considerable increase of composite strength and decrease of water absorption. Composite strength improved as a result of increased inherent strength of the wood, but interfacial adhesion might be modified as well. When wood was treated with resin solutions of larger concentrations, the strength of the composites decreased, first slightly, then drastically to a very small value. A larger amount of resin results in a thick coating on wood with inferior mechanical properties. At large resin contents the mechanism of deformation changes; the thick coating breaks very easily leading to the catastrophic failure of the composites at very small loads

Supply chain security management through data process decomposition : an architecture perspective

In today's volatile environment, we have never been more reliant on a tightly knit supply chain (SC). Globalisation, mass manufacturing, and specialisation are now hallmarks of our integrated, industrialised world. Decision-makers rely heavily on accurate up-to-the-minute data. Even the tiniest interruption in data flow can have a huge effect on the quality of decision-making and performance. In the full interconnection paradigm, this dependency has inadvertently pushed device connectivity toward an Industrial Internet of Things (IIoT) approach. This has allowed the provision of 'added value resources' such as SC optimisation for Industry 4.0 (I4.0) or enhanced process controls. While system interconnectivity has increased, Internet of Things (IoT) and I4.0 SC protection measures have lagged behind. The root cause of this disparity is the existing mainstream security practices inherited from industrial networks and linking systems that neglect any specific security capability. This paper introduces the preliminary design of an I4.0 SC architecture that offers a complete protocol break about how exacting security functions could be implemented by isolation, a rigorous access control system, and surveillance to ensure the proposed architecture's end-to-end security to I4.0 SC

RACIAL DISCRIMINATION IN THE CANADIAN CRIMINAL JUSTICE SYSTEM: HOW ANTI-BLACK RACISM BY THE TORONTO POLICE HARMS US ALL

Due to the persistent and tenacious practices of anti-Black racism, embedded in White supremacist policing practices, Black and Indigenous people are overwhelmingly overrepresented in the Canadian criminal justice system. Unsurprisingly, a disproportionate number of Black people are killed at the hands of police in Toronto. The Canadian criminal justice system is complicit in perpetuating anti-Black racism through practices of surveillance, carding, and racial profiling. This paper contributes to the analysis of anti-Black racism in the Canadian criminal justice system, emphasizing the circumstances of Black people in Toronto. The goal is to wed the study of Black criminalization with the analysis of anti-Black racism and social stratification in Canada to show how existing patterns of racism and socioeconomic marginalization are reinforced by a White supremacist criminal justice system. The paper offers recommendations to address the issue of anti-Black racism, including the hiring of more Black people in the police force. Conceptually, the paper contributes to our understanding of how anti-Black racism ricochets to hurt us all in society.En raison des pratiques persistantes et tenaces du racisme contre les Noirs, ancrées dans les pratiques policières influencées par la suprématie blanche, les Noirs et les Autochtones sont surreprésentés dans le système de justice pénale canadien. Il n’est donc pas surprenant qu’un nombre disproportionné de Noirs soient tués par la police à Toronto. Le système de justice pénale canadien est complice de la perpétuation du racisme contre les Noirs par des pratiques de surveillance, de fichage et de profilage racial. Cet article contribue à l’analyse du racisme contre les Noirs dans le système de justice pénale canadien, en mettant l’accent sur la situation des personnes noires à Toronto. L’objectif est de lier l’étude de la criminalisation des Noirs à l’analyse du racisme contre les Noirs et l’analyse de la stratification sociale au Canada, afin de montrer comment les modèles existants de racisme et de marginalisation socioéconomique sont renforcés par un système de justice pénale fondé sur la suprématie blanche. L’article propose des recommandations pour combattre le racisme contre les Noirs, notamment l’embauche d’un plus grand nombre de personnes noires dans les forces de police. Sur le plan conceptuel, l’article contribue à notre compréhension de la façon dont le racisme contre les Noirs affecte négativement toute la société