Women protest high food prices

Inscriptions: Verso: [stamped] Credit must be given to Freda Leinwand from Monkmeyer Press Photo Service.

Heart monitor in the Coronary intensive care unit at Douglas County hospital in Alexandria, Minnesota

Inscriptions: Verso: [stamped] Credit must be given to Leinwand from Monkmeyer Press Photo Service].

An evaluation of physician predictions of discharge on a general medicine service.

The goal of this study was to evaluate general medicine physicians' ability to predict hospital discharge. We prospectively asked study subjects to predict whether each patient under their care would be discharged on the next day, on the same day, or neither. Discharge predictions were recorded at 3 time points: mornings (7-9 am), midday (12-2 pm), or afternoons (5-7 pm), for a total of 2641 predictions. For predictions of next-day discharge, the sensitivity (SN) and positive predictive value (PPV) were lowest in the morning (27% and 33%, respectively), but increased by the afternoon (SN 67%, PPV 69%). Similarly, for same-day discharge predictions, SN and PPV were highest at midday (88% and 79%, respectively). We found that although physicians have difficulty predicting next-day discharges in the morning prior to the day of expected discharge, their ability to correctly predict discharges continually improved as the time to actual discharge decreased. Journal of Hospital Medicine 2015;10:808-810. © 2015 Society of Hospital Medicine.

Essays in Empirical Operations Management: Bayesian Learning of Service Quality and Structural Estimation of Complementary Product Pricing and Inventory Management

This dissertation contributes to the rapidly growing empirical research area in the field of operations management. It contains two essays, tackling two different sets of operations management questions which are motivated by and built on field data sets from two very different industries --- air cargo logistics and retailing.

The first essay, based on the data set obtained from a world leading third-party logistics company, develops a novel and general Bayesian hierarchical learning framework for estimating customers' spillover learning, that is, customers' learning about the quality of a service (or product) from their previous experiences with similar yet not identical services. We then apply our model to the data set to study how customers' experiences from shipping on a particular route affect their future decisions about shipping not only on that route, but also on other routes serviced by the same logistics company. We find that customers indeed borrow experiences from similar but different services to update their quality beliefs that determine future purchase decisions. Also, service quality beliefs have a significant impact on their future purchasing decisions. Moreover, customers are risk averse; they are averse to not only experience variability but also belief uncertainty (i.e., customer's uncertainty about their beliefs). Finally, belief uncertainty affects customers' utilities more compared to experience variability.

The second essay is based on a data set obtained from a large Chinese supermarket chain, which contains sales as well as both wholesale and retail prices of un-packaged perishable vegetables. Recognizing the special characteristics of this particularly product category, we develop a structural estimation model in a discrete-continuous choice model framework. Building on this framework, we then study an optimization model for joint pricing and inventory management strategies of multiple products, which aims at improving the company's profit from direct sales and at the same time reducing food waste and thus improving social welfare.

Collectively, the studies in this dissertation provide useful modeling ideas, decision tools, insights, and guidance for firms to utilize vast sales and operations data to devise more effective business strategies.

Market reforms and privatisation in the English National Health Service

The article examines developments in the marketisation and privatisation of the English National Health Service, primarily since 1997. It explores the use of competition and contracting out in ancillary services and the levering into public services of private finance for capital developments through the Private Finance Initiative. A substantial part of the article examines the repeated restructuring of the health service as a market in clinical services, initially as an internal market but subsequently as a market increasing opened up to private sector involvement. Some of the implications of market processes for NHS staff and for increased privatisation are discussed. The article examines one episode of popular resistance to these developments, namely the movement of opposition to the 2011 health and social care legislative proposals. The article concludes with a discussion of the implications of these system reforms for the founding principles of the NHS and the sustainability of the service.

An Examination of Customers’ Attitudes about Table Top Technology in Full-Service Restaurants

This paper examines the influence of customer-facing technology in full-service restaurants. As a new addition to the service experience, tabletop devices offer the customer more control over the dining experience, and also increase customer participation in the service process, which has the potential to upset the traditional exchange between service providers and customers in restaurants. To examine how customers react to the use of tabletop devices, this study examines 1,343 point-of-sales transactions from 20 units of a full-service casual dining restaurant chain and matches customer in-restaurant transactions to their reactions to tabletop devices used during their meals. Results show that over 70% of the customers who used tabletop devices reported positive affect toward the device, with approximately 79% of customers reporting that the device improved their experience, citing convenience, ease of use, and credit card security as some benefits of using the technology. Approximately 80% of the customers who used the device reported that they would return to the restaurant because of the positive affect. The results also indicate that likeability of the device and tip percentage were positively and significantly connected to customer reports of the devices having a positive effect on experience and on desire to return. In addition, when customers reported increased return intentions, likeability of the device was higher regardless of reports of the device improving restaurant experience, showing that the introduction of tabletop devices had a positive effect for most—but not all—customers.

Does Tipping Help to Attract and Retain Better Service Workers?

A survey of several hundred restaurant servers in the United States found that servers’ attitudes toward working for tips and average tip sizes were weakly related (at best) to their service-orientation, intended job-tenure, and occupational-tenure. These findings suggest that tipping does not substantially help to attract and retain more service-oriented workers. Restaurateurs can eliminate tipping at their restaurants without fear that doing so will reduce the quality of their wait-staff.

The Influence of Table Top Technology in Full-service Restaurants

The use of tabletop technology continues to grow in the restaurant industry, and this study identifies the strengths and weakness of the technology, how it influences customers, and how it can improve the bottom line for managers and business owners. Results from two studies involving a full-service casual dining chain show that dining time was significantly reduced among patrons who used the tabletop hardware to order or pay for their meals, as was the time required for servers to meet the needs of customers. Also, those who used the devices to order a meal tended to spend more than those who did not. Patrons across the industry have embraced guest-facing technology, such as online reservation systems, mobile apps, payment apps, and tablet-based systems, and may in fact look for such technology when deciding where to dine. Guests’ reactions have been overwhelmingly positive, with 70 to 80 percent of consumers citing the benefits of guest-facing technology and applications. The introduction of tabletop technology in the full-service segment has been slower than in quick-service restaurants (QSRs), and guests cite online reservation systems, online ordering, and tableside payment as preferred technologies. Restaurant operators have also cited benefits of guest-facing technology, for example, the use of electronic ordering, which led to increased sales as such systems can induce the purchase of more expensive menu items and side dishes while allowing managers to store order and payment information for future transactions. Researchers have also noted the cost of the technology and potential problems with integration into other systems as two main factors blocking adoption.

Pooling Restaurant Reservations to Increase Service Efficiency

This paper examines whether restaurant reservations should be locked to specific tables at the time the reservation is made, or whether the reservations should be pooled and assigned to tables in real-time. In two motivating studies, we find that there is a lack of consensus in the restaurant industry on handling reservations. Contrary to what might be expected based on research that shows the benefits of resource pooling in other contexts, a survey of 425 restaurants indicated that over 80% lock reservations to tables. In two simulation studies, we determine that pooling reservations enables a 15-minute reduction in table turn times more than 15% of the time, which consequently increases service efficiency and enables a restaurant to serve more customers during peak periods. Pooling had the most consistent advantage with higher customer service levels, with larger restaurants, with customers who arrive late, and with larger variation in customer arrival time.

Evaluation of Select Food Additive Exposures in Children with Crohn's Disease

Thesis (Master's)--University of Washington, 2016-09

Percepção dos profissionais de saúde do Hospital Municipal do Huambo-Angola sobre a fisioterapia: projecto de implementação de um serviço de fisioterapia

Mestrado em Fisioterapia.

Microbiological assessment of indoor air quality at different hospital sites

Poor hospital indoor air quality (IAQ) may lead to hospital-acquired infections, sick hospital syndrome and various occupational hazards. Air-control measures are crucial for reducing dissemination of airborne biological particles in hospitals. The objective of this study was to perform a survey of bioaerosol quality in different sites in a Portuguese Hospital, namely the operating theater (OT), the emergency service (ES) and the surgical ward (SW). Aerobic mesophilic bacterial counts (BCs) and fungal load (FL) were assessed by impaction directly onto tryptic soy agar and malt extract agar supplemented with antibiotic chloramphenicol (0.05%) plates, respectively using a MAS-100 air sampler. The ES revealed the highest airborne microbial concentrations (BC range 240-736 CFU/m(3) CFU/m(3); FL range 27-933 CFU/m(3)), exceeding, at several sampling sites, conformity criteria defined in national legislation [6]. Bacterial concentrations in the SW (BC range 99-495 CFU/m(3)) and the OT (BC range 12-170 CFU/m(3)) were under recommended criteria. While fungal levels were below 1 CFU/m(3) in the OT, in the SW (range 1-32 CFU/m(3)), there existed a site with fungal indoor concentrations higher than those detected outdoors. Airborne Gram-positive cocci were the most frequent phenotype (88%) detected from the measured bacterial population in all indoor environments. Staphylococcus (51%) and Micrococcus (37%) were dominant among the bacterial genera identified in the present study. Concerning indoor fungal characterization, the prevalent genera were Penicillium (41%) and Aspergillus (24%). Regular monitoring is essential for assessing air control efficiency and for detecting irregular introduction of airborne particles via clothing of visitors and medical staff or carriage by personal and medical materials. Furthermore, microbiological survey data should be used to clearly define specific air quality guidelines for controlled environments in hospital settings.

O marketing em um hospital universitário na relação com o trabalho da enfermagem: um estudo de caso

No setor hospitalar, o marketing compõe um grupo interdependente de serviços e tem como objetivo principal aproximar clientes - externos, internos e corpo gestor -, através de estratégias específicas que promovem satisfação e qualidade. Esta organização possui uma larga diversidade de profissionais da saúde e o marketing, neste sentido, auxilia no processamento de seus serviços de forma a lapidá-los sob a ótica do cliente, buscando efetividade e produtividade. Neste cenário encontra-se o enfermeiro, cujo trabalho é composto pelas dimensões cuidar, gerenciar, educar/pesquisar, que se entrelaçam e caracterizam o serviço deste profissional. No entanto, costumeiramente, a enfermagem não declara o marketing como uma ferramenta estratégica ao seu processo de trabalho – fato verificável na exploração de publicações científicas -, e, paralelamente, depara-se com empecilhos na execução de seu trabalho que podem comprometer a sua excelência. Assim, este estudo busca analisar a relação do marketing com o trabalho do enfermeiro nas dimensões cuidar, gerenciar, ensinar/pesquisar. Para sua efetivação, optou-se pelo referencial metodológico Estudo de Caso, onde o fenômeno é verificado como ocorre em seu cenário real. Assim, a coleta, caracterizada por pesquisador e unidade únicos, ocorreu em um hospital universitário, geral e público no sul do país que declara publica e virtualmente o marketing institucional. Como fontes de evidência, foram utilizadas: entrevista focada com quatro sujeitos de áreas estratégicas para esta pesquisa; análise de documentação criada pela assessoria de marketing e observação direta. O tratamento e a análise dos dados ocorreram por meio da Análise Temática, que possibilitou a exposição dos resultados através de dois artigos: “A relação do marketing com o processo de trabalho do enfermeiro na dimensão cuidar” e “A relação do marketing com o processo de trabalho do enfermeiro nas dimensões gerenciar e educar/pesquisar”. Os resultados evidenciaram que o marketing no cuidar - auxilia a efetividade do cuidado através de novas estratégias de comunicação com o usuário, produz materiais elucidativos, lúdicos para sua continuação e manutenção e o divulga no meio intra e extra-hospitalar; no gerenciar - auxilia a o enfermeiro a ter um método mais inovador e criativo, a focar no cliente e no bom relacionamento interpessoal com a equipe; no educar/pesquisar - cria canais de comunicação interna e campanhas únicas que, além de auxiliar na realização da educação permanente e na atualização de enfermeiros, propicia meios para transmitir novos achados científicos à prática da enfermagem hospitalar. Através deste estudo, percebeu-se que ações de marketing podem contribuir para a efetividade do trabalho do enfermeiro em suas facetas dimensionais, aproximando este agente de saúde do usuário ao qual seu serviço é destinado e da gestão da organização, propiciando a este profissional maior visibilidade e valorização no espaço hospitalar e social.