Time Schedule Research Articles

Reducing Delays in MRIs Under Sedation and General Anesthesia Using Quality Improvement Tools

ObjectiveDevelop structured, quality improvement interventions to achieve a 15%-point reduction in MRIs performed under sedation or general anesthesia (GA) delayed more than 15 min within a 6-month period. MethodsA prospective audit of MRIs under sedation or GA from January 2022 to June 2023 was conducted. A multidisciplinary team performed process mapping and root cause analysis for delays. Interventions were developed and implemented over four Plan, Do, Study, Act (PDSA) cycles, targeting workflow standardization, preadmission patient counseling, reinforcing adherence to scheduled scan times and written consent respectively. Delay times (compared with Kruskal-Wallis and Dunn’s tests), delays more than 15 min and delays of 60 min or more at baseline and after each PDSA cycle were recorded. ResultsIn all, 627 MRIs under sedation or GA were analyzed, comprising 443 at baseline and 184 postimplementation. Of the 627, 556 (88.7%) scans were performed under sedation, 22 (3.5%) under monitored anesthesia care, and 49 (7.8%) under GA. At baseline, 71.6% (317 of 443) scans were delayed over 15 min and 28.2% (125 of 443) scans by 60 min or more, with a median delay of 30 min. Postimplementation, there was a 34.7%-point reduction in scans delayed more than 15 min, a 17.5%-point reduction in scans delayed by 60 min or more, and a reduction in median delay time by 15 min (P < .001). DiscussionStructured interventions significantly reduced delays in MRIs under sedation and GA, potentially improving outcomes for both patients and providers. Key factors included a diversity of perspectives in the study team, continued stakeholder engagement and structured quality improvement tools including PDSA cycles.

The impact of melatonin on postoperative delirium in geriatric patients after colorectal surgery: a randomized placebo-controlled trial.

The current study was designed to evaluate the role of prophylactic melatonin administration in reducing delirium occurrence in elderly patients undergoing colorectal cancer surgeries. One hundred patients of both genders undergoing elective colorectal cancer surgeries under general anesthesia were randomly allocated into two equal groups. A treatment group of patients (Melatonin group) received five mg of melatonin the night before surgery, twelve hours before the scheduled surgery time, and an additional five mg of melatonin two hours before surgery. The control group of patients received placebo tablets at the same time points. Delirium score, sedation score, pain score, hemodynamics, oxygen saturation, and blood requirements were recorded. Twenty-eight patients (56%) in the control group versus 18 (36%) in the melatonin group developed delirium (P=0.045), OR=2.26, 95% CI: 1.013-5.05. Five patients (18%) in the control group versus six (33%) ‎in the melatonin group developed delirium on discharge from the ‎recovery room (P=0.749), OR=1.22, 95% CI: 0.34-4.31, while 23 patients (82%) in the control group versus ‎‎12 (66%) in the melatonin group developed delirium six hours postoperative (P=0.021), OR=1.705, 95% CI: 1.02-2.81 ‎with higher nursing delirium screening score in the control group 2 (1, 4) versus 1 (0, 2) in the melatonin group (P=0.002), 95% CI: 1.77-2.71. The prophylactic administration of melatonin may decrease the incidence of postoperative delirium in elderly patients undergoing colorectal surgeries under general anesthesia.

VSEMERA: pilot project assessing health profession students’ experiences in an international virtual research program

BackgroundThe “Virtual Semester for Medical Research Aachen” (vSEMERA) is an international, interdisciplinary, virtual education program developed for health profession students. The first edition (2021) was hosted by the Medical Faculty of RWTH Aachen University (Germany) in cooperation with Centro Universitário Christus (Brazil) and Universidad Peruana Cayetano Heredia (Peru). The primary aim of the 12-weeks program was to provide students with skills in health science research and prepare them for scientific career paths.MethodsvSEMERA was built on a virtual learning platform, the “vSEMERA-Campus”, designed to foster students’ learning process and social interactions. Maximum flexibility was offered through synchronous and asynchronous teaching, enabling participants to join via any device from any part of the Globe alongside their regular studies. For the program’s first edition (September - November 2021), health profession students from Germany, Brazil, Peru, Spain, and Italy filled all 30 available spots. Satisfaction, quality of the program and courses offered, as well as perceived learning outcomes, were examined using questionnaires throughout and at the end of the program.ResultsThe program received a rating of 4.38 out of 5 stars. While it met most expectations (4.29 out of 5), participants were unable to attend as many courses as intended (2.81 out of 5), mainly due to scheduling conflicts with the home university schedule (46%), internships (23%), and general timing issues (31%). Participants acknowledged considerable improvements in their scientific skills, English language skills, confidence in scientific project management, research career progression, and enthusiasm for a scientific career.ConclusionsvSEMERA represents a promising example of an online international learning and exchange program using pedagogical and technological elements of virtual collaboration and teaching. In addition to advancing future vSEMERA editions, our results may offer insights for similar projects that address the targeted integration of scientific research education into an international, digital learning environment.

Anesthesia Practitioners' Goals for Sevoflurane Minimum Alveolar Concentration at the End of Surgery and the Incidence of Prolonged Extubations: A Prospective and Observational Study.

Prolonged times to tracheal extubation (≥15 minutes from dressing on the patient) are consequential based on their clinical and economic effect. We evaluated the variability among anesthesia practitioners in their goals for the age-adjusted end-tidal minimum alveolar concentration ofsevoflurane (MAC) at surgery end and achievement of their goals. We prospectively studied a cohort of 56 adult patients undergoing general anesthesia with sevoflurane as the sole anesthetic agent, scheduled operating room time of at least 3 hours, and non-prone positioning. At the start of surgical closure, an observer asked the anesthesia practitioner their goal for MAC when the surgical drapes are lowered (i.e., the functional end of surgery for the studied procedures). When the drapes were lowered, the MAC achieved was recorded, and the values were compared. The standard deviation of the practitioners' MAC goal was large, 0.199 (N = 56 cases, 95% confidence interval 0.17-0.24), not significantly different from the standard deviation of the MAC achieved of0.253, P= 0.071. The MAC goal and MAC achieved were correlated pairwise, Pearson r=0.65, P< 0.0001. There was no incremental effect of operating room conversation(s) related tocase progress on the association (partial correlation ‑0.01, P= 0.96). Differences among practitioners in the MAC achieved at surgery end were consequential. Specifically, for the N = 12cases with prolonged extubation, the mean MAC was 0.60 (standard deviation 0.10) versus 0.48 (0.21) among the N = 44 cases without prolonged extubation (P = 0.0070). The standard deviation ofthe MAC goal among practitioners was sufficiently large to contribute significantly tothe variability in the MAC achieved at the end of surgery. We confirmed prospectively that the age-adjusted end-tidal MAC at the end of surgery matters clinically and economically because differences of0.60 versus 0.48 were associated with more prolonged extubations. Our novel finding isthat the MAC achieved ≥0.60 werecaused in part by the anesthesia practitioners' stated MAC goals when surgical closures started.

The modified placenta model for microsurgery training: Recommended methods for comprehensive microsurgery experience

PurposeCurrently, rats are the most preferred models for microsurgery training. However, living rats come with several limitations. The use of the placenta in this field is still restricted. Our aim was to increase the realism of the placenta model by introducing several improvements such as pulsation and thrombus models. Additionally, it was also aimed to provide a specific time schedule for the reliable use of the placenta. MethodsThe study included 30 placentas and 10 participants. Placentas were divided into three groups; Group A (ten placentas) were allocated for training. At the end of each training day, trainees were asked to complete a questionnaire. To obtain samples for histopathological evaluation another group (Group B) was formed. The placentas of both of the groups (A and B) were used as fresh at the first day and then stored in the refrigerator (under 4 ​°C) for the following 3 days. The remaining ten placentas (Group C) were kept at room temperature. This group was also subjected to histopathological analysis. Histopathological evaluation was performed to determine the necrosis ratio within the layers of Endothelium and Media (E/M). Vessels were divided into 6 levels and microscopically analysis was performed to determine the diameters of these vessels. ResultsThe average questionnaire scores throughout the first three days were high enough to indicate a better/significantly better microsurgery experience compared to that on rats. Subsequent necrosis ratios (E/M) were relatively low during the first three days which confirms the results of the questionnaire. This is mainly attributed to the cold ischemia precautions taken during the study. The vessel diameters (A/V) of the placenta from level 1 to level 6 were as follows; 2.95/6.64, 3.56/3.84, 2.65/2.97, 1.63/1.82, 1.19/1.48 and 0.56/0.49 ​mm respectively. ConclusionThe inclusion of pulsation and thrombus models in the modified placenta model enhances the realism of the microsurgery training experience. According to trainee feedback, the modified placenta model offered a superior training experience compared to living rats during the first three days. We recommend integrating this model with a living rat in a hybrid approach to obtain a comprehensive microsurgery training program.

A generalized disjunctive graph model for a complex production problem

This work focuses on the modeling of the features of a real-world pharmaceutical production problem, where several limited resources must be gathered and scheduled in order to mix and process active substances. The problem can be modelled as a generalization of the job-shop scheduling problem, in which each job corresponds to an order. Besides the standard precedence and capacity constraints of a classical job-shop scheduling problem, release, no-wait and time interval production constraints are added. Furthermore, the processing of each job task must be assisted by an appropriate number of operators and performed by a specific machine, out of a set of feasible machines, that is temporarily installed in a compatible clean room. An innovative generalized disjunctive graph that models all the constraints and the resource conflicts is presented.

Creating digital branding and a visual identity for Edupark Cocoa Bigaran

The Bigaran Cocoa Edupark business combines aspects of education and tourism with a focus on the chocolate industry. However, the Bigaran Cacao Edupark tour which was just pioneered in 2022 does not yet have a visual identity and is not widely known by the wider community. This community service activity aims to improve partners' skills related to the program related to digital branding of tourism and designing the visual identity of Bigaran Cocoa Edupark. This program is carried out with a participatory method which is focused on 1) training on tourism digital branding, and 2) designing the visual identity of Bigaran Cocoa Edupark. The implementation of activities is starting with observation, socialization, visual identity design, digital branding training and assistance, as well as monitoring and evaluation. The result of this program is the establishment of Instagram and Tiktok social media accounts accompanied by a time schedule content for 1 year as a promotional media. In addition, 1 set of graphic standard manual visual identity of Bigaran Cocoa Edupark consisting of logo, packaging and business card was also created along with the grant of chocolate molding goods.

A Decision-Making Model for Fast-Track High-Rise Buildings Using Structural Equation Modelling

Fast-track is a project management technique used to address time constraints and schedule overrun on construction projects. One of the major impediments in the application of fast-track technique in Pakistan’s construction industry is the lack of a comprehensive decision-making model. The aim of this research is to develop a comprehensive decision-making model for fast-track high-rise buildings which can highlight the impact of each decision-making aspect on its relevant project success indicator i.e., time variance(TV), cost variance(CV), quality variance(QV) or scope variance(SV) and the impact of cost, quality, and scope variances on time variance. Structural equation modelling (SEM) was used to develop this model. Questionnaire based on 5-point Likert’s scale was used to collect data from 159 construction industry professionals. Data was analysed using smart PLS-4 software. Results showed that on fast-track projects, scope variance has the greatest impact on time variance whereas quality variance has the least impact. Early scope freeze, early involvement of the contractor in design phase and early procurement of long-lead-time items are the most important decisions on fast-track projects whereas quality optimization decisions have an adverse impact on project duration. The proposed model has high out-of-sample predictive ability making it a universally applicable decision-making model. DOI: https://doi.org/10.52783/pst.434

Parental Involvement in Academic Performance of Girl Child in Primary Schools in Buseta Sub-County of Kibuku District, Uganda

The study examined parental participation and girl-child academic achievement in elementary schools in Buseta Sub County, Kibuku District. Cross-sectional survey research design was used for the study and data were collected via questionnaires. The findings showed that numerous socio-economic factors affected parental involvement in girl-child education in Buseta Sub County elementary schools including social class, income, parents' attitudes towards girl-child education, cultural norms, parental education, inadequate government policy, and school distance were among these factors. Based on the findings, the study calls for parents and guardians should be educated on the benefits of lowering girls’ workload at home. Furthermore, private primary schools should offer scholarships to underprivileged girls. Since parents are stakeholders in the girl child's education, School Management Committees should educate them on their roles. Parents and guardians should schedule time to help their children, especially girls, access school resources. Finally, the government should provide energy and subsidise solar power projects in rural areas to assist children in finishing their homework with parents/guardians. Keywords: Academic performance, Education subsidy, Girl child, Parental involvement, School management committee

Influence of radiotherapy interruption on esophageal cancer with intensity-modulated radiotherapy: a retrospective study

BackgroundRadiotherapy interruption (RTI) prolongs the overall total treatment time and leads to local control loss in many cancers, but it is unclear in esophageal cancer. We aimed to evaluate the influence of RTI on the overall survival (OS), progression-free survival (PFS), and local-regional recurrence-free survival (LRFS) of patients with esophageal cancer undergoing chemoradiotherapy.MethodsA total of 299 patients with esophageal squamous cell carcinoma from 2017 to 2019 were retrospectively analyzed to investigate the effect of RTI on OS, PFS, and LRFS. The delayed time of radiotherapy interruption was calculated as the actual radiation treatment time minus the scheduled time. The univariate and multivariate analyses were performed by the COX proportional hazards regression models, and the survival analysis was performed through the Kaplan‒Meier method, and compared with the log-rank test.ResultsThe 3-year OS, PFS, and LRFS rates were 53.0%, 42.0%, and 48.0%, respectively. The univariate and multivariate analyses showed that the delayed time > 3 days was an independent adverse prognostic factor for OS (HR = 1.68, 95% CI 1.10–2.55, p = 0.016), and LRFS (HR = 1.74, 95% CI 1.18–2.57, p = 0.006). The patient with a delayed time of > 3 days had poorer survival rates of OS, and LRFS than patients with a delayed time of ≤ 3 days (OS, p = 0.047; LRFS, p = 0.013), and the survival outcomes of patients with shorter delayed time (1–3 days) were slightly different from the patients without interruptions. The impact of delay time on PFS is not statistically significant, but the survival outcomes of the two groups were slightly different.ConclusionThere was a significant correlation between delayed time and local control of esophageal cancer. The delayed time for more than 3 days might decrease the survival outcome, and increase the local recurrence risk.

Developing a Cost-Effective Surgical Scheduling System Applying Lean Thinking and Toyota's Methods for Surgery-Related Big Data for Improved Data Use in Hospitals: User-Centered Design Approach.

Surgical scheduling is pivotal in managing daily surgical sequences, impacting patient experience and hospital resources significantly. With operating rooms costing approximately US $36 per minute, efficient scheduling is vital. However, global practices in surgical scheduling vary, largely due to challenges in predicting individual surgeon times for diverse patient conditions. Inspired by the Toyota Production System's efficiency in addressing similar logistical challenges, we applied its principles as detailed in the book "Lean Thinking" by Womack and Jones, which identifies processes that do not meet customer needs as wasteful. This insight is critical in health care, where waste can compromise patient safety and medical quality. This study aims to use lean thinking and Toyota methods to develop a more efficient surgical scheduling system that better aligns with user needs without additional financial burdens. We implemented the 5 principles of the Toyota system: specifying value, identifying the value stream, enabling flow, establishing pull, and pursuing perfection. Value was defined in terms of meeting the customer's needs, which in this context involved developing a responsive and efficient scheduling system. Our approach included 2 subsystems: one handling presurgery patient data and another for intraoperative and postoperative data. We identified inefficiencies in the presurgery data subsystem and responded by creating a comprehensive value stream map of the surgical process. We developed 2 Excel (Microsoft Corporation) macros using Visual Basic for Applications. The first calculated average surgery times from intra- or postoperative historic data, while the second estimated surgery durations and generated concise, visually engaging scheduling reports from presurgery data. We assessed the effectiveness of the new system by comparing task completion times and user satisfaction between the old and new systems. The implementation of the revised scheduling system significantly reduced the overall scheduling time from 301 seconds to 261 seconds (P=.02), with significant time reductions in the revised process from 99 seconds to 62 seconds (P<.001). Despite these improvements, approximately 21% of nurses preferred the older system for its familiarity. The new system protects patient data privacy and streamlines schedule dissemination through a secure LINE group (LY Corp), ensuring seamless flow. The design of the system allows for real-time updates and has been effectively monitoring surgical durations daily for over 3 years. The "pull" principle was demonstrated when an unplanned software issue prompted immediate, user-led troubleshooting, enhancing system reliability. Continuous improvement efforts are ongoing, except for the preoperative patient confirmation step, which requires further enhancement to ensure optimal patient safety. Lean principles and Toyota's methods, combined with computer programming, can revitalize surgical scheduling processes. They offer effective solutions for surgical scheduling challenges and enable the creation of a novel surgical scheduling system without incurring additional costs.

Managing Materials Vendor Risks for Improved Project Operational Performance

Highlight: Sound risk management implementation is well noted for helping organisations to overcome operational inefficiencies. However, the management of risk associated with construction materials vendors, and how they impact project operational performance appear to have not been extensively researched. Goal: In this study, the effect of materials vendor risk management (vendor risk identification and vendor risk prevention) on project operational performance (project quality and scheduled completion time) was investigated. We also interrogate the mediating role of risk-oriented culture in the relationship between vendor risk management and operational performance. Design/Methodology/Approach: The target population was all 1,044 registered public construction firms under the Urban Regeneration Programme in Nigeria. The cross-sectional survey design was adopted, and random sampling was used to select 173 project managers, engineers, surveyors, vendors/contractors, and store representatives. Primary data was collected through the structured questionnaire, they were analysed via the Structural Equation Modelling (SEM) technique. Results: Three main conclusions are made about managing vendor risks: First, properly identified materials vendor risks (in terms of material handling issues, price escalation, non-compliance to specification, delivery delay, and sharp procurement practices) is positively related to operational performance. Second, implementing context-specific risk prevention measures (prior assessment score, vendor financial capacity, warranty policy, continuous monitoring, technical capacity) positively enhances operational outcomes. Third, paying attention to risk culture orientation of project stakeholders positively impact their risk prevention capability and operational performance of construction projects. Limitations: Study was limited to few operational performance indicators in project management. Future study could include other performance indicators. Practical Implications: The results can help project operations managers in industry address numerous risks associated with materials vendor. Originality/Values: The numerous abandoned and failed construction projects in developing countries as a result of less attention to vendor risks management prompted this study.

Research on Task Scheduling for Internet of Things Cloud Computing Based on Improved Chicken Swarm Optimization Algorithm

Aiming at the shortcomings of long completion time and high consumption cost of cloud computing batch task scheduling in IoT, an Improved Chicken Swarm Optimization Algorithm (ICSO) for task scheduling in cloud computing scenarios is proposed. Specifically, in order to solve the problems of slow convergence and falling into local optimum of the chicken swarm optimization algorithm, we adopt the nonlinear decreasing technique of the rooster and the weighting technique of the hen, optimize the following coefficients of the chicks, and apply ICSO to cloud computing task scheduling. In simulation experiments, we conducted a large number of experiments using four standard benchmark functions with different number of tasks and the results show that ICSO algorithm reduces 25.8%, 9.3%, 8.8%, 7.5% in small task time compared to CSO, DCSO, GCSO, ABCSO in large task time by 30.8%, 8.3%, 7.8%, 6.3%, 11.8%, 10.3%, 8.8%, 7.5% savings in small task cost and 25.8%, 11.2%, 10.8%, 9.3% savings in large task cost. This method effectively reduces task scheduling time and cost consumption. Meanwhile, we tested it in combination with an IoT-based cloud platform and achieved very satisfying Results.

Weighted target indications spiking neural P systems with inhibitory rules and time schedule

Weighted target indications spiking neural P systems with inhibitory rules and time schedule

Development and content validity of the DizzyQuest

IntroductionVestibular disorders have a high prevalence and impact on general health. Currently questionnaires to measure vestibular symptoms and the impact on daily life, do not capture disease-specific symptoms or induce recall bias. The DizzyQuest was introduced, to measure vestibular symptoms in the flow of daily life, using the ecological momentary assessment (EMA) strategy. The development and content validity of the DizzyQuest are described in this article.MethodsThe development process consisted of two stages: First, the development of a concept version of the DizzyQuest based on the conceptual model of positive health, semi-structured interviews with patients diagnosed with bilateral vestibulopathy (BV) and expert input. Second, the assessment of content validity through a 4-week pilot trial, followed by focus group meetings with patients and professionals separately.ResultsPatient interviews, an expert meeting and a conceptual model resulted in the first pilot version of the DizzyQuest, which included a morning-, within-day-, evening- and attack-questionnaire. To report patient characteristics, complimentary patient- and doctor-questionnaires were added. The pilot trial (N = 5) and two patient focus group meetings resulted in multiple suggestions for response options. Two professional focus group meetings provided recommendations for sampling time and sampling schedule. As a result, two versions of the DizzyQuest were developed, consisting of a regular DizzyQuest (DQ) and an extended DizzyQuest-XL (DQ-XL).ConclusionThe DizzyQuest enables the administration of multiple questionnaires during the flow of daily life, therefore increasing reliability and ecological validity. The DQ and DQ-XL, using a big data approach, has the potential to improve precision medicine.

Methods for implementing integrated step-selection functions with incomplete data

Integrated step-selection analyses (iSSAs) are versatile and powerful frameworks for studying habitat and movement preferences of tracked animals. iSSAs utilize integrated step-selection functions (iSSFs) to model movements in discrete time, and thus, require animal location data that are regularly spaced in time. However, many real-world datasets are incomplete due to tracking devices failing to locate an individual at one or more scheduled times, leading to slight irregularities in the duration between consecutive animal locations. To address this issue, researchers typically only consider bursts of regular data (i.e., sequences of locations that are equally spaced in time), thereby reducing the number of observations used to model movement and habitat selection. We reassess this practice and explore four alternative approaches that account for temporal irregularity resulting from missing data. Using a simulation study, we compare these alternatives to a baseline approach where temporal irregularity is ignored and demonstrate the potential improvements in model performance that can be gained by leveraging these additional data. We also showcase these benefits using a case study on a spotted hyena (Crocuta crocuta).

Dynamic stream partitioning for time-triggered traffic in Time-Sensitive Networking

Time-Sensitive Networking (TSN) is a promising network technology that can ensure bounded latency and jitter for industrial real-time scenarios. It establishes the IEEE 802.1 Qbv standard to precisely control the periodic transmission time of the time-triggered (TT) traffic. However, it is still a challenge to efficiently schedule the TT traffic in large-scale networks with high transmission performance. In this paper, we propose a novel method called dynamic stream partitioning (DSP) to solve this problem. It satisfies the IEEE 802.1 Qbv standard and can significantly reduce the scheduling time by reducing the number of constraints. Based on the DSP method, we analyze the impact of stream partitioning on the transmission performance of the TT traffic, and propose an indicator called Normalized Degradation of Performance (NDOP) to quantify it dynamically. Furthermore, we design a partitioning-aware dynamic routing (PADR) to expand the scheduling space. Integrated with NDOP and PADR, we propose a joint routing and dynamic stream partitioning (JR/DSP) algorithm. Extensive simulation experiments verify that the proposed JR/DSP algorithm has higher scalability, transmission performance, and schedulability compared to the static stream partitioning algorithms.

Transformation of Prayer Time Schedules: from A Static-Passive to A Dynamic-Variative Perspective

Prayer times are extremely important for Muslims, as they serve as a guide for the beginning of prayer times. However, there are still people who do not fully understand the impact of changes in the position of the Sun, which causes the start of prayer times to change daily. Additionally, some people still use perpetual prayer time schedules. Although they use the term "perpetual," in reality, prayer time schedules are not everlasting, as they cannot be used over long periods. This research is a library study with a phenomenological-astronomical approach. The results of this study show that prayer times change every day. Someone who believes that the start of Maghrib prayer is always at 18:00 WIB and the start of Fajr prayer is always at 04:30 WIB may find that on some days, their prayer or fasting is invalid, as the start of Maghrib prayer may occur between 18:01 and 18:08 WIB and the start of Fajr prayer may occur between 04:31 and 04:34 WIB. These changes can serve as an understanding for the community that the correctness of prayer time schedules is not static-passive but dynamic-variable. This means that the start of prayer times each day and year is not always the same as the following days and years, and the changes vary. Therefore, this study provides a scientific guide for the community to better understand and be cautious in using prayer time schedules, considering that the beginning of prayer times determines the validity of a Muslim's prayer.

Integrated decision of production scheduling and condition-based maintenance planning for multi-unit systems with variable replacement thresholds

In practice, production scheduling and maintenance planning are two popular technologies that are interdependent, but they are most often performed independently. In this study, we have developed an integrated model for coordinating single-machine scheduling and condition-based maintenance planning. Firstly, we build upon existing scheduling research that often views the system as a whole and further consider the degradation and maintenance of multiple units within the system during the scheduling process. Secondly, in contrast to traditional degradation modeling which usually assumes a single threshold to trigger maintenance/replacement, we also consider the variability of replacement thresholds caused by the heterogeneity of scheduling tasks. Based on this foundation, we propose an integrated policy that considers both scheduling and condition-based maintenance. Furthermore, we have developed an integrated decision model for multi-unit systems. The model aims to minimize the total weighted expected completion time over the entire scheduling time horizon. Moreover, the genetic algorithm was employed to optimize the integrated model. Finally, we present an example of an SA adjustable multi-axis machine and conduct a sensitivity analysis of key parameters to validate the integration policy.

Home care service providers in Brussels: time adjustments during COVID-19 and the consequences for frontline home care workers

Home care service providers have been considerably affected by the COVID-19 crisis. Since the beginning of the pandemic, their internal organisation has undergone important changes, including in terms of time schedules, to adapt to the needs of the older population and those of workers. In most cases, they had to reduce the provision of services, either because care workers – the majority of whom are women – were no longer available to cover the shifts, or because families had cancelled the services. In other cases, they had to meet increased demand. The most dramatic consequences were borne by female care workers, who had to combine working time adjustments with family obligations. Drawing from the material collected before and after the impact of the pandemic in Belgium, which includes interviews with public and private home care providers, this article explores the consequences that time adjustments had on frontline care workers and on the organisations themselves.