Endometriosis,an unknown entity: the consumer's perspective

This paper reports the findings of a consumer‐driven investigation conducted by the Centre for Clinical Nursing Research at Epworth Hospital in conjunction with the Endometriosis Association (Victoria, Australia) aimed at identifying the information and support needs of women experiencing endometriosis. Women's experiences of endometriosis and laparoscopy were examined. A questionnaire was designed to explore women's experiences of, and informational need for, the four categories of: diagnosis of endometriosis, endometriosis, laparoscopy and managing at home. A total of 465 women who had a positive diagnosis of endometriosis, including patients at the Epworth Endometriosis Centre and members of the Endometriosis Association, were included. The data were analysed in terms of frequency of responses and themes that arose from the research. Five main themes consistently emerged from the overall analysis of the questionnaire; these included: lack of communication, no‐one listens, the emotional turmoil, expressions of gratitude to the Endometriosis Association and being young and helpless. Also identified was a lack of understanding of endometriosis and laparoscopy, on behalf of both the patient and the practitioner, which has led to communication of misinformation, extended physical pain and emotional distress. Based on these findings, recommendations were made for education strategies to be focused towards increasing awareness of endometriosis and for information to be disseminated using the preferred printed format and to be made available from gynaecologists, hospitals and schools. Through consumer participation, the information obtained in this study is of benefit to all women who come in contact with endometriosis by (a) validating women's experiences of endometriosis and (b) identifying women's needs in relation to the disease.     

Analysing the impact of the single European market and European integration upon local economies: A case study of Gloucestershire

Greater economic integration in the European Community (EC) will have far-reaching effects for businesses and individuals throughout the UK. Indeed, prior to the commencement of the Single European Market (SEM) — the only certain element of European economic integration — there was much evidence of organisations and industries restructuring, increased inward investment, and mergers and acquisitions. Such activities are likely to have far-reaching implications for local economies. Increasing numbers of local authorities are undertaking studies to assess the implications of the SEM measures for their own areas, and to suggest ways in which local government and other economic development actors might respond to the challenge of the opportunities and threats of the SEM. However, in assessing the impact of the SEM, it is important not to lose sight of the wider process of economic integration which has followed in its wake. This article details the methodology used in a study to assess the impact of the SEM upon the economy of one particular local area: Gloucestershire. The methodology employed would be capable of replication in other local areas. Some of the key findings from the Gloucestershire study are also outlined. Although there is only limited scope for public sector organisations at the local level in helping businesses to respond to the threats and opportunities of the SEM, suggestions for a general role for the County Council, the Training and Enterprise Council, and other organisations were identifiable, and specific recommendations for training policies, promotional activities, and planning policies were forthcoming.     

Scheduling and resource allocation in a food service system

The scheduling of food production is often accomplished informally based upon approximate time requirements stated in recipes and the judgment and experience of a food production manager, administrative dietician, or cook. Such schedules are seldom optimized to least overall duration and consequently contain periods of non-productive time on the part of personnel and resources. In addition, these schedules often attempt to avoid resource conflicts through the early scheduled completion of work activity; this leads to many of the menu items being completed sufficiently in advance of serving time that undesirable changes in the nutritional, organoleptic and microbiological properties of the food can take place.In this paper, a branch and bound algorithm is presented as a solution procedure for the foodservice scheduling problem. The advantage of branch and bound in comparison to a heuristic based scheduling procedure is that it can produce schedules which are optimized to least overall duration from start to finish. The added computational cost of the branch and bound procedure is justified, because most foodservice systems cycle their menus. Consequently, each of a finite number of schedules is reused numerous times over an extended period resulting in long-term productivity gains.Another advantage of the algorithm is that right-shifted or late start schedules may be produced. This is in keeping with our objective of minimizing the delay time between the completion of the food and its being served to the consumer.The paper describes a method by which the process time for each of the various steps in a recipe may be computed as a function of the number of servings being prepared. Although these are normally considered to be linear relationships, the algorithm can easily be modified to accept other types of relationships as well.Perhaps the most important aspect of the this research is that the branch and bound algorithm has been implemented to perform branching operations over two classes of decisions. The first class of decisions involves the selection of which recipe steps or activities are to be scheduled at a certain time, and the second class of decisions involves the choice of which resource class to assign to the activities in those cases where alternative resources are allowed. This dual branching philosophy provides a great deal of flexibility to the decision maker for handling the type of scheduling problems commonly found in practice. The expense of this added flexibility, however, is a substantial increase in the size of the decision tree which must be developed and explored.In order to demonstrate the performance of the algorithm for practical purposes, the lunch menus of a short term, acute case, 300 bed hospital in Syracuse, New York were used to develop production schedules. These menus included a total of 89 different hot food items whose recipes were placed into a menu file in the computer along with the coefficients needed to develop process time estimates as a function of numbers of servings to be prepared. In total, fourteen lunch menus are cycled at the hospital; the number of items appearing on the menus ranges from 8 to 14 hot food items.In the first series of tests, resources were assumed not to be interchangeable. The branch and bound procedure was successful in producing optimal solutions for eleven of the fourteen schedules. The three menus which were not optimally solved were aborted, because the size of the solutions tree grew beyond that which could be stored in 500K bytes of common memory. In spite of this, however, the upper bound solutions given by the aborted problems were found to be very close to lower bound values and therefore may be considered as very good solutions.In the second series of tests, certain resources were allowed to be interchangeable for some of the activities. Specifically, we assumed two labor classes. The first of these are called special cooks who are more experienced personnel. Normally special cooks prepare entree items, but they may be called upon in some cases to perform any activity normally performed by the second labor class- the less experienced cooks—who normally prepare soups, sauces and vegetables. The cooks, on the other hand, are never allowed to prepare menu items which call for special cooks. These groundrules are identical to those currently in practice at the hospital from which the test problems were obtained. Ten of the fourteen menus were selected for this series of tests. In all of the ten cases, the algorithm successfully developed optimal solutions without exceeding the 500K byte common memory limitation. And, in spite of the vastly increased tree size resulting from the dual decision branches, the computation times for these tests were only modestly greater than those of the first set of tests where alternative resources were not considered. The success of the algorithm in solving the dual decision problems resulted in large part from its ability to develop strong upper bounds very early in solution process. In addition, the characteristics of food production scheduling problems are such that the lower bound pruning is very effective especially in the early stages of tree development.It is important to note that the use of an algorithm such as this in a practical setting affords a very friendly user interface. Once the foodservice system's menu items have been placed into a file, the user may easily select any set of these items to include in a given schedule. Only three lines of data input are required. The first line specifies the number of items as well as the zero-hour or serving time. The second line identifies the item numbers of the hot-food items to be scheduled. And the third line specifies the number of servings for each of those items which must be prepared. Kitchen personnel with limited experience can be trained to input the data in less than 15 minutes of instruction time.     

Short-run monetary control: Evidence under a non-borrowed reserve operating procedure

This paper examines two issues — the prediction and short-run control of the money stock — associated with the experience following the Federal Reserve's adoption of a non-borrowed reserve-oriented operating procedure in October 1979. Regarding predictability, our analysis suggests that econometric models offer no improvement over the Board's judgmental forecasting procedure in terms of a lower multiplier forecast error. Regarding the question of whether alternative operating targets would have lowered monthly variability in the money stock, our findings suggest that neither a total reserve nor a monetary base operating target would have enhanced the precision of short-run monetary control relative to a non-borrowed reserve operating target.     

Revenue raising trade-restricting policies under uncertainty: The sub-optimality of the expected welfare criterion and some safety-first results

The analysis of trade-restricting policies under uncertainty has typically argued in favour of the specific tariff over alternative commercial policies such as the ad valorem tariff and the quota, when the raising of revenue and maintenance of consumer's welfare are the policy objectives. This paper reconsiders this result. It is demonstrated that, when the shape of the welfare probability distribution is considered explicitly, the quota may be the dominant trade-restricting policy. In addition, the analysis of trade-restricting instruments is analysed for the case where the principle of safety-first is applied to the revenue-raising objective.We should like to thank an anonymous referee for helpful comments on an earlier draft.     

Aiding Agricultural Development — Some Lessons1

The indivisibility of Canada's national and international political and economic interests is recognized. These interests can be furthered only if the interdependence of economic, social and political considerations are expressed through clear cut national policy goals for integrating rural and urban interests. These goals in themselves are meaningless without the requisite government authority backed up by resources and personnel for the implementation process. An integral part of implementation is the need to ensure participation of the resident population in development goal setting and implementation of programs. Current international experience supporting the need for local residents to be so involved are presented. L'AIDE AU DÉVELOPPEMENT AGRICOLE: L'indivisibilité des intérêts économiques et politiques du Canada au niveau national et international est déjà reconnue. Ces intérêts peuvent être favoriser seulement si l'interdépendance des considérations économiques, sociales et politiques sont exprimées à trovers une politique nationals précise afin d'intégrer les intérêts rurals et urbains. Ces ambitions sont en eux-mêmes sans signification, sans l'autoritée gouvernementale secondée par les ressources et le personnel pour un meilleur développement. Une partie intégrante de ce développement sera le besoin d'assurer la participation de la population résidante dans un cadre de croissance. Les expériences courantes, supportant le besoin des résidents locaux àêtre engager, sont présentées.