Short interval forecasting of emergency phone call (911) work loads

There has been an increasing emphasis over the last 5 to 10 years to improve productivity in the Service Sector of the U.S. economy. Much of the improvement obtained by these managers has come about through better scheduling of the work force in these organizations. Effective scheduling of this personnel requires good estimates of demand, which may exhibit substantial variations between days for certain times of the year. The Indianapolis Police Department (IPD) Communications area is one such organization that exhibits varying workloads and is interested in improving staff scheduling of dispatch operators.This article explores the use of six different forecasting techniques for predicting daily emergency call workloads for the IPD's communications area. Historical call volume data are used to estimate the model parameters. A hold-out sample of five months compares forecasts and actual daily call levels. The forecast system utilizes a rolling horizon approach, where daily forecasts are made for the coming month from the end of the prior month. The forecast origin is then advanced to the end of the month, where the current month's actual call data are added to the historical database, new parameters are estimated, and then the next month's daily estimates are generated. Error measures of residual standard deviation, mean absolute percent error, and bias are used to measure performance. Statistical analyses are conducted to evaluate if significant differences in performance are present among the six models.The research presented in this article indicates that there are clearly significant differences in performance for the six models analyzed. These models were tailored to the specific structure and this work suggests that the short interval forecasting problems faced by many service organizations has several structural differences compared to the typical manufacturing firm in a made-to-stock environment. The results also suggests two other points. First, simple modeling approaches can perform well in complex environments that are present in many service organizations. Second, special tailoring of the forecasting model is necessary for many service firms. Historical data patterns for these organizations tend to be more complex than just trend and seasonal elements, which are normally tracked in smoothing models. These are important conclusions for both managers of operating systems and staff analysts supporting these operating systems. The design of an appropriate forecasting system to support effective staff planning must consider the nature, scope, and complexity of these environments.     

Learning behavior and mixed-strategy Nash equilibria

The paper considers whether an adaptive justification, like those commonly available for non-interactive optimization models, can be found for the mixed-strategy Nash equilibrium. Although it is known that such a justification is frequently available for pure-strategy equilibria, it is shown that all members of a wide class of behaviorally plausible learning mechanisms must fail to converge in ‘almost all’ games in which the equilibrium involves mixed strategies. An exact formal analogy is developed, which allows these learning mechanisms to be viewed as discrete ta?tonnement processes in properly chosen competitive exchange economies. In the analogy, the instability derives from the independence of excess demand functions (except at the boundaries) from ‘own’ prices. This independence arises because of the linearity in probabilities of von Neumann-Morgenstern risk preferences, and therefore does not extend to pure-strategy equilibria in general. Thus, assuming that agents will play equilibrium strategies implicitly assumes more sophistication when the equilibrium involves mixed strategies than when it involves only pure strategies.     

Environmental performance and competitive advantage in Canada's paper industry

A new environmental performance model is developed, explained and subsequently applied to a study of the Canadian recycled paper industry. The strategic position of the industry is explored as it takes the progressive steps needed to improve its environmental performance and competitive advantage in response to this rising regulatory agenda. Three policy options facing the Canadian pulp and paper industry are examined: the status quo, process technology innovation and product development. The strategic position of the industry is also examined using measurement of stance, attitude, government response, values, planning horizon and environmental integration. The supplier-consumer relationship, capital-technology and locational factors are also used to further discuss the links between competitive advantage and environmental performance. From this discussion, conclusions are drawn on competitive environmentalism: ethics and profit are compatible; newsprint mills must improve their locational, technology and market actions; the industry must proactively seek out environmental market and stakeholder opportunities and; further management research is needed to demonstrate the links between environmental performance, innovation and competitiveness.     

The economic burden of end-of-life care in metastatic breast cancer

Objective: To assess end-of-life (EOL) total healthcare costs and resource utilization during the last 6 months of claims follow-up among patients with metastatic breast cancer (MBC) who received systemic anti-neoplastic therapy.

Methods: Newly diagnosed females with MBC initiating treatment January 1, 2003–June 30, 2011 were identified in a large commercial claims database. Two cohorts were defined based on a proxy measure for EOL 1 month prior to the end of last recorded follow-up within the study period: patients who were assumed dead at end of claims follow-up (EOL cohort) and patients who were alive (no-end-of-life [NEOL] cohort). Proxy measures for EOL were obtained from published literature and clinical expert opinion. Cost and resource utilization were evaluated for the 6 months prior to end of claims follow-up. Baseline variables, resource utilization, and costs were compared between cohorts with univariate statistical tests. Adjusted relative risks were calculated for resource utilization measures. A covariate-adjusted generalized linear model evaluated 6-month total healthcare costs.

Results: Of the 3,878 females included, 18.5% (n?=?718) met the criteria for EOL. Mean observational time (MBC onset to end of claims follow-up) was shorter for the EOL cohort (EOL, 32 months vs NEOL, 35 months; p?p?2 times higher in the EOL cohort (p?Conclusions: Potential EOL presented a greater economic burden in the 6 months prior to death. EOL month-to-month costs increased precipitously in the last 2 months of life and were driven by acute inpatient care.     

Clinical and economic benefits of extended treatment with apixaban for the treatment and prevention of recurrent venous thromboembolism in Canada

Background and objective Venous thromboembolism (VTE) is associated with long-term clinical and economic burden. Clinical guidelines generally recommend at least 3 months of anticoagulation, but, in clinical practice, concerns over bleeding risk often limit extended treatment. Apixaban was studied for extended VTE treatment in the AMPLIFY-EXT trial, demonstrating superiority to placebo in VTE reduction without increasing risk of major bleeding. This study assessed the long-term clinical and economic benefits of extending treatment with apixaban when clinical equipoise exists compared to standard of care with enoxaparin/warfarin and other novel oral anti-coagulants (NOACs) for the treatment and prevention of recurrent VTE in Canada.

Methods A Markov model was developed to follow patients with VTE over their lifetimes. Efficacy and safety for apixaban and enoxaparin/warfarin were based on AMPLIFY and AMPLIFY-EXT, while relative efficacy to other NOACs was synthesized by network meta-analysis (NMA). Dosages for NOACs and enoxaparin/warfarin were based on their respective trials and were given up to 18 months and up to 6 months, followed by no treatment, respectively. Patient quality adjusted life years (QALYs) were based on published studies, and costs for resource utilization were from a Ministry of Health perspective, expressed as 2014 CAD ($).

Results Extended treatment with apixaban compared to enoxaparin/warfarin resulted in fewer recurrent VTEs, VTE-related deaths, and bleeding events, but at slightly increased cost. The incremental cost-effectiveness ratio was $4828 per QALY gained. Compared to other NOACs, apixaban had the fewest bleeding events, similar recurrent VTE events, and the lowest overall cost, which was driven by the strong bleeding profile. In scenario analyses of acute and lifetime treatments, apixaban was cost-effective against all strategies.

Conclusions Extended treatment with apixaban can offer substantial clinical benefits and is a cost-effective alternative to enoxaparin/warfarin and other NOACs.     

Collusion and combines in Canada, 1880–1890

ABSTRACT

It is a little-known fact that Canada adopted its own antitrust law one year before the landmark Sherman Antitrust Act of 1890. The Anti-Combines Act of 1889 (‘the Act’) was adopted after a decade in which ‘combines’ (the Canadian equivalent of ‘trusts’) had grown more numerous. From the combines’ numbers, Canadian historians, legal scholars, and economists have inferred that consumer welfare was hindered. However, price and output evidence has never been marshalled to provide even a first step towards assessing the veracity of this inference. This paper undertakes that task. I highlight the fact that the output from industries accused of collusion increased faster than national output in the decade before the passage of the Act and that their prices accordingly fell faster than the national price index. I argue that these findings militate for the position that the origins of Canada's Anti-Combines Act were partially rooted in rent-seeking processes similar to those that American scholars have found driving the Sherman Antitrust Act of 1890.     

A framework of environmental mitigation for the convention and exhibition centers in the China greater Bay area

The numerous participants in convention and exhibition (C&E) events and the consequently huge consumption of direct and indirect resources have increased the environmental pressure on C&E centers to implement environmentally friendly practices and procedures. This paper explores the innovative methods adopted by green-certified C&E centers and synthesizes a reference framework of environmental mitigation practices for the C&E sector in the Greater Bay Area, which was recently designated as a major regional development area in China. Eleven green-certified C&E centers were selected to establish a comprehensive and indicative framework containing 59 actual environmental practices in three major categories. Suggestions made by 12 experts for modifying the fit of the constructed framework to suit the local geographical and climatic situations of C&E centers in the China Greater Bay Area were examined.     

Assessing dimensions of organizational trust across cultures: A comparative analysis of U.S. and Indian full service hotels

This study delves into the organizational trust based similarities and differences across “individualist” and “collectivist” service employees in hotels. Specifically, the three dimensions of organizational trust, i.e., integrity, commitment and dependability are compared across the two samples from the U.S. and India to highlight how employees perceive the level of each of the three dimensions across cultures. Findings suggest that the three dimensions represent the trust construct across different national cultures. However, in comparing the individual dimension of the trust construct, a significant difference exists between the perceptions of employees in the two cultures, suggesting that perception-based differences exist across cultures.