We designed and implemented a decision support system to organize the delivery network for the products of a large dairy. To deal with this complex problem, we employed a five-level hierarchic structure distributing the clients among the sales promoters in the levels of greater aggregation and assigning shops to individual drivers in the level with the greatest detail, which corresponds to a version of the traveling salesman problem with time windows. We implemented the model on a microcomputer, importing the necessary data from the company mainframe.
Group prenatal care support has been studied in order to increase maternal and neonatal benefits, such as breastfeeding initiation rates, in front of standard care. In our area, especially in some high risk sub-groups, it could be an important intervention to improve individual care.The aim of the pilot initiative is to compare the effect of group prenatal care support versus only standard individual care on breastfeeding initiation rates and other perinatal outcomes. A retrospective cohort study was made analyzing all deliveries at Hospital del Mar in Barcelona during 1 year. All pregnant women were compared depending on whether they had received the group prenatal care support by midwifes or only standard care. 1383 women gave birth at Hospital del Mar in Barcelona in 2015. 207 received group prenatal care support (15% of total). In group prenatal care there significantly were more nulliparous and native women. Breastfeeding initiation rate was higher in group prenatal care women (94.2% vs. 86.7%, p=0.01). Other outcomes like cesarean section rates, prematurity and low birth weight rates also improved in group prenatal care support in front of standard care.Our study suggests that group prenatal care support improves breastfeeding initiation rates and some other maternal and perinatal outcomes.
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