47 research outputs found
Improving demand forecasting in the air cargo handling industry: A case study
Air transportation plays a crucial role in the agile and dynamic environment of contemporary supply chains. This industry is characterized by high air cargo demand uncertainty, making forecasting extremely challenging. An in-depth case-study has been undertaken in order to explore and untangle the factors influencing demand forecasting and consequently to improve the operational performance of an Air Cargo Handling Company. It has been identified that in practice, the demand forecasting process does not provide the necessary level of accuracy, to effectively cope with the high demand uncertainty. This has a negative impact on a whole range of air cargo operations, but especially on the management of the workforce, which is the most expensive resource in the air cargo handling industry. Besides forecast inaccuracy, a range of additional hidden factors that affect operations management have been identified. A number of recommendations have been made to improve demand forecasting and workforce management
Exploring the role of supplier relationship management for sustainable operations: an OR perspective
This is an Accepted Manuscript of an article published by Taylor & Francis in
Journal of the Operational Research Society on 13/11/2013, available online: https://www.tandfonline.com/doi/full/10.1057/jors.2013.145This paper provides a systems-based approach to the exploration of the relationship and integration between Supplier Relationship Management (SRM) factors as part of a Sustainable Operations Management (SOM) agenda. The authors have chosen electronic procurement (e-Procurement) as a suitable context in this light. Through a review of extant literature, a Systems Archetype (SA) model was developed (based on the ‘Accidental Adversaries’ archetype) and findings from a quantitative pilot study exploring key factors pertinent to e-Procurement SRM were gathered, and hence evaluated against SOM factors. The objective of this research was to describe and visualise the causal interrelationships involved in SRM-SOM through the application of a SA (as an Operations Research tool). The authors believe that this research also provides a unique approach to developing and harnessing the useful and unique properties of Systems Thinking (ST), by attempting to reduce and organise the (generally ad hoc and wide-ranging) sequence of subjective perspectives commonly experienced in causal mapping experiments. The paper builds upon the extant literature, and provides further basis for continuing research in the areas of ST, SAs and the application of operational research to plan sustainable operations
Prehospital transdermal glyceryl trinitrate in patients with ultra-acute presumed stroke (RIGHT-2): an ambulance-based, randomised, sham-controlled, blinded, phase 3 trial
Background
High blood pressure is common in acute stroke and is a predictor of poor outcome; however, large trials of lowering blood pressure have given variable results, and the management of high blood pressure in ultra-acute stroke remains unclear. We investigated whether transdermal glyceryl trinitrate (GTN; also known as nitroglycerin), a nitric oxide donor, might improve outcome when administered very early after stroke onset.
Methods
We did a multicentre, paramedic-delivered, ambulance-based, prospective, randomised, sham-controlled, blinded-endpoint, phase 3 trial in adults with presumed stroke within 4 h of onset, face-arm-speech-time score of 2 or 3, and systolic blood pressure 120 mm Hg or higher. Participants were randomly assigned (1:1) to receive transdermal GTN (5 mg once daily for 4 days; the GTN group) or a similar sham dressing (the sham group) in UK based ambulances by paramedics, with treatment continued in hospital. Paramedics were unmasked to treatment,
whereas participants were masked. The primary outcome was the 7-level modified Rankin Scale (mRS; a measure of functional outcome) at 90 days, assessed by central telephone follow-up with masking to treatment. Analysis was hierarchical, first in participants with a confirmed stroke or transient ischaemic attack (cohort 1), and then in all participants who were randomly assigned (intention to treat, cohort 2) according to the statistical analysis plan. This trial is registered with ISRCTN, number ISRCTN26986053.
Findings
Between Oct 22, 2015, and May 23, 2018, 516 paramedics from eight UK ambulance services recruited 1149 participants (n=568 in the GTN group, n=581 in the sham group). The median time to randomisation was 71 min (IQR 45–116). 597 (52%) patients had ischaemic stroke, 145 (13%) had intracerebral haemorrhage, 109 (9%) had transient ischaemic attack, and 297 (26%) had a non-stroke mimic at the final diagnosis of the index event. In the GTN group, participants’ systolic blood pressure was lowered by 5·8 mm Hg compared with the sham group (p<0·0001), and diastolic blood pressure was lowered by 2·6 mm Hg (p=0·0026) at hospital admission. We found no difference in mRS between the groups in participants with a final diagnosis of stroke or transient ischaemic stroke (cohort 1): 3 (IQR 2–5; n=420) in the GTN group versus 3 (2–5; n=408) in the sham group, adjusted common odds ratio for poor outcome 1·25 (95% CI 0·97–1·60; p=0·083); we also found no difference in mRS between all patients (cohort 2: 3 [2–5]; n=544, in the GTN group vs 3 [2–5]; n=558, in the sham group; 1·04 [0·84–1·29]; p=0·69). We found no difference in secondary outcomes, death (treatment-related deaths: 36 in the GTN group vs 23 in the sham group [p=0·091]), or serious adverse events (188 in the GTN group vs 170 in the sham group [p=0·16]) between treatment groups.
Interpretation
Prehospital treatment with transdermal GTN does not seem to improve functional outcome in patients with presumed stroke. It is feasible for UK paramedics to obtain consent and treat patients with stroke in the ultraacute prehospital setting.
Funding British Heart Foundation
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Parent-child relationship quality and child psychological adjustment in families created using egg donation: children's perspectives at age 5 years.
STUDY QUESTION: What are children's perspectives of the quality of their relationships with their parents and their own psychological well-being in families created using egg donation? SUMMARY ANSWER: Children's scores indicated good parent-child relationship quality and high levels of psychological well-being, with children in families created using egg donation rating their relationships with their mothers as higher in warmth/enjoyment than children in a comparison group of families created using IVF. WHAT IS KNOWN ALREADY: Little is known about how children in families created through egg donation view their family relationships and their own psychological well-being. Research with 7-and-10-year-olds in anonymous egg donation families has indicated good parent-child relationship quality from children's perspectives, but studies have not involved younger children or those conceived following identity-release egg donation. STUDY DESIGN, SIZE, DURATION: This study included 50 children who had been born through egg donation and a comparison group of 43 children conceived through IVF with the parents' own gametes. Data were collected between April 2018 and December 2019. The sample forms part of a larger longitudinal study examining family functioning in families created through fertility treatment. PARTICIPANTS/MATERIALS, SETTING, METHODS: Children were aged 5 years old and had been born into families with different-sex couple parents. All families were visited at home. Children were administered the Berkeley Puppet Interview, a standardized assessment of parent-child relationship quality and psychological well-being. MAIN RESULTS AND THE ROLE OF CHANCE: Children in egg donation families rated their relationships with their mothers as higher in warmth and enjoyment than did children in IVF families. No differences were found between the two family types in children's ratings of the father-child relationship, or in children's ratings of their own psychological well-being. LIMITATIONS, REASONS FOR CAUTION: It is possible that children who did not consent to take part in the research had less positive perceptions of their family and themselves than children who participated. WIDER IMPLICATIONS OF THE FINDINGS: The findings are relevant to UK clinics offering identity-release egg donation, to parents who have used egg donation to create their family and to individuals and couples considering their fertility treatment options. That children in egg donation families were more similar than different to children in IVF families in their self-concept and perception of their family relationships should prove reassuring. STUDY FUNDING/COMPETING INTEREST(S): This research was supported by a Wellcome Trust Collaborative Award [208013/Z/17]. The authors have no conflicts of interest to declare. TRIAL REGISTRATION NUMBER: N/A
The impact of e-business on supply chain management
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