Stochastic last mile relief network design with resource reallocation

We study a last mile distribution network design problem for situations where there exist local distribution centers (LDCs) with pre-positioned supplies. Given the information on the existing pre-disaster relief network, the problem determines the locations and capacities of LDCs and points of distribution in the relief network, while capturing the uncertain aspects of the post-disaster environment. We introduce new accessibility metrics, and develop two alternate two-stage stochastic optimization models that would allow more accessible and equitable distribution of relief supplies. Since solving the proposed optimization models is computationally challenging, we employ decomposition-based branch-and-cut algorithms. We perform numerical analysis based on the real-world data from the 2011 Van earthquake in Turkey to provide insights about the proposed models, and also conduct a computational study that demonstrates the effectiveness of the solution method

Coping with production time variability via dynamic lead-time quotation

In this paper, we propose two dynamic lead-time quotation policies in an M/GI/1 type make-to-stock queueing system serving lead-time sensitive customers with a single type of product. Incorporating non-exponential service times in an exact method for make-to-stock queues is usually deemed difficult. Our analysis of the proposed policies is exact and requires the numerical inversion of the Laplace transform of the sojourn time of an order to be placed. The first policy assures that the long-run probability of delivering the product within the quoted lead-time is the same for all backlogged customers. The second policy is a refinement of the first which improves the profitability if customers are oversensitive to even short delays in delivery. Numerical results show that both policies perform close to the optimal policy that was characterized only for exponential service times. The new insight gained is that the worsening impact of the production time variability, which is felt significantly in systems accepting all customers by quoting zero lead times, decreases when dynamic lead-time quotation policies are employed

A taxonomy of supply chain innovations

In this paper, a taxonomy of supply chain and logistics innovations was developed and presented. The taxonomy was based on an extensive literature survey of both theoretical research and case studies. The primary goals are to provide guidelines for choosing the most appropriate innovations for a company, and help companies in positioning themselves in the supply of chain innovations landscape. To this end, the three dimensions of supply chain innovations, namely the goals, supply chain attributes, and innovation attributes were identified and classified. The taxonomy allows for the efficient representation of critical supply chain innovations information, and serves the mentioned goals, which are fundamental to companies in a multitude of industries

Stochastic last mile relief network design with resource reallocation

We study a last mile distribution network design problem for situations where there exist local distribution centers (LDCs) with pre-positioned supplies. Given the information on the existing pre-disaster relief network, the problem determines the locations and capacities of LDCs and points of distribution in the relief network, while capturing the uncertain aspects of the post-disaster environment. We introduce a new accessibility metric and develop a two-stage stochastic programming model that would allow more accessible and equitable distribution of relief supplies. Since solving the proposed stochastic optimization model is computationally challenging, we employ a scenario decomposition-based branch-and-cut algorithm. We perform a computational study -- based on the real-world data from the 2011 Van earthquake in Turkey -- to provide insights about the model and demonstrate the effectiveness of the solution method

Manisa merkez yarı kentsel bölgede bir aile sağlığı birimine kayıtlı kadınlarda bazı birinci basamak sağlık hizmet özelliklerinin değerlendirilmesi

Özet                       Amaç: Birinci basamak sağlık hizmet özellikleri kaynakça doğrultusunda bilimsel olarak ölçülebilir niteliktedir ve ilk başvuru, süreklilik, kapsayıcılık ve koordinasyon gibi temel hizmet özellikleri üzerinden değerlendirilir. Yöntem: Örnek seçiminde çok aşamalı küme örnekleme yöntemi kullanılmış, veriler yüz yüze görüşme tekniğine göre yapılandırılmış anketle toplanmıştır. Araştırma bölgesindeki toplam hane sayısı 870’tir. Küme örnekleme yöntemi ile 376 haneden 318 kadına ulaşılmıştır. Araştırmanın ulaşılabilirlik oranı % 84.6’dır. Araştırmanın bağımlı değişkenleri; İlk başvuru, Süreklilik, Kapsayıcılık ve OHS (Olağan Hizmet Sürekliliği) gibi hizmet özellikleridir. Bağımsız değişkenler ise kadının ve eşinin yaşı, kadın ve eşinin eğitimi, medeni hal, kadının çalışma durumu, sosyal sınıf (eşin işine göre), gelir algısı, bölgede yaşama yılı, göç edilen bölge, sağlık güvencesi, aile tipi, beş yaşından küçük çocuk varlığı ve hanedeki çocuk sayısı kullanılmıştır. Bulgular: Katılımcıların yaş ortalaması 38.3±15.3’tür. Bir sağlık sorunu nedeniyle aile hekimine başvurma % 61.0, ondan bir önceki sağlık sorununda AH’ne (Aile Hekimi) başvuru %55,2 oranındadır. Bu soruların her ikisine de “aynı aile hekimine başvururum” cevabını verenlerin (OHS) oranı  %40.1 olmuştur. Aile Sağlığı Birimini yakın, normal mesafe bulanların oranı %93.1’dir. Aile hekiminin ismini bilme %84, ebenin ismini bilme %36.2, her türlü sorununuzla sürekli ilgilenen bir hekim veya sağlık kuruluşuna kayıtlı olduğunu söyleyenlerin %74.5’tir. Son bir yılda evime ebe ziyareti aldım diyenler %40.6 oranındadır. Sonuç: Araştırmanın yapıldığı ASB’de geçen bir yıllık ilk AH uygulama döneminde sosyalleştirme dönemiyle karşılaştırıldığında, tedavi edici hizmet örüntüsünün değişmediği buna karşın gezici ebe hizmetlerinin azaldığı görülmüştür.Anahtar Kelimeler: Aile sağlığı birimi, ilk başvuru, süreklilik, kapsayıcılık, olağan hizmet sunucu sürekliliğiAbstractAim: The capability of primary care services can be scientifically measured and assessed via basic elements of these services such as accessibility, longitidunality, comprehensiveness and coordination. Methods: A multistage cluster sampling method was used and the data were collected by face to face interviews with a structured questionnaire. An overall 870 households which were recorded in  a Family Practice Unit (FPU) consisted of the universe of this study and 318 women were identified from a sample of 376 households by cluster sampling method. The response rate was of 84.6%. The dependent variables in the study were, the First contact care, Continuity (Usual provider continuity), Comprehensiveness; whereas independent variables were, the women’s and husband's age, the women's and husband's education, marital status, women's occupational status, family social class, perception of income, years of residency in the region, the area of emigration, health insurance status, family type, existence of children under five years of age. Results: The average age of participants was 38.3 ± 15.3. The percentage of women who preferred FPU services for their most recent health problem was 61.0%, whereas this percentage was 55.2% for the previous experienced health problem. The Usual Provider Continuity (UPC) rate was 40.1%. 93.1 percent of women stated that FPU is quite close to their house. The proportion of the women who knew the name of their family physician was 84.0% and 36.2% them knew the name of their midwife. Of the respondents, 74.5% had been registered with a PHC facility or a primary care physician.  Midwives visited 40.6% of the respondents at least once during the last year. Conclusion: This research indicates that, the pattern of therapeutic services was not changed in the new FPU system, compared to the previous socialized health organization in the Primary Care services. Besides this fact, mobile midwife services might be said to have decreased in the new FPU system.Key Words: Family health unit, the first contact, continuity, comprehensiveness, usual provider continuity.                                                 </span