scholarly journals Improving Chemotherapy Infusion Operations through the Simulation of Scheduling Heuristics: a case study

2021 ◽  
Author(s):  
Ryan F Slocum ◽  
Herbert Lee Jones ◽  
Matthew T Fletcher ◽  
Thom J Hodgson ◽  
Javad Taheri ◽  
...  
Keyword(s):  
Discrete Event ◽  
The United States ◽  
Outpatient Services ◽  
Average Patient ◽  
Expected Length ◽  
Chemotherapy Infusion ◽  
Patient Waiting Time ◽  
Treat All ◽  
The Impact

Over the last decade, chemotherapy treatments have dramatically shifted to outpatient services such that nearly 90% of all infusions are now administered outpatient. This shift has challenged oncology clinics to make chemotherapy treatment as widely available as possible while attempting to treat all patients within a fixed period of time. Historical data from a Veterans Affairs chemotherapy clinic in the United States and staff input informed a discrete event simulation model of the clinic. The case study examines the impact of altering the current schedule, where all patients arrive at 8:00 AM, to a schedule that assigns patients to two or three different appointment times based on the expected length of their chemotherapy infusion. The results identify multiple scheduling policies that could be easily implemented with the best solutions reducing both average patient waiting time and average nurse overtime requirements.

Sanctioned to Survive: How Foreign Firms Perform when Economic Sanctions Affect their Business Relationships—A Study of Contemporary Economic Sanction Actions and their Impact

2017 ◽  
Vol 16 (5) ◽  
pp. 501-538
Author(s):  
Blaine Stout
Keyword(s):  
Single Case ◽  
Economic Sanctions ◽  
The United States ◽  
Study Strategies ◽  
Foreign Firms ◽  
Case Study Methodology ◽  
Exxon Mobil ◽  
Historical Accounts ◽  
The Impact

Abstract The intent of this study is to examine the effects of economic sanctions on companies with significant fdi operating in the sanctioned country. Using case study methodology, we consider the impact of sanctions imposed on the Russian Federation (rf) by the United States of America for its intrusion into the sovereign rights of Ukraine. Past sanction events in South Africa and pre-rf formation are reviewed. Two measurable frameworks are developed to study strategies based on ‘divestment and non-divestment’ (Malone and Goodin 1997) dimensions and coupled with variables related to ‘direct and indirect’ effects on financial performance, forgone potential, (Losman 1988) and foreign direct investment (Biglaiser and Lektzian 2011). This research also relies on the historical accounts of Hufbauer et al. (2007) for the compilation of facts related to economic sanctions. Through literature review, the study asks: 1) Strategically, how does a company respond to the economic sanctions imposed by its home country on the sanctioned country in which it has significant fdi? 2) Financially, how do economic sanctions affect the company’s performance and fdi? and 3) Organizationally, how do economic sanctions affect the relationships with those recipient companies of fdi? The study focus is on the energy industry in which the rf economy relies upon for 40 percent of its sustainability and the company of focus is Exxon Mobil (xom). The author readily acknowledges that a single case study may not provide the degree of conclusiveness found in a cross-case study format. However, the outcome of the study does provide a template for use in future case reviews.

Educating Students with Chronic Illness

2020 ◽  
pp. 578-597
Author(s):  
Margaret Tseng ◽  
Rebecca Magee Pluta
Keyword(s):  
United States ◽  
Middle School ◽  
Chronic Illness ◽  
Civil Rights ◽  
The United States ◽  
Middle School Student ◽  
Physical Location ◽  
Available Technology ◽  
The Impact

Students with chronic illness have historically received an education via home and hospital instruction during their absences. This instruction is significantly inferior in both quality and quantity when compared with the educational experience of students able to attend school. This case study details the experiences of a middle school student in the mid-Atlantic Region of the United States whose chronic illness presented unique and multifaceted challenges that could not be met by her district's inflexible policies and disconnected resources. This case illuminates the need for schools to break away from the traditional administrative special education mold when responding to the challenges of educating frequently absent students with chronic illness. The educational Civil Rights of these students can be preserved, however, by utilizing affordable, available technology to minimize the impact of frequently missed classes, provide continuity of instruction and allow educational access regardless of a student's physical location during their absences from school.

The Women of the Cheyenne River Sioux Tribe Reservation

2019 ◽  
pp. 87-104
Author(s):  
Claradina Soto ◽  
Toni Handboy ◽  
Ruth Supranovich ◽  
Eugenia L. Weiss
Keyword(s):  
United States ◽  
Native Americans ◽  
Indigenous Communities ◽  
The United States ◽  
Indigenous Women ◽  
Future Generations ◽  
The World ◽  
The Impact ◽  
Cheyenne River

This chapter describes the impact of colonialism on indigenous women with a focus on the experience of the Lakota women on the Cheyenne River Sioux Tribe Reservation in South Dakota. It explores the experiences of indigenous women as related to history, culture, intrapersonal violence, and internalized oppression. A case study of a Lakota woman is provided as an example of strength and triumph in overcoming adversity and being empowered despite the challenges of marginalization faced by many Native Americans in the United States and indigenous women throughout the world. The chapter discusses how readers can be advocates and actively engage in decolonizing and dismantling systems of oppression to protect future generations and to allow indigenous communities to heal and revitalize.

Brazilian Foreign Policy and the Dominican Crisis: The Impact of History and Events

1972 ◽  
Vol 29 (1) ◽  
pp. 62-77
Author(s):  
Ralph G. Santos
Keyword(s):  
Foreign Policy ◽  
Dominican Republic ◽  
Latin American ◽  
The United States ◽  
Military Force ◽  
Santo Domingo ◽  
American Military ◽  
The Impact ◽  
American Nation

On May 24, 1965, nearly a month after the first U. S. Marines landed in Santo Domingo, an inter-American military force under the command of a Brazilian general took over peacekeeping activities in the Dominican Republic. Although the first Brazilian contingent to arrive comprised only 300 troops, it later reached a total of 1,250, the largest contribution by a single Latin American nation. While Brazil's participation in the Dominican crisis was a clear indication that the independent foreign policy of Quadros and Goulart had been discarded in favor of a realignment once again with the United States, it also signified an abrupt departure from one of the basic tenets of Brazilian foreign policy—nonintervention. The case study of Brazil's role in the Dominican Republic in 1965 which follows provides a unique opportunity to examine the impact of traditional forces and contemporary events on Brazilian foreign policy at a critical juncture in that nation's history.

scholarly journals Impact of government policies on Sustainable Petroleum Supply Chain (SPSC): A case study – Part I (Models)

2020 ◽  
Vol 14 (1) ◽  
Author(s):  
Davoud Ghahremanlou ◽  
Wieslaw Kubiak
Keyword(s):  
Supply Chain ◽  
General Model ◽  
Programming Model ◽  
The United States ◽  
Policy Impact ◽  
Renewable Fuel Standard ◽  
Stochastic Programming Model ◽  
The Government ◽  
The Impact

Environmental concerns and energy security have led governments to establish legislations to convertConventional Petroleum Supply Chain (CPSC) to Sustainable Petroleum Supply Chain (SPSC). The United States(US), one of the biggest oil consumers in the world, has created regulations to manage ethanol production and con-sumption for the last half century. Though these regulations have created new opportunities, they have also added newburdens to the obligated parties. It is thus key for the government, the obligated parties, and related businesses to studythe impact of the policies on the SPSC. We develop a two-stage stochastic programming model, General Model (GM),which incorporates Renewable Fuel Standard 2 (RFS2), Tax Credits, Tariffs, and Blend Wall (BW) to study the policyimpact on the SPSC using cellulosic ethanol. The model, as any other general model available in the literature, makesit highly impractical to study the policy impact due to the model’s computational complexity. We use the GM to derivea Lean Model (LM) to study the impact by running computational experiments more efficiently and consequently byarriving at robust managerial insights much faster. We present a case study of the policy impact on the SPSC in theState of Nebraska using the LM in the accompanying part II (Ghahremanlou and Kubiak 2020).

Waste-to-Energy Project Economics and Financing: A Look Into the Factors Influencing the Future

2006 ◽  
Author(s):  
Jeffrey F. Clunie
Keyword(s):  
United States ◽  
The United States ◽  
Fuel Oil ◽  
Waste To Energy ◽  
Recent Analysis ◽  
Economic Factors ◽  
The Future ◽  
The Cost ◽  
The Impact

This paper focuses on significant changes in the overall economics of waste-to-energy (WTE) during the last 30 years. The WTE industry in this country has seen several different business cycles occur since 1975, as different market drivers have caused the industry to rise and fall. This paper compares: (1) those economic factors that were in play in 1975, when the first WTE facility in the United States was built, and the industry was in its infancy; (2) the factors at play when the WTE industry was at its height in 1990; and (3) some of the factors that caused the industry’s steep downward trend since 1994, when the last greenfield WTE facility in the United States was built. The paper will identify changes that have occurred with regard to the pricing of electricity and the ability of public sectors to charge non-market-based tipping fees. The paper discusses the drivers of 2006 and focuses on completed economic factors to be considered when comparing WTE with other waste disposal means. The paper discusses the drivers of 2006 and whether the industry is finally poised to begin an upward turn in the cycle. The paper focuses on the impact of the cost of diesel fuel oil on the overall economics of long-haul transfer, and how that is likely to impact the future development of WTE facilities. The paper also presents a case study of a recent analysis that was undertaken for two counties that were evaluating the financial viability of WTE as compared to other disposal options.

A systematic literature review of the impact of 5-HT3RA use on health care utilization in patients with chemotherapy-induced nausea and vomiting in the United States.

2013 ◽  
Vol 31 (31_suppl) ◽  
pp. 269-269
Author(s):  
Michael S. Broder ◽  
Claudio Faria ◽  
Annette Powers ◽  
Jehangeer Sunderji ◽  
Dasha Cherepanov
Keyword(s):  
Rescue Medication ◽  
Human Subjects ◽  
Healthcare Services ◽  
The United States ◽  
Nausea And Vomiting ◽  
Care Utilization ◽  
Outpatient Services ◽  
Medical Subject Headings ◽  
Inpatient Services ◽  
The Impact

269 Background: Uncontrolled chemotherapy-induced nausea and vomiting (CINV) can lead to nutrient depletion, diminished function, disruption of chemotherapy, and increased costs. Standard antiemetic therapy includes 5-HT3RAs for CINV prophylaxis, with palonosetron recommended in National Comprehensive Cancer Network (NCCN), Multinational Association of Supportive Care in Cancer (MASCC), and ASCO guidelines as the preferred 5-HT3RA for CINV prophylaxis with MEC. There is evidence that using 5-HT3RAs can reduce costs but no comprehensive review of the evidence is available. Methods: We searched MEDLINE, National Institute for Health Research (NIHR), Centre for Reviews and Dissemination (CRD databases, 4 conferences (Academy of Managed Care Pharmacy, ASCO, International Society for Pharmacoeconomics and Outcomes Research, MASCC), and bibliographies of included articles. We queried Medical Subject Headings (MeSH) and key terms: “ondansetron,” “granisetron,” “palonosetron,” “dolasetron mesylate,” “costs,” “cost analysis,” and “economics.” Included records reported data on cost/utilization (rescue medication, outpatient/inpatient services) related to 5-HT3RA use for CINV in English, in human subjects, and published after 1997. Results: Of the 433 identified records, the 16 reporting utilization in the US were reviewed (excluded: 29 duplicates, 388 off-topic records). Studies varied significantly in designs, patients, 5-HT3RA regimens, and definition of outcomes. Twelve studies reported rescue medication use for CINV in patients using different 5-HT3RAs. In 5 studies, fewer patients treated with palonosetron required rescue medication versus ondansetron users (56% vs. 61%, 28% vs. 83%, 14% vs. 24%, 8% vs. 11%, 6% vs. 11%); 2 studies found palonosetron users had fewer outpatient services versus ondansetron users (5% vs. 10%, 8% vs. 10%). Four studies, with a variety of patients and outcomes, reported fewer patients treated with palonosetron versus ondansetron or other 5-HT3RAs used inpatient care (e.g., 0.2% vs. 0.4%, 16% vs. 23%, 7% vs. 10%, 0% vs. 5%), while 2 studies reported similar use (1% vs. 1%, 0% vs. 0%). Conclusions: CINV prophylaxis with palonosetron is generally associated with lower use of rescue medications, outpatient and inpatient services compared to ondansetron or other 5-HT3RAs. Use of palonosetron as a standard treatment may lead to reduced utilization of rescue medications and healthcare services for CINV and subsequent cost savings.

Road Closures and Freight Diversion

2012 ◽  
Vol 2269 (1) ◽  
pp. 51-57 ◽  
Author(s):  
David Pierce ◽  
Jeffrey Short
Keyword(s):  
Performance Measures ◽  
The United States ◽  
Valuable Insight ◽  
Data Set ◽  
Sensing Technology ◽  
Global Positioning ◽  
Data Points ◽  
System Data ◽  
The Impact

The FHWA-sponsored Freight Performance Measures (FPM) program generates and monitors a series of performance measures related to the freight transportation system of the United States. The primary information analyzed by the FPM program is a data set consisting of billions of Global Positioning System data points from trucks. These data can be used to demonstrate empirically changes in truck travel patterns and freight performance independent of the availability of roadside sensing technology. A case study that was based on the flooding closure of Arkansas Interstate 40 in May 2011 was presented to show how FPM data can be used to analyze diversion behavior around road closures. This type of empirical analysis is in contrast to the majority of current diversion analyses, which rely on modeling to generate results. Not only do FPM data provide a viable alternative to modeling for studying past events, but the data may provide valuable insight into the underlying assumptions of future models designed to predict the impact of disaster scenarios. By understanding more fully how previous events unfolded, planners can prepare better for the next disaster.

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