Days Of Disruption Research Articles

HANDLING OF OVERDISPERSION CASES IN MORBIDITY DATA IN SELUMA REGENCY

The problem of overdispersion as a violation of the assumption of equidispersion in Poisson regression is generally caused by sources of unobserved heterogeneity, missing observations on predictor variables, outliers in the data, errors in the specification of the bridging function, and many observed values that are zero. The purpose of this study is to find out the right model and the variables that affect data that occurs overdispersion and excess zero in the case of the number of days of disruption at work, school, or other daily activities due to health complaints. The methods used were Poisson Regression, Negative Binomial Regression, Hurdle Poisson Regression, Zero Inflated Poisson Regression, Zero Inflated Negative Binomial Regression, and Hurdle Negative Binomial Regression. The data used were morbidity taken from data on the number of days of disruption at work, school or other daily activities due to health complaints in Seluma district, Bengkulu Province. It was found that the best model is Zero Inflated Negative Poisson with the smallest Akaike Information Criterion (AIC) value of 1620.609 and the variables that have a significant effect on the log model and the logit model are marital status and work variables.

Short\u2010term outcomes in children following emergency department visits for minor injuries sustained at home

BackgroundMinor injuries are very common in the pediatric population and often occur in the home environment. Despite its prevalence, little is known about outcomes in children following minor injury at home. Understanding the impact of these injuries on children and their families is important for treatment, prevention, and policy. The objectives of our study were (1) To describe the distribution of short-term outcomes following pediatric minor injuries sustained at home and (2) To explore the relationship of injury type and patient and household demographics with these outcomes.MethodsChildren (n = 102) aged 0–7 years with a minor injury sustained at home were recruited in an urban pediatric emergency department as part of the Child Housing Assessment for a Safer Environment (CHASE) observational study. Each patient had a home visit following the emergency department visit, where five parent-reported outcomes were assessed. Relationships were explored with logistic regression.ResultsThe most common type of injury was soft tissue (57.8 %). 13.2 % of children experienced ≥ 7 days of pain, 21.6 % experienced ≥ 7 days of abnormal activity, 8.9 % missed ≥ 5 days of school, 17.8 % of families experienced ≥ 7 days of disruption, and 9.1 % of parents missed ≥ 5 days of work. Families reported a total of 120 missed school days and 120 missed work days. Children who sustained a burn had higher odds of experiencing pain (OR 6.97), abnormal activity (OR 8.01), and missing school (OR 8.71). The parents of children who sustained a burn had higher odds of missing work (OR 14.97).ConclusionsFamilies of children suffering a minor injury at home reported prolonged pain and changes in activity as well as significant school and work loss. In this cohort, burns were more likely than other minor injuries to have these negative short-term outcomes reported and represent an important target for interventions. The impact of these injuries on missed school and disruption of parental work warrants further consideration.

Corona virus, tariffs, trade wars and supply chain evolutionary design

PurposeUsing the constructal law of physics this study aims to provide guidance to future scholarship on global supply chain management. Further, through two case studies the authors are developing, the authors report interview findings with two senior VPs from two multi-national corporations being disrupted by COVID-19. This study suggests how this and recent events will impact on the design of future global supply chains.Design/methodology/approachThe authors apply the constructal law to explain the recent disruptions to the global supply chain orthodoxy. Two interviews are presented from case studies the authors are developing in the USA and UK – one a multi-national automobile parts supplier and the other is a earth-moving equipment manufacture. Specifically, this is an exploratory pathway work trying to make sense of the COVID-19 pandemic and its impact on supply chain scholarship.FindingsAdopting the approach of Bejan, the authors believe that what is happening today with COVID-19 and other trade disruptions such as Brexit and the USA imposing tariffs is creating new obstacles that will redirect the future flow of supply chains.Research limitations/implicationsIt is clear that the COVID-19 response introduced a bullwhip effect in the manufacturing sector on a scale never-before seen. For scholars, the authors would suggest there are four pathway topics going forward. These topics include: the future state of global sourcing, the unique nature of a combined “demand” and “supply shortage” bullwhip effect, the resurrection of lean and local production systems and the development of risk-recovery contingency strategies to deal with pandemics.Practical implicationsSupply chain managers tend to be iterative and focused on making small and subtle changes to their current system and way of thinking, very often seeking to optimize cost or negotiate better contracts with suppliers. In the current environment, however, such activities have proved to be of little consequence compared to the massive forces of economic disruption of the past three years. Organizations that have more tightly compressed supply chains are enjoying a significant benefit during the COVID-19 crisis and are no longer being held hostage to governments of another country.Social implicationsAn implicit assumption in the press is that COVID-19 caught everyone by surprise, and that executives foolishly ignored the risks of outsourcing to China and are now paying the price. However, noted scholars and epidemiologists have been warning of the threats of pandemics since the severe acute respiratory syndrome (SARS) virus. The pundits would further posit that in their pursuit of low-cost production, global corporations made naive assumptions that nothing could disrupt them. Both the firms the authors have interviewed had to close plants to protect their workforce. It was indicated in the cases the authors are developing that it is going to take manufacturers on average one month to recover from 4–6 days of disruption. These companies employ many thousands of people, and direct and ancillary workers are now temporarily laid off and face an uncertain future as/when they will recover back to normal production.Originality/valueUsing the constructal law of physics, the authors seek to provide guidance to future scholarship on global supply chain management. Further, through two case studies, the authors provide the first insight from two senior VPs from two leading multi-national corporations in their respective sectors being disrupted by COVID-19. This study is the first indication to how this and recent disruptive events will impact on the design of future global supply chains. Unlike the generic work, which has recently appeared in HBR and Forbes, it is grounded in real operational insight.

Reducing the number and impact of outbreaks of nosocomial viral gastroenteritis: time-series analysis of a multidimensional quality improvement initiative

BackgroundNosocomial norovirus infections and their control measures disrupt patient care, increase staff workload and raise healthcare costs.ObjectiveTo determine the impact on outbreaks of nosocomial viral gastroenteritis, staff and patients affected,...

Evaluation of the addition of cromolyn sodium to bronchodilator maintenance therapy in the long-term management of asthma

Three hundred ninety-seven patients, aged 5 to 63 years, took part in a year-long international multicenter, double-blind, placebo-controlled trial. The patients, whose asthma was considered not adequately controlled, were divided into two groups according to their principal medication at entry (group A, oral and/or inhaled β 2-bronchodilators; group B, methylxanthines, with or without β 2-agonists) and randomly allocated to additional treatment with cromolyn sodium (metered-dose inhaler, 2 mg, four times a day, or capsules, 20 mg, four times a day) or matching placebo. A 2-month baseline preceded 10 to 12 months of treatment. After 4 to 8 weeks of treatment, patients were encouraged to reduce bronchodilator usage. Patients used diary cards to record asthma severity, sleep difficulty, morning and evening peak expiratory flow rates, days of disruption of normal activity, use of test treatments, and concomitant medication. Significant differences favoring cromolyn sodium ( p < 0.05 and better) were observed for most of the treatment period in respect to (1) asthma severity, (2) morning and evening peak expiratory flow rates, and (3) days of disruption of normal activity. Patients receiving cromolyn sodium experienced fewer exacerbations and tended to use less concomitant medication than patients receiving placebo. Patients' opinions of treatment significantly favored cromolyn sodium. These results demonstrate the value of the addition of cromolyn sodium to existing therapy in the long-term management of asthma and endorse its use as a first-line treatment.