Scheduling in the manufacture of evaporative air conditioners

The MISG examined the problem of scheduling production of air conditioners at Seeley International. Seeley's objective was to meet their demand in a more cost-effective way. Two models are proposed to achieve this objective. A long term master production schedule with a yearly planning horizon was formulated to give Seeley a broad based schedule for planning production to meet forecast demands and production constraints. Output from this model is designed to provide the appropriate number of units of each product type or sub-assembly item to be produced in the following week. This output is then designed to be the input to a more detailed short term model for scheduling production at the machine level. The short term model is formulated to handle a mixture of both finished products and sub-assemblies. The objective of the short term model is to minimise total production time to free up the use of resources in order to allow for external orders. Directions for further work are discussed

Autonomy, evidence and intuition: nurses and decision-making

Aim: This paper is a report of a study conducted to examine how nurses represent professional clinical decision-making processes, and to determine what light Jamous and Peloille’s ‘Indeterminacy/Technicality ratio’ concept can shed on these representations. Background: Classic definitions of professional work feature autonomy of decision-making and control over the field of work. Sociologists Jamous and Peloille have described professional work as being high in ‘indeterminacy’ (the use of tacit judgements) relative to technicality (activity able to be codified). The rise of the evidence-based practice movement has been seen as increasing the realm of technical decision-making in healthcare, and it is relevant to analyse nurses’ professional discourse and study how they respond to this increase. Method: Three focus groups with qualified nurses attending post-qualifying courses at a London university were held in 2008. Participants were asked to talk about influences on their decision-making. The discussions were tape-recorded, transcribed, and subjected to discourse analysis. Findings: Participants described their decision-making as influenced by both indeterminate and technical features. They acknowledged useful influences from both domains, but pointed to their personal ‘experience’ as the final arbiter of decision-making. Their accounts of decision-making created a sense of professional autonomy while at the same time protecting it against external critique. Conclusion: Pre- and post-registration nurse education could encourage robust discussion of the definition and roles of ‘irrational’ aspects of decision-making and how these might be understood as components of credible professional practice

Professional autonomy in 21st century healthcare: nurses’ accounts of clinical decision-making

Autonomy in decision-making has traditionally been described as a feature of professional work, however the work of healthcare professionals has been seen as steadily encroached upon by State and managerialist forces. Nursing has faced particular problems in establishing itself as a credible profession for reasons including history, gender and a traditional subservience to medicine. This paper reports on a focus group study of UK nurses participating in post-qualifying professional development in a London university in 2008. Three groups of nurses in different specialist areas comprised a total of 26 participants. The study uses accounts of decision-making to gain insight into contemporary professional nursing. The study also aims to explore the usefulness of a theory of professional work set out by Jamous and Peloille in 1970. The analysis draws on notions of interpretive repertoires and elements of narrative analysis. We identified two interpretive repertoires: ‘clinical judgement’ which was used to describe the different grounds for making judgements; and ‘decision-making’ which was used to describe organisational circumstances influencing decision-making. Jamous and Peloille’s theory proved useful for interpreting instances where the nurses collectively withdrew from the potential dangers of too extreme claims for technicality or indeterminacy in their work. However, their theory did not explain the full range of accounts of decision-making that were given. Taken at face value, the accounts from the participants depict nurses as sometimes practising in indirect ways in order to have influence in the clinical and bureaucratic setting. However, a focus on language use and in particular, interpretive repertoires, has enabled us to suggest that despite an overall picture of severely limited autonomy, nurses in the groups reproduced stories of the successful accomplishment of moral and influential action

Strength, Toughness, Damage And Fatigue Of Rock

Assessment of rock mechanical properties depends on sample size and testing methodologies. Even for samples cored from the same rock outcrop the difference in properties appears to be sensitive to the local thermal and stress histories of the rock structure. Variations in the fracture toughness, unconfined compressive strength and tensile strength of a suite of granite samples, when tested using different procedures, are discussed in terms of experimental errors of the loading system as well as the thermal history

Vitamin D: beyond bone.

In recent years, vitamin D has been received increased attention due to the resurgence of vitamin D deficiency and rickets in developed countries and the identification of extraskeletal effects of vitamin D, suggesting unexpected benefits of vitamin D in health and disease, beyond bone health. The possibility of extraskeletal effects of vitamin D was first noted with the discovery of the vitamin D receptor (VDR) in tissues and cells that are not involved in maintaining mineral homeostasis and bone health, including skin, placenta, pancreas, breast, prostate and colon cancer cells, and activated T cells. However, the biological significance of the expression of the VDR in different tissues is not fully understood, and the role of vitamin D in extraskeletal health has been a matter of debate. This report summarizes recent research on the roles for vitamin D in cancer, immunity and autoimmune diseases, cardiovascular and respiratory health, pregnancy, obesity, erythropoiesis, diabetes, muscle function, and aging

Cholecystogastric fistula: a brief report and review of the literature.

Cholecystogastric fistula is a rare, life-threatening complication of cholelithiasis that presents a difficult challenge to the surgeon when it occurs in elderly and co-morbid patients. Following a case of a 68-year-old female who presented with a short history of epigastric pain and vomiting, and in whom a cholecystogastric fistula was identified on abdominal computed tomography and confirmed on upper gastrointestinal endoscopy, we performed a systematic review of the literature on the management of cholecystogastric fistula. Our patient underwent laparotomy without excision of the fistula nor cholecystectomy and had an uncomplicated post-operative course. Surgical management using an open approach remains the mainstay of treatment of cholecystogastric fistula although laparoscopic techniques are used with increasing success. Surgical closure of the fistula is not always necessary. Improved surgical techniques including the use of laparoscopic surgery have led to improved outcomes in the management of cholecystogastric fistula