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This research gives an insight into the difficulties found to handle logistics and presents solution to manage logistics saving costs without sacrificing customer satisfaction.

Introduction Physical inactivity is a major cause of reduced quality of life, as well as many common diseases and even premature death. Most people, globally, are scarcely or rarely physically active. Consequently, physical inactivity influences the burden of disease, and increases its societal costs. In view of this, it is necessary to ask how health care should respond when the population and the patients are either inactive or rarely physically active. Cost-effectiveness analyses of the promotion of physical activity in health care can contribute substantially to health care policy. Aims The overall aim of this thesis was to investigate the cost-effectiveness of physical activity promotion in the health care system. The specific aims were: (I) to provide a model for analyzing cost-effectiveness and equity in health for community-promoted physical activity, (II) to review current knowledge about the cost-effectiveness of health care based interventions aimed at improving physical activity, (III) to evaluate the cost effectiveness of physical activity promotion as a treatment method in primary health care, (IV) to illustrate the importance of enjoyment of exercise in interventions aimed at promoting physical activity, and (V) to describe a method of valuing the time spent on exercise. Methods Standard methods for economic evaluation were studied and adapted to create a model for the evaluation of physical activity promotion (I). Relevant databases were searched for published articles, and the articles found were analyzed using this economic evaluation model (II). A trial in primary health care was evaluated in a cost-utility analysis based on the model (III). In the same trial, the association between time spent on exercise and enjoyment of exercise was analyzed (IV). A model for valuing the time spent on exercise was developed based on existing approaches to the valuation of time, and used in two different groups of exercisers; experienced and inexperienced (V). Results An economic evaluation model was developed, as was a model to calculate an intervention’s effect on equity in health (I). In total, 26 articles were found regarding the cost-effectiveness of physical activity promotion in health care, and 20 of these described interventions, which the authors considered to be cost-effective (II). The treatment of patients in primary health care by the promotion of physical activity was shown to be cost-effective (III). For the same group of patients, time spent on exercise was associated with enjoyment of exercise (IV). A model for valuing the time spent on exercise was developed and used. Time costs were significantly higher among inexperienced exercisers (V). Conclusions There are many examples of interventions promoting physical activity that may be regarded as cost-effective. In general, it seems to be cost effective to promote physical activity among patients with increased risk, or who manifest poor health associated with physical inactivity. Unfortunately, there is still little evidence of when physical activity should be used, or what the best design of such an intervention might be. Although there is still a need for stronger evidence, the Swedish health care system should use the promotion of physical activity as a standard method among the following patients: • those who manifest increased risk (such as high blood pressure) of ill health due to a physically inactive lifestyle; • frail older people, especially those with increased risk of fall injuries; • those requiring rehabilitation after heart failure.

Objectives:<br>1. Describe patient-related and hospice-related characteristics such as gender, average length of hospice stay, primary diagnoses, average daily census, number of admissions per year, net operating revenues, inpatient unit (IPU) operating costs, and medication expenditures of hospices in Ohio and compare it with NHPCO data.<br>2. Identify and analyze therapeutic drug classes and medications with the most frequent utilization rates and largest percentage of expenditures in hospice care.<br><br>Method:<br>Hospice Pharmacy Benefit Managers (PBM) employ pharmacists to provide comprehensive pharmaceutical care services for patients under hospice care and one component of pharmacist provided services include comprehensive medication review. To study the impact of pharmacist-led medication review on hospice costs and medication utilization, PBM claims data for year 2007 were obtained from five hospices in Ohio. The data included information on utilization and costs of medications, patient-related (gender, average length of hospice service, and primary diagnoses) and hospice-related (number of admissions per year, average daily census, net operating revenues, inpatient unit [IPU] operating costs and pharmacy costs) characteristics. Claims data were analyzed to identify the most frequently used therapeutic drug classes and those classes which contributed to the largest percentage of pharmacy expenditures. Prescription drug count and total cost for medications under the identified therapeutic drug classes were also obtained. For benchmarking purposes, analysis was conducted to compare patient and hospice-related data obtained from the five hospices to the 2007 NHPCO data.<br><br>Results:<br>The average number of admissions per hospice for the year 2007 was 627 patients. Average daily census (136 patients) and total patient days (51,350 days) in these five hospices were 1.5 times higher as compared to that of NHPCO data (90 patients and 31,300 days, respectively.). Annual drug expenditures per hospice ranged from $67,580 to $763,413 while average hospice medication cost per patient per day (PPPD) was $11.12 ($12.43 PPPD for home care and $8.5 PPPD for nursing care). Average PPPD excluding outliers such as enoxaparin was $10.72 ($12.05 PPPD for home care and $8.25 PPPD for nursing care).<br>Approximately 1,020 different drugs under 246 therapeutic classes were utilized in the five hospices. The most frequently utilized therapeutic class of drugs, based on prescription drug volume included analgesic-narcotics (15.6%) followed by laxatives-cathartics (7.5%), and anti-anxiety drugs (7%). Therapeutic classes contributing to the majority of drug expenditures, included analgesics-narcotics (16.5%), SSRIs (4.7%), and anti-anxiety drugs (4.5%). Medications whose frequency of use accounted for high expense included morphine sulfate (5.3% - utilization, 4.4% - expenditure), lorazepam (4.4%, 3.1%), furosemide (4%, 0.6%), methadone (3%, 0.9%), and prednisone (3.1%, 0.5%). Medications such as enoxaparin injections whose frequency of utilization was low (0.01%), contributed to 3.1% of total medication expenditure. Likewise, fentanyl and oxycodone contributed to 3.5% and 3.7%, respectively to the total medication expenditure, but their frequency of utilization was only 0.9% and 1.9%, respectively.<br><br>Conclusion:<br>The five hospices in Ohio utilized preferred drugs recommended by pharmacists following a medication review to identify potential drug related problems (DRPs) and encourage cost-effective drug utilization. As a result of these interventions, the utilization of expensive medications is low. Pharmacists specializing in hospice and palliative care are able to recommend preferred medications in end-of-life care thus producing cost-savings. More importantly, hospice pharmacists frequently identify DRP's which can improve patient outcomes. Hospices should consider interventions made by pharmacists and place emphasis on the utilization of cost effective drugs that can be used among terminally ill patients to provide a high level of quality care with fiscal responsibility. / Mylan School of Pharmacy and the Graduate School of Pharmaceutical Sciences; / Pharmacy Administration; / MS; / Thesis;

This research paper will, based on the frame of references and through a quantitative study, describe how Generation Y prefers to communicate with customer service departments. The purpose is to help companies lower their expenses by focusing on one of the two traditional communication tools, telephone or e-mail. Since more knowledge can arouse new questions this study was executed with an abductive approach. After studying theories regarding Generation Y a hypothesis was created: Customers from Generation Y will choose e-mail rather than telephone, when they are in need of personal customer service from a company. A simulation is used to get a better understanding of social behaviour. In this case two scenarios was simulated to test the research hypothesis. In the first scenario, the customer needs to contact customer service because of an error the company had made. However, in the second scenario is the contact necessary because of a mistake done by the customer. In these scenarios the participants had to make a choice between telephone and e-mail. The reasons for two scenarios are founded on the hypothesis that Generation Y prefers e-mail as communication tool, regardless of the situation. In this quantitative study with Facebook as survey platform, two hundred fifty-nine answers were gathered. Out of these, two hundred twenty-five were respondents belonging to Generation Y. The data collected from this research was analysed and the result showed we could reject our hypothesis in scenario one. In this case it was significantly proved that members from Generation Y prefer telephone instead of e-mail when the company has made an error. In scenario two where the customer had made a mistake there was a slight tendency to choose telephone. However, this could not be significantly proved and therefore we could not reject our hypothesis. To further explore the respondents’ choices a comparison between scenario one and two was made. A cross-tabulation showed that more than fifty per cent of the respondents that chose telephone in scenario one changed their preferred communication tool in scenario two. Our research led to a conclusion that members of Generation Y do not have one communication tool they always prefer to use and their choice of communication tool is not based on the fact that they were brought up during the digital revolution.

Agency theory, proposed by previous studies such as Guidry, Leone, and Rock (1999) and Arya and Huey-Lian (2004), suggests that bonus and other accounting-metric-based compensation can motivate managers to perform well in the short horizon while equity-based compensation, such as restricted shares and stock options, can serve the purpose of aligning the long run interests of shareholders and managers. The empirical evidence, for example Jensen and Murphy (1990), Kaplan (1994), Hall and Liebman (1998), Murphy (1999), Zhou (2000), and Chowdhury and Wang (2009), confirms that incentive compensation is popular in many countries. However, recent studies suggest that the relation between performance and incentive compensation is weak. Shaw and Zhang (2010) find that CEO bonus compensation is less sensitive to poor earnings performance than it is to good earnings performance. Fahlenbrach and Stulz (2011) study the relation between bank performance during the 2008 bank crisis and the bonus and equity-based compensation of bank CEOs. They find that banks with CEOs whose incentives were better aligned with the interests of shareholders performed worse than other banks. This study examines whether ownership structure can explain the differences among compensation structures of chief executive officers (CEOs). In particular, we examine the compensation structure of three distinct groups: family-controlled, institution-controlled, and widely-held firms. We distinguish these three kinds of firms to represent different levels of market imperfection. Compared with family-controlled and institution-controlled firms, widely held firms have dispersed ownership. The most significant weakness of a widely-held ownership structure is the lack of shareholder monitoring due to the unmatched benefit and cost of monitoring for small shareholders. In contrast, a holder of a large block of shares will have the same monitoring costs but the benefits to this shareholder from monitoring management and reducing agency costs would be substantial and larger than the costs of monitoring. Thus the presence of a large shareholder will reduce the agency costs. In addition, large shareholders may be willing to spend time and effort continuously to collect more information on management performance or to estimate the firms investment projects. This behaviour will reduce the problems that arise from information asymmetry and will decrease the waste of free cash flows by managers. Both family-controlled firms and institution-controlled firms have large shareholders. However, whether or not the control shareholders are playing an active monitoring role is still an important issue. From the viewpoint of aligning the interests of managers and shareholders, the family-controlled group is superior to the institution-controlled group. First, institutions are more flexible in moving their ownership from one firm to another depending on performance. If the costs of monitoring are high in comparison to the costs of rebalancing portfolios, institutions will choose to rebalance instead of monitoring. In contrast, a family that controls a firm does not have this flexibility. Second, family-controlled firms generally assign influential positions to family members whose focus is in line with that of the family group. Even though a non family member may be appointed as the manager, the level of monitoring is significant given the high ownership concentration by the family. However, the level of monitoring by a family may not necessarily translate into a reduction of agency costs for minority shareholders. Indeed, previous studies suggest that significant family ownership may lead to agency costs of its own. The family may divert company resources for its own benefit despite the presence of a manager who may or may not be a family member. Essentially, the family and the manager can collude to spend on perks and personal benefits at the expense of minority shareholders. Chourou (2010) suggests that excessive compensation of chief executive officers at some family owned Canadian corporations may be viewed as expropriation of minority rights. Overall, the main objective of this study is to examine whether block-holder monitoring is a substitute to the incentive components of compensation. We propose that as we move from widely-held to institution-controlled the level of monitoring may or may not increase. However, as we move further into higher control, as may be suggested by family ownership, the level of monitoring will increase but this monitoring may not necessarily reduce agency costs. The results show that the institution-controlled firms pay significantly less bonus compensation per dollar of assets than widely-held firms but the differences in equity based compensation are not significant. In addition, the family-controlled corporations offer the lowest performance-based compensation, bonus per dollar of assets, in comparison to the institution-controlled and the widely-held groups. These results indicate that the family-controlled Canadian corporations rely more on monitoring managers than paying them incentive payments in the form of bonus payments. In addition, our results indicate that the institutions which control corporations may be monitoring the managers of these corporations but this monitoring does not significantly reduce the need for the long-term incentive components of compensation. This result suggests that institutions may monitor the short-term performance effectively but they may prefer rebalancing their portfolio rather than monitoring long term performance.

Securities legislation in Canada and around the world does not mandate firms to fulfill announced share repurchase programs. As such, a firms repurchase program completion rate can be interpreted as a measure of the firms voluntary compliance, which communicates to investors the degree to which the firm is responsible, reliable and makes good faith efforts to fulfill its announced programs. We therefore expect that the voluntary compliance may reduce the riskiness of a firm and thus its cost of capital. In a sample of Canadian repurchase programs announced between 1995 and 2004, surprisingly, we find little evidence to suggest that a significant relationship exists between the firms repurchase program completion rate and the cost of equity. We present a number of explanations for this result.

In recent years, the beef industry has been forced to examine improving supply chain coordination in order to respond to the declining consumer demand for beef. Exploring the different supply chain structures being used by beef industry participants to improve coordination and provide consumers with differentiated beef products is important. The problem is that it is not clear how the different attributes often included in branded beef programs affect transaction costs and result in the formation of particular supply chain structures. This thesis examines what makes a successful supply chain alliance in the beef industry. Essentially, this study examines the sustainability and effectiveness of different alliance types and their ability to coordinate various branded beef programs and the product attributes included under these programs. A predictive transaction cost model is developed, which examines how different product attributes result in the emergence of particular transaction characteristics. The model shows how the structure of the supply chain adapts in order to minimize the associated transaction costs. In order to better understand the relative importance of different transaction characteristics to supply chain participants, a two-part empirical study was conducted. In the first portion of the study the relative importance of key transaction characteristics to cow-calf operators was examined through the use of conjoint analysis. The results from the conjoint analysis indicate that certain transaction characteristics, namely asset specific investments, limit the willingness of cow-calf operators to participate in alliances due to the associated transaction costs. Cow-calf operators placed an emphasis on premiums, which shows that while they are willing to make trade-offs and accept increased costs, associated with asset specific investments and price uncertainty, they are only willing to do this when benefits are greater than costs. To further understand the importance of different transaction characteristics to supply chain participants, key managers and directors of different beef alliances throughout Canada and the United States were interviewed. Based on the interviews it appears that alliances have typically limited the level of asset specific investments required. Consequently, the degree of coordination is not affected to, any great extent, by the level of investments required. Instead, the degree of coordination appears to more a result of how an alliance is aligned with a particular brand name label. It appears that greater coordination occurs when an alliance owns a brand name label or is an exclusive supplier to a brand name label, as there is a higher risk of opportunistic behaviour and, as a result, higher transaction costs. The use of grid-based pricing systems and the number of buyers/sellers in the market did not appear to have a significant affect on the method of coordination chosen. Based on the results obtained from both the cow-calf operator conjoint-based analysis and interviews with alliance members this thesis identifies several critical success factors and challenges to improving coordination in the beef industry. Most significantly, when developing alliances it is necessary to understand the importance of different transaction characteristics to supply chain participants. This research demonstrates that supply chain participants in the beef industry are willing to make trade-offs between the benefits received from improved coordination and the transaction costs that arise, as long as the benefits exceeds the increase in costs.

Process variables of electrolytic technology to reduce the energy consumption of harvesting Nonnocloropsis salina were investigated including electro-coagulation, electro-floatation, and electro-flocculation. Electro-coagulation and electro-flocculation showed significant cost savings, however electro-floatation did not. The objectives were to determine the effects of electrode material, pH adjustment and electro-polymer addition for electro-coagulation and determine the performance characteristics for electro-coagulation and electro-flocculation. Both treatments proved to be competitive with the energy consumption of a centrifuge. The best electrolytic treatments were electro-coagulation with aluminum and nickel electrodes. Energy requirements at optimum conditions were 239 and 344 kWh/ton. The best treatment combination using electro-flocculation was 432 kWh/ton with no electrode consumption, which could lead to potential cost savings.

At a time where cutbacks on spending are a huge focal point across all government levels, the prison system, and effectively combating crime, has been intensely focused upon. With the United States having the highest rate of incarceration of any country in the world, the significance of this focus is understandable. Its prison system is much larger compared to that of other nations, and therefore is a high priority for the United States. As stated in The Economist, “No other rich country is nearly as punitive as the Land of the Free.” With such high costs associated with the prison system, understanding the most effective ways to operate the facilities and programs is necessary. When looking at the impact of the system on reducing crime, there are various programs that have different effects on crime reduction. Analyzing what has the most potential for reducing crime while taking costs into account is useful for the government in an attempt to most effectively utilize resources and the allotted budget.