Supply Chain Performance Measurement Practices of Indian Industries

In any Industry the Supply chain performance plays a crucial role and it is vital in growth of the industry. Through this study an attempt is made to find some insight to the supply chain performance measurement practices of Indian industries through an exploratory survey. The study reveals almost all the respondents (84%) felt that supply chain performance measurement system employed in their organisation has a clear purpose. Also the study reveals that most supply chain performance measurement system provides high importance to quality measurements and includes both financial and non-financial indicators. The study gave clarity in understanding the objectives of implementing supply chain performance measurement systems and metrics (measures) used in supply chain performance measurement systems The Multivariate analysis revealed three factors emerged from this study are ‘Strategic Orientation’ followed by ‘Internal Focus’ and ‘Motivation and Control’

OASIS: clinical audit in a tertiary care centre

Background: Obstetric anal sphincter injury involves injury to the anal sphincter and rectal mucosa sustained at time of vaginal delivery and can result in significant long-term morbidity. These injuries have been defined as 3rd and 4th degree lacerations that involve disruption of the anal sphincter and rectal mucosa respectively. Objectives of this study were to find out the incidence of obstetrical anal sphincter injuries, to identify the risk factors for of OASIS and the outcome of primary repair in terms of anal incontinence and its associated complications.Methods: We did a descriptive study of OASIS by retrospective analysis of the labour case records. The study period was 1 year between August 2016 to July 2017. Inclusion criteria were singleton pregnancy, vertex presentation, instrumental and normal vaginal delivery. Exclusion criteria were multiple pregnancy, non-vertex presentation and caesarean section. Proforma was developed to capture the age, parity, gestational age in weeks, induction of labour, epidural analgesia, delivery duration, type of episiotomy, instrumentation, shoulder dystocia, occipito posterior position,manual support, weight of the baby, suturing method. Postnatal evaluation after 6 weeks and 6 months for perineal discomfort, pain, incontinence, wound infection, breakdown, fistula were noted. Results: The incidence of OASIS was 1.4%. 81.8% women had 3rd degree perineal and 18.1% had 4th degree perineal tear. The mean age of the patients were 27.9 years, gestational age of 39.45 weeks, 72.7% were primiparous. Induction of labour with prostaglandins was done in 36.36% and Pitocin augmentation for 81.81%. The duration of second 36.36% had 60-89 min and 27.27% had duration more than 90 min. 54.54% had epidural analgesia, 36.36% had shoulder dystocia, 36.36% had instrumental delivery. 72.72% babies had birth weight between 3-3.5 kg, 9% between 3.5-4 kg. Ano vaginal fistula developed in 9%.Conclusions: Appropriate training, anticipating and identifying major degrees of perineal tear helps in reducing the complications. Anovaginal fistula is distressing and disabling the patient and to her near ones

Persistence of small-scale anisotropy of magnetic turbulence as observed in the solar wind

The anisotropy of magnetophydrodynamic turbulence is investigated by using solar wind data from the Helios 2 spacecraft. We investigate the behaviour of the complete high-order moment tensors of magnetic field increments and we compare the usual longitudinal structure functions which have both isotropic and anisotropic contributions, to the fully anisotropic contribution. Scaling exponents have been extracted by an interpolation scaling function. Unlike the usual turbulence in fluid flows, small-scale magnetic fluctuations remain anisotropic. We discuss the radial dependence of both anisotropy and intermittency and their relationship.Comment: 7 pages, 2 figures, in press on Europhys. Let

Dynamical equations for high-order structure functions, and a comparison of a mean field theory with experiments in three-dimensional turbulence

Two recent publications [V. Yakhot, Phys. Rev. E {\bf 63}, 026307, (2001) and R.J. Hill, J. Fluid Mech. {\bf 434}, 379, (2001)] derive, through two different approaches that have the Navier-Stokes equations as the common starting point, a set of steady-state dynamic equations for structure functions of arbitrary order in hydrodynamic turbulence. These equations are not closed. Yakhot proposed a "mean field theory" to close the equations for locally isotropic turbulence, and obtained scaling exponents of structure functions and an expression for the tails of the probability density function of transverse velocity increments. At high Reynolds numbers, we present some relevant experimental data on pressure and dissipation terms that are needed to provide closure, as well as on aspects predicted by the theory. Comparison between the theory and the data shows varying levels of agreement, and reveals gaps inherent to the implementation of the theory.Comment: 16 pages, 23 figure

Is peer support in group clinics as effective as traditional individual appointments? The first study in patients with Celiac disease

INTRODUCTION: Celiac disease (CD) is common, affecting approximately 1% of the population. The cornerstone of management is a gluten-free diet, with dietetic advice being the key to aiding implementation. The aim of the study was to assess group clinics in comparison with traditional individual appointments. METHODS: Patients with a new diagnosis of CD, confirmed histologically, were prospectively recruited over 18 months in Sheffield, United Kingdom. Patients received either a group clinic or traditional one-to-one appointment, led by a dietitian. Quality-of-life questionnaires were completed at baseline, as well as biochemical parameters being recorded. Patients were followed up at 3 months, where adherence scores were assessed as well as biochemical parameters and quality of life questionnaires being completed. RESULTS: Sixty patients with CD were prospectively recruited and received either an individual (n = 30) or group clinic (n = 30). A statistically significant reduction in tissue transglutaminase was noted following group clinics (mean 58.5, SD 43.4 U/mL vs mean 13.2, SD 5.7 U/mL, P < 0.01). No significant differences in baseline and follow-up biochemical parameters between one-to-one and group clinics were noted. At follow-up, there was no statistically significant difference between mean gluten-free diet adherence scores (mean 3.1, SD 0.4 vs mean 3.1, SD 0.7, P = 0.66) between one-to-one and group clinics. DISCUSSION: This first study assessing group clinics in CD demonstrates they are as effective as traditional one-to-one clinics, with the added benefits of peer support and greater efficiency, with an estimated 54% reduction of dietetic resources

Prescribing gluten-free foods in general practice

The Department of Health and Social Care has recently published their consultation outcome regarding the availability of gluten-free foods (GFF) on NHS prescriptions.1 Following an unprecedented number of responses from patients, healthcare professionals, and professional bodies, the Government has decided to continue to provide GFF on prescription but restrict the products available to breads and mixes. This favoured option by the majority of consultation responders has now proceeded to formal ratification, through an amendment to the NHS Regulations 2004, Schedule 1. In this editorial, we discuss the controversies that have existed regarding prescription of GFF in coeliac disease where the gluten-free diet is the treatment, and discuss the future implications that this decision may have on both patients and the NHS