Decrease Labor Costs Research Articles

Nurses Respond to Healthcare Restructuring

The most recent period of Massachusetts healthcare system reorganization began in the early 1980s. In part, this has been a response to soaring healthcare costs, countering them with diminished reimbursements. To decrease labor costs and survive in an increasingly competitive and market-driven healthcare environment, hospitals downsized and laid off nursing staff. Patient care and safety has concomitantly suffered. These efforts severely challenged nurses' status. Radicalized rank and file members of the Massachusetts Nurses Association mobilized against the association leadership's weak efforts to protect nurses' social and economic interests and the deteriorating quality of care. They transformed an association whose main focus was supporting nursing's professional image to one which became an activist labor union of professional workers. The history of this often contentious transformation is presented here within the context of these healthcare system changes. The MNA's successes and pending challenges within the Massachusetts healthcare system are also discussed.

Early Postmortem Injection and Tumble Marination Effects on Broiler Breast Meat Tenderness

Several processors use inline injection and tumble marination practices to decrease labor costs and product handling. However, the stimulation of this early postmortem (PM) muscle may cause increased toughness. Therefore, the objective of this study was to compare marination of early PM meat by using injection, vacuum tumbling, or both to determine their effects on tenderness of broiler breast fillets. Breast fillets from 45 broilers were deboned at 3 h PM and injected, tumbled (30 min, 635 mmHg, 14 rpm), or injected + tumbled with a 10% solution of 0.54%. NaCl + 0.42% sodium tripoly phosphate (STPP). Nonmarinated controls deboned at 3 and 6 h PM were also included. Shear value, sarcomere length, and cook loss were determined on each of the fillets. The control and tumbled fillets had the highest shear value compared with the remaining 3-h treatments. The injected + tumbled and tumbled fillets had the highest cook loss followed by 3-h control and injected treatments. Tumble marination at 3 h PM produced significantly tougher meat then the injection treatment.Experiment 2 was conducted to test marinade penetration through the fillets because penetration could have affected the results of the previous study. Broiler breast fillets were deboned from 60 broilers at 3 h PM and were vacuum tumbled (30 min, 635 mmHg, 14 rpm) with a 15% solution of 0.54% NaCl and 0.42% STPP. We determined shear value and cooked meat moisture of the fillets and sodium ion migration into the fillets. Although there were no significant differences in shear value between control and tumbled fillets, the cooked meat moisture was significantly higher in tumbled fillets when compared with the controls. Sodium ion concentration was significantly higher on the surface (especially the lateral surface) of the fillets when compared with the center, which suggested some uneven distribution.

Effect of the Insect Growth Regulator Novaluron (Pedestal) on Silverleaf Whitefly Reproduction

Insect growth regulators, which are primarily used to kill the larval stages of certain insect groups, have indirect effects on the adult stage of whiteflies. In this study, we assessed the effect of the insect growth regulator novaluron (Pedestal) on the reproduction of silverleaf whitefly (Bemisia argentifolii). Two experiments were conducted by exposing adult female silverleaf whiteflies to the low [0.47 mL·L-1 (6 floz/100 gal)] and high [0.63 mL·L-1 (8 floz/100 gal)] label-recommended rates of novaluron. There was also an untreated control. Infested plants [mist flower (Eupatorium coelenstinum) and transvaal daisy (Gerbera jamesonii) for Expt. 1 and Expt. 2, respectively] containing adult female silverleaf whiteflies were sprayed with novaluron using a carbon dioxide (CO2) backpack sprayer. Plants were immediately placed into cages covered with antivirus insect screening. After 24 hours, six adult female silverleaf whiteflies were aspirated from the treated plants, and immobilized with CO2 before being placed onto untreated plants [transvaal daisy for Expt. 1, and rose-of-china (Hibiscus rosa-sinensis) for Expt. 2]. Three munger cells containing two adult female silverleaf whiteflies per cell were attached to leaves of each of the untreated plants. The number of live and dead eggs, and live nymphs per plant was assessed 4 and 8 days after treatment (DAT). In Expt. 1, the low rate of novaluron significantly reduced egg viability compared to the untreated control based on live nymphal counts 8 DAT. In Expt. 2, both rates of novaluron significantly reduced egg viability compared to the untreated control, based on live nymphal counts and number of dead eggs 8 DAT. The results from this study indicate that novaluron negatively affected female silverleaf whitefly reproduction by reducing egg viability, which may decrease the number of silverleaf whiteflies produced during a cropping cycle. This is an important long-term pest management strategy that may reduce the number of insecticide applications and decrease labor costs.

Real-time polymerase chain reaction as an aid for the detection of SYT-SSX1 and SYT-SSX2 transcripts in fresh and archival pediatric synovial sarcoma specimens: report of 25 cases from St. Jude Children's Research Hospital.

Synovial sarcoma is the most common nonrhabdomyosarcomatous soft tissue sarcoma in children and adolescents and is characterized by a reciprocal t(X;18)(p11;q11) which results in the fusion of the SYT gene on chromosome 18q11 to either of two closely related genes, SSX1 (Xp11.23) or SSX2 (Xp11.21). Detection of this translocation or its resultant gene fusion by molecular methods is helpful in the pathologic diagnosis of synovial sarcoma, especially in poorly differentiated tumors. This study was designed to evaluate the utility of a real-time reverse transcriptase-polymerase chain reaction (RT-PCR) assay to detect and distinguish SYT-SSX1 and SYT-SSX2 fusions in fresh and archival specimens of synovial sarcoma in pediatric patients seen at St. Jude Children's Research Hospital. In addition, the clinicopathologic features of the tumors with SYT-SSX1 vs. SYT-SSX2 fusions were compared. The 25 patients studied had a median age of 13 years 9 months (range 5 to 19 years). Estimates of survival and event-free survival at 5 years were 78.7 +/- 10.5% and 56.2 +/- 13.2%, respectively. Seventeen (68%) tumors were monophasic, eight (32%) were biphasic. Seven tumors contained poorly differentiated areas. Positive results for either SYT-SSX1 or SYT-SSX2 were obtained in 21/25 (84%) cases. Three cases did not have a detectable gene fusion and one had no amplifiable RNA. SYT-SSX1 transcripts were found in 18/24 (75%) of the tumors while SYT-SSX2 transcripts were identified in 3/24 (12.5%). All of the poorly differentiated tumors and seven out of eight tumors from patients who developed lung metastases had an SYT-SSX1 fusion transcript. Real-time PCR is useful in detecting and distinguishing SYT-SSX1 from SYT-SSX2 gene fusions in synovial sarcoma. Valuable aspects of this methodology are the applicability to both frozen and formalin-fixed samples, decreased labor costs, and the rapidity of results. In addition, distinguishing SYT-SSX1 from SYT-SSX2 fusions with these methods allow for prospective collection of information that may clarify issues of prognostic relevance.

A statistical analysis of weekday operating room anesthesia group staffing costs at nine independently managed surgical suites.

At many surgical suites, surgeons and patients schedule elective cases on whatever future workday they choose, resulting in there being no limit on the number of cases performed each day. Staff are then scheduled in the manner that satisfies the marketing guarantee to the surgeons, satisfies labor contracts, and minimizes staffing costs. We assessed weekday nurse anesthesia group staffing at nine such suites to determine whether statistical methods can identify staffing solutions whereby all the cases are covered but for which staffing costs are less than those obtained using the staffing plans implemented by anesthesia groups' managers. Two years of operating room information system case duration and staffing data were analyzed. First- and second-shift staffing was assessed using previously published algorithms. The statistical methods identified staffing solutions with significantly decreased labor costs than those currently being used at eight of the nine surgical suites. The statistical methods relied more on overtime than second-shift staffing. The incremental decrease in staffing costs achievable by using overlapping 8-, 10-, and 13-h shifts was negligible. Overall, we found that statistical methods can identify, for some surgical suites, staffing solutions whereby all the cases are covered but for which costs are significantly less and productivity significantly more than those obtained using the plans developed by the managers based on their experience and the data. Statistical methods can identify, for some surgical suites, anesthesia staffing solutions whereby all the cases are covered but for which labor costs are significantly less than those obtained using the staffing plans developed by the managers based on data and their experience.

U.S. Army Nutrition Care Initiatives Creating Efficient Organizations Through Best Practices

Army dietitians are leading the way in the Military Health System with innovative thinking and cost efficiencies while simultaneously meeting the demands of their wartime roles. In 1997, senior Army dietitians devised a strategic plan to identify the best practices in foodservices and medical nutrition operations. An integral part of that plan was the Nutrition Care Benchmarking Program. This program enhances customer satisfaction and improves operational efficiencies through cost analysis. It ensures that dietitians are critically reviewing their operations and identifies the most efficient and innovative strategies. Information for the baseline year of 1997 and 1998 was collected on Total Meals Served, Labor Costs Per Meal Served, and Total Costs Per Meal Served. A survey of business practices and initiatives designed to increase cost efficiencies was also conducted. Outcomes shown were: A 7% increase in total meals served while decreasing labor costs by 7%. Business reengineering led to an 11% decrease in total costs per meal, 67% of facilities reduced labor costs through staffing and scheduling changes and 89% of operations increased revenues through innovative programs such as mobile food carts, menu redesign and expansion of the customer base.

Packaged Weight Vs. Actual Weight of Specific Portion Controlled Foods Used in Controlled Electrolyte Diets

LEARNING OUTCOME: To determine weight variance in stated packaged weight versus the actual weight of food items used in controlled electrolyte diets. The preparation of diets for research studies requires accurate calculations and food preparation methods. Pre-packaged portion controlled foods (PCs) are useful in research diets; they ease production and decrease labor costs. A metabolic diet examines specific nutrients and requires many foods to be weighed individually in order to achieve precise nutrient target goals. Under FDA regulation, the nutrition labeling law allows a 20% deviation for all nutrients and product weight. This regulation promotes a homogenous product, but leaves room for error when using PC's for research diets. To examine the variance in stated packaged weight versus the actual weight of products commonly used in diets controlled in electrolyte content, twenty-two different pre-packaged foods were weighed six times. Deviations are reported as percentages (absolute deviation/ stated weight). Mean difference in actual weight was +/- 6.44%. Out of the 22 PC foods selected, 21 were within the 20% stated weight limits, one cereal product exceeded limits by 80%. Average deviations for food groups ranged from a low of 0% deviation to a high of 33%. By food groups, these average weight deviations were: Cereals 33%, Canned Fruit 6.5%, Breads 6.3%, Snacks 4.3%, Cookies 3.5%, Canned juices 2.6%, Soups 2.3%, and Peanut Butter 0%. The variance between the stated nutrition label weight and the actual weight was minute for most products. These weight differences altered the stated nutrient label content in one product by an average of 1.5 mEq Na+ and in another product by 2mEq K+. To be able to use PC foods on controlled electrolyte diets, the actual product weight must be within the allowed 20% deviation from the nutrition label and still coincide with the nutrient targets for the protocol diet order. Periodic quality assurance of PC's is necessary to monitor product weights and maintain nutrient accuracy of the research diet.

Large scale manufacturing of compound semiconductors by MOVPE

As more compound semiconductor devices reach large volume manufacturing levels, a trend toward the use of the MOVPE technique is clear. In this paper we examine the criteria needed for MOVPE equipment suitable for large scale manufacturing. We find that although uniformity and device performance are necessary, reproducibility is also critical, along with high throughput and low operating costs. These points are illustrated by actual examples including MMIC power amplifiers, HB-LEDs, and solar cells. A realistic COO model provides a tool for evaluating MOVPE systems of different capacities. In situ control of key parameters during growth is now feasible, and will become an important method for increasing reproducibility and throughput. Lastly we look at the prospects for automation, for decreasing labor costs as well as wafer handling. This is likely to first have an impact on systems for the growth of electronic device structures on large (100 and 150 mm) wafers.

Development of Puree Meat Products for Long Term Institutionalized Residents with Dysphagia Using a Stephan Micro-Cutter

Current literature supports that nearly 39% of elderly in long term care facilities receive some type of textured altered diets with approximately 13% being of a pureed texture. Puree diets can pose a problem in the food service operations due to lack of standardized recipes, wear and tear on expensive puree machines and the demands it makes on labor. Poor resident acceptance can be related to pH, viscosity, temperature, size shape volume and visual appeal. The use of prepared meat entrees using a Stephan Micro-cutter broth and starch was tested in a nursing home that prepared approximately 280 purees a day. Average savings of labor of 5 hours per day was documented using time motion sheets. Anecdotal information on plate waste study prior to formal documentation yielded an overwhelming positive acceptance by nursing personnel and residents. When bacon and sausage were added to breakfast there was a documented 75-100% acceptance which can be translated to a 5-8 gram high biological protein increase per puree resident per breakfast meal. Other success of resident and customer acceptance is measured by sales in which 1st quarter of 94 was 2,600 pounds and 1st quarter 95 was 63,000 pounds. Pre-made pureed meat products by the Stephan Micro-cutter may be helpful in long term care facilities to decrease labor costs, increase resident's food consumption.

Employee benefits: A growing source of psychological contract violations

AbstractSince the 1940s, the number of employee benefits provided by employers and costs related to these benefits have increased dramatically. However, in the face of intensified product market competition, more and more organizations are decreasing their benefits packages as part of broader efforts to decrease labor costs. At the same time, many employees have become dependent on employer‐provided benefits to help satisfy basic security needs. This article examines the evolution of this predicament and the associated consequences that are likely to arise as a result of this conflict between worker expectations and employer practices. Ideas for resolution of this employee–employer conflict are also discussed.

Survey of robotics in the health care industry

The American health care industry has been experiencing considerable change in the 1980s. Health care administrators and interested outsiders have scrutinized the current health care operations in searching for avenues to decrease health care costs. The impetus behind this concern for cost containment resulted from the changing of reimbursement by the federal government to health care institutions for medicare patients [3]. Several solution have been forwarded and implemented, but the search for cost containment is far from over. The increased awareness of cost conscienceness is not new to Americans. The manufacturing industry began similar evolvement during the 1970s. The impetus being the inflationary environmental influences. Solutions to manufacturing labor costs are applicable to the health care industry. One solution that manufacturing implemented to decrease labor costs was the use of robots. The health care industry is very labor intensive. This paper addresses the possibilities of robotics applied in the health care industry. The current use of robots in the health care industry are identified along with future practical applications of robotics. The human interaction with a patient is important in some areas of health care service. The patient is the customer and the reactions of the patient to robotic care must be considered in determining practical applications of robotics within the health care industry. Final remarks will be directed at future research avenues.

A real time information system in a steel plant

Turing the past six years a network of computers has been built for the automatic handling of information regarding a production section reaching from blast furnaces to slabbing mills. In this section liquid pig iron produced by the blast furnaces is converted to ingots (blocks of steel) ready for rolling in the mills.This production section is called the “steel sector”. To control the production in this sector an enormous amount of information handling (collection, processing, communicating, displaying, reporting) is required. To improve the effectiviness and quality of this informationhandling with decreasing labor costs an automatic informationsystem has been built. History, design, implementation, results obtained and possible future developments concerning this project will be described.

Use of oleic acid derivatives to accelerate drying of thompson seedless grapes

AbstractPilot scale procedures were developed for the use of fatty acid ester emulsions to decrease the time to dry the Thompson seedless grapes to raisins. Both sun and mechanical drying were used in these experiments. Mechanically harvested grapes were dipped in a 1% or 2% fatty acid ester emulsion and dehydrated at drying times less than those required for the soda‐dipped raisins. Spraying grapes on the vine with a commercial ethyl ester mixture, which contained an emulsifier and added potassium carbonate, allowed the grapes to dry faster than the conventional sun drying procedures. These procedures produced light colored raisins of acceptable quality. In addition, these methods show savings by decreasing labor costs.

Large Herd Management in the South and Southwest

Because of inflation, decreasing profit per unit, and specialization there has arisen a need for large herd management in the South and Southwest. The manager of the large herd is faced with a multitude of problems encompassing labor, feed, disease, climate and, above all, profit. Today in this area, the problem of labor-quality and quanti ty--is foremost in the mind of management. More and more time is being spent dealing' with the different aspects of labor management. Total pounds of milk per man and number of animals per man are some of the comnmn denonfinators used in labor management decisions. More capital is required to utilize labor effectively. Like all large agricultural businesses, the dairies in the South and Southwest have been affected by the Federal Wage and Hour Law. There appears to have been little change in labor costs, because managers of most of the large herds pay substantially more than the one dollar an hour. In the Knolle operation, the minimum wage law has made us realize more fully the costs of equipment breakdowns and employee tardiness and has made us more efficient in labor usage. Feed requirements. The second major concern to management is the herd feed requirement. In much of the South and, especially in the Southwest, drought conditions exist much of the time. The average rainfall varies in different regions between 6 and 40 inches. The old saying, When it rains, it pours, applies to the Gulf Coast, where most of the rain is unevenly distributed. Irrigation is used where underground or river water is available. This increases the cost per ton of feed, but is partially offset by the availability of a green crop much o£ the year. Cotton and milo are predominant crops in the region and provide a cheap source of protein and roughage through cottonseed meal and hulls, milo grain, and gluten feed. Roughages grown include the hybrid sorghum Sudans, corn (mainly in the South), and alfalfa (in the upper Southwest). Coastal Bermuda and Midland Bermuda comprise the pasture land because they make excellent permanent pasture when skilled management is employed. In addition to the common feeds, most large herds utilize carrots and citrus pulp when available. These products constitute an inexpensive source of roughage and increase the pounds of milk per cow. A new feed on the market is alfalfa cubes from New Mexico. Cubes decrease labor costs and lower waste by eliminating grinding. Irrigation, longer growing season, and the availability of feed byproducts give this area a great advantage in total feed costs per pound of milk. Weather effects. Changeable weather conditions in the Southwest hinder milk production. Hot, humid conditions characterize the Coastal Bend section. Dry, semi-arid conditions prevail in the upper Southwest, where irrigation is necessary to produce a crop. In both of these areas rapid weather changes occur which affect both production and labor. In Texas the morning may be beautiful, the afternoon dusty, and the evening may bring a snow storm. The temperature seldom goes above 105 F along the Coast, but rises to 110 F further inland. Because of short winters, few free stall housing installations are being built in the region and the cost of housing per cow is kept at a minimum. Shade, windbreaks, and warm and cool drinking water are aids in coping with effects of climate on cattle. Disease problems. Due to the larger herds' using dry lot dairying, diseases are a major concern to management. Cows are subjected to more confinement and receive less individual attention. In the Southern region where hot, humid conditions prevail, brucellosis, leptospirosis, internal parasites, and flies exist. As numbers of cattle increase, hazards of disease and the importance of immunization are increased. Immunization increases costs, but is essential. Diseases are not as prevalent in the semi-arid regions. Profits and management. Profit is the chief factor in any dairy enterprise. The successful manager must have a good business background and some practical experience. Breeding decisions, such as whether to raise replacements relying on proven sires or to buy them, are of most importance. The large herd manager in the South and Southwest must plan for the future and try to stay three years ahead of problems. As one authority said, I f you are doing things today like you did just five years ago, then there is a 50-50 chance that you are doing them wrong. As a good businessman