Rupesh Kumar Pati

Reverse logistics in the pharmaceuticals industry: a systemic analysis

Purpose – The purpose of this paper is to present a systemic analysis of the complex interaction of factors affecting the reverse logistics (RL) processes in a pharmaceutical supply chain (PSC). Design/methodology/approach – This study uses a systems thinking approach. Initial problem structuring involved the analysis of behavior-over-time of main variables and incorporated stakeholder analysis. Further, a participative group model building process was used to develop a systems model. Findings – The model was analysed to identify a set of feedback loops operating in the system responsible for the complexities of the problem. To address this, the stakeholders identified three strategic interventions. The first intervention relates to returns avoidance by alleviating market flooding of medicines, second intervention aims at improving the infrastructure for quality and performance management and the third targets balanced risk sharing between the main stakeholders involved in the supply chain. The findings s...

Research on management issues in the pharmaceutical industry: a literature review

Purpose – This paper aims to present a review of literature to assess the progress of research on managerial issues in the pharmaceutical industry globally.Design/methodology/approach – Literature from peer‐reviewed journals available on online databases was collected for the last decade, using the keyword search technique, and then classifying it according to major managerial issues, research methodologies used and geographical zones.Findings – Behavioral issues at the consumer/physician level and non‐behavioral issues in pricing and medical expenses are studied the most, followed by supply chain management, research and development and manufacturing and services operations management. There is scope for conjunction of research efforts across themes and players. The studies focus on the developed nations through the application of field research and mathematical modeling techniques. The studies in the American region focus more on development and marketing while studies in Europe are aligned towards manu...

Economic paper blending optimization model with competing materials

Purpose – Demanding customers, legislation and raw materials shortages in the modern world have forced companies to minimize the systems environmental impact. The paper seeks to analyze the economic impact of blending in sustainable paper industries in countries such as India.Design/methodology/approach – A linear programming model for a paper supply chain is proposed to minimize paper manufacturing cost by optimally blending wood pulp and after‐use paper under various conventional supply chain constraints. The issues of quality, environmental concern and reusability in the paper industry have also been taken into account.Findings – Improving quality of after‐use paper by proper recovery network reduces the manufacturing cost. Increasing proportion of wood fiber in the finished paper decreases the cost, even at the cost of degradation in the environment. Thus, it is up to the manufacturer to reflect its degree of environmental concern to the government and society by assigning appropriate environmental a...

Integrated chain analysis of recycled vis-à-vis wood pulp paper industry: an Indian manufacturer viewpoint

Strict environmental regulations and the ever-increasing shortages in the availability of natural resources are making reverse logistics an area of growing importance. From the manufacturers point of view, this paper proposes a linear programming optimisation model for the Indian paper industry with two different sources of raw materials (i.e., wood and wastepaper). The objective of the model is to minimise the paper supply chain cost, which includes costs of collection, transportation, segregation and disposal (for recycled paper), inventory, and manufacturing. The inclusions of environmental cost and cost of quality added a new dimension to the said model, which was not explored earlier in the supply chain context. To know the behaviour of the system under different scenarios, sensitivity analysis, shortage analysis and finally, indifference curve analysis have been performed on the model. The model will help the manufacturer make strategic decision under different shortage scenarios of the paper supply chain.

Cost optimisation model in recycled waste reverse logistics system

This study presents a cost optimisation model for multi-variety (or multi-type) Recycled Waste Reverse Logistics System (RWRLS). A linear analytical model is formulated which minimises the total reverse logistics costs for multi-variety Recycled Waste Reverse Logistics System (RWRLS) subjected to constraints that take into account various internal and external factors affecting the RWRLS. Internal factors include unit inventory carrying costs, initial inventories, inventory capacities, unit manufacturing costs etc., whereas external factors include demand, distance, unit travelling costs, etc. between the stages for different varieties of recyclable waste. The model helps the organisation in developing an appropriate manufacturing strategy, e.g. units of various varieties of paper produced, by comparing the costs in different scenarios of demand. The described model may help in deciding about the transaction of goods/material/varieties taking place in the long term. The model may be helpful in making strategic inventory management decisions.

Sustainability in healthcare for nations overall growth in developing and underdeveloped countries

The purpose of this study was to explore and describe communication effectiveness and communication satisfaction experienced by professional nurses in selected public health care services. Quantitative, explorative and descriptive research was conducted to determine the communication effectiveness and levels of communication satisfaction. The Downs and Adrian (2004) structured questionnaire was adapted and used to collect the data. The study population consisted of three groups of professional nurses, namely nurse managers (n=18), operational managers (n=22) and professional nurses (n=90). The study highlighted areas of effective and ineffective communication, as well as areas of communication satisfaction and dissatisfaction, among professional nurses. The findings revealed that although professional nurses are satisfied with their supervisorsubordinate communication, they are dissatisfied with personal feedback between all categories of professional nurses. Recommendations for the improvement of the communication effectiveness and communication satisfaction of professional nurses are aimed at creating an organisational atmosphere conducive to two-way communication.I reliability is an important consideration in instrument development as well as in the ongoing fidelity of measurements that can be somewhat subjective.The Cohen’s kappa statistic takes chance into consideration and thus, provides a more robust measurement of agreement than inter-rater reliability. This analysis was an important step in a program evaluation of an innovative, multi-faceted professional nursing frameworkthat incorporated a newly developed instrument. In order to evaluate the implementation and diffusion of the innovation, site visits were conducted by a team of two investigators using the instrument comprised of six unit-level components. The two investigators met separately with nursing staff and leaders on all study units in 50% of the military hospitals included in the program evaluation. Using the “Optimized Performance Checklist,” each rated the implementation as met, not met, or partially met. Each of the 34 units was rated separately on 20 data elements, or items, in the checklist, generating 675 pairs of data elements for the observers. The formula for the kappa statistic (observed-expected agreement/1-expected agreement) was applied. The observers agreed on 652 of the 675 ratings, resulting in 97% agreement. However, when taking into consideration chance agreements and disagreements, the Cohen’s kappa statistic was .91. The Cohen’s kappa indicates a very high level of agreement even when chance is considered. The kappa is an easy to calculate statistic that provides a more conservative and realistic estimate of inter-rater reliability. It should be used when attempting to verify observer fidelity.Hospital Acquired Pressure Injuries (HAPI) reflects upon nursing care effectiveness and is seen as a nursing quality outcome measure. HAPIs are a global concern due to many factors and contribute to an increase in treatment costs, increase length of stay, possible litigation, and reimbursement issues. HAPIs are seen as a preventable adverse event as identified by Centers for Medicare and Medicaid services (CMS). Data gathered before initiation of this project indicated that within a 12-month period both the MICU and SICU demonstrated a HAPI rate of 47% of the total HAPI occurrences in the hospital. Goal Statement: Among intensive care patients would daily clinical skin assessment rounding, done with a wound nurse expert and bedside nurse, versus current standard practice, decrease Hospital Acquired Pressure Injuries rates? Utilizing the Evidence-Based Practice Institute Conceptual Model, as well as the United States National Pressure Ulcer Advisory Panel Staging System as a guide for this project, the certified wound expert rounded on each patient with the assigned critical care nurse and made focused Head-to-Toe assessments. Informal teaching by the wound expert was provided at the bedside with instruction on pressure relieving interventions, HAPI risk factors, and proper identifiable staging. Assessment of 450 patients demonstrated no identified stage II or greater HAPIs and a clinically relevant reduction in the incidence of pressure injuries during the project period. Benefits to patients included improved skin surveillance and early HAPI detection. An educational focus on Medical-Device Related HAPIs should be considered in future projects. Sharp Grossmont Hospital, USAÖZ Çalışmanın amacı Türkiye’de ebelik mesleğinin mevcut durumunu yasal düzenlemeler, eğitim ve bilimsel araştırma boyutlar ile ortaya koymaktır. Bu çalışma, literatüre dayalı olarak niteliksel çoklu vaka çalışması deseninde yapılmıştır. Bu desen içinde, scholar. google.com.tr web sayfası üzerinden “ebelik ve Türkiye’de ebelik” kavramları ile tarama yapılmıştır. Daha önceden bilinen kitap, makale ve diğer literatürde yer alan bilgiler elde edilmiş, sübjektif ve deneyime dayalı bilgilerden yararlanılmıştır. Elde edilen veriler tarihi gelişim içinde öyküsel anlatım ile sunulmuş ve gereksinim olduğunda tablolaştırılmıştır. Türkiye’de ebelik yasası çalışmaları devam etmekle birlikte, ebelik eğitimi, özlük hakları, görev, yetki ve sorumlulukları ile ilgili önemli yasal düzenlemeler mevcuttur. Ebelik eğitimi uluslararası standarda ulaştırılmış ve lisans, yüksek lisans ve doktora düzeylerinde verilmektedir. Ancak halen ebelik eğitiminin önemli bir bölümü, başta hemşireler olmak üzere diğer sağlık meslek üyeleri tarafından verilmektedir. Yasal düzenlemeler bulunmasına rağmen, halen ebelerin çalışma alanlarında görev, yetki ve sorumluluklarda ciddi karmaşa bulunmaktadır. Bu doğrultuda ebe ve hemşirelerin görevlerinin birbirine karıştırıldığı, ebelerden hemşirelik görevlerinin beklendiği ve ebelerin kendi yeterlik alanı dışında çalıştırıldığı ya da isteyerek çalıştıkları gözlenmektedir. Ebelikte lisansüstü eğitimin gecikmesine paralel olarak bilimsel araştırma yapma ve yayınlamadaki gelişmeler de yetersizdir. Bu çalışmada Türkiye’de ebelik mesleğinin eğitim ve uygulanmasına ilişkin genel olarak yasal düzenlemelerin bulunmasına rağmen, mevcut uygulamalarda sonunlar olduğu ve ebelik araştırmalarının yetersiz olduğu sonuçları elde edilmiştir. Mevcut uygulamaların yasal düzenlemelere göre yeniden yapılandırılması, ebelik eğitim ve araştırmalarına ilişkin stratejik çalışmaların yapılması ile ebelik mesleğinin gelişimine katkı sağlanabilir.T purpose of this research was to examine the association between electronic bullying victimization and psychological distress in a nationally-representative sample of US high school students stratified by gender, race/ethnicity, grade level, and year. For this research, data from the pooled 2011 and 2013 Youth Risk Behavior Survey (YRBS) were analyzed using the Complex Samples Module of IBM SPSS 23TM. The dependent variables used include 1) depressive symptoms, 2) suicidal ideation and 3) suicide attempts. We analyzed data using multiple logistic regression analyses for all students, and also separately for males and females. Results showed females were more likely to experience both electronic bullying victimization and psychological distress than males. There was also a significant relationship between electronic bullying victimization and psychological distress among both males and females. The relationship between grade level and psychological distress and between race/ethnicity and psychological distress were each contingent upon gender. These results show the devastating effects of electronic bullying on psychological well-being among high school students. As social media is an integral part of today’s adolescent experience, nurses and other professionals must recognize that electronic bullying victimization is distressing, and related to suicidality. Vigilant assessment and intervention within a traumainformed model of care is essential. Further research is needed to identify best practices for screening and intervention.Objective Literature suggests that the need to belong influences health and well‐being, behavioural, emotional and cognitive responses. This paper describes the impending development and validation of a toolkit for nurses to create the experience of belongingness with a team approach, for student nurses undertaking a clinical placement. Setting and Subjects The design of the toolkit will be developed from a selected Delphi panel process involving nursing experts’ experience and opinions. The toolkit will then be distributed to nurses in selected clinical areas for use during periods of clinical placements. Primary Argument Clinical placements are essential for professional socialisation in which nurses provide compelling role models for how to think, feel and act. However, students have often identified a sense of alienation through poor clinical experiences. The need to belong and be part of a team exerts a powerful influence on cognitive processes and behavioural responses. The absence of meaningful interpersonal relationships can result in failure to develop optimal clinical reasoning and critical thinking skills to manage patient care safely. Conclusion More needs to be achieved than to simply justify the core attributes of a good clinical learning environment. Understanding of the key role that clinical leaders and supervisors exert to create a belongingness environment can influence positively the attitude of other staff towards students. For a valued positive clinical learning experience to become the benchmark of best practice, it requires a structured process, a toolkit to enable nurses to comprehend the concept of belongingness and to support them in embedding this model into their role of supervision.Background: Compassion has been an attractive subject for the p ublic and the health service sector in the last decade. Nursing service without compassion leads to the pa tients’ dissatisfaction therefore compassion is required for health service practices as a guiding principle. Aim: This is a methodological study and aims to test t he reliability and validity of the Turkish version of the Compassion of Others’ Lives Scale (The COOL). Methods: 349 nursing students took part in the survey resear ch between January and February 2015 and 100 students were retested. Cronbach’s alpha coefficien t has been used for the questionnaire’s reliability analysis. Results: The analysis reveals that scale items were concentr at d on two factors as it was in the original scale . The factor analysis found that the two factors expl ained 44.10% of the total variance. Factor 1, allev iat suffering subscale had the most explanatory power w ith a total variance of 34.70%. Demographic charact eristics should be taken into account while dealing with com passion. Conclusion: Turkish version of the Compassion of Others’ Lives Scale is found as a reliable and valid scale .The Compassion of Others’ Lives Scale might be helpful for measuring compassion level in health professionals.Injuries among seniors such as fall injuries are one major problem today even though various actions are taken in promoting healthy ageing and self-management. However age is one of the most important independent fall predictors since the body does change with age. A decline of visual ability is one of the natural changes and it is known that affected visual ability is one of the most predictive risk factor of falling both independently and in combination with other risk factors. In a population of independently living seniors 70 years and older (n=212) 43%, 36 men and 55 women, reported at least one fall. Both perceived and performance-based visual ability and its association to falls were investigated. The National Eye Institute Visual Function Questionnaire (NEI VFQ-25) was used assessing various dimensions of self-reported vision functioning in daily life activities such as going down steps or curbs, and difficulties in noticing objects off to the side while walking along. Significant associations with falling (p<5%) were found for nine out of eleven NEI VFQ- 25 vision-related subscales for men, but none for women. However regarding performance-based visual ability such as visual acuity, contrast sensitivity, stereopsis and visual field no associations were found with falls(p<5%). The majority of the seniors presented normal performance- based visual ability even though falls were common. One reason may be that at an eye clinic the conditions are optimal and standardized and do not agree with the conditions in the seniors’ daily life where difficulties may occur. The results shows that when planning fall prevention actions it is of importance investigating seniors’ perceived visual ability when performing various daily life activities.Background: It is the right of every patient to receive necessary care appropriately, safely, and at the right time. However nurse shortages cause omission of less critical nursing tasks by nurses. The aims of the study were to examine the nature and prevalence of missed care; and to assess relationship between missed care and selected care outcomes. Methods: Mixed method was used (descriptive and intervention) to collect data from186 nurses providing direct adult care in 4 hospitals, and 120 patients/relatives. Ethical clearance was obtained from the HREC of Cross River State Ministry of Health. Nurses identified activities omitted in part or whole, or delayed in the previous seven days from a validated list of required care activities. Intervention comprised capacity building on certain care issues. Data were collected through researcher-developed and validated questionnaires. Descriptive and inferential statistics were used analyse data on SPSS 18.0. Results: Most nurses (83.9%) reported they had left one or more care activities undone. At post-test experimental group mean reduced significantly. Care most missed were routine bath (34.9%), spiritual support (33.9%), assessing effectiveness of pain medication (28.0%), patient education (26.3%), pain assessment before administering medication (25.8%), etc. Others like chronic wound care and updating care plans were delayed but not totally missed. After intervention both prevalence and overall Means of missed care for experimental group reduced significantly (p = 0.001). Missed care was significantly related to all outcomes. Higher mean scores on missed care related with poor rating of outcomes, except on one outcome. Study did not consider staffing levels. Conclusion: Nurses reported frequently leaving “non-critical” care activities undone. Closer supervision is required to reduce missed care in staff. 1Department of Nursing Science, College of Medical Sciences, University of Calabar, Calabar, Nigeria 2University of Uyo Teaching Hospital, Uyo, Nigeria *Corresponding author Mildred Edet John, Department of Nursing Science, College of Medical Sciences, University of Calabar, Calabar, Nigeria, Tel: +234 8037178881; E-mail: miljohn2k@yahoo.com Submitted: 04 Oct 2016; Accepted: 24 Oct 2016; Published: 28 Oct 2016Background: To explore three schools based transitions and their impact on positive Self- Reported- Health (SRH), pre-school to elementary school (6–10 y), elementary school to junior high school ( ...E is facing a critical situation regarding the fertility indicators: the 2014 Egypt Demographic and Health survey indicates that fertility has increased after more than 20 years of decline. Shortcomings in human resources including low capacities and mal-distribution of health care providers across geographic regions especially in rural areas added to the complexity. A model was implemented to increase the utilization of FP services through rotatory mobilization of resources (health care providers) from low priority area to high priority area. The study findings revealed that the percent change of the intrauterine uterine device use before and after the intervention was 51% . In addition the percent change in the number of new FP users accounted for 42%. The study concluded that tailored initiatives through low cost effective interventions within the available resources is the way to overcome the reproductive health challenges in Egypt.

Analysis of Aadhaar: A Project Management Perspective

Increasing Indian population, migration from neighbouring countries as well as numerous variants of identity cards like ration card, voter ID card forced Government of India to form ‘Unique Identification Authority of India (UIDAI)’. The primary responsibility of the UIDAI is to issue Unique Identification Number (UID) or Aadhaar number to Indian residents which can be used for all the government transactions/benefits schemes like gas subsidy, Mahatma Gandhi National Rural Employment Gurantee Act (MGNREGA). This study conducts a systematic review of the materials/articles available through secondary sources such as newspapers, research papers and government reports on Aadhaar project. This has been categorized as a developmental project in the study due to high uncertainty associated with it in various dimensions. An attempt has been made through this study to understand the planning and implementation stage of Aadhaar Project till 2014. The study also attempts to identify potential risks (diamond framework has been used to provide interesting insights) and suggest a contingency plan for this and similar government projects in future, to ensure a better success rate. This study identifies various gaps and recommends a plan of action as well as appropriate process changes to enhance project success of Aadhaar Project in future. Based on the insights from this study a model to enhance the success rate of similar projects has also been proposed.

Modelling Bullwhip Effect in a Closed Loop Supply Chain with ARMA Demand

The growing importance of environmental concerns and focus on recycling has encouraged our research efforts to study the bullwhip effect on Closed Loop Supply Chain (CLSC). This article attempts to measure bullwhip effect in a six echelon CLSC with recycling as a reprocessing option for materials like paper and plastics (perhaps the first time in CLSC literature). The proposed model considers the effect of two critical parameters of CLSC: quality of recyclable raw material (in terms of its yield) and degree of segregation at source. It is assumed that the echelons in CLSC employ an Order-Up-To (OUT) inventory policy with Minimum Mean Square Error (MMSE) forecasting scheme, and that the demand forecast is performed via a first order Auto Regressive Moving Average model (ARMA [1, 1]). The model developed is employed to investigate the impact of Auto Regressive (AR) and Moving Average (MA) parameter, yield of recycled material, degree of segregation at source and the lead-time on the bullwhip effect. The model enables the CLSC managers to anticipate the downstream demand. In order to avoid order-process instability, a careful selection of Auto Regressive (AR) and the MA parameters is advised. Sensitivity analysis on replenishment lead-times provides managerial insights for effective design of recycling—distribution system, with constant accumulated lead-time. Further, the analysis reveals that increased degree of segregation at the source reduces the bullwhip effect.