A non-linear discrete stochastic optimization model for Advanced Access patient appointment scheduling

Access to healthcare is a major problem in which patients are deprived of receiving timely admission to healthcare. Poor access has resulted in significant but avoidable healthcare cost, poor quality of healthcare, and deterioration in the general public health. Advanced Access is a simple and direct approach to appointment scheduling in which the majority of a clinic's appointments slots are kept open in order to provide access for immediate or same day healthcare needs and therefore, alleviate the problem of poor access the healthcare. This research formulates a non-linear discrete stochastic mathematical model of the Advanced Access appointment scheduling policy. The model objective is to maximize the expected profit of the clinic subject to constraints on minimum access to healthcare provided. Patient behavior is characterized with probabilities for no-show, balking, and related patient choices. Structural properties of the model are analyzed to determine whether Advanced Access patient scheduling is feasible. To solve the complex combinatorial optimization problem, a heuristic that combines greedy construction algorithm and neighborhood improvement search was developed. The model and the heuristic were used to evaluate the Advanced Access patient appointment policy compared to existing policies. Trade-off between profit and access to healthcare are established, and parameter analysis of input parameters was performed. The trade-off curve is a characteristic curve and was observed to be concave. This implies that there exists an access level at which at which the clinic can be operated at optimal profit that can be realized. The results also show that, in many scenarios by switching from existing scheduling policy to Advanced Access policy clinics can improve access without any decrease in profit. Further, the success of Advanced Access policy in providing improved access and/or profit depends on the expected value of demand, variation in demand, and the ratio of demand for same day and advanced appointments. The contributions of the dissertation are a model of Advanced Access patient scheduling, a heuristic to solve the model, and the use of the model to understand the scheduling policy trade-offs which healthcare clinic managers must make. ^

Factors that differentiate persistence beyond the first session at a for-profit university

An increasing number of students are selecting for-profit universities to pursue their education (Snyder, Tan & Hoffman, 2006). Despite this trend, little empirical research attention has focused on these institutions, and the literature that exists has been classified as rudimentary in nature (Tierney & Hentschke, 2007). The purpose of this study was to investigate the factors that differentiated students who persisted beyond the first session at a for-profit university. A mixed methods research design consisting of three strands was utilized. Utilizing the College Student Inventory, student’s self-reported perceptions of what their college experience would be like was collected during strand 1. The second strand of the study utilized a survey design focusing on the beliefs that guided participants’ decisions to attend college. Discriminant analysis was utilized to determine what factors differentiated students who persisted from those who did not. A purposeful sample and semi-structured interview guide was used during the third strand. Data from this strand were analyzed thematically. Students’ self-reported dropout proneness, predicted academic difficulty, attitudes toward educators, sense of financial security, verbal confidence, gender and number of hours worked while enrolled in school differentiated students who persisted in their studies from those who dropped out. Several themes emerged from the interview data collected. Participants noted that financial concerns, how they would balance the demands of college with the demands of their lives, and a lack of knowledge about how colleges operate were barriers to persistence faced by students. College staff and faculty support were reported to be the most significant supports reported by those interviewed. Implications for future research studies and practice are included in this study.

A Critical Review of the Implied Cost of Equity: A New Way to Estimate the Expected Return

For the last three decades, the Capital Asset Pricing Model (CAPM) has been a dominant model to calculate expected return. In early 1990% Fama and French (1992) developed the Fama and French Three Factor model by adding two additional factors to the CAPM. However even with these present models, it has been found that estimates of the expected return are not accurate (Elton, 1999; Fama &French, 1997). Botosan (1997) introduced a new approach to estimate the expected return. This approach employs an equity valuation model to calculate the internal rate of return (IRR) which is often called, 'implied cost of equity capital" as a proxy of the expected return. This approach has been gaining in popularity among researchers. A critical review of the literature will help inform hospitality researchers regarding the issue and encourage them to implement the new approach into their own studies.

Characterizing Poor Performance in For-Profit and Not-for-Profit Food Service Operations

In this article the authors explore the performance-related employee behaviors that are the most troublesome in food service. Four subsegments of food service were surveyed and differences in profit and not-for-profit operations analyzed. Significant differences were found between the two groups, with for-profit operations indicating more severe problems in all but one behavior category.

Placement for Profit: Menu Item Arrangement on Customer-Activated Computer Screens

Can profitable menu items be placed on a computer screen where they will be selected more readily than other items? The author examines whether printed menu theories and techniques can be applied, with the same results, to a computer menu screen

The Foodservice Industry's Social Responsibility Regarding the Obesity Epidemic, Part II: Incorporating Strategic Corporate Social Responsibility into Foodservice Operations

Just as all types of business firms are now expected to go beyond their profit-oriented activities in boosting the well-being of the community, so, too, is corporate social responsibility (CSR) expected from foodservice firms. The significance of the obesity epidemic, combined with the foodservice industry's role in the development of this epidemic, suggests that the industry has an ethical responsibility to implement CSR activities that will help reduce obesity, particularly among children. CSR should be seen as an efficient management strategy through which a firm voluntarily integrates social and environmental concerns into its business operations and its interactions with stakeholders. Although costs are associated with CSR initiatives, benefits accrue to the firm. Decisions regarding alternative CSR activities should be based on a cost-benefit analysis and calculation of the present value of the revenue stream that can be identified as resulting from the specific CSR activities. CSR initiatives should be viewed as long-term investments that will enhance the firms’ value. Key areas for foodservice firms' CSR activities include marketing practices, particularly practices impacting advertising to children and marketing that will enhance the firms’ visibility; portion-size modification; new-product development; and consistent nutrition labeling on menus.

Singing About Expected Behaviors for Group Instruction

The proposed study will be displayed on a poster board that contains the research methods and results due to the use of music intervention with students with ASD.

Best Practices: Lessons Learned by a South Florida Non-Profit Community Based Organization while Designing and Implementing a Career Exploration Evidence Informed Framework in Urban Communities

All A’s was designed to support of the agency’s family strengthening initiatives in South Florida. All A’s uses evidence informed strategies poised to be an inclusive curriculum that teaches self-determination and adaptive behavior skills. The framework incorporates problem based learning and adult learning theory and follows the Universal Design for Learning. Since 2012, the agency has served over 8500 youth and 4,000 adults using the framework. The framework addresses educational underachievement and career readiness in at risk populations. It is used to enhance participants AWARENESS of setting SMART goals to achieve future goals and career aspirations. Participants are provided with ACCESS to resources and opportunities for creating and implementing an ACTION plan as they pursue and ACHIEVE their goals. All A’s promotes protective factors and expose youth to career pathways in Science, Technology, Engineering and Math (STEM) related fields. Youth participate in college tours, job site visits, job shadowing, high school visits, online college and career preparation assistance, service learning projects, STEM projects, and the Winning Futures© mentoring program. Adults are assisted with résumé development; learn job search strategies, interview techniques, job shadowing experiences, computer and financial literacy programs. Adults and youth are also given the opportunity to complete industry-recognized certifications in high demand industries (food service, general labor, and construction), and test preparation for the General Educational Development Test.