Time-differentiated service parts distribution: Costs under hierarchical and non-hierarchical setups

Author(s):  
Mohsin Nasir Jat ◽  
Luc Muyldermans
Author(s):  
P.W. Shannon

Increasing material, processing, and distribution costs have raised superphosphate prices to a point where many farms cannot support the costs of meeting maintenance phosphate requires men& Alternatives to superphosphate, particularly those that have lower processing costs and contain more P, may offer a solution to the problem provided they are agronomically as effective. Phosphate rock may indeed be such an alternative. Preliminary results from a series of five trials in Northland show that on soils of moderate P fertility, with low phosphate retention (PR) and high pH (5.9.6.0), initial pasture growth responses to rock phosphates are smaller than those from single or triple superphosphate. On one soil of higher PR and lower pH, the differences in yield between the rock-phosphates and the super. phosphates were smaller. Of the rock phosphates tested, Sechura and North Carolina (unground and ungranulated) tended to be more effective than ground and granulated Chatham Rise phosphorite. The effect on production of applying fertilisers once every three years, as opposed to annual applications is being investigated using triple superphosphate and Sechura phosphate rock. After two years, production levels appear largely unaffected by differences in application frequency. A comparison of locally-produced superphosphate with a reference standard showed that both performed similarly, indicating that the local product was of satisfactory quality.


BMJ Open ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. e047443
Author(s):  
Jonathan Ross ◽  
Gad Murenzi ◽  
Sarah Hill ◽  
Eric Remera ◽  
Charles Ingabire ◽  
...  

IntroductionCurrent HIV guidelines recommend differentiated service delivery (DSD) models that allow for fewer health centre visits for clinically stable people living with HIV (PLHIV). Newly diagnosed PLHIV may require more intensive care early in their treatment course, yet frequent appointments can be burdensome to patients and health systems. Determining the optimal parameters for defining clinical stability and transitioning to less frequent appointments could decrease patient burden and health system costs. The objectives of this pilot study are to explore the feasibility and acceptability of (1) reducing the time to DSD from 12 to 6 months after antiretroviral therapy (ART) initiation,and (2) reducing the number of suppressed viral loads required to enter DSD from two to one.Methods and analysesThe present study is a pilot, unblinded trial taking place in three health facilities in Kigali, Rwanda. Current Rwandan guidelines require PLHIV to be on ART for ≥12 months with two consecutive suppressed viral loads in order to transition to less frequent appointments. We will randomise 90 participants to one of three arms: entry into DSD at 6 months after one suppressed viral load (n=30), entry into DSD at 6 months after two suppressed viral loads (n=30) or current standard of care (n=30). We will measure feasibility and acceptability of this intervention; clinical outcomes include viral suppression at 12 months (primary outcome) and appointment attendance (secondary outcome).Ethics and disseminationThis clinical trial was approved by the institutional review board of Albert Einstein College of Medicine and by the Rwanda National Ethics Committee. Findings will be disseminated through conferences and peer-reviewed publications, as well as meetings with stakeholders.Trial registration numberNCT04567693.


1942 ◽  
Vol 6 (4) ◽  
pp. 412
Author(s):  
H. H. Maynard ◽  
Malcolm P. McNair ◽  
Stanley F. Teele ◽  
Francis G. Mulhearn
Keyword(s):  

2004 ◽  
Vol 20 (3) ◽  
pp. 375-387 ◽  
Author(s):  
Thomas R. Willemain ◽  
Charles N. Smart ◽  
Henry F. Schwarz

1948 ◽  
Vol 12 (4) ◽  
pp. 455
Author(s):  
Rayburn D. Tousley
Keyword(s):  

2020 ◽  
Vol 4 (2) ◽  
Author(s):  
Alfan Juli Andri ◽  

Abstract As a maritime country, Indonesia is given an abundance of marine wealth. In an effort to distribute fish from sea products, fishermen in Labuhan Maringgai District, East Lampung Regency collect their prey to Usaha Dagang X (UDX). UDX has 3 main ordering partners for 3 categories of seafood, namely shrimp, fish and crab. Transportation problems at UDX cause distribution costs to increase in delivery of goods to the customer. This study provides an alternative minimum cost solution that can be issued by UDX in distributing goods that are available using existing limitations. The results showed that the minimum shipping cost was IDR 5281200 where the 3 proposed methods showed the same results but had different alternative options.


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