Reducing the delivery lead time in a food distribution SME through the implementation of six sigma methodology

Purpose – Six sigma is a systematic data driven approach to reduce the defect and improve the quality in any type of business. The purpose of this paper is to present the findings from the application of six sigma in a food service “small to medium sized enterprise” (SME) in a lean environment to reduce the waste in this field. Design/methodology/approach – A simplified version of six sigma is adopted through the application of appropriate statistical tools in order to focus on customer's requirements to identify the defect, the cause of the defect and improve the delivery process by implementing the optimum solution. Findings – The result suggests that modification in layout utilization reduced the number of causes of defect by 40 percent resulting in jumping from 1.44 sigma level to 2.09 Sigma level which is substantial improvement in SME. Research limitations/implications – Simplicity of six sigma is important to enabling any SME to identify the problem and minimize its cause through a systematic approach. Practical implications – Integrating of supply chain objectives with any quality initiatives such as lean and six sigma has a substantial effect on achieving to the targets. Originality/value – This paper represents a potential area in which six sigma methodology along side the lean management can promote supply chain management objectives for a food distribution SME

Contact area, pressure distribution and mechanical stability in external arthrodesis of the ankle joint

The ankle joint is often affected by arthritis, giving a joint that is painful, stiff, and restricts movement. This can result in a huge loss of mobility for the sufferer. Unlike replacement of the hip, the replacement of a diseased ankle joint is not as straightforward and the outcomes do not reach the same success levels. The preferred surgical choice is arthrodesis, a procedure whereby the two bones forming the joint are fused together to eliminate the joint and hence pain. The success of the procedure is dependent upon several factors, two of the most significant being the levels of contact area and pressure achieved during the compression period, during which bone growth occurs across the two bones being compressed together. These factors influence joint stability and micromotion at the bone to bone interface during this growth phase. This study investigates the levels of contact areas and pressures that can be achieved for different arthodesis variables. These variables include the joint shape, which can be curved or flat, and the position of the compression pin within the talus, namely anteriorly or centrally positioned with reference to the talar dome. Influence of the Achilles tendon in joint stability is also investigated. A test rig was developed allowing load/deflection curves to be determined for various configurations of these variables. Models representing the bones under consideration, together with pressure sensitive film, allowed measurement of contact areas and pressures within the joint under compression, achieved using pins and instrumented compression rods. Results indicate there is little significant variation in contact area and pressure for the different shaped joint cuts, however, if the talar pin is placed in a more anterior position then the contact area can be improved over a centrally positioned pin. Anterior pin placement also gives increased resistance to motion and mechanical stability. It has been established that the athrodesis construct is especially weak in terms of rotation about the tibial axis, and the results from this study indicate that through the use of a curved joint shape the resistance to this motion can be improved greatly

Evaluating sustainability in the UK fast food supply chain: Dimensions, Awareness and Practice

Purpose - This paper investigates the level of concern and practice of sustainable management in the fast food supply chain in the North of England, targeting a business population with cultural, social and economic diversity. Methodology – A questionnaire using Likert Scoring recorded variations in current practice and attitudes towards sustainable business. A two-stage Cluster Analysis was conducted to analyse the multi-attribute ordinal data obtained from the questionnaire. Findings - Significant differences were found among clusters of Fast food businesses in terms of their sustainability concern and practice, which is of interest to policy makers, consumers and supply chain partners. Medium-sized fast food dealers emerge with high environmental and social concern, but poor practice; larger retailers and fast food chains appear to have both fair social and environmental awareness and practice; and there is a cluster of small takeaway-specific outlets that have particularly low levels of knowledge of sustainability or sustainable practices. Market failure is prevalent amongst these businesses and without regulation this represents a possible threat to the sector. Research limitations – Reliance on stated rather than revealed preferences and the regional focus of the study may limit the implications of this analysis but it is a major step forward in understanding what has in the past been a very difficult sector to investigate due to data paucity. Practical implications - Fast food is a sector with a lack of transparency which has attracted little academic attention to date, due to the difficulties of empirical analysis rather than lack of interest in a key food consumption sector. The message for the sector is to monitor its act, across all business types or face regulatory and policy intervention. Originality - The research conducts a three-dimensional sustainability analysis of fast food supply chains to investigate the differences and trade-offs between different sustainability dimensions

Hubungan Antara Preloading Cairan Kristaloid dengan Status Tekanan Darah Intra Anestesi Spinal

Teknik anestesi spinal ialah memasukan obat anestesi lokal ke ruangan subarachnoid guna mendapat analgesia setinggi dermatom tertentu. Obat spinal anestesi memiliki efek vasodilatasi pembuluh darah hingga sistem saraf simpatis mengalami blockade dan memicu perubahan aliran darah di jantung. Komplikasi paling umum anestesi spinal adalah hipotensi (turunnya tekanan darah). Satu diantara cara guna mencegah kasus hipotensi ialah pemberian preloading cairan dengan kristaloid. Tujuan : Mengetahui hubungan antara preloading cairan dengan status tekanan darah intra anestesi spinal serta tingkatan keeratannya. Metode : Studi ini ialah penelitian cross sectional korelasi. Studi dilakukan dibulan Maret 2022. Subyek studi sejumlah 30 pasien hendak dilaksanakan operasi dengan anestesi spinal yang selaras dengan kriteria inklusi di IBS RSUD Batang. Alat ukur menggunakan observasi rumus 421 sebelum anestesi spinal serta observasi MAP 10 menit selepas tindakan anestesi spinal. Pengujian yang dipergunakan ialah pengujian Chi-square dan koefisiensi kontingensi. Hasil Penelitian : Capaian penganalisisan mempergunakan pengujian Chi-square dengan capaian ? = 0,000 (? < 0,05) bahwa H1 diterima serta H0 ditolak, dengan koefisiensi kontingensi nilai 0,554 yakni tingkatan keeratan sedang. Kesimpulan : Ada hubungan antara preloading cairan kristaloid dengan status tekanan darah intra anestesi spinal dengan tingkatan keeratan yang sedang antara dua variabel

Assessment of key sustainability indicators in a UK fast food supply chain: a life cycle perspective

The purpose of this article is to investigate the understanding of businesses and end consumers of key sustainability measures in the UK fast food Supply Chain. A quantitative method was used in which two sets of well-structured questionnaires were designed separately for fast food businesses and end consumers. The data analysis was conducted through “cluster analysis”. It was found that social responsibility was scored as the most important fast food sustainability concern for businesses, whilst the end consumers were found to be more concern about environmental impact of fast food industry. However, no statistical difference was found between fast food businesses and end consumer views. This research was carried out in north of England, where may have different proportion of cultural, social and economical diversity. The collected data from fast food businesses was also not scattered evenly, as there were more responds from smaller fast food firms than food manufacturers and processers. More research attention is needed in this field in which there are various issues and challenges to promote a lean and green food supply chain. This research could partly investigate these challenges including the different trade-offs between social, environmental and economic measures of sustainability in a specific food supply chain. This article conducts a research investigation in three dimensional sustainability of fast food supply chain, which includes all types of businesses in this sector to investigate the differences between end consumers and businesses to promote lean and green fast food supply chain

Gambaran Tingkat Kecemasan Pada Pasien Pre Operasi Fraktur Femur Di Rso Prof. Dr. R. Soeharso Surakarta

Latar Belakang. Data PT Jasa Raharja, di Jawa Tengah pada tahun 2006 adalah 14.790 kendaraan yang terlibat kecelakaan. Tingginya angka kecelakaan menyebabkan angka kejadian atau insiden fraktur tinggi, dan salah satu fraktur yang paling sering terjadi adalah fraktur femur. Data rekam medik yang didapatkan di RSO Prof. DR. R. Soeharso Surakarta angka kejadian fraktur femur dari bulan Juli sampai Desember 2011 berjumlah 360 orang dari usia 3 tahun sampai 90 tahun, rata – rata per bulan terdapat 60 orang. Penatalaksanaan untuk tulang fraktur femur terdiri dari tindakan operatif dan non operatif. Tindakan operatif atau pembedahan baik elektif maupun kedaruratan adalah peristiwa kompleks yang menegangkan. Kebanyakan prosedur pembedahan dilakukan di ruang operasi rumah sakit. Tindakan pembedahan terdiri dari praoperatif, intraoperatif dan pascaoperatif. Segala bentuk prosedur pembedahan selalu didahului dengan reaksi emosional tertentu oleh pasien, sebagai contoh kecemasan praoperatif. Tujuan. Mengetahui gambaran tingkat kecemasan pada pasien pre operasi fraktur femur di RSO Prof. DR. R. Soeharso Surakarta pada tahun 2012. Metode Penelitian. Penelitian ini menggunakan metode deskriptif dengan pendekatan cross sectional. Pengambilan sampel dengan menggunakan tehnik accidental sampling sebanyak 20 responden pasien pre operasi fraktur femur. Instrumen penelitian ini dengan menggunakan koesioner. Data diolah dengan tabulasi secara manual dan progam komputer SPSS Versi 16.00 dengan analisa data modus dan mean. Hasil. Pasien pre operasi fraktur femur dari responden sebanyak 20 menunjukan hasil ada 90% kecemasan ringan, 10% kecemasan sedang, 0% kecemasan berat dan panik dengan rata – rata nilai kecemasan 15,65. Kesimpulan. Kecemasan pada pasien pre operasi rata – rata mengalami kecemasan ringa

The performance of ultra-hard cutting tool materials in maching aerospace alloy TA48

A study has been made of the respective performance of cubic boron nitride (CBN) and polycrystalline diamond (PCD) cutting tool materials and compared to various coated and uncoated tungsten carbide grades when cutting titanium alloy workpieces. Two important experimental techniques were employed during the course of this work, firstly a quasi-static contact method was employed to establish the workpiece/tool interfacial temperature above which strongly adherent layers may be formed. This technique revealed that the critical temperatures which marked adhesion and welding, were 740, 820 and 800 °C for coated and uncoated carbides, and 760 and 900 °C for PCD and CBN tools respectively. Furthermore, the technique has been used to study the integrity of the bulk; tool material, and/or individual coatings on their substrates, when welded junctions formed between the tool and workpiece are separated. With regard to the latter it was observed that in all cases fracture was initiated in the bulk of the harder tool material rather than in the workpiece or at the welded junction interface. Secondly, a quick-stop technique was used to study chip formation and tool wear when cutting with carbides, CBN and PCD tools under nominally the same conditions.The predominant wear mechanisms for each of the tool materials was found to be based on a diffusion/dissolution process. The wear process is discussed in detail for each of the tool materials and reasons advanced for observed differences in performance when removing material from a titanium alloy workpiece. The wear resistance and quality of the machined surface was found to be superior when cutting with the ultra-hard materials than with the carbide grades and in particular the PCD tool was found to produce exceptionally good surface finish. In the case of coated carbide tool grades rapid removal of the coated layers occurred leaving the substrate vulnerable to reaction with the workpiece material and this is considered to explain the seeming absence of beneficial effects when cutting with these grades

Pengaruh Pemberian Edukasi Pra Anestesi Terhadap Tingkat Kecemasan Pada Pasien Laparatomy Dengan General Anestesi

Background Surgical planning for preoperative patients is a psychosocial stressor that can cause stress, anxiety, and depression. Preoperative is the period before surgery is performed, starting from the time the decision is made for surgery until the patient is on the operating table. Laparotomy is one of the major surgical procedures by making an incision in the lining of the abdominal wall to obtain problems in the abdominal organs, such as cancer, bleeding, obstruction, and perforation. Research objectives: The general objective of this study was to determine the effect of implementing education on anxiety levels in preoperative apparatus patients with general anesthesia. Research methodology: This type of research is a quantitative study, with a quasy experimental research plan, with a non-randomized post-test one group design. . Results: It is known that the asymo.sig, (2-tailed) value is 0.000 <0.05. So it can be concluded that the "hypothesis is accepted". Thus it can be said that there are differences in the results of the intervention group and the control group. Because there is a significant difference, it is said that "there is an effect of providing education to preoperative laparotomy patients" Conclusion: Based on the results of the research and discussion that has been put forward under the title "the effect of providing pre-anesthesia education on anxiety levels in laparotomy patients with general anesthesia" it can be concluded as follows: There is a significant effect on providing education on preoperative anxiety of laparotomy with general anesthesia p = 0.000 (p <0.05) in the central surgical installation of Siti Fatimah Az-Zahra Hospital, South Sumatra Province. &nbsp

The performance of ultra-hard cutting tool materials in maching aerospace alloy TA48

A study has been made of the respective performance of cubic boron nitride (CBN) and polycrystalline diamond  (PCD) cutting tool materials and compared to various coated and uncoated tungsten carbide grades when cutting  titanium alloy workpieces. Two important experimental techniques were employed during the course of this work,  firstly a quasi-static contact method was employed to establish the workpiece/tool interfacial temperature above  which strongly adherent layers may be formed. This technique revealed that the critical temperatures which  marked  adhesion and welding, were 740, 820 and 800 °C for coated and uncoated carbides, and 760 and 900 °C  for PCD and CBN tools respectively. Furthermore, the technique has been used to study the integrity of the bulk  tool material, and/or individual coatings on their substrates, when welded junctions formed between the tool and  workpiece are separated. With regard to the latter it was observed that in all cases fracture was initiated in the bulk of the harder tool material rather than in the workpiece or at the welded junction interface. Secondly, a quick-stop  technique was used to study chip formation and tool wear when cutting with carbides, CBN and PCD tools under  nominally the same conditions.The predominant wear mechanisms for each of the tool materials was found to be based on a diffusion/dissolution  process. The wear process is discussed in detail for each of the tool materials and reasons advanced for observed  differences in performance when removing material from a titanium alloy workpiece. The wear resistance and quality of the machined surface was found to be superior when cutting with the ultra-hard materials  than with the carbide grades and in particular the PCD tool was found to produce exceptionally good surface finish.  In the case of coated carbide tool grades rapid removal of the coated layers occurred leaving the substrate  vulnerable to reaction with the workpiece material and this is considered to explain the seeming absence of  beneficial effects when cutting with these grades

Examining consumers' continued use of retailers' branded mobile applications

The aim of this research is to expand our understanding of consumers’ continuous usage of traditional retail smartphone branded mobile applications (apps). Previous research in technology acceptance and continuous usage of technological innovations mainly focuses on functional and hedonic variables specifically related to the technology under research. Also, past research typically focuses on the continuous use of e-services reflecting the loyalty of consumers toward a specific e-service (e.g. loyalty toward a website or m-commerce). While this research examines utilitarian and hedonic variables that influence consumers to be satisfied and motivate them to continue to use smartphone branded apps, it finds that variables related to the brand motivate consumers to continue to use traditional retail smartphone branded apps. Therefore, this research shows that while utilitarian and hedonic variables that are related to the technical characteristics of the technology in use are essential to motivate consumers to continue to use a technological innovation, brand-related variables related to the traditional retailer (e.g. long-term brand reputation and loyalty) are important in motivating consumers to continue to use branded mobile apps. Considering the limited knowledge available on what motivates consumers to continue using traditional retail smartphone branded mobile apps in a multi-channel retail environment, this research adopted a mixed methods approach. The research utilised an exploratory qualitative method in the form of 21 semi-structured individual in-depth interviews conducted in the UK to explore the drivers that motivate consumers to continue to use traditional retail smartphone branded apps and to refine the theoretical model that is tested in the quantitative phase of this research. The quantitative phase utilised an online questionnaire with 1009 consumers who retain and have continued to use traditional retail branded smartphone apps for a period of more than six months from John Lewis, M&S, Next and H&M. This research highlights several findings on what motivates consumers’ satisfaction with the smartphone branded app user experience and the continuous intention to use the app. The findings highlight that the utilitarian variables (perceived ease of use, usefulness, and personalisation), and the hedonic variable (enjoyment) increases consumers’ satisfaction with the branded app user experience leading to an increase in consumers’ continuous intention to use traditional retail smartphone branded apps. Furthermore, this research finds that utilitarian variables of perceived usefulness, compatibility and the hedonic variable of enjoyment, are capable of influencing consumers to continue using traditional retail smartphone branded apps even when they are not satisfied with the app user experience. Furthermore, this research finds that satisfaction with the app user experience mediates escapism negatively, while escapism also has a significant negative relationship with the continuous intention to use the smartphone branded app. Also, the escapism finding in this study contradicts the previous literature on the usual role of escapism in e-services generally. Furthermore, the subjective norm (e.g. social influence) does not influence the continuous intention to use the smartphone branded app directly or indirectly through satisfaction with the app user experience. Also, this research highlights that consumers’ satisfaction with app user experience significantly increases consumers’ continuous intention to use the smartphone branded app. The findings of this research also highlight that the retailer’s long-term brand reputation and loyalty intention toward the traditional retailer’s brand, which are variables that are not related to the technical characteristics of smartphone branded apps, play an important role in influencing consumers’ intention to continue using traditional retail smartphone branded apps. Furthermore, this research finds that loyalty intention toward the traditional retailer mediates the relationship of satisfaction with the branded app user experience to consumers’ continuous intention to use traditional retail smartphone branded apps. Also, loyalty intention toward the traditional retailer influences the consumers’ continuous intention to use the branded app directly. Interestingly, consumers’ perceptions of long-term reputation of the traditional retail brand do not influence the continuous intention directly as hypothesised. However, long-term brand reputation influences consumers’ continuous intention to use the branded app through the mediated relationship of loyalty intention toward the traditional retailer brand. This research contributes by enhancing our understanding of the variables that influence consumers’ intentions to continue to use traditional retail smartphone branded applications. Furthermore, this research presents a theoretical model that provides theoretical implications and offers managerial implications for understanding the continuous usage of smartphone branded apps in a multi-channel retail context.The aim of this research is to expand our understanding of consumers’ continuous usage of traditional retail smartphone branded mobile applications (apps). Previous research in technology acceptance and continuous usage of technological innovations mainly focuses on functional and hedonic variables specifically related to the technology under research. Also, past research typically focuses on the continuous use of e-services reflecting the loyalty of consumers toward a specific e-service (e.g. loyalty toward a website or m-commerce). While this research examines utilitarian and hedonic variables that influence consumers to be satisfied and motivate them to continue to use smartphone branded apps, it finds that variables related to the brand motivate consumers to continue to use traditional retail smartphone branded apps. Therefore, this research shows that while utilitarian and hedonic variables that are related to the technical characteristics of the technology in use are essential to motivate consumers to continue to use a technological innovation, brand-related variables related to the traditional retailer (e.g. long-term brand reputation and loyalty) are important in motivating consumers to continue to use branded mobile apps. Considering the limited knowledge available on what motivates consumers to continue using traditional retail smartphone branded mobile apps in a multi-channel retail environment, this research adopted a mixed methods approach. The research utilised an exploratory qualitative method in the form of 21 semi-structured individual in-depth interviews conducted in the UK to explore the drivers that motivate consumers to continue to use traditional retail smartphone branded apps and to refine the theoretical model that is tested in the quantitative phase of this research. The quantitative phase utilised an online questionnaire with 1009 consumers who retain and have continued to use traditional retail branded smartphone apps for a period of more than six months from John Lewis, M&S, Next and H&M. This research highlights several findings on what motivates consumers’ satisfaction with the smartphone branded app user experience and the continuous intention to use the app. The findings highlight that the utilitarian variables (perceived ease of use, usefulness, and personalisation), and the hedonic variable (enjoyment) increases consumers’ satisfaction with the branded app user experience leading to an increase in consumers’ continuous intention to use traditional retail smartphone branded apps. Furthermore, this research finds that utilitarian variables of perceived usefulness, compatibility and the hedonic variable of enjoyment, are capable of influencing consumers to continue using traditional retail smartphone branded apps even when they are not satisfied with the app user experience. Furthermore, this research finds that satisfaction with the app user experience mediates escapism negatively, while escapism also has a significant negative relationship with the continuous intention to use the smartphone branded app. Also, the escapism finding in this study contradicts the previous literature on the usual role of escapism in e-services generally. Furthermore, the subjective norm (e.g. social influence) does not influence the continuous intention to use the smartphone branded app directly or indirectly through satisfaction with the app user experience. Also, this research highlights that consumers’ satisfaction with app user experience significantly increases consumers’ continuous intention to use the smartphone branded app. The findings of this research also highlight that the retailer’s long-term brand reputation and loyalty intention toward the traditional retailer’s brand, which are variables that are not related to the technical characteristics of smartphone branded apps, play an important role in influencing consumers’ intention to continue using traditional retail smartphone branded apps. Furthermore, this research finds that loyalty intention toward the traditional retailer mediates the relationship of satisfaction with the branded app user experience to consumers’ continuous intention to use traditional retail smartphone branded apps. Also, loyalty intention toward the traditional retailer influences the consumers’ continuous intention to use the branded app directly. Interestingly, consumers’ perceptions of long-term reputation of the traditional retail brand do not influence the continuous intention directly as hypothesised. However, long-term brand reputation influences consumers’ continuous intention to use the branded app through the mediated relationship of loyalty intention toward the traditional retailer brand. This research contributes by enhancing our understanding of the variables that influence consumers’ intentions to continue to use traditional retail smartphone branded applications. Furthermore, this research presents a theoretical model that provides theoretical implications and offers managerial implications for understanding the continuous usage of smartphone branded apps in a multi-channel retail context