Master chemotherapy planning and clinicians rostering in a hospital outpatient cancer centre

Central European Journal of Operations Research - In the past years, the number of patients in need of chemotherapy treatments has been constantly increasing. Chemotherapy treatments must be...     

Quantitative measurements in thermo-fluid dynamics based on colour processing

Colour can be expressed as a weighted combination of three attributes: hue, intensity, and saturation. Non-coherent light reflected by thermo-sensitive liquid crystals holds a variable hue, moving in a generally narrow temperature interval and also depending on its inclination with respect to the plane of the crystals and on the characteristics of the impinging light. In experimental practice it is not feasible to ensure uniform lighting over an extensive area and its entire view under the same angle. Thus, the acquired hue field is non-uniform even if the liquid crystal sheet is isothermal. However, by means of proper filtering and calibration of the colour attribute, this optical technique, besides being non-intrusive and inexpensive, is capable of mapping the temperature with an accuracy better than 5% of its measuring-range amplitude. A similar method can be applied for measuring the thickness of a thin liquid film. In this case, the colour attribute to be processed is its intensity. In fact, the light transmitted through a dyed liquid decreases with an increasing thickness of the layer. Again, a perfectly uniform light source is unattainable and the recorded intensity field is non-homogeneous even if the liquid free surface is flat. Nevertheless, the film thickness can be determined by this colour-processing procedure with an accuracy better than 8% of the measuring-range amplitude, which is dictated by the utilised dyestuff concentration. Further thermo-fluid dynamic measurements performed over extensive areas could be handled with analogous methodologies. Surface temperature by emitted infrared waves and void fraction in ducts by light absorption are particular examples.     

WEFTA interlaboratory comparison on total lipid determination in fishery products using the Smedes method

Lipid determination by the Smedes method was tested in an interlaboratory trial performed by nine laboratories from seven countries belonging to the West European Fish Technologists Association Analytical Methods Working Group. Five samples of fish and fishery products with different lipid contents, including two blind duplicates, were distributed among the participants. All laboratories applied a slightly modified Smedes method, which included extraction of lipids by cyclohexane and isopropanol, transfer of lipids to the cyclohexane phase by addition of water, phase separation by centrifugation, and gravimetric lipid determination. The results indicate that the RSD for reproducibility (RSD(R)) was between 4.11 and 6.31% for samples with moderate (7%) and high (14%) lipid content, depending on the sample. Larger SDs among the laboratories were obtained for a cod sample with low lipid content of 0.5%. The method is judged to be suitable as a routine method for lipid determination in fish and fishery products.     

A pre-assignment heuristic algorithm for the Master Surgical Schedule Problem (MSSP)

In this paper a 0–1 linear programming model and a solution heuristic algorithm are developed in order to solve the so-called Master Surgical Schedule Problem (MSSP). Given a hospital department made up of different surgical units (i.e. wards) sharing a given number of Operating Rooms (ORs), the problem herein addressed is determining the assignment among wards and ORs during a given planning horizon, together with the subset of patients to be operated on during each day. Different resource constraints related to operating block time length, maximum OR overtime allowable by collective labour agreement and legislation, patient length of stay (LOS), available OR equipment, number of surgeons, number of stay and ICU beds, are considered. Firstly, a 0–1 linear programming model intended to minimise a cost function based upon a priority score, that takes into proper account both the waiting time and the urgency status of each patient, is developed. Successively, an heuristic algorithm that enables us to embody some pre-assignment rules to solve this NP-hard combinatorial optimisation problem, is presented. In particular, we force the assignment of each patient to a subset of days depending on his/her expected length of stay in order to allow closing some stay areas during the weekend and hence reducing overall hospitalisation cost of the department. The results of an extensive computational experimentation aimed at showing the algorithm efficiency in terms of computational time and solution effectiveness are given and analysed.     

External proficiency testing exercises on human leukocyte antigen typing in Italy between 1998 and 2002

External proficiency testing exercises are essential tools for measuring the quality of different kinds of performances related to health care and to ensure that they are uniform throughout a region. For many years, the Italian National Transplant Centre and the Italian National Institute of Health have been organizing external proficiency testing exercises for serological and genomic human leukocyte antigen (HLA) typing, following the rules of the European Federation of Immunogenetics. This society provides accreditation for immunogenetical tests to those European countries which want to collaborate on programmes on solid organ and bone marrow transplantation. The results of the Italian external proficiency testing exercises are very satisfactory because of the progressive improvement of the quality of HLA typing seen in Italian laboratories between 1998 and 2002. The attained outcome will certainly guarantee a more reliable service in clinical practice, and will contribute to the process of approaching the highest quality in health care.     

An agent-based simulation model to evaluate alternative co-payment scenarios for contributing to health systems financing

Ageing populations, rapid technological progress and recent public budget cuts currently threaten the sustainability of public health systems. To meet growing needs with declining resources, decision-makers must identify new ways to avoid reducing the quality of services offered to citizens. This paper focuses on the so-called “co-payment” tools aimed to obtain additional resources for the public health budget directly from citizens. Whereas certain forms of co-payments have always been introduced within health systems to prevent moral hazard behaviours, other co-payment mechanisms are explicitly intended to help finance public healthcare systems. Literature and empirical findings do not agree about the final impact of such co-payment tools, particularly whether they can attain system sustainability and guarantee equitably delivered services. In this paper, we develop an agent-based simulation model which can be used by decision-makers as a decision support tool to compare different co-payment rules and evaluate their impact on the public budget and the health expense of different groups of citizens.