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Sample records for total leg lean

  1. TRUNK LEAN DURING A SINGLE-LEG SQUAT IS ASSOCIATED WITH TRUNK LEAN DURING PITCHING.

    Science.gov (United States)

    Plummer, Hillary A; Oliver, Gretchen D; Powers, Christopher M; Michener, Lori A

    2018-02-01

    Impaired trunk motion during pitching may be a risk factor for upper extremity injuries. Specifically, increased forces about the shoulder and elbow have been observed in pitchers with excessive contralateral trunk lean during pitching. Because of the difficulty in identifying abnormal trunk motions during a high-speed task such as pitching, a clinical screening test is needed to identify pitchers who have impaired trunk motion during pitching. The purpose of this study was to determine the relationship between the degree of lateral trunk lean during the single-leg squat and amount of trunk lean during pitching and if trunk lean during pitching can be predicted from lean during the single-leg squat. Controlled Laboratory Study; Cross-sectional. Seventy-three young baseball pitchers (11.4 ± 1.7 years; 156.3 ± 11.9 cm; 50.5 ± 8.8 kg) participated. An electromagnetic tracking system was used to obtain trunk kinematic data during a single-leg squat task (lead leg) and at maximum shoulder external rotation of a fastball pitch. Pearson correlation coefficients for trunk lean during the single-leg squat and pitching were calculated. A linear regression analysis was performed to determine if trunk lean during pitching can be predicted from lean during the single-leg squat. There was a positive correlation between trunk lean during the single-leg squat and trunk lean during pitching (r = 0.53; plean during the single-leg squat predicted the amount of lateral trunk lean during pitching (R 2 = 0.28; p lean during an SLS and pitching. Trunk lean during the single-leg squat explained 28% of the variance in trunk lean during pitching. Diagnosis, level 3.

  2. Six weeks' aerobic retraining after two weeks' immobilization restores leg lean mass and aerobic capacity but does not fully rehabilitate leg strenght in young and older men

    DEFF Research Database (Denmark)

    Vigelsø Hansen, Andreas; Gram, Martin; Wiuff, Caroline

    2015-01-01

    OBJECTIVE: To determine the effect of aerobic retraining as rehabilitation after short-term leg immobilization on leg strength, leg work capacity, leg lean mass, leg muscle fibre type composition and leg capillary supply, in young and older men. SUBJECTS AND DESIGN: Seventeen young (23 ± 1 years...... immobilization had marked effects on leg strength, and work capacity and 6 weeks' retraining was sufficient to increase, but not completely rehabilitate, muscle strength, and to rehabilitate aerobic work capacity and leg lean mass (in the young men)....

  3. Leg strength and lean mass symmetry influences kicking performance in Australian football.

    Science.gov (United States)

    Hart, Nicolas H; Nimphius, Sophia; Spiteri, Tania; Newton, Robert U

    2014-01-01

    Differential loading patterns during game-based participation may produce or exacerbate strength imbalances between the lower limbs. It is currently unknown whether such imbalances are functionally beneficial or detrimental to performance. This study assessed the influence of lower limb strength and lean mass symmetry on kicking accuracy in Australian Football. Thirty-one Australian footballers were required to perform a kicking assessment, producing ten drop punt kicks over twenty metres to a player target. Athletes were subsequently separated into accurate (n = 15) and inaccurate (n = 16) groups, with lower-body lean mass assessed using whole body DXA scans, and lower-body strength assessed using an isometric protocol. Accurate kickers demonstrated significantly higher relative lean mass (~8% to 16%; p = 0. 001 to 0.004) and significantly lower relative fat mass (~21% to 40%; p = 0.001 to 0.024) than inaccurate kickers. Accurate kickers did not contain any significant difference in lean mass or unilateral strength between lower limbs. Inaccurate kickers displayed significant asymmetry in lean mass (~3%; p ≤ 0.003), producing significant imbalances in strength (~8%; p ≤ 0.002) highlighting a deficiency in their support leg. Greater relative strength and improved lower limb symmetry in strength and muscularity could increase the capacity of an athlete to be technically proficient in favour of greater accuracy. Key PointsStrength deficits in the support leg may lead to inaccurate kicking outcomes.An asymmetry of 3% in lean mass generated an 8% imbalance in leg strength.Greater levels of relative lower-body strength and muscle mass are associated with improved kicking accuracy performance.

  4. Total and Lower Extremity Lean Mass Percentage Positively Correlates With Jump Performance.

    Science.gov (United States)

    Stephenson, Mitchell L; Smith, Derek T; Heinbaugh, Erika M; Moynes, Rebecca C; Rockey, Shawn S; Thomas, Joi J; Dai, Boyi

    2015-08-01

    Strength and power have been identified as valuable components in both athletic performance and daily function. A major component of strength and power is the muscle mass, which can be assessed with dual-energy x-ray absorptiometry (DXA). The primary purpose of this study was to quantify the relationship between total body lean mass percentage (TBLM%) and lower extremity lean mass percentage (LELM%) and lower extremity force/power production during a countermovement jump (CMJ) in a general population. Researchers performed a DXA analysis on 40 younger participants aged 18-35 years, 28 middle-aged participants aged 36-55 years, and 34 older participants aged 56-75 years. Participants performed 3 CMJ on force platforms. Correlations revealed significant and strong relationships between TBLM% and LELM% compared with CMJ normalized peak vertical ground reaction force (p lean mass percentages. The findings have implications in including DXA-assessed lean mass percentage as a component for evaluating lower extremity strength and power. A paired DXA analysis and CMJ jump test may be useful for identifying neuromuscular deficits that limit performance.

  5. Limb shortening osteotomy in a patient with achondroplasia and leg length difference after total hip arthroplasty

    Directory of Open Access Journals (Sweden)

    Christian L. Galata

    2013-07-01

    Full Text Available Introduction: Achondroplasia is the most common reason for disproportionate short stature. Normally, orthopedic limb lengthening procedures must be discussed in the course of this genetic disorder and have been successful in numerous achondroplastic patients in the past. In some cases, the disease may lead to leg length differences with need for surgical correction. Case Report: We report a case of achondroplastic dysplastic coxarthrosis with symptomatic leg length difference after bilateral total hip arthroplasty in a 52-year-old female patient, in which a distal femoral shortening osteotomy was successfully performed. Conclusion: Femoral shortening osteotomy is very uncommon in patients with achondroplasia. We conclude, however, that in rare cases it can be indicated and provide the advantage of shorter operation time, less perioperative complications and faster recovery compared to leg lengthening procedures. Keywords: Achondroplasia, dysplastic coxarthrosis, limb shortening, distal femur osteotomy.

  6. In-vivo determination of total body water and lean body mass in subjects by deuterium dilution

    Energy Technology Data Exchange (ETDEWEB)

    Blagojevic, N; Allen, B J; Baur, L; Gaskin, K

    1988-12-01

    Total body water (TBW) estimation is one of a number of basic techniques required for the determination of body composition in normal and malnourished subjects. When combined with total body nitrogen (TBN) analysis by prompt gamma neutron activation, an accurate compartmental model of in vivo body composition can be formed, providing valuable nutritional and other data. This study examines the role of TBW on its own in evaluating lean body mass. Total body water was studied in six male and five female subjects using deuterium oxide and a Fourier transform infrared spectrometer. The lean body mass calculated from the results was compared with the lean body mass deduced from established total body nitrogen measurements. A four-compartment model was also used to calculate lean body mass. Excellent agreement was shown between lean body mass derived from TBW, the four-compartment model and TBN. Hence, TBW can provide a fast, cost-efficient method for evaluating normal subjects. However, for disease-induced malnutrition, or highly developed athletes, both TBN and TBW measurements are essential to establish an accurate picture of their body composition. TBW measurements alone can monitor the hydration state of patients and as such have a useful diagnostic value.

  7. In-vivo determination of total body water and lean body mass in subjects by deuterium dilution

    International Nuclear Information System (INIS)

    Blagojevic, N.; Allen, B.J.; Baur, L.; Gaskin, K.

    1988-01-01

    Total body water (TBW) estimation is one of a number of basic techniques required for the determination of body composition in normal and malnourished subjects. When combined with total body nitrogen (TBN) analysis by prompt gamma neutron activation, an accurate compartmental model of in vivo body composition can be formed, providing valuable nutritional and other data. This study examines the role of TBW on its own in evaluating lean body mass. Total body water was studied in six male and five female subjects using deuterium oxide and a Fourier transform infrared spectrometer. The lean body mass calculated from the results was compared with the lean body mass deduced from established total body nitrogen measurements. A four-compartment model was also used to calculate lean body mass. Excellent agreement was shown between lean body mass derived from TBW, the four-compartment model and TBN. Hence, TBW can provide a fast, cost-efficient method for evaluating normal subjects. However, for disease-induced malnutrition, or highly developed athletes, both TBN and TBW measurements are essential to establish an accurate picture of their body composition. TBW measurements alone can monitor the hydration state of patients and as such have a useful diagnostic value

  8. Normalized knee-extension strength or leg-press power after fast-track total knee arthroplasty

    DEFF Research Database (Denmark)

    Aalund, Peter K; Larsen, Kristian; Hansen, Torben Bæk

    2013-01-01

    OBJECTIVE: (s): To investigate which of the two muscle-impairment measures for the operated leg, normalized knee extension strength or leg press power, is more closely associated to performance-based and self-reported measures of function shortly following total knee arthroplasty (TKA). DESIGN...... and dynamic leg presses to determine their body-mass normalized knee extension strength and leg press power, respectively. The 10-m fast speed walking and 30-s chair stand tests were used to determine performance-based function, while the Western Ontario McMaster University Osteoarthritis Index (WOMAC......) and Oxford Knee scores were used to determine self-reported function. RESULTS: Normalized leg press power was more closely associated to both performance-based (r=.82, P...

  9. Total endoscopic free flap harvest of a serratus anterior fascia flap for microsurgical lower leg reconstruction

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    Erdmann, Alfons

    2014-04-01

    Full Text Available [english] Background: A tremendous number of free flaps have been developed in the past. As the surgical result depends not only on a successful flap transfer but also on the harvest, this paper details the procedures for undertaking the first total endoscopic harvest of a serratus fascia flap for free flap transplantation to the lower leg. Patient and methods: In September 2012 we performed the first total endoscopic serratus anterior fascia free flap harvest. The incision of 2.5 cm length was made 10 cm in front of anterior muscle border of the latissimus dorsi at level with the midthorax. After insertion of a flexible laparoscopic single port system we started CO gas insufflation. We used this setting to meticulously prepare a neo cavity between atissimus dorsi and M. serratus anterior. The vessels were dissected and the thoraco-dorsal nerve was separated. With a second auxiliary incision we used a clamp to support the raising of the fascia flap from the underlying muscle. Finally we clipped the vessels to the latissimus dorsi muscle and the flap vessels at the Arteria and Vena axillaris. The flap was extracted via the 2.5 cm incision.Results: We were able to perform a total endoscopic harvest of a serratus fascia flap for free flap reconstruction of soft tissues. With this new operative technique we were able to avoid a long skin incision, which in our view lowers the morbidity at the harvest area.Conclusion: We describe a new method for the total endoscopic harvest of the serratus fascia flap for free flap transfer. The flap was harvested within reasonable time and following surgery leaves the patient with minimal donor site morbidity compared to the open technique.

  10. 7S’s System Foundation of Total Productive Maintenance House for Lean Organization

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    Georgescu Daniel

    2009-12-01

    Full Text Available The goal of Lean TPM or TPM for lean organization approach is maintaining international competitiveness . This Lean TPM from our article, approach proposes tree additions to the current understanding of the TPM system: the 7Ss as a critical first step in any improvement program; instant maintenance; improvement setup operations. A company cannot make business gains solely by using cost-cutting measures because it cannot cost enough to become a world-class competitor. Instead, it must invest resources in productivity improvement. This generally increases factory throughput and cuts costs at the same time. Maintaining equipment in its optimal state and continually improving its productivity is the whole strategy behind TPM. The main objective of the 7S system is to grow the value added to each worker. To grow the added value, we must create ordered and well adjusted production lines based on the principles of the 7S’s: organization and order. Above all these two S’s bring to the factory standard positions and acknowledgement. Focus on the first two S’s brings a new perspective on understanding the 7S’s.

  11. Leg lengthening and femoral-offset reduction after total hip arthroplasty: where is the problem - stem or cup positioning?

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    Al-Amiry, Bariq; Mahmood, Sarwar; Krupic, Ferid; Sayed-Noor, Arkan

    2017-09-01

    Background Restoration of femoral offset (FO) and leg length is an important goal in total hip arthroplasty (THA) as it improves functional outcome. Purpose To analyze whether the problem of postoperative leg lengthening and FO reduction is related to the femoral stem or acetabular cup positioning or both. Material and Methods Between September 2010 and April 2013, 172 patients with unilateral primary osteoarthritis treated with THA were included. Postoperative leg-length discrepancy (LLD) and global FO (summation of cup and FO) were measured by two observers using a standardized protocol for evaluation of antero-posterior plain hip radiographs. Patients with postoperative leg lengthening ≥10 mm (n = 41) or with reduced global FO >5 mm (n = 58) were further studied by comparing the stem and cup length of the operated side with the contralateral side in the lengthening group, and by comparing the stem and cup offset of the operated side with the contralateral side in the FO reduction group. We evaluated also the inter-observer and intra-observer reliability of the radiological measurements. Results Both observers found that leg lengthening was related to the stem positioning while FO reduction was related to the positioning of both the femoral stem and acetabular cup. Both inter-observer reliability and intra-observer reproducibility were moderate to excellent (intra-class correlation co-efficient, ICC ≥0.69). Conclusion Post THA leg lengthening was mainly caused by improper femoral stem positioning while global FO reduction resulted from improper positioning of both the femoral stem and the acetabular cup.

  12. Lean maturity, lean sustainability

    DEFF Research Database (Denmark)

    Jørgensen, Frances; Matthiesen, Rikke; Nielsen, Jacob

    2007-01-01

    . A framework for describing levels of lean capability is presented, based on a brief review of the literature and experiences from 12 Danish companies currently implementing lean. Although still in its emerging phase, the framework contributes to both theory and practice by describing developmental stages......Although lean is rapidly growing in popularity, its implementation is far from problem free and companies may experience difficulties sustaining long term success. In this paper, it is suggested that sustainable lean requires attention to both performance improvement and capability development...... that support lean capability development and consequently, lean sustainability....

  13. [Improvement approaches in the hospital setting: From total quality management to Lean].

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    Curatolo, N; Lamouri, S; Huet, J-C; Rieutord, A

    2015-07-01

    Hospitals have to deal strong with economic constraints and increasing requirements in terms of quality and safety of care. To address these constraints, one solution could be the adoption of approaches from the industry sector. Following the decree of April 6, 2011 on the quality management of the medication use process, some of these approaches, such as risk management, are now part of the everyday work of healthcare professionals. However, other approaches, such as business process improvement, are still poorly developed in the hospital setting. In this general review, we discuss the main approaches of business process improvements that have been used in hospitals by focusing specifically on one of the newest and most currently used: Lean. Copyright © 2014. Published by Elsevier Masson SAS.

  14. Comparison of nodal staging with lean body mass based and with total body weight based in lung cancer

    International Nuclear Information System (INIS)

    Lee, H. Y.; Chung, J. K.; Kang, W. J.; So, Y.; Lee, D. S.; Lee, M. C.

    2004-01-01

    The standardized uptake (SUV) is semiquantitative evaluation parameter in positron emission tomography (PET). But there is no consensus about the application or process of SUV measurement. In this study, we used measured lean body mass (LBM) and total weight for application in SUV measurement. Also we compared the each nodal staging with SUV between measured LBM, and total weight, in non small cell lung cancer (NSCLC). Total 21 patients with lung cancer were enrolled (M:F=17:4, age 45[+-]8 years). PET-CT was done before operation with Gemini (Philips, Milpitas, U.S.). Each image was reconstructed twice with measured weight and lean body mass. Maximum SUVs of 103 dissected lymph nodes were measured and compared with histological result. For the deciding on the cut off value, receiver operating characteristic (ROC) analysis was done. 14 lymph nodes in the 103 dissected lymph nodes were metastatic lesions. From the ROC analysis, the cut off value of SUV was 1.7 with measured LBM and 2.3 with total weight. With measured LBM, Sensitivity and specificity were 92.5%. 78.2% and area under curve was 0.881. With total weight, sensitivity and specificity was 92.5% and 77%, Area under curve was 0.859. The normalization of SUV could be done with measured LBM. With the normalization of SUV with LBM, the nodal staging of NSCLC using SUV could be more accurate than using total weight in the reconstruction and measurement of SUV for lymph node lesions

  15. Relationship Between Changes in Fat and Lean Depots Following Weight Loss and Changes in Cardiovascular Disease Risk Markers.

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    Clifton, Peter M

    2018-04-04

    Gluteofemoral fat mass has been associated with improved cardiovascular disease risk factors. It is not clear if loss of this protective fat during weight loss partially negates the effect of loss of visceral fat. The aim of this study was to examine regional fat loss in a large weight-loss cohort from one center and to determine if fat loss in the leg and total lean tissue loss is harmful. We combined the data from 7 of our previously published 3-month weight-loss studies and examined the relationship between regional fat and lean tissue loss and changes in cardiovascular disease risk factors in 399 participants. At baseline, leg fat was positively associated with high-density lipoprotein cholesterol in women and inversely with fasting triglyceride level in both sexes. Abdominal lean tissue was also related to systolic blood pressure in men. Changes in regional fat and lean tissue were positively associated with changes in glucose, insulin, total cholesterol, triglycerides, low-density lipoprotein cholesterol and systolic and diastolic blood pressure ( r =0.11-0.22, P lean tissue dominating in multivariate regression. After adjustment for total weight or total fat change, these relationships disappeared except for a positive relationship between arm and lean leg mass loss and changes in triglycerides and systolic blood pressure. Loss of leg fat and leg lean tissue was directly associated with beneficial changes in cardiovascular disease risk markers. Loss of lean tissue may not have an adverse effect on cardiovascular disease risk, and measures to retain lean tissue during weight loss may not be necessary. © 2018 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.

  16. Assessment of asymmetric leg loading before and after total hip arthroplasty using instrumented shoes

    NARCIS (Netherlands)

    Martínez-Ramírez, Alicia; Weenk, D.; Lecumberri, Pablo; Verdonschot, Nicolaas Jacobus Joseph; Pakvis, Dean; Veltink, Petrus H.

    2013-01-01

    The stance time and the average vertical ground reaction force measured with the instrumented shoes during walking, and their symmetry index, showed significant differences before and after total hip arthroplasty. However, the data obtained with the sit to stand test did not reveal this improvement

  17. Pseudotumor from Metal-on-Metal Total Hip Arthroplasty Causing Unilateral Leg Edema: Case Presentation and Literature Review

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    Caleb W. Grote

    2018-03-01

    Full Text Available Metal-on-metal (MoM total hip arthroplasty (THA can be associated with adverse metal reactions, including pseudotumors. This case report describes a 58-year-old female with an MoM THA-related pseudotumor that caused unilateral leg edema from compression of her external iliac vein. After thorough preoperative workup to rule out infection and deep vein thrombosis and consultation with a vascular surgeon, the patient underwent revision THA and excision of her pseudotumor. She had complete resolution of her swelling at 4 years after surgery. Review of all available case reports for this rare complication revealed that almost all patients were female. All patients underwent revision THA, with resolution of their symptoms. Literature review demonstrates that women are disproportionally affected by complications associated with MoM THA. We recommend close monitoring of patients with MoM THA, particularly women, for development of adverse metal reactions.

  18. The relationship of endogenous plasma concentrations of β-Hydroxy β-Methyl Butyrate (HMB) to age and total appendicular lean mass in humans.

    Science.gov (United States)

    Kuriyan, Rebecca; Lokesh, Deepa P; Selvam, Sumithra; Jayakumar, J; Philip, Mamatha G; Shreeram, Sathyavageeswaran; Kurpad, Anura V

    2016-08-01

    The maintenance of muscle mass and muscle strength is important for reducing the risk of chronic diseases. The age- related loss of muscle mass and strength is associated with adverse outcomes of physical disability, frailty and death. β-Hydroxy β-Methyl Butyrate (HMB), a metabolite of leucine, has beneficial effects on muscle mass and strength under various catabolic conditions. The objectives of the present study were to determine if age- related differences existed in endogenous plasma HMB levels, and to assess if HMB levels correlated to total appendicular lean mass and forearm grip strength. Anthropometry, dietary and physical activity assessment, and the estimation of fasting plasma HMB concentrations and handgrip strength were performed on the 305 subjects (children, young adults and older adults). Lean mass, which serves as a surrogate for muscle mass was measured using dual energy X-ray absorptiometry (DEXA). Mean plasma HMB concentrations were significantly lower with increasing age groups, with children having highest mean HMB concentration (pHMB concentrations. A significant positive correlation between HMB concentrations and appendicular lean mass normalized for body weight (%), appendicular lean mass (r=0.37; pHMB concentrations in young adults (r=0.58; pHMB concentrations in humans and the HMB concentrations were positively correlated with appendicular lean mass and hand grip strength in young adults and older adults group. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

  19. [Posturographic study of total prostheses in the leg. Apropos of 88 patients examined].

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    Lord, G; Gentaz, R; Gagey, P M; Baron, J B

    1976-01-01

    By suppressing certain articular sensory receptors, the reconstructive surgery of joints using total prostheses modifies tonic postural activity and, by this means, alters the regulation of balance in the subjects of operation. This doubtless explains certain discrepancies between the apparently excellent results in respect of joint movement and muscle strength and poor utilisation of the joint in every day life (instability, use of sticks or failure to use the joint in walking). Drawing on the experience and basic work of specialists in posture, the authors have undertaken a study of tonic postural activity in patients who had received a total prosthesis in the lower limb, both from the clinical aspect and by graphic measurement using an electronic apparatus, the statokinesiometer. Fourteen normal subjects were tested to calibrate the apparatus and 8 patients suffering from established osteoarthritis of the hip were studied as controls. Analysis of tonic postural activity was made in 66 patients who had received total prostheses in the lower limb. The results showed significant disturbance in balance in ankle prostheses, minimal disturbance in knee prostheses and not significant disturbance in hip prostheses. Certain therapeutic implications are derived from this study.

  20. Lean muscle mass in classic or ovulatory PCOS: association with central obesity and insulin resistance.

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    Mario, F M; do Amarante, F; Toscani, M K; Spritzer, P M

    2012-10-01

    This age-matched case-control study assessed total and segmental lean muscle mass in classic or ovulatory polycystic ovary syndrome (PCOS) patients and investigated whether lean mass is associated with hormone and metabolic features. Participants underwent anthropometric and clinical evaluation. Habitual physical activity was assessed with a digital pedometer, and body composition by dual-energy X-ray absorptiometry. Laboratory measurements included total cholesterol, cholesterol fractions, triglycerides, glucose, total serum testosterone, serum insulin, estradiol, luteinizing hormone, and SHBG. Energy intake was calculated using a food frequency questionnaire. Classic PCOS patients had higher body mass index (BMI), waist circumference, testosterone and lipid accumulation product values than ovulatory PCOS and controls. Energy consumption, homeostasis model assessment index, SHBG, free androgen index and triglycerides, total and trunk lean mass were higher only in classic PCOS women vs. controls. Arm, leg, trunk, total or limb lean masses were not correlated with hormone levels in any of the groups. However, in PCOS women lipid accumulation product was positively correlated with total (r=0.56, p=0.001), trunk (r=0.59, p=0.001), arm (r=0.54, p=0.001), leg (r=0.44, p=0.03) and limb (r=0.48, p=0.001) lean masses. BMI was positively correlated with all lean mass segments and independently associated with total lean mass. Lipid accumulation product and BMI were independently associated with trunk lean mass variation. The increase in lean mass in classic PCOS appears to be associated with insulin resistance and central obesity rather than with energy intake, physical activity or androgens. © J. A. Barth Verlag in Georg Thieme Verlag KG Stuttgart · New York.

  1. Lean consumption.

    Science.gov (United States)

    Womack, James P; Jones, Daniel T

    2005-03-01

    During the past 20 years, the real price of most consumer goods has fallen worldwide, the variety of goods and the range of sales channels offering them have continued to grow, and product quality has steadily improved. So why is consumption often so frustrating? It doesn't have to be--and shouldn't be--the authors say. They argue that it's time to apply lean thinking to the processes of consumption--to give consumers the full value they want from goods and services with the greatest efficiency and the least pain. Companies may think they save time and money by off-loading work to the consumer but, in fact, the opposite is true. By streamlining their systems for providing goods and services, and by making it easier for customers to buy and use those products and services, a growing number of companies are actually lowering costs while saving everyone time. In the process, these businesses are learning more about their customers, strengthening consumer loyalty, and attracting new customers who are defecting from less user-friendly competitors. The challenge lies with the retailers, service providers, manufacturers, and suppliers that are not used to looking at total cost from the standpoint of the consumer and even less accustomed to working with customers to optimize the consumption process. Lean consumption requires a fundamental shift in the way companies think about the relationship between provision and consumption, and the role their customers play in these processes. It also requires consumers to change the nature of their relationships with the companies they patronize. Lean production has clearly triumphed over similar obstacles in recent years to become the dominant global manufacturing model. Lean consumption, its logical companion, can't be far behind.

  2. Performance effect of Lean

    DEFF Research Database (Denmark)

    Kristensen, Thomas Borup; Israelsen, Poul

    2016-01-01

    To understand how the practices of Lean affect performance, we tested and validated a system-wide approach using mediating relationships in a structural equation model. We used a cross-sectional survey of 200 Danish companies that indicated that they used Lean. Thus, this study is especially...... relevant to Denmark, but the approach is empirically more generalizable. We show that the effect of Lean standardized flow production practices on performance is mediated by analytical continuous improvement empowerment practices and by delegation of decision rights practices. Thus, standardized flow...... of decision rights. The paper provides evidence that supports the view that middle managers’ actions further enhance performance in Lean companies. The right Lean behavior by middle managers increases the level of analytical continuous improvement empowerment. In total, high-performing Lean companies...

  3. Twenty-four hour total and dietary fat oxidation in lean, obese and reduced-obese adults with and without a bout of exercise.

    Directory of Open Access Journals (Sweden)

    Audrey Bergouignan

    Full Text Available It has been hypothesized that obese and reduced-obese individuals have decreased oxidative capacity, which contributes to weight gain and regain. Recent data have challenged this concept.To determine (1 whether total and dietary fat oxidation are decreased in obese and reduced-obese adults compared to lean but increase in response to an acute exercise bout and (2 whether regular physical activity attenuates these metabolic alterations.We measured 24-hr total (whole-room calorimetry and dietary fat (14C-oleate oxidation in Sedentary Lean (BMI = 21.5±1.6; n = 10, Sedentary Obese (BMI = 33.6±2.5; n = 9, Sedentary Reduced-Obese (RED-SED; BMI = 26.9±3.7; n = 7 and in Physically Active Reduced-Obese (RED-EX; BMI = 27.3±2.8; n = 12 men and women with or without an acute exercise bout where energy expended during exercise was not replaced.Although Red-SED and Red-EX had a similar level of fatness, aerobic capacity and metabolic profiles were better in Red-EX only compared to Obese subjects. No significant between-group differences were seen in 24-hr respiratory quotient (RQ, Lean: 0.831±0.044, Obese: 0.852±0.023, Red-SED: 0.864±0.037, Red-EX: 0.842±0.039, total and dietary fat oxidation. A single bout of exercise increased total (+27.8%, p<0.0001 and dietary (+6.6%, p = 0.048 fat oxidation across groups. Although exercise did not impact RQ during the day, it decreased RQ during sleep (p = 0.01 in all groups. Red-EX oxidized more fat overnight than Red-SED subjects under both resting (p = 0.036 and negative energy balance (p = 0.003 conditions, even after adjustment for fat-free mass.Obese and reduced-obese individuals oxidize as much fat as lean both under eucaloric and negative energy balance conditions, which does not support the hypothesis of reduced oxidative capacity in these groups. Reduced-obese individuals who exercise regularly have markers of metabolic health similar to those seen in lean

  4. Large meta-analysis of genome-wide association studies identifies five loci for lean body mass.

    Science.gov (United States)

    Zillikens, M Carola; Demissie, Serkalem; Hsu, Yi-Hsiang; Yerges-Armstrong, Laura M; Chou, Wen-Chi; Stolk, Lisette; Livshits, Gregory; Broer, Linda; Johnson, Toby; Koller, Daniel L; Kutalik, Zoltán; Luan, Jian'an; Malkin, Ida; Ried, Janina S; Smith, Albert V; Thorleifsson, Gudmar; Vandenput, Liesbeth; Hua Zhao, Jing; Zhang, Weihua; Aghdassi, Ali; Åkesson, Kristina; Amin, Najaf; Baier, Leslie J; Barroso, Inês; Bennett, David A; Bertram, Lars; Biffar, Rainer; Bochud, Murielle; Boehnke, Michael; Borecki, Ingrid B; Buchman, Aron S; Byberg, Liisa; Campbell, Harry; Campos Obanda, Natalia; Cauley, Jane A; Cawthon, Peggy M; Cederberg, Henna; Chen, Zhao; Cho, Nam H; Jin Choi, Hyung; Claussnitzer, Melina; Collins, Francis; Cummings, Steven R; De Jager, Philip L; Demuth, Ilja; Dhonukshe-Rutten, Rosalie A M; Diatchenko, Luda; Eiriksdottir, Gudny; Enneman, Anke W; Erdos, Mike; Eriksson, Johan G; Eriksson, Joel; Estrada, Karol; Evans, Daniel S; Feitosa, Mary F; Fu, Mao; Garcia, Melissa; Gieger, Christian; Girke, Thomas; Glazer, Nicole L; Grallert, Harald; Grewal, Jagvir; Han, Bok-Ghee; Hanson, Robert L; Hayward, Caroline; Hofman, Albert; Hoffman, Eric P; Homuth, Georg; Hsueh, Wen-Chi; Hubal, Monica J; Hubbard, Alan; Huffman, Kim M; Husted, Lise B; Illig, Thomas; Ingelsson, Erik; Ittermann, Till; Jansson, John-Olov; Jordan, Joanne M; Jula, Antti; Karlsson, Magnus; Khaw, Kay-Tee; Kilpeläinen, Tuomas O; Klopp, Norman; Kloth, Jacqueline S L; Koistinen, Heikki A; Kraus, William E; Kritchevsky, Stephen; Kuulasmaa, Teemu; Kuusisto, Johanna; Laakso, Markku; Lahti, Jari; Lang, Thomas; Langdahl, Bente L; Launer, Lenore J; Lee, Jong-Young; Lerch, Markus M; Lewis, Joshua R; Lind, Lars; Lindgren, Cecilia; Liu, Yongmei; Liu, Tian; Liu, Youfang; Ljunggren, Östen; Lorentzon, Mattias; Luben, Robert N; Maixner, William; McGuigan, Fiona E; Medina-Gomez, Carolina; Meitinger, Thomas; Melhus, Håkan; Mellström, Dan; Melov, Simon; Michaëlsson, Karl; Mitchell, Braxton D; Morris, Andrew P; Mosekilde, Leif; Newman, Anne; Nielson, Carrie M; O'Connell, Jeffrey R; Oostra, Ben A; Orwoll, Eric S; Palotie, Aarno; Parker, Stephen C J; Peacock, Munro; Perola, Markus; Peters, Annette; Polasek, Ozren; Prince, Richard L; Räikkönen, Katri; Ralston, Stuart H; Ripatti, Samuli; Robbins, John A; Rotter, Jerome I; Rudan, Igor; Salomaa, Veikko; Satterfield, Suzanne; Schadt, Eric E; Schipf, Sabine; Scott, Laura; Sehmi, Joban; Shen, Jian; Soo Shin, Chan; Sigurdsson, Gunnar; Smith, Shad; Soranzo, Nicole; Stančáková, Alena; Steinhagen-Thiessen, Elisabeth; Streeten, Elizabeth A; Styrkarsdottir, Unnur; Swart, Karin M A; Tan, Sian-Tsung; Tarnopolsky, Mark A; Thompson, Patricia; Thomson, Cynthia A; Thorsteinsdottir, Unnur; Tikkanen, Emmi; Tranah, Gregory J; Tuomilehto, Jaakko; van Schoor, Natasja M; Verma, Arjun; Vollenweider, Peter; Völzke, Henry; Wactawski-Wende, Jean; Walker, Mark; Weedon, Michael N; Welch, Ryan; Wichmann, H-Erich; Widen, Elisabeth; Williams, Frances M K; Wilson, James F; Wright, Nicole C; Xie, Weijia; Yu, Lei; Zhou, Yanhua; Chambers, John C; Döring, Angela; van Duijn, Cornelia M; Econs, Michael J; Gudnason, Vilmundur; Kooner, Jaspal S; Psaty, Bruce M; Spector, Timothy D; Stefansson, Kari; Rivadeneira, Fernando; Uitterlinden, André G; Wareham, Nicholas J; Ossowski, Vicky; Waterworth, Dawn; Loos, Ruth J F; Karasik, David; Harris, Tamara B; Ohlsson, Claes; Kiel, Douglas P

    2017-07-19

    Lean body mass, consisting mostly of skeletal muscle, is important for healthy aging. We performed a genome-wide association study for whole body (20 cohorts of European ancestry with n = 38,292) and appendicular (arms and legs) lean body mass (n = 28,330) measured using dual energy X-ray absorptiometry or bioelectrical impedance analysis, adjusted for sex, age, height, and fat mass. Twenty-one single-nucleotide polymorphisms were significantly associated with lean body mass either genome wide (p lean body mass and in 45,090 (42,360 of European ancestry) subjects from 25 cohorts for appendicular lean body mass was successful for five single-nucleotide polymorphisms in/near HSD17B11, VCAN, ADAMTSL3, IRS1, and FTO for total lean body mass and for three single-nucleotide polymorphisms in/near VCAN, ADAMTSL3, and IRS1 for appendicular lean body mass. Our findings provide new insight into the genetics of lean body mass.Lean body mass is a highly heritable trait and is associated with various health conditions. Here, Kiel and colleagues perform a meta-analysis of genome-wide association studies for whole body lean body mass and find five novel genetic loci to be significantly associated.

  5. Healthcare Lean.

    Science.gov (United States)

    Long, John C

    2003-01-01

    Lean Thinking is an integrated approach to designing, doing and improving the work of people that have come together to produce and deliver goods, services and information. Healthcare Lean is based on the Toyota production system and applies concepts and techniques of Lean Thinking to hospitals and physician practices.

  6. Structural imaging of the brain reveals decreased total brain and total gray matter volumes in obese but not in lean women with polycystic ovary syndrome compared to body mass index-matched counterparts.

    Science.gov (United States)

    Ozgen Saydam, Basak; Has, Arzu Ceylan; Bozdag, Gurkan; Oguz, Kader Karli; Yildiz, Bulent Okan

    2017-07-01

    To detect differences in global brain volumes and identify relations between brain volume and appetite-related hormones in women with polycystic ovary syndrome (PCOS) compared to body mass index-matched controls. Forty subjects participated in this study. Cranial magnetic resonance imaging and measurements of fasting ghrelin, leptin and glucagon-like peptide 1 (GLP-1), as well as GLP-1 levels during mixed-meal tolerance test (MTT), were performed. Total brain volume and total gray matter volume (GMV) were decreased in obese PCOS compared to obese controls (p lean PCOS and controls did not show a significant difference. Secondary analyses of regional brain volumes showed decreases in GMV of the caudate nucleus, ventral diencephalon and hippocampus in obese PCOS compared to obese controls (p lean patients with PCOS had lower GMV in the amygdala than lean controls (p PCOS, suggests volumetric reductions in global brain areas in obese women with PCOS. Functional studies with larger sample size are needed to determine physiopathological roles of these changes and potential effects of long-term medical management on brain structure of PCOS.

  7. Per meal dose and frequency of protein consumption is associated with lean mass and muscle performance.

    Science.gov (United States)

    Loenneke, Jeremy P; Loprinzi, Paul D; Murphy, Caoileann H; Phillips, Stuart M

    2016-12-01

    It has been hypothesized that for older adults evenly distributing consumption of protein at 30-40 g per meal throughout the day may result in more favorable retention of lean mass and muscular strength. Such a thesis has not, to our knowledge, been tested outside of short-term studies or acute measures of muscle protein synthesis. To examine whether the number of times an individual consumed a minimum of 30 g of protein at a meal is associated with leg lean mass and knee extensor strength. Data from the 1999-2002 NHANES were used, with 1081 adults (50-85 y) constituting the analytic sample. A "multiple pass" 24-h dietary interview format was used to collect detailed information about the participants' dietary intake. Knee extensor strength was assessed objectively using the Kin Com MP dynamometer. Leg lean mass was estimated from whole-body dual-energy X-ray absorptiometry (DXA) scans. Participants with 1 vs. 0 (β adjusted  = 23.6, p = 0.002) and 2 vs. 0 (β adjusted  = 51.1, p = 0.001) meals of ≥30 g protein/meal had greater strength and leg lean mass (1 vs. 0, β adjusted  = 1160, p frequency with leg lean mass and strength plateaued at ∼45 g protein/meal for those consuming 2 vs. 0 meals above the evaluated protein/meal threshold. However, for those with only 1 meal at or above the evaluated threshold, the response plateaued at 30 g/meal. Leg lean mass mediated the relationship between protein frequency and strength, with the proportion of the total effect mediated being 64%. We found that more frequent consumption of meals containing between 30 and 45 g protein/meal produced the greatest association with leg lean mass and strength. Thus, the consumption of 1-2 daily meals with protein content from 30 to 45 g may be an important strategy for increasing and/or maintaining lean body mass and muscle strength with aging. Copyright © 2016 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

  8. Lean production

    OpenAIRE

    Veselková, Jana

    2011-01-01

    The goal of this Bachelor's Thesis is to describe the general principles of lean production and afterwards apply these principles in a particular company. Due to the changing conditions on the world market is among companies growing concern about such innovative business systems. The theoretical part of this work deals with the general characteristics of lean production, including their history and focus on Toyota, as the originator of most lean systems. Mentioned are also the economic aspect...

  9. Negotiating Lean

    DEFF Research Database (Denmark)

    Rahbek Pedersen, Esben; Muniche, Mahad

    2011-01-01

    Purpose – The purpose of this paper is to analyse how negotiations between the constituencies affect the processes and outcomes of lean projects in Danish public sector organisations. Design/methodology/approach – The paper is based on a qualitative analysis of interviews with managers...... projects in the Danish public sector. It cannot be concluded that the findings can be generalised to reflect all types of lean projects across organisational and geographical settings. Originality/value – The paper adds value to the relatively scarce literature on lean management in the public sector...... and employees who have participated in lean projects in the Danish public sector. Negotiated order theory serves as the overarching theoretical framework for the analysis. Findings – The paper concludes that the processes and outcomes of lean depend not only on the technology itself, but also the negotiation...

  10. Lower Lean Mass Measured by Dual-Energy X-ray Absorptiometry (DXA) is Not Associated with Increased Risk of Hip Fracture in Women: The Framingham Osteoporosis Study.

    Science.gov (United States)

    McLean, Robert R; Kiel, Douglas P; Berry, Sarah D; Broe, Kerry E; Zhang, Xiaochun; Cupples, L Adrienne; Hannan, Marian T

    2018-01-05

    Although muscle mass influences strength in older adults, it is unclear whether low lean mass measured by dual-energy X-ray absorptiometry (DXA) is an independent risk factor for hip fracture. Our objective was to determine the association between DXA lean mass and incident hip fracture risk among 1978 women aged 50 years and older participating in the Framingham Study Original and Offspring cohorts. Leg and total body lean mass (kg) were assessed from whole-body DXA scans collected in 1992-2001. Hip fracture follow-up extended from DXA assessment to the occurrence of fracture, death, drop-out, or end of follow-up in 2007. Cox proportional hazards regression was used to calculate hazard ratios (HR) and 95% confidence intervals (CI) estimating the relative risk of hip fracture associated with a 1-kg increase in baseline lean mass. Mean age was 66 years (range 50-93). Over a median of 8 years of follow-up, 99 hip fractures occurred. In models adjusted for age, height, study cohort, and percent total body fat, neither leg (HR 1.11; 95% CI 0.94, 1.31) nor total body (HR 1.06; 95% CI 0.99, 1.13) lean mass were associated with hip fracture. After further adjustment for femoral neck bone mineral density, leg lean mass results were similar (HR 1.10; 95% CI 0.93, 1.30). In contrast, 1 kg greater total body lean mass was associated with 9% higher hip fracture risk (HR 1.09; 95% CI 1.02, 1.18). Our findings suggest that in women, lower lean mass measured by DXA is not associated with increased risk of hip fracture.

  11. Lean Management

    OpenAIRE

    Picot, Arnold

    1994-01-01

    In this article the possibility of increase of competitiveness of the domestic enterprises by means of Lean management system is considered, and also the analysis of introduction of the mentioned system at the Russian enterprises is carried out. Besides, the key conditions necessary for successful introduction of system are presented. Lean management is a world-spread way of solving the problems, aimed at making the company competitive; it is the organized activity of staff of the company, fo...

  12. Does the brake response time of the right leg change after left total knee arthroplasty? A prospective study.

    Science.gov (United States)

    Marques, Carlos J; Barreiros, João; Cabri, Jan; Carita, Ana I; Friesecke, Christian; Loehr, Jochen F

    2008-08-01

    Patients undergoing total knee arthroplasty often ask when they can safely resume car driving. There is little evidence available on which physicians can rely when advising patients on this issue. In a prospective study we assessed the brake response time of 24 patients admitted to the clinic for left total knee arthroplasty preoperatively and then 10 days after surgery. On each measurement day the patients performed two tasks, a simple and a complex brake response time task in a car simulator. Ten days after left TKA the brake response time for the simple task had decreased by 3.6% (p=0.24), the reaction time by 3.1% (p=0.34) and the movement time by 6.6% (p=0.07). However, the performance improvement was not statistically significant. Task complexity increased brake response time at both time points. A 5.8% increase was significant (p=0.01) at 10 days after surgery. Based on our results, we suggest that patients who have undergone left total knee arthroplasty may resume car driving 10 days after surgery as long as they drive a car with automatic transmission.

  13. Migration of a Broken Steinman Pin into the Posterior Compartment of the Leg 12 Years after Total Hip Arthroplasty

    Directory of Open Access Journals (Sweden)

    Ali Birjandi Nejad

    2013-09-01

    Full Text Available This report is on a migration of a Steinman pin into the posterior com Department of the calf. It was used to fix a greater trochanteric osteotomy in a total hip arthroplasty. The puzzling note is how this metal piece passed through the anterolateral compartment of the thigh to the posterior compartment of the calf. Accord ing to our literature review, migration of fixation pins through the knee joint is an extremely rare occurrence and could be missed by an inattentive physician.  

  14. Performance Improvement through Implementation of Lean Maintenance

    OpenAIRE

    S. Kolanjiappan; Dr. K. Maran

    2011-01-01

    Lean Maintenance is a relatively new term, invented in the last decade of the twentieth century, but the principles are well established in Total Productive Maintenance (TPM). Lean Maintenance—taking its lead from Lean Manufacturing—applies some new techniques to TPM concepts to render a more structured implementation path. Tracing its roots back to Henry Ford with modern refinements born in Japanese manufacturing, specifically the Toyota Production System (TPS). Lean seeks to eliminate a...

  15. Lean healthcare.

    Science.gov (United States)

    Weinstock, Donna

    2008-01-01

    As healthcare organizations look for new and improved ways to reduce costs and still offer quality healthcare, many are turning to the Toyota Production System of doing business. Rather than focusing on cutting personnel and assets, "lean healthcare" looks to improve patient satisfaction through improved actions and processes.

  16. Cross-sex hormone therapy in transgender persons affects total body weight, body fat and lean body mass: a meta-analysis.

    Science.gov (United States)

    Klaver, M; Dekker, M J H J; de Mutsert, R; Twisk, J W R; den Heijer, M

    2017-06-01

    Weight gain and body fat increase the risk of cardiometabolic disease. Cross-sex hormone therapy in transgender persons leads to changes in body weight and body composition, but it is unclear to what extent. We performed a meta-analysis to investigate the changes in body weight, body fat and lean body mass during cross-sex hormone therapy in transgender persons. We searched the PubMed database for eligible studies until November 2015. Ten studies reporting changes in body weight, body fat or lean mass in hormone naive transgender persons were included, examining 171 male-to-female and 354 female-to-male transgender people. Pooled effect estimates in the male-to-female group were +1.8 kg (95% CI: 0.2;3.4) for body weight, +3.0 kg (2.0;3.9) for body fat and -2.4 kg (-2.8; -2.1) for lean body mass. In the female-to-male group, body weight changed with +1.7 kg (0.7;2.7), body fat with -2.6 kg (-3.9; -1.4) and lean body mass with +3.9 kg (3.2;4.5). Cross-sex hormone therapy increases body weight in both sexes. In the male-to-female group, a gain in body fat and a decline in lean body mass are observed, while the opposite effects are seen in the female-to-male group. Possibly, these changes increase the risk of cardiometabolic disease in the male-to-female group. © 2016 Blackwell Verlag GmbH.

  17. Leg pain

    Science.gov (United States)

    ... in the blood Medicines (such as diuretics and statins) Muscle fatigue or strain from overuse, too much exercise, or holding a muscle in the same position for a long time An injury can also cause leg pain from: A torn or overstretched muscle ( strain ) Hairline ...

  18. Broken Leg

    Science.gov (United States)

    ... the leg, which can result in a fracture. Stress fractures outside of sport situations are more common in people who have: ... shoes. Choose the appropriate shoe for your favorite sports or activities. And ... can prevent stress fractures. Rotate running with swimming or biking. If ...

  19. Increased Leg Bone Mineral Density and Content During the Initial Years of College Sport.

    Science.gov (United States)

    Scerpella, John J; Buehring, Bjoern; Hetzel, Scott J; Heiderscheit, Bryan C

    2018-04-01

    Scerpella, JJ, Buehring, B, Hetzel, SJ, and Heiderscheit, BC. Increased leg bone mineral density and content during the initial years of college sport. J Strength Cond Res 32(4): 1123-1130, 2018-Bone mineral density (BMD) and bone mineral content (BMC) data are useful parameters for evaluating how training practices promote bone health. We used dual-energy X-ray absorptiometry (DXA) to longitudinally assess sport-specific growth in leg and total body BMD/BMC over the initial 2 years of collegiate training. Eighty-five Division 1 collegiate basketball, hockey, and soccer athletes (50 males and 35 females; age 19.0 [0.8] years) underwent annual DXA scans. Leg and total body BMD/BMC were compared within and across two 1-year intervals (periods 1 and 2) using repeated-measures analysis of variance, adjusting for age, sex, race, and sport. Leg BMD, leg BMC, and total body BMC all increased over period 1 (0.05 g·cm [p = 0.001], 0.07 kg [p = 0.002], and 0.19 kg [p BMC (p BMC (p = 0.005). Leg lean mass increased more during period 2 than period 1 (p = 0.018). Sports participation was the only significant predictor of change in leg BMD. Significant increases in both leg BMD and BMC were demonstrated over both 2-year periods, with greater gains during period 1. These gains highlight the importance of attentive training procedures, capitalizing on attendant physical benefits of increased BMD/BMC. Additional research in young adults, evaluating bone mass acquisition, will optimize performance and decrease risk of bone stress injury among collegiate athletes.

  20. Lean years

    Energy Technology Data Exchange (ETDEWEB)

    Barnet, R J

    1982-01-01

    The author attempts to take stock of five critical systems of resources: Energy, mineral resources, food, water, and human abilities. All five systems have been integrated, to an ever-increasing extent in global control systems. These control systems determine how many people, in what parts of the world, will be faced with hunger, cold, or unemployment. The author tries to find out who is in charge of these control systems, how they have come into existence, and on what strategies they are based. In the final chapter, ''Policy of survival'', the author states that the secret of survival in the lean years to come is still in the dark. Man's most fundamental desire is to be human, i.e. to be in harmony with nature both psychologically and biologically. Politics should take account of this and provide us with the means for doing what is necessary.

  1. The maintenance management for lean organization

    OpenAIRE

    Daniel D. GEORGESCU

    2010-01-01

    The goal of lean maintenance approach is to maintain organization international competitiveness. In the spirit of continuously improvement, in the paper it is shown how by adjusting some Lean manufacturing specific techniques for Total Productive Maintenance (TPM) system, was born new maintenance system named Lean TPM. This is a systemic approach with three techniques, which don’t exclude specific techniques of TPM pillars, but complete them: the 7Ss as a critical first step in any improvemen...

  2. High-Intensity Jump Training Is Tolerated during 60 Days of Bed Rest and Is Very Effective in Preserving Leg Power and Lean Body Mass: An Overview of the Cologne RSL Study.

    Science.gov (United States)

    Kramer, Andreas; Kümmel, Jakob; Mulder, Edwin; Gollhofer, Albert; Frings-Meuthen, Petra; Gruber, Markus

    2017-01-01

    Space agencies are looking for effective and efficient countermeasures for the degrading effects of weightlessness on the human body. The aim of this study was to assess the effects of a novel jump exercise countermeasure during bed rest on vitals, body mass, body composition, and jump performance. 23 male participants (29±6 years, 181±6 cm, 77±7 kg) were confined to a bed rest facility for 90 days: a 15-day ambulatory measurement phase, a 60-day six-degree head-down-tilt bed rest phase (HDT), and a 15-day ambulatory recovery phase. Participants were randomly allocated to the jump training group (JUMP, n = 12) or the control group (CTRL, n = 11). A typical training session consisted of 4x10 countermovement jumps and 2x10 hops in a sledge jump system. The training group had to complete 5-6 sessions per week. Peak force for the reactive hops (3.6±0.4 kN) as well as jump height (35±4 cm) and peak power (3.1±0.2 kW) for the countermovement jumps could be maintained over the 60 days of HDT. Lean body mass decreased in CTRL but not in JUMP (-1.6±1.9 kg and 0±1.0 kg, respectively, interaction effect p = 0.03). Resting heart rate during recovery was significantly increased for CTRL but not for JUMP (interaction effect pjump training and maintained high peak forces and high power output during 60 days of bed rest. The countermeasure was effective in preserving lean body mass and partly preventing cardiac deconditioning with only several minutes of training per day.

  3. High-Intensity Jump Training Is Tolerated during 60 Days of Bed Rest and Is Very Effective in Preserving Leg Power and Lean Body Mass: An Overview of the Cologne RSL Study.

    Directory of Open Access Journals (Sweden)

    Andreas Kramer

    Full Text Available Space agencies are looking for effective and efficient countermeasures for the degrading effects of weightlessness on the human body. The aim of this study was to assess the effects of a novel jump exercise countermeasure during bed rest on vitals, body mass, body composition, and jump performance.23 male participants (29±6 years, 181±6 cm, 77±7 kg were confined to a bed rest facility for 90 days: a 15-day ambulatory measurement phase, a 60-day six-degree head-down-tilt bed rest phase (HDT, and a 15-day ambulatory recovery phase. Participants were randomly allocated to the jump training group (JUMP, n = 12 or the control group (CTRL, n = 11. A typical training session consisted of 4x10 countermovement jumps and 2x10 hops in a sledge jump system. The training group had to complete 5-6 sessions per week.Peak force for the reactive hops (3.6±0.4 kN as well as jump height (35±4 cm and peak power (3.1±0.2 kW for the countermovement jumps could be maintained over the 60 days of HDT. Lean body mass decreased in CTRL but not in JUMP (-1.6±1.9 kg and 0±1.0 kg, respectively, interaction effect p = 0.03. Resting heart rate during recovery was significantly increased for CTRL but not for JUMP (interaction effect p<0.001.Participants tolerated the near-daily high-intensity jump training and maintained high peak forces and high power output during 60 days of bed rest. The countermeasure was effective in preserving lean body mass and partly preventing cardiac deconditioning with only several minutes of training per day.

  4. Perioperative Testosterone Supplementation Increases Lean Mass in Healthy Men Undergoing Anterior Cruciate Ligament Reconstruction: A Randomized Controlled Trial.

    Science.gov (United States)

    Wu, Brian; Lorezanza, Dan; Badash, Ido; Berger, Max; Lane, Christianne; Sum, Jonathan C; Hatch, George F; Schroeder, E Todd

    2017-08-01

    Rehabilitation after repair of the anterior cruciate ligament (ACL) is complicated by the loss of leg muscle mass and strength. Prior studies have shown that preoperative rehabilitation may improve muscle strength and postoperative outcomes. Testosterone supplementation may likewise counteract this muscle loss and potentially improve clinical outcomes. The purpose was to investigate the effect of perioperative testosterone administration on lean mass after ACL reconstruction in men and to examine the effects of testosterone on leg strength and clinical outcome scores. It was hypothesized that testosterone would increase lean mass and leg strength and improve clinical outcome scores relative to placebo. Randomized controlled trial; Level of evidence, 1. Male patients (N = 13) scheduled for ACL reconstruction were randomized into 2 groups: testosterone and placebo. Participants in the testosterone group received 200 mg of intramuscular testosterone weekly for 8 weeks beginning 2 weeks before surgery. Participants in the placebo group received saline following the same schedule. Both groups participated in a standard rehabilitation protocol. The primary outcome was the change in total lean body mass at 6 and 12 weeks. Secondary outcomes were extensor muscle strength, Tegner activity score, and Knee injury and Osteoarthritis Outcome Score. There was an increase in lean mass of a mean 2.7 ± 1.7 kg at 6 weeks postoperatively in the testosterone group compared with a decrease of a mean 0.1 ± 1.5 kg in the placebo group ( P = .01). Extensor muscle strength of the uninjured leg also increased more from baseline in the testosterone group (+20.8 ± 25.6 Nm) compared with the placebo group (-21.4 ± 36.7 Nm) at 12 weeks ( P = .04). There were no significant between-group differences in injured leg strength or clinical outcome scores. There were no negative side effects of testosterone noted. Perioperative testosterone supplementation increased lean mass 6 weeks after ACL

  5. The maintenance management for lean organization

    Directory of Open Access Journals (Sweden)

    Daniel D. GEORGESCU

    2010-12-01

    Full Text Available The goal of lean maintenance approach is to maintain organization international competitiveness. In the spirit of continuously improvement, in the paper it is shown how by adjusting some Lean manufacturing specific techniques for Total Productive Maintenance (TPM system, was born new maintenance system named Lean TPM. This is a systemic approach with three techniques, which don’t exclude specific techniques of TPM pillars, but complete them: the 7Ss as a critical first step in any improvement program; instantaneous maintenance; improvement setup operations. In the spirit of Lean principle, Lean TPM adjusts overall equipment effectiveness concept for all supply-chain from supplier to customer. Maintaining equipment in its optimal state and continually improving its productivity is the whole strategy behind Lean TPM.

  6. Lean spare parts delivery chain

    OpenAIRE

    Sjöstrand, Niklas; Larsson, Mona-Liza

    2015-01-01

    AbstractWhen a product has been sold to a customer a new market arises for the company to earn profit from and to differentiate itself within. According to Bartwal, et al. (2010) the after sales market generally does not provide great revenues but good profits of the total revenue. In order to gain competiveness and live up to customer’s expectations a company needs to be efficient (Atkinson, 2004). He continuous that this can be accomplished if companies implement Lean. Lean is different too...

  7. Internal lean practitioner's challenges in lean principles ...

    African Journals Online (AJOL)

    The approach to this paper is to answer the questions such as “how does internal management commitment impact the Lean principles?”, “how does Supply Chain Management practices impact the lean principles?”, “can Supply Chain Management practices be embedded with internal management commitment?

  8. Implementation of lean leadership

    Directory of Open Access Journals (Sweden)

    Trenkner Małgorzata

    2016-12-01

    Full Text Available The Toyota case proves that lean leadership is of critical importance for the successful implementation and permanent functioning of Lean Production System. There is no ready formula for developing Toyota style lean leadership. However, one may gain inspiration from its experience.

  9. Lean information management

    NARCIS (Netherlands)

    Hammer, D.K.

    1997-01-01

    The concept of a Lean Enterprise has proven to be extremely valuable for making companies fit for today's competitive business environment. Lean Information Management denotes the type of information management that is appropriate for such all organization. According to the paradigm of a Lean

  10. THE LEAN AND SIX SIGMA SINERGY

    Directory of Open Access Journals (Sweden)

    Mirko Sokovic

    2008-12-01

    Full Text Available Many organizations, dealing with continuous improvement methods, have realized that Lean and Six Sigma methodologies complement each other. Lean manufacturing focuses on the remova l of waste so that all processes in the total system add value from the customers' perspectives. The main emphasis of Six Sigma is the application of statistical tools in a disciplined manner, which requires data-driven decision-making. The integration of Lean and Six Sigma provides a synergetic effect, a rapid process improvement strategy for attaining organizational goals. When separated, Lean manufacturing cannot bring a process under statistical control, and Six Sigma cannot dramatically improve cycle time or reduce invested capital. Together, synergistic qualities are created to maximize the potential for a process improvement. The paper deals with Lean and Six Sigma principles and approaches used in modern manufacturing for process improvements, and bring forward benefits that are gained when these two methodologies are integrated.

  11. Researching Lean: Methodological implications of loose definitions

    DEFF Research Database (Denmark)

    Brännmark, Mikael; Langstrand, Jostein; Johansson, Stina

    2012-01-01

    practices seem to overlap with other popular management concepts, such as High Performance Work Systems, World Class Manufacturing and Total Quality Management. This confusion, combined with different methodological and theoretical traditions, has led to much debate and contradictory conclusions regarding...... Lean. The purpose of the paper is to illustrate some key methodological issues that need to be considered in future Lean research to allow increased understanding of Lean effects for different stakeholders, primarily meaning the customer, employer and employees. Design/methodology/approach – The paper...... on the case studies, we suggest that future investigations describe the Lean interventions in more detail. General descriptions or analogies, e.g. ‘learning organizations’, presumably increase the present confusion regarding Lean impact on different stakeholders. The case studies also illustrate...

  12. Relationship between Leg Mass, Leg Composition and Foot Velocity on Kicking Accuracy in Australian Football.

    Science.gov (United States)

    Hart, Nicolas H; Nimphius, Sophia; Spiteri, Tania; Cochrane, Jodie L; Newton, Robert U

    2016-06-01

    Kicking a ball accurately over a desired distance to an intended target is arguably the most important skill to acquire in Australian Football. Therefore, understanding the potential mechanisms which underpin kicking accuracy is warranted. The aim of this study was to examine the relationship between leg mass, leg composition and foot velocity on kicking accuracy in Australian Football. Thirty-one Australian Footballers (n = 31; age: 22.1 ± 2.8 years; height: 1.81 ± 0.07 m; weight: 85.1 ± 13.0 kg; BMI: 25.9 ± 3.2) each performed ten drop punt kicks over twenty metres to a player target. Athletes were separated into accurate (n = 15) and inaccurate (n = 16) kicking groups. Leg mass characteristics were assessed using whole body DXA scans. Foot velocity was determined using a ten-camera optoelectronic, three-dimensional motion capture system. Interactions between leg mass and foot velocity evident within accurate kickers only (r = -0.670 to -0.701). Relative lean mass was positively correlated with kicking accuracy (r = 0.631), while no relationship between foot velocity and kicking accuracy was evident in isolation (r = -0.047 to -0.083). Given the evident importance of lean mass, and its interaction with foot velocity for accurate kickers; future research should explore speed-accuracy, impulse-variability, limb co-ordination and foot-ball interaction constructs in kicking using controlled with-in subject studies to examine the effects of resistance training and skill acquisition programs on the development of kicking accuracy. Key pointsAccurate kickers expressed a very strong inverse relationship between leg mass and foot velocity. Inaccurate kickers were unable to replicate this, with greater volatility in their performance, indicating an ability of accurate kickers to mediate foot velocity to compensate for leg mass in order to deliver the ball over the required distance.Accurate kickers exhibited larger quantities of relative lean mass and lower quantities

  13. Surgery-induced changes and early recovery of hip-muscle strength, leg-press power, and functional performance after fast-track total hip arthroplasty: a prospective cohort study.

    Directory of Open Access Journals (Sweden)

    Bente Holm

    Full Text Available By measuring very early changes in muscle strength and functional performance after fast-track total hip arthroplasty (THA, post-operative rehabilitation, introduced soon after surgery, can be designed to specifically target identified deficits.Firstly, to quantify changes (compared to pre-operative values in hip muscle strength, leg-press power, and functional performance in the first week after THA, and secondly, to explore relationships between the muscle strength changes, and changes in hip pain, systemic inflammation, and thigh swelling.Prospective, cohort study.Convenience sample of patients receiving a THA at Copenhagen University Hospital, Hvidovre, Denmark, between March and December 2011.Thirty-five patients (65.9 ± 7.2 years undergoing THA.Hip muscle strength, leg-press power, performance-based function, and self-reported disability were determined prior to, and 2 and 8 days after, THA (Day 2 and 8, respectively. Hip pain, thigh swelling, and C-Reactive Protein were also determined.Five patients were lost to follow-up. Hip muscle strength and leg press power were substantially reduced at Day 2 (range of reductions: 41-58%, P<0.001, but less pronounced at Day 8 (range of reductions: 23-31%, P<0.017. Self-reported symptoms and function (HOOS: Pain, Symptoms, and ADL improved at Day 8 (P<0.014. Changes in hip pain, C-Reactive Protein, and thigh swelling were not related to the muscle strength and power losses.Hip muscle strength and leg-press power decreased substantially in the first week after THA - especially at Day 2 - with some recovery at Day 8. The muscle strength loss and power loss were not related to changes in hip pain, systemic inflammation, or thigh swelling. In contrast, self-reported symptoms and function improved. These data on surgery-induced changes in muscle strength may help design impairment-directed, post-operative rehabilitation to be introduced soon after surgery.ClinicalTrials.gov NCT01246674.

  14. LEAN dig ikke tilbage

    DEFF Research Database (Denmark)

    Weirsøe, Mathilde

    2011-01-01

    Fit, slankere, hurtigst. Lean-konceptet ruller ind over de offentlige institutioner, hvor det skal trimme og effektivisere arbejdsprocesser. Men hvor er den maksimale grænse for effektivitet? Er der et ’tipping point’, hvor Lean ikke længere motiverer, men snarere udmatter......Fit, slankere, hurtigst. Lean-konceptet ruller ind over de offentlige institutioner, hvor det skal trimme og effektivisere arbejdsprocesser. Men hvor er den maksimale grænse for effektivitet? Er der et ’tipping point’, hvor Lean ikke længere motiverer, men snarere udmatter...

  15. Surgery-induced changes and early recovery of hip-muscle strength, leg-press power, and functional performance after fast-track total hip arthroplasty

    DEFF Research Database (Denmark)

    Holm, Bente; Thorborg, Kristian; Husted, Henrik

    2013-01-01

    By measuring very early changes in muscle strength and functional performance after fast-track total hip arthroplasty (THA), post-operative rehabilitation, introduced soon after surgery, can be designed to specifically target identified deficits.......By measuring very early changes in muscle strength and functional performance after fast-track total hip arthroplasty (THA), post-operative rehabilitation, introduced soon after surgery, can be designed to specifically target identified deficits....

  16. Leg Injuries and Disorders

    Science.gov (United States)

    ... are important for motion and standing. Playing sports, running, falling, or having an accident can damage your legs. Common leg injuries include sprains and strains, joint dislocations, and fractures. ...

  17. Lean Six Sigma implementation and organizational culture.

    Science.gov (United States)

    Knapp, Susan

    2015-01-01

    The purpose of this paper is to examine the relationship between four organizational cultural types defined by the Competing Values Framework and three Lean Six Sigma implementation components - management involvement, use of Lean Six Sigma methods and Lean Six Sigma infrastructure. The study involved surveying 446 human resource and quality managers from 223 hospitals located in Maine, New Hampshire, Vermont, Massachusetts and Rhode Island using the Organizational Culture Assessment Instrument. Findings - In total, 104 completed responses were received and analyzed using multivariate analysis of variance. Follow-up analysis of variances showed management support was significant, F(3, 100)=4.89, p cultures having significant interactions with management support. The relationship between organizational culture and Lean Six Sigma in hospitals provides information on how specific cultural characteristics impact the Lean Six Sigma initiative key components. This information assists hospital staff who are considering implementing quality initiatives by providing an understanding of what cultural values correspond to effective Lean Six Sigma implementation. Managers understanding the quality initiative cultural underpinnings, are attentive to the culture-shared values and norm's influence can utilize strategies to better implement Lean Six Sigma.

  18. Lean Production : Werkzeuge zur Realisierung

    OpenAIRE

    Binner, Hartmut F.

    2008-01-01

    INHALT: l. Einleitung und Standortbestimmung 2. Japanische Wertvorstellungen 3. Inhalte der Lean Production 4. Fertigungssegmentierung 5. Informationsmanagement mit CIM- und Logistik-Komponenten 6. Logistikgerechte Strukturen der Lean Production 7. Realisierung der Lean Production 8. Zusammenfassung

  19. Lean and Information Technology Toolkit

    Science.gov (United States)

    The Lean and Information Technology Toolkit is a how-to guide which provides resources to environmental agencies to help them use Lean Startup, Lean process improvement, and Agile tools to streamline and automate processes.

  20. Moving on - beyond lean thinking

    OpenAIRE

    Koskela, Lauri

    2004-01-01

    Lean Thinking is currently often positioned as the underlying theory of lean production among practitioners and academics, although its originators, Womack and Jones, seem not to have presented it as a theory. This paper endeavors to analyze whether Lean Thinking can be viewed as a theory of lean production. For this purpose, a critical assessment of Lean Thinking is carried out. Lean Thinking is argued to lack an adequate conceptualization of production, which has led to imprecise concepts, ...

  1. lean-ISD.

    Science.gov (United States)

    Wallace, Guy W.

    2001-01-01

    Explains lean instructional systems design/development (ISD) as it relates to curriculum architecture design, based on Japan's lean production system. Discusses performance-based systems; ISD models; processes for organizational training and development; curriculum architecture to support job performance; and modular curriculum development. (LRW)

  2. Healthy Lean Through HRD

    DEFF Research Database (Denmark)

    Jørgensen, Frances

    2008-01-01

    The paper reports on findings from the initial, exploratory phase of a longitudinal research study aimed at developing a framework for implementing lean while ensuring employee well-being. Data from observations and in-depth dialogues with persons involved in lean implementation, along...

  3. LEAN and energy efficiency; Lean og energieffektivisering

    Energy Technology Data Exchange (ETDEWEB)

    Jespersen, Per T; Vesterager Christensen, D; Andersen, Hans [Teknologisk Institut, Energi og Klima, Taastrup (Denmark); Dam Wied, M; Dam, M [NRGi Raadgivning, Aarhus (Denmark); Thorndahl, M [Horsens Kommune, Horsens (Denmark); Weldingh, P [Lokal Energi, Viby J. (Denmark); Maagoee, P; Kristensen, Kenneth T [Viegand og Maagoee, Copenhagen (Denmark); Kirketerp Friis, A [Novozymes, Bagsvaerd (Denmark)

    2010-03-15

    By means of theoretical reports and three specific cases, the project showed how Lean principles can improve energy consulting efficiency, thus making it easier for end-users and energy consultants to record and document energy savings achieved. The three cases documented various types of extra benefits of integrating energy efficiency improvement in Lean processes. As a result of process optimisation, one manufacturing company successfully reduced both staffing and energy consumption, thus making production in Denmark competitive with out-sourced production in Asia. (LN)

  4. Foot, leg, and ankle swelling

    Science.gov (United States)

    Swelling of the ankles - feet - legs; Ankle swelling; Foot swelling; Leg swelling; Edema - peripheral; Peripheral edema ... Foot, leg, and ankle swelling is common when the person also: Is overweight Has a blood clot in the leg Is older Has ...

  5. Large meta-analysis of genome-wide association studies identifies five loci for lean body mass

    NARCIS (Netherlands)

    Zillikens, M.C.; Demissie, Serkalem; Hsu, Yi Hsiang; Yerges-Armstrong, Laura M.; Chou, Wen Chi; Stolk, Lisette; Livshits, Gregory; Broer, Linda; Johnson, Toby; Koller, Daniel L.; Kutalik, Zoltán; Luan, J.A.; Malkin, Ida; Ried, Janina S.; Smith, Albert V.; Thorleifsson, Gudmar; Vandenput, Liesbeth; Hua Zhao, Jing; Zhang, Weihua; Aghdassi, Ali; Åkesson, Kristina; Amin, Najaf; Baier, Leslie J.; Barroso, Inês; Bennett, David A.; Bertram, Lars; Biffar, Rainer; Bochud, Murielle; Boehnke, Michael; Borecki, Ingrid B.; Buchman, Aron S.; Byberg, Liisa; Campbell, Harry; Campos Obanda, Natalia; Cauley, Jane A.; Cawthon, Peggy M.; Cederberg, Henna; Chen, Zhao; Cho, Nam H.; Jin Choi, Hyung; Claussnitzer, Melina; Collins, Francis; Cummings, Steven R.; Jager, De Philip L.; Demuth, Ilja; Dhonukshe-Rutten, Rosalie A.M.; DIatchenko, Luda; Eiriksdottir, Gudny; Enneman, Anke W.; Erdos, Mike; Eriksson, Johan G.; Eriksson, Joel; Estrada, Karol; Evans, Daniel S.; Feitosa, Mary F.; Fu, Mao; Garcia, Melissa; Gieger, Christian; Girke, Thomas; Glazer, Nicole L.; Grallert, Harald; Grewal, Jagvir; Han, Bok Ghee; Hanson, Robert L.; Hayward, Caroline; Hofman, Albert; Hoffman, Eric P.; Homuth, Georg; Hsueh, Wen Chi; Hubal, Monica J.; Hubbard, Alan; Huffman, Kim M.; Husted, Lise B.; Illig, Thomas; Ingelsson, Erik; Ittermann, Till; Jansson, John Olov; Jordan, Joanne M.; Jula, Antti; Karlsson, Magnus; Khaw, Kay Tee; Kilpelaïnen, Tuomas O.; Klopp, Norman; Kloth, Jacqueline S.L.; Koistinen, Heikki A.; Kraus, William E.; Kritchevsky, Stephen; Kuulasmaa, Teemu; Kuusisto, Johanna; Laakso, Markku; Lahti, Jari; Lang, Thomas; Langdahl, Bente L.; Launer, Lenore J.; Lee, Jong Young; Lerch, Markus M.; Lewis, Joshua R.; Lind, Lars; Lindgren, Cecilia M.; Liu, Yongmei; Liu, Tian; Liu, Youfang; Ljunggren, Östen; Lorentzon, Mattias; Luben, Robert N.; Maixner, William; McGuigan, Fiona E.; Medina-Gomez, Carolina; Meitinger, Thomas; Melhus, Håkan; Mellström, Dan; Melov, Simon; Michaëlsson, Karl; Mitchell, Braxton D.; Morris, Andrew P.; Mosekilde, Leif; Newman, Anne; Nielson, Carrie M.; O'Connell, Jeffrey R.; Oostra, Ben A.; Orwoll, Eric S.; Palotie, Aarno; Parker, Stephan; Peacock, Munro; Perola, Markus; Peters, Annette; Polasek, Ozren; Prince, Richard L.; Raïkkönen, Katri; Ralston, Stuart H.; Ripatti, Samuli; Robbins, John A.; Rotter, Jerome I.; Rudan, Igor; Salomaa, Veikko; Satterfield, Suzanne; Schadt, Eric E.; Schipf, Sabine; Scott, Laura; Sehmi, Joban; Shen, Jian; Soo Shin, Chan; Sigurdsson, Gunnar; Smith, Shad; Soranzo, Nicole; Stančáková, Alena; Steinhagen-Thiessen, Elisabeth; Streeten, Elizabeth A.; Styrkarsdottir, Unnur; Swart, Karin M.A.; Tan, Sian Tsung; Tarnopolsky, Mark A.; Thompson, Patricia; Thomson, Cynthia A.; Thorsteinsdottir, Unnur; Tikkanen, Emmi; Tranah, Gregory J.; Tuomilehto, Jaakko; Schoor, van Natasja M.; Verma, Arjun; Vollenweider, Peter; Völzke, Henry; Wactawski-Wende, Jean; Walker, Mark; Weedon, Michael N.; Welch, Ryan; Wichman, H.E.; Widen, Elisabeth; Williams, Frances M.K.; Wilson, James F.; Wright, Nicole C.; Xie, Weijia; Yu, Lei; Zhou, Yanhua; Chambers, John C.; Döring, Angela; Duijn, Van Cornelia M.; Econs, Michael J.; Gudnason, Vilmundur; Kooner, Jaspal S.; Psaty, Bruce M.; Spector, Timothy D.; Stefansson, Kari; Rivadeneira, Fernando; Uitterlinden, André G.; Wareham, Nicholas J.; Ossowski, Vicky; Waterworth, Dawn M.; Loos, Ruth J.F.; Karasik, David; Harris, Tamara B.; Ohlsson, Claes; Kiel, Douglas P.

    2017-01-01

    Lean body mass, consisting mostly of skeletal muscle, is important for healthy aging. We performed a genome-wide association study for whole body (20 cohorts of European ancestry with n = 38,292) and appendicular (arms and legs) lean body mass (n = 28,330) measured using dual energy X-ray

  6. Diccionario Lean Manufacturing

    OpenAIRE

    Muñoz Ellner, Sarah María

    2016-01-01

    El Diccionario Bilingüe de Lean Manufacturing pretende ser un instrumento de apoyo a todo aquel que tenga la responsabilidad de planear, ejecutar o simplemente algún interés con las actividades de Lean Manufacturing, aportando así también conceptos claros tanto en castellano como en inglés, con el fin de entender de forma integral el alcance mismo que puede llegar a tener dicha filosofía, al igual que se proporcionara una serie de siglas y herramientas para la implementación del Lean Manufact...

  7. Implementing lean in Malaysian universities: Lean awareness level in an engineering faculty of a local university

    Science.gov (United States)

    Azim Khairi, M.; Rahman, Mohamed Abd

    2018-01-01

    Many academic articles were published in Malaysia promoting the goodness of lean in manufacturing and industrial sectors but less attention was apparently given to the possibility of obtaining the same universal benefits when applying lean in non-manufacturing sectors especially higher education. This study aims to determine the level of lean awareness among a local university’s community taking its Faculty of Engineering (FoE) as the case study. It also seeks to identify typical FoE’s staff perception on lean regarding its benefits and the obstacles in implementing it. A web-based survey using questionnaires was carried out for 215 respondents consisting of academic and administrative staff of the faculty. Statistical Package for the Social Science (SPSS) was used to analyze the survey data collected. A total of 13.95% of respondents returned the forms. Slightly more than half of those responded (56.7%) have encountered some of the lean terms with mean 1.43 and standard deviation 0.504. However, the large amount of standard deviation somewhat indicates that the real level of lean awareness of FoE as a group was low. In terms of lean benefits, reduction of waste was favored (93.3%) by the respondents with mean 0.93 and standard deviation 0.254. For obstacles in implementing lean, lack of knowledge was selected by most respondents (86.7%) to be the major factor with mean 0.87 and standard deviation 0.346. Through the analysis done, the study may conclude that level of lean awareness among the university‘s community was low thus may hinder implementation of lean concept.

  8. Lean og arbejdsmiljø

    DEFF Research Database (Denmark)

    Jensen, Kenneth

    Bogen tager udgangspunkt i en undersøgelse af 10 private og offentlige virksomheders erfaringer med lean. Undersøgelsen viser at der ikke findes entydige sammenhænge mellem lean og det psykosociale arbejdsmiljø. Bogen forholder sig til sammenhængen mellem lean og ledelse, lean og medarbejderens...... rolle, lean og lean og forandringsprocessen. Bogen kommer desuden med anbefalinger til hvorledes virksomheden kan gribe dialogen an for at opnå et godt lean forløb der inddrager hensynet til og effekterne af et godt psykosocialt arbejdsmiljø....

  9. Orchestrating Lean Implementation

    DEFF Research Database (Denmark)

    Riis, Jens Ove; Mikkelsen, Hans; Andersen, Jesper Rank

    2008-01-01

    The notion of Lean Manufacturing is not merely confined to a set of well defined techniques, but represents a broad approach to managing a company. Working with lean entails many aspects, such as production planning and control, production engineering, product development, supply chain......, and organizational issues. To become effective, many functional areas and departments must be involved. At the same time companies are embedded in a dynamic environment. The aim of the paper is to propose a comprehensive approach to better implementation of lean initiatives, based on two empirical studies. The paper...... will discuss how a concerted effort can be staged taking into account the interdependencies among individual improvement initiatives. The notion of orchestration will be introduced, and several means for orchestration will be presented. Critical behavioral issues for lean implementation will be discussed....

  10. Lean Government Methods Guide

    Science.gov (United States)

    This Guide focuses primarily on Lean production, which is an organizational improvement philosophy and set of methods that originated in manufacturing but has been expanded to government and service sectors.

  11. Lean Enterprise Value Phase

    National Research Council Canada - National Science Library

    Shields, John T

    2005-01-01

    ... using a philosophy called "lean." LAl's mission is to research, develop, and promulgate practices, tools, and knowledge that enable and accelerate the envisioned transformation of the greater US aerospace enterprise through people and processes...

  12. The lean service machine.

    Science.gov (United States)

    Swank, Cynthia Karen

    2003-10-01

    Jefferson Pilot Financial, a life insurance and annuities firm, like many U.S. service companies at the end of the 1990s was looking for new ways to grow. Its top managers recognized that JPF needed to differentiate itself in the eyes of its customers, the independent life-insurance advisers who sell and service policies. To establish itself as these advisers' preferred partner, it set out to reduce the turnaround time on policy applications, simplify the submission process, and reduce errors. JPF's managers looked to the "lean production" practices that U.S. manufacturers adopted in response to competition from Japanese companies. Lean production is built around the concept of continuous-flow processing--a departure from traditional production systems, in which large batches are processed at each step. JPF appointed a "lean team" to reengineer its New Business unit's operations, beginning with the creation of a "model cell"--a fully functioning microcosm of JPF's entire process. This approach allowed managers to experiment and smooth out the kinks while working toward an optimal design. The team applied lean-manufacturing practices, including placing linked processes near one another, balancing employees' workloads, posting performance results, and measuring performance and productivity from the customer's perspective. Customer-focused metrics helped erode the employees' "My work is all that matters" mind-set. The results were so impressive that JPF is rolling out similar systems across many of its operations. To convince employees of the value of lean production, the lean team introduced a simulation in which teams compete to build the best paper airplane based on invented customer specifications. This game drives home lean production's basic principles, establishing a foundation for deep and far-reaching changes in the production system.

  13. Peak bone mineral density, lean body mass and fractures

    NARCIS (Netherlands)

    Boot, Annemieke M.; de Ridder, Maria A. J.; van der Sluis, Inge M.; van Slobbe, Ingrid; Krenning, Eric P.; Keizer-Schrama, Sabine M. P. F. de Muinck

    Background: During childhood and adolescence, bone mass and lean body mass (LBM) increase till a plateau is reached. In this longitudinal and cross-sectional study, the age of reaching the plateau was evaluated for lumbar spine and total body bone mass measurements and lean body mass. The

  14. Lyden-af-Leg

    DEFF Research Database (Denmark)

    Toft, Herdis

    Præsentation af seniorforsker-projekt Lyden-af-Leg i et traderingsperspektiv og med indledende fokus på YouTube som traderings-platform.......Præsentation af seniorforsker-projekt Lyden-af-Leg i et traderingsperspektiv og med indledende fokus på YouTube som traderings-platform....

  15. EPA Lean Government Initiative: How to Replicate Lean Successes

    Science.gov (United States)

    This Lean Replication Primer describes how EPA Offices and Regions can identify and adapt successful practices from previous Lean projects to “replicate” their successes and generate further improvements.

  16. Using lean methodologies for economically and environmentally sustainable foundries

    Directory of Open Access Journals (Sweden)

    R. M. Torielli

    2011-02-01

    Full Text Available Lean manufacturing is often seen as a set of tools that reduce the total cost and improve the quality of manufactured products. The lean management philosophy is one which targets waste reduction in every facet of the manufacturing business; however, only recently have studies linked lean management philosophies with improving environmental sustainability. These studies suggest that lean manufacturing is more than a set of lean tools that can optimize manufacturing efficiencies; it is a process and mindset that needs to be integrated into daily manufacturing systems to achieve sustainability. The foundry industry, as well as manufacturing in general, has significant challenges in the current regulatory and political climate with developing an economically and environmentally sustainable business model. Lean manufacturing has proven itself as a model for both economic sustainability and environmental stewardship. Several recent studies have shown that both lean and green techniques and “zero-waste” policies also lead to reductions in overall cost. While these strategies have been examined for general manufacturing, they have not been investigated in detail for the foundry industry. This paper will review the current literature and describe how lean and green can provide a relevant framework for environmentally and economically sustainable foundries. Examples of lean and green technologies and techniques which can be applied to foundries in a global context will be described.

  17. Effects of sheep production systems on oxidative storage stability of lean lamb patties.

    Science.gov (United States)

    Rhee, Ki Soon; Lupton, C J; Ziprin, Y A; Rhee, K C

    2003-10-01

    Rambouillet lambs were assigned to three production systems varying in physical environment and diet: RF (a new, raised-floor feeding structure, with animals fed a pelleted mixture of 85% oat hay, 7.5% barley and 7.5% molasses); FL (a feedlot, with animals fed high-concentrate rations); and P (a pasture, with animals given access to the pasture and a high-concentrate supplement). Lengths of time on feed were adjusted to produce similar final shorn weights for each system. Ground meat patties were made with knife-separable lean from hind legs and aerobically refrigerated. Fat content of patties was not significantly different between RF and FL or P, while total unsaturated fatty acid percentage was slightly lower (P<0.05) for RF treatment. Patty color (redness) was most stable for RF. Lipid oxidation in raw patties also was lower (P<0.05) for RF than FL, but oxidation in cooked patties was greater for RF.

  18. Can lean save lives?

    Science.gov (United States)

    Fillingham, David

    2007-01-01

    The purpose of this paper is to show how over the last 18 months Bolton Hospitals NHS Trust have been exploring whether or not lean methodologies, often known as the Toyota Production System, can indeed be applied to healthcare. This paper is a viewpoint. One's early experience is that lean really can save lives. The Toyota Production System is an amazingly successful way of manufacturing cars. It cannot be simply translated unthinkingly into a hospital but lessons can be learned from it and the method can be adapted and developed so that it becomes owned by healthcare staff and focused towards the goal of improved patient care. Working in healthcare is a stressful and difficult thing. Everyone needs a touch of inspiration and encouragement. Applying lean to healthcare in Bolton seems to be achieving just that for those who work there.

  19. Rethinking Lean Service

    Science.gov (United States)

    Seddon, John; O'Donovan, Brendan; Zokaei, Keivan

    Ever since Levitt's influential Harvard Business Review article 'Production-Line Approach to Service' was published in 1972, it has been common for services to be treated like production lines in both the academic literature and more widely in management practice. The belief that achieving economies of scale will reduce unit costs is a common feature of management decision-making. As technological advancement has produced ever more sophisticated IT and telephony, it has become increasingly easier for firms to standardise and off-shore services. The development of the 'lean' literature has only helped to emphasise the same underlying management assumptions: by managing cost and workers' activity, organisational performance is expected to improve. This chapter argues that through misinterpretation of the core paradigm 'lean' has become subsumed into the 'business as usual' of conventional service management. As a result, 'lean' has become synonymous with 'process efficiency' and the opportunity for significant performance improvement - as exemplified by Toyota - has been missed.

  20. Lean Management Genesis

    Directory of Open Access Journals (Sweden)

    Parkes Aneta

    2015-12-01

    Full Text Available Lean Management is a philosophy and management concept, based on reduction of the waste and resources used in the process of producing goods and providing services. Lean Management genesis dates back to scientific management in America (for example concepts of H. Ford and F.W. Taylor and quality management, including development of TQM concept. Japanese Toyota Production System has been inspired by chosen elements of these concepts, and then it evolved towards global concept called Toyota Way (which connects production rules with values and work attitude.

  1. Improving Healthcare through Lean Management

    DEFF Research Database (Denmark)

    Nielsen, Anders Paarup; Edwards, Kasper

    2011-01-01

    The ideas and principles from lean management are now widely being adopted within the healthcare sector. The analysis in this paper shows that organizations within healthcare most often only implement a limited set of tools and methods from the lean tool-box. Departing from a theoretical analysis...... of the well-known and universal lean management principles in the context of the healthcare this paper will attempt to formulate and test four hypotheses about possible barriers to the successful implementation of lean management in healthcare. The first hypothesis states that lean management in healthcare....... The paper concludes by discussing the implications of hypothesis two, three, and four for the successful application of lean management within healthcare. Is it concluded that this requires a transformative and contingent approach to lean management where the universal principles of the lean philosophy...

  2. Lean in Air Permitting Guide

    Science.gov (United States)

    The Lean in Air Permitting Guide is designed to help air program managers at public agencies better understand the potential value and results that can be achieved by applying Lean improvement methods to air permitting processes.

  3. The Lean and Environment Toolkit

    Science.gov (United States)

    This Lean and Environment Toolkit assembles practical experience collected by the U.S. Environmental Protection Agency (EPA) and partner companies and organizations that have experience with coordinating Lean implementation and environmental management.

  4. Relationship between Leg Mass, Leg Composition and Foot Velocity on Kicking Accuracy in Australian Football

    Directory of Open Access Journals (Sweden)

    Nicolas H. Hart, Jodie L. Cochrane, Tania Spiteri, Sophia Nimphius, Robert U. Newton

    2016-06-01

    Full Text Available Kicking a ball accurately over a desired distance to an intended target is arguably the most important skill to acquire in Australian Football. Therefore, understanding the potential mechanisms which underpin kicking accuracy is warranted. The aim of this study was to examine the relationship between leg mass, leg composition and foot velocity on kicking accuracy in Australian Football. Thirty-one Australian Footballers (n = 31; age: 22.1 ± 2.8 years; height: 1.81 ± 0.07 m; weight: 85.1 ± 13.0 kg; BMI: 25.9 ± 3.2 each performed ten drop punt kicks over twenty metres to a player target. Athletes were separated into accurate (n = 15 and inaccurate (n = 16 kicking groups. Leg mass characteristics were assessed using whole body DXA scans. Foot velocity was determined using a ten-camera optoelectronic, three-dimensional motion capture system. Interactions between leg mass and foot velocity evident within accurate kickers only (r = -0.670 to -0.701. Relative lean mass was positively correlated with kicking accuracy (r = 0.631, while no relationship between foot velocity and kicking accuracy was evident in isolation (r = -0.047 to -0.083. Given the evident importance of lean mass, and its interaction with foot velocity for accurate kickers; future research should explore speed-accuracy, impulse-variability, limb co-ordination and foot-ball interaction constructs in kicking using controlled with-in subject studies to examine the effects of resistance training and skill acquisition programs on the development of kicking accuracy.

  5. Lean leadership: an ethnographic study

    NARCIS (Netherlands)

    Aij, K.H.; Visse, M.A.; Widdershoven, G.A.M.

    2015-01-01

    Purpose – The purpose of this study is to provide a critical analysis of contemporary Lean leadership in the context of a healthcare practice. The Lean leadership model supports professionals with a leading rolein implementing Lean.This article presents a case study focusing specifcally on

  6. Lean With a Human Face

    DEFF Research Database (Denmark)

    Hasle, Peter; Jensen, Per Langaa

    2008-01-01

    The consequences for quality of work of lean manufacturing is discussed in the international litterature, and several authors suggest increased work speed, stress, and muscoskeletal diseases as a consequence of lean. The Danish experience with lean has been studied through interviews with managers...

  7. RESTLESS LEGS SYNDROME

    Directory of Open Access Journals (Sweden)

    Dmitriy Valer'evich Artem'ev

    2009-01-01

    Full Text Available The paper describes the epidemiology, etiology, pathogenesis, clinical picture, diagnosis, differential diagnosis, and treatment of restless legs syndrome. Recommendations are given how to choose therapeutic modalities and drugs in relation to different factors.

  8. Design thinking & lean

    DEFF Research Database (Denmark)

    Bravos, Cynthia; Adler, Isabel K.

    2015-01-01

    This paper aims at presenting how a Brazilian innovation consultancy guided a collaborative development of a mobile solution using the Design Thinking approach (Vianna et al, 2012) and Lean principles (Ries, 2011). It will describe tools and methods used and how it was applied to requirement gath...

  9. Indian girls have higher bone mineral content per unit of lean body than boys through puberty.

    Science.gov (United States)

    Khadilkar, Anuradha V; Sanwalka, Neha; Mughal, M Zulf; Chiplonkar, Shashi; Khadilkar, Vaman

    2018-05-01

    Our aim is to describe changes in the muscle-bone unit assessed as a ratio of bone mineral content (BMC) to lean body mass (LBM) through puberty at total body and various skeletal sites in Indian boys and girls. A cross-sectional study was conducted (888 children, 480 boys, aged 5-17 years) in Pune, India. Pubertal staging was assessed. BMC, LBM and fat percentage at the arms, legs, android, gynoid and total body (less the head) were assessed by dual energy X-ray absorptiometry. The amount of BMC per unit LBM (BMC/LBM) was computed. Changes in mean BMC/LBM at 5 Tanner (pubertal) stages after adjustment for age and fat percentage were calculated. In boys, adjusted BMC/LBM was significantly higher with successive Tanner stages [legs (TS-II vs TS-I), android (TS-III vs TS-II, TS-IV vs TS-III) and gynoid region (TS-III vs TS-II and TS-II vs TS-I) (p LBM was significantly higher with successive Tanner stages at total body, legs and gynoid (TS-III vs TS-II; TS-II vs TS-I; TS-V vs TS-IV), arms (TS-I to TS-V) and android regions (TS-V vs TS-IV) (p LBM than girls at earlier Tanner stages (TS-I to TS-III), whereas girls had significantly higher adjusted BMC/LBM than boys at later Tanner stages (TS-IV, TS-V) (p LBM with successive pubertal stages. Girls had higher BMC/LBM than boys which may possibly act as a reservoir for later demands of pregnancy and lactation.

  10. Android subcutaneous adipose tissue topography in lean and obese women suffering from PCOS: comparison with type 2 diabetic women.

    Science.gov (United States)

    Horejsi, R; Möller, R; Rackl, S; Giuliani, A; Freytag, U; Crailsheim, K; Sudi, K; Tafeit, E

    2004-07-01

    The new optical device, the lipometer, enables the noninvasive, quick, safe, and precise determination of the thickness of subcutaneous adipose tissue (SAT) layers at any given site of the human body. Fifteen anatomically well-defined body sites from neck to calf describe a SAT topography (SAT-Top) like an individual "fingerprint" of a subject. This SAT-Top was examined in 16 women with polycystic ovary syndrome (PCOS) and compared to the body fat distribution of 87 age-matched healthy controls and 20 type-2 diabetic women. SAT-Top differences of these three groups were described and, to render the possibility of visual comparison, the 15-dimensional body fat information was condensed to a two-dimensional factor plot by factor analysis. All PCOS patients had an android body fat distribution with significantly thinner SAT layers on the legs as compared to healthy controls. Moreover, a hierarchical cluster analysis resulted in two distinctly different groups of PCOS women, a lean (PCOSL) and an obese (PCOSO) cluster: compared to healthy women, lean PCOS patients had significantly lower total SAT development, even though height, weight, and body mass index did not deviate significantly. Especially on the legs, their SAT layers were significantly lowered, indicating a more "apple-like" fat distribution type. Obese PCOS women showed a SAT-Top pattern very similar to that of women with type-2 diabetes, although the mean age difference between these groups was more than 30 years. Compared to healthy controls, the SAT-Top of these obese PCOS patients was strongly shifted into the android direction, appearing as "super-apples" with a significantly increased upper trunk obesity to 237.8% and a significantly decreased leg SAT development to 79.8%. Copyright 2004 Wiley-Liss, Inc.

  11. Lean start-up

    DEFF Research Database (Denmark)

    Rasmussen, Erik Stavnsager; Tanev, Stoyan

    2016-01-01

    The risk of launching new products and starting new firms is known to be extremely high. The Lean Start-up approach is a way of reducing these risks and enhancing the chances for success by validating the products and services in the market with customers before launching it in full scale. The ma...... and the final business model. In other words: The start-up must first nail the problem together with the customers, then develop the solution and test, and then in the end scale it to a full-grown business model.......The risk of launching new products and starting new firms is known to be extremely high. The Lean Start-up approach is a way of reducing these risks and enhancing the chances for success by validating the products and services in the market with customers before launching it in full scale. The main...

  12. Green and lean management

    CERN Document Server

    Davim, J

    2017-01-01

    This book focusses on the challenges and changes organizational management faces in an era when the need to develop environmentally aware processes meets high levels of competition. It covers the synergetic effects, how re-use, recycling, waste reduction, and other sustainable production strategies can add value, low costs and time of production. Sustainable business behavior is not only an environmental perspective on management, but more and more contains an organizational perspective. Taking into account these issues, green and lean management appears as the way managers can drive their employees to continuously improve the management processes that add value to the organization and costumers. This book provides information on principles, strategies, models, and applications of green and lean management, and at the same time communicates the latest research activity relating to this scientific field world-wide.

  13. Lean Leadership - Organizational Buy - Ins

    Directory of Open Access Journals (Sweden)

    Dr. Revathi Iyer

    2017-05-01

    Full Text Available Great organizations have become leaders due to their leadership and sustainable initiatives. One such initiative is adoption of lean leadership to align core strategies with all functional areas of business. Leadership is likely to take place in a lean environment because improvements that happen are continual and can only be supported by leadership which understands this important aspect. The topic of lean leadership organizational buy ins speaks on how lean leadership could affect organizations that adopt lean and other quality tools. Purpose of the study This study has been undertaken to understand When leadership more of is likely to take place in lean . Leadership plays a very important role while adopting lean processes and how lean leadership can address the process problem. Application of leadership lenses to lean processes needs great foresight thought and creativity. It has been also observed that lean management and lean processes can happen only if leadership is able to effectively communicate the thought of continual improvement to bring in a lean organization and a future state of processes where everything of a firm process and procedure is continually improving and the best strategies to manage this change becomes a philosophy. Lean leadership is associated with such a change. This enables leadership vision to be clear as it paves the way for current state and is clear to everyone. It is this leadership vision which enables employees to think and act in a way that perpetrates continual improvement. Hence leadership buys ins for lean are very necessary. The purpose of the study is also to understand how leaders can not only use cost reduction but also reducing time-to-market improving service quality and reducing risk exposure by adopting lean methods . it has been also seen that there is overall productivity and efficiency in organizations holistically when leadership endorses lean methodology. Radnor Z. and Bucci G. 2007

  14. Approach to leg edema

    Directory of Open Access Journals (Sweden)

    Fulvio Pomero

    2017-09-01

    Full Text Available Edema is defined as a palpable swelling caused by an increase in interstitial fluid volume. Leg edema is a common problem with a wide range of possible causes and is the result of an imbalance in the filtration system between the capillary and interstitial spaces. Major causes of edema include venous obstruction, increased capillary permeability and increased plasma volume secondary to sodium and water retention. In both hospital and general practice, the patient with a swollen leg presents a common dilemma in diagnosis and treatment. The cause may be trivial or life-threatening and it is often difficult to determine the clinical pathway. The diagnosis can be narrowed by categorizing the edema according to its duration, distribution (unilateral or bilateral and accompanying symptoms. This work provides clinically oriented recommendations for the management of leg edema in adults.

  15. Leg som ustyrlig deltagelseskultur

    DEFF Research Database (Denmark)

    Toft, Herdis

    2017-01-01

    - og spilteoretikere Johan Huizinga og Roger Caillois. Deres teorier og begrebsdannelser har været brugt til at påpege leg dels som et æstetisk baseret betydningssystem, dels som et affektivt og stemningsbaseret oplevelsessystem samt endelig som et socialt baseret relationssystem. I artiklen vælger vi...... at fokusere på leg som et socialt baseret relationssystem og yderligere zoome ind på et af legens systemiske væsenstræk, nemlig brugen af regulerbare regelsæt, som legerne uden ’politi’ forhandler sig frem til før, under og efter legen. Fælles for Huizinga og Caillois er, at de knytter leg uløseligt sammen...

  16. Lean leadership: an ethnographic study.

    Science.gov (United States)

    Aij, Kjeld Harald; Visse, Merel; Widdershoven, Guy A M

    2015-01-01

    The purpose of this study is to provide a critical analysis of contemporary Lean leadership in the context of a healthcare practice. The Lean leadership model supports professionals with a leading role in implementing Lean. This article presents a case study focusing specifically on leadership behaviours and issues that were experienced, observed and reported in a Dutch university medical centre. This ethnographic case study provides auto-ethnographic accounts based on experiences, participant observation, interviews and document analysis. Characteristics of Lean leadership were identified to establish an understanding of how to achieve successful Lean transformation. This study emphasizes the importance for Lean leaders to go to the gemba, to see the situation for one's own self, empower health-care employees and be modest. All of these are critical attributes in defining the Lean leadership mindset. In this case study, Lean leadership is specifically related to healthcare, but certain common leadership characteristics are relevant across all fields. This article shows the value of an auto-ethnographic view on management learning for the analysis of Lean leadership. The knowledge acquired through this research is based on the first author's experiences in fulfilling his role as a health-care leader. This may help the reader examining his/her own role and reflecting on what matters most in the field of Lean leadership.

  17. Leg og dannelse

    DEFF Research Database (Denmark)

    Skovbjerg, Helle Marie

    2017-01-01

    lederen i det pædagogiske tidskrift Asterisk: ”Leg i skolen, leg i klasserummet, ja legende læring i skolen udgør derimod en enorm, seriøs og ubrugt læringsressource – ikke alene med effekter på kreativiteten, men også på den faglige læring” (Holm, 2015, p. 2). Legens værdi gøres altså først og fremmest...

  18. Venous leg ulcers

    Science.gov (United States)

    2008-01-01

    Introduction Leg ulcers usually occur secondary to venous reflux or obstruction, but 20% of people with leg ulcers have arterial disease, with or without venous disorders. Between 1.5 and 3.0/1000 people have active leg ulcers. Prevalence increases with age to about 20/1000 in people aged over 80 years. Methods and outcomes We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of standard treatments, adjuvant treatments, and organisational interventions for venous leg ulcers? What are the effects of interventions to prevent recurrence of venous leg ulcers? We searched: Medline, Embase, The Cochrane Library, and other important databases up to September 2007 (BMJ Clinical Evidence reviews are updated periodically, please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA). Results We found 80 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions. Conclusions In this systematic review we present information relating to the effectiveness and safety of the following interventions: compression bandages and stockings, cultured allogenic (single or bilayer) skin replacement, debriding agents, dressings (cellulose, collagen, film, foam, hyaluronic acid-derived, semi-occlusive alginate), hydrocolloid (occlusive) dressings in the presence of compression, intermittent pneumatic compression, intravenous prostaglandin E1, larval therapy, laser treatment (low-level), leg ulcer clinics, multilayer elastic system, multilayer elastomeric (or non-elastomeric) high-compression regimens or bandages, oral treatments (aspirin, flavonoids, pentoxifylline, rutosides, stanozolol, sulodexide, thromboxane alpha2 antagonists, zinc), peri

  19. Creatine Loading Does Not Preserve Muscle Mass or Strength During Leg Immobilization in Healthy, Young Males

    NARCIS (Netherlands)

    Backx, Evelien M.P.; Hangelbroek, Roland; Snijders, Tim; Verscheijden, Marie Louise; Verdijk, Lex B.; Groot, de Lisette C.P.G.M.; Loon, van Luc J.C.

    2017-01-01

    Background: A short period of leg immobilization leads to rapid loss of muscle mass and strength. Creatine supplementation has been shown to increase lean body mass in active individuals and can be used to augment gains in muscle mass and strength during prolonged resistance-type exercise

  20. Serum Predictors of Percent Lean Mass in Young Adults.

    Science.gov (United States)

    Lustgarten, Michael S; Price, Lori L; Phillips, Edward M; Kirn, Dylan R; Mills, John; Fielding, Roger A

    2016-08-01

    Lustgarten, MS, Price, LL, Phillips, EM, Kirn, DR, Mills, J, and Fielding, RA. Serum predictors of percent lean mass in young adults. J Strength Cond Res 30(8): 2194-2201, 2016-Elevated lean (skeletal muscle) mass is associated with increased muscle strength and anaerobic exercise performance, whereas low levels of lean mass are associated with insulin resistance and sarcopenia. Therefore, studies aimed at obtaining an improved understanding of mechanisms related to the quantity of lean mass are of interest. Percent lean mass (total lean mass/body weight × 100) in 77 young subjects (18-35 years) was measured with dual-energy x-ray absorptiometry. Twenty analytes and 296 metabolites were evaluated with the use of the standard chemistry screen and mass spectrometry-based metabolomic profiling, respectively. Sex-adjusted multivariable linear regression was used to determine serum analytes and metabolites significantly (p ≤ 0.05 and q ≤ 0.30) associated with the percent lean mass. Two enzymes (alkaline phosphatase and serum glutamate oxaloacetate aminotransferase) and 29 metabolites were found to be significantly associated with the percent lean mass, including metabolites related to microbial metabolism, uremia, inflammation, oxidative stress, branched-chain amino acid metabolism, insulin sensitivity, glycerolipid metabolism, and xenobiotics. Use of sex-adjusted stepwise regression to obtain a final covariate predictor model identified the combination of 5 analytes and metabolites as overall predictors of the percent lean mass (model R = 82.5%). Collectively, these data suggest that a complex interplay of various metabolic processes underlies the maintenance of lean mass in young healthy adults.

  1. Organizational change through Lean Thinking.

    Science.gov (United States)

    Tsasis, Peter; Bruce-Barrett, Cindy

    2008-08-01

    In production and manufacturing plants, Lean Thinking has been used to improve processes by eliminating waste and thus enhancing efficiency. In health care, Lean Thinking has emerged as a comprehensive approach towards improving processes embedded in the diagnostic, treatment and care activities of health-care organizations with cost containment results. This paper provides a case study example where Lean Thinking is not only used to improve efficiency and cost containment, but also as an approach to effective organizational change.

  2. Restless Legs Syndrome

    Science.gov (United States)

    ... disorder, particularly if they experience onset at an early age; many years may pass before symptoms occur regularly. top What causes restless legs syndrome? In most cases, the cause of RLS is unknown (called primary RLS). However, RLS has a genetic component and ...

  3. The mangled lower leg

    NARCIS (Netherlands)

    Hoogendoorn, Jochem Maarten

    2002-01-01

    A surgeon faced with a patient presenting with an open tibial/fibular fracture in combination with severe damage of the surrounding soft tissues, has to make the difficult decision whether to attempt salvage or to perform an immediate amputation of the leg. Until late in the nineteenth century the

  4. Applying lean thinking in construction

    Directory of Open Access Journals (Sweden)

    Remon Fayek Aziz

    2013-12-01

    Full Text Available The productivity of the construction industry worldwide has been declining over the past 40 years. One approach for improving the situation is using lean construction. Lean construction results from the application of a new form of production management to construction. Essential features of lean construction include a clear set of objectives for the delivery process, aimed at maximizing performance for the customer at the project level, concurrent design, construction, and the application of project control throughout the life cycle of the project from design to delivery. An increasing number of construction academics and professionals have been storming the ramparts of conventional construction management in an effort to deliver better value to owners while making real profits. As a result, lean-based tools have emerged and have been successfully applied to simple and complex construction projects. In general, lean construction projects are easier to manage, safer, completed sooner, and cost less and are of better quality. Significant research remains to complete the translation to construction of lean thinking in Egypt. This research will discuss principles, methods, and implementation phases of lean construction showing the waste in construction and how it could be minimized. The Last Planner System technique, which is an important application of the lean construction concepts and methodologies and is more prevalent, proved that it could enhance the construction management practices in various aspects. Also, it is intended to develop methodology for process evaluation and define areas for improvement based on lean approach principles.

  5. Lean software development in action

    CERN Document Server

    Janes, Andrea

    2014-01-01

    This book illustrates how goal-oriented, automated measurement can be used to create Lean organizations and to facilitate the development of Lean software, while also demonstrating the practical implementation of Lean software development by combining tried and trusted tools. In order to be successful, a Lean orientation of software development has to go hand in hand with a company's overall business strategy. To achieve this, two interrelated aspects require special attention: measurement and experience management. In this book, Janes and Succi provide the necessary knowledge to establish "

  6. First Lean, then modularisation

    DEFF Research Database (Denmark)

    Petersen, Kristian R.; Madsen, Erik Skov; Bilberg, Arne

    2016-01-01

    of Europe’s leading offshore wind power operators with more than 1,000 wind turbine generators in operation. By focusing on this company, in-depth insights into its operations and maintenance processes are investigated. Findings – Lean is identified to constitute an important first step before...... and resources can take place. The authors also establish a foundation for the development of a software tool to support the development of the modularisation of maintenance tasks. Originality/value – The present study contributes to the rather immature field of research on the operations and maintenance...

  7. Increased protein intake reduces lean body mass loss during weight loss in athletes.

    Science.gov (United States)

    Mettler, Samuel; Mitchell, Nigel; Tipton, Kevin D

    2010-02-01

    To examine the influence of dietary protein on lean body mass loss and performance during short-term hypoenergetic weight loss in athletes. In a parallel design, 20 young healthy resistance-trained athletes were examined for energy expenditure for 1 wk and fed a mixed diet (15% protein, 100% energy) in the second week followed by a hypoenergetic diet (60% of the habitual energy intake), containing either 15% (approximately 1.0 g x kg(-1)) protein (control group, n = 10; CP) or 35% (approximately 2.3 g x kg(-1)) protein (high-protein group, n = 10; HP) for 2 wk. Subjects continued their habitual training throughout the study. Total, lean body, and fat mass, performance (squat jump, maximal isometric leg extension, one-repetition maximum (1RM) bench press, muscle endurance bench press, and 30-s Wingate test) and fasting blood samples (glucose, nonesterified fatty acids (NEFA), glycerol, urea, cortisol, free testosterone, free Insulin-like growth factor-1 (IGF-1), and growth hormone), and psychologic measures were examined at the end of each of the 4 wk. Total (-3.0 +/- 0.4 and -1.5 +/- 0.3 kg for the CP and HP, respectively, P = 0.036) and lean body mass loss (-1.6 +/- 0.3 and -0.3 +/- 0.3 kg, P = 0.006) were significantly larger in the CP compared with those in the HP. Fat loss, performance, and most blood parameters were not influenced by the diet. Urea was higher in HP, and NEFA and urea showed a group x time interaction. Fatigue ratings and "worse than normal" scores on the Daily Analysis of Life Demands for Athletes were higher in HP. These results indicate that approximately 2.3 g x kg(-1) or approximately 35% protein was significantly superior to approximately 1.0 g x kg(-1) or approximately 15% energy protein for maintenance of lean body mass in young healthy athletes during short-term hypoenergetic weight loss.

  8. Lean approach in knowledge work

    Directory of Open Access Journals (Sweden)

    Hanna Kropsu-Vehkapera

    2018-05-01

    Full Text Available Purpose: Knowledge work productivity is a key area of improvement for many organisations. Lean approach is a sustainable way to achieve operational excellence and can be applied in many areas. The purpose of this novel study is to examine the potential of using lean approach for improving knowledge work practices. Design/methodology/approach: A systematic literature review has been carried out to study how lean approach is realised in knowledge work. The research is conceptual in nature and draws upon earlier research findings. Findings: This study shows that lean studies’ in knowledge work is an emerging research area. This study documents the methods and practices implemented in knowledge work to date, and presents a knowledge work continuum, which is an essential framework for effective lean approach deployment and to frame future research focus in knowledge work productivity. Research limitations/implications: This study structures the concept of knowledge work and outlines a concrete concept derived from earlier literature. The study summarises the literature on lean in knowledge work and highlights, which methods are used. More research is needed to understand how lean can be implemented in complex knowledge work environment and not only on the repetitive knowledge work. The limitations of this research are due to the limited availability of previous research. Practical implications: To analyse the nature of knowledge work, we implicate the areas where lean methods especially apply to improving knowledge work productivity. When applying lean in knowledge work context the focus should be using the people better and improving information flow. Originality/value: This study focuses on adapting lean methods into a knowledge work context and summarises earlier research done in this field. The study discusses the potential to improve knowledge work productivity by implementing lean methods and presents a unique knowledge work continuum to

  9. Intermittent hypoxia induces hyperlipidemia in lean mice.

    Science.gov (United States)

    Li, Jianguo; Thorne, Laura N; Punjabi, Naresh M; Sun, Cheuk-Kwan; Schwartz, Alan R; Smith, Philip L; Marino, Rafael L; Rodriguez, Annabelle; Hubbard, Walter C; O'Donnell, Christopher P; Polotsky, Vsevolod Y

    2005-09-30

    Obstructive sleep apnea, a syndrome leading to recurrent intermittent hypoxia (IH), has been associated previously with hypercholesterolemia, independent of underlying obesity. We examined the effects of experimentally induced IH on serum lipid levels and pathways of lipid metabolism in the absence and presence of obesity. Lean C57BL/6J mice and leptin-deficient obese C57BL/6J-Lep(ob) mice were exposed to IH for five days to determine changes in serum lipid profile, liver lipid content, and expression of key hepatic genes of lipid metabolism. In lean mice, exposure to IH increased fasting serum levels of total cholesterol, high-density lipoprotein (HDL) cholesterol, phospholipids (PLs), and triglycerides (TGs), as well as liver TG content. These changes were not observed in obese mice, which had hyperlipidemia and fatty liver at baseline. In lean mice, IH increased sterol regulatory element binding protein 1 (SREBP-1) levels in the liver, increased mRNA and protein levels of stearoyl-coenzyme A desaturase 1 (SCD-1), an important gene of TG and PL biosynthesis controlled by SREBP-1, and increased monounsaturated fatty acid content in serum, which indicated augmented SCD-1 activity. In addition, in lean mice, IH decreased protein levels of scavenger receptor B1, regulating uptake of cholesterol esters and HDL by the liver. We conclude that exposure to IH for five days increases serum cholesterol and PL levels, upregulates pathways of TG and PL biosynthesis, and inhibits pathways of cholesterol uptake in the liver in the lean state but does not exacerbate the pre-existing hyperlipidemia and metabolic disturbances in leptin-deficient obesity.

  10. EDUCATION FOR LEAN & LEAN FOR EDUCATION: A LITERATURE REVIEW

    Directory of Open Access Journals (Sweden)

    Saveta Vukadinovic

    2017-03-01

    Full Text Available The purpose of this paper is to investigate and understand how tools and principles of Lean philosophy can be adopted to improve the effectiveness of engineering education by providing services beyond the competition and costs below the competition, and how engineering education can provide better prepared engineering professionals capable to work in dynamic Lean environments by developing multidisciplinary knowledge and skills. Paper will be based on analysis of relevant scientific and professional literature sources, including certain elements of description, classification, explanation and prediction. The authors will use detailed literature review to explain complex relationship and interdependence between Lean philosophy and engineering education and answer the question what benefits modern Lean enterprises may expect from properly educated and qualified engineers and how application of Lean tools and principles can improve the system of engineering education.

  11. Ares Launch Vehicles Lean Practices Case Study

    Science.gov (United States)

    Doreswamy, Rajiv, N.; Self, Timothy A.

    2008-01-01

    This viewgraph presentation describes test strategies and lean philisophies and practices that are applied to Ares Launch Vehicles. The topics include: 1) Testing strategy; 2) Lean Practices in Ares I-X; 3) Lean Practices Applied to Ares I-X Schedule; 4) Lean Event Results; 5) Lean, Six Sigma, and Kaizen Practices in the Ares Projects Office; 6) Lean and Kaizen Success Stories; and 7) Ares Six Sigma Practices.

  12. LEAN thinking in Finnish healthcare.

    Science.gov (United States)

    Jorma, Tapani; Tiirinki, Hanna; Bloigu, Risto; Turkki, Leena

    2016-01-01

    Purpose - The purpose of this study is to evaluate how LEAN thinking is used as a management and development tool in the Finnish public healthcare system and what kind of outcomes have been achieved or expected by using it. The main focus is in managing and developing patient and treatment processes. Design/methodology/approach - A mixed-method approach incorporating the Webropol survey was used. Findings - LEAN is quite a new concept in Finnish public healthcare. It is mainly used as a development tool to seek financial savings and to improve the efficiency of patient processes, but has not yet been deeply implemented. However, the experiences from LEAN initiatives have been positive, and the methodology is already quite well-known. It can be concluded that, because of positive experiences from LEAN, the environment in Finnish healthcare is ready for the deeper implementation of LEAN. Originality/value - This paper evaluates the usage of LEAN thinking for the first time in the public healthcare system of Finland as a development tool and a management system. It highlights the implementation and achieved results of LEAN thinking when used in the healthcare environment. It also highlights the expectations for LEAN thinking in Finnish public healthcare.

  13. Dynamically Stable Legged Locomotion.

    Science.gov (United States)

    1983-01-27

    digitai~y thro)ugh a ribbon cable. lhe dcsign effort required to mount power sources and computing u(m board would hive distracted us fiorn our main...angular momentum. "The model used in this paper, shown in Fig. 6-1, has 3 single springy leg that articular •s ,ith respect to a body about a simple hince

  14. Two Legged Walking Robot

    OpenAIRE

    Kraus, V.

    2015-01-01

    The aim of this work is to construct a two-legged wirelessly controlled walking robot. This paper describes the construction of the robot, its control electronics, and the solution of the wireless control. The article also includes a description of the application to control the robot. The control electronics of the walking robot are built using the development kit Arduino Mega, which is enhanced with WiFi module allowing the wireless control, a set of ultrasonic sensors for detecting obstacl...

  15. Dynamically Stable Legged Locomotion

    Science.gov (United States)

    1981-11-30

    the laboratory. Harry Asada, Wayne Book, Nancy Cornelius, Sesh Murthy and Ivan Sutherland read various drafts of this report, for which we are...particularly helpful in providing an atmosphere where things could get started. Craig Fields and Clint Kelly deserve special credit for letting the idea of...legged technology capture their imaginations, even before we could show them tangible results. We are especially indebted to Ivan Sutherland for his

  16. Legāti

    OpenAIRE

    Segliņa, Aiga

    2010-01-01

    Autore teorētiski analizē legāta jēdzienu testamentārās mantošanas ietvaros un atspoguļo praktiska pētījuma rezultātus. Teorētiskā daļa apskata legāta nodibināšanas formu un spēkā esamību, tā iegūšanu un atraidīšanu, izpildi un zaudēšanu, novēlējuma robežas un aprobežojumus. Pētījums veikts aptaujas veidā ar mērķi noskaidrot, cik liela Latvijas iedzīvotāju daļa apzinās legāta nodrošinātās priekšrocības testamentārajā mantošanā. Apskatīts notāra neitralitātes jautājums attiecībā pret mantošana...

  17. Stable walking with asymmetric legs

    International Nuclear Information System (INIS)

    Merker, Andreas; Rummel, Juergen; Seyfarth, Andre

    2011-01-01

    Asymmetric leg function is often an undesired side-effect in artificial legged systems and may reflect functional deficits or variations in the mechanical construction. It can also be found in legged locomotion in humans and animals such as after an accident or in specific gait patterns. So far, it is not clear to what extent differences in the leg function of contralateral limbs can be tolerated during walking or running. Here, we address this issue using a bipedal spring-mass model for simulating walking with compliant legs. With the help of the model, we show that considerable differences between contralateral legs can be tolerated and may even provide advantages to the robustness of the system dynamics. A better understanding of the mechanisms and potential benefits of asymmetric leg operation may help to guide the development of artificial limbs or the design novel therapeutic concepts and rehabilitation strategies.

  18. Lean management beyond manufacturing a holistic approach

    CERN Document Server

    Bhasin, Sanjay

    2015-01-01

    Exploring Lean manufacturing in a holistic manner, this book helps organizations to implement Lean principles successfully by offering theoretical, empirical and practical knowledge. It empirically demonstrates how a successful Lean initiative can improve organizational efficiency, and incorporates valuable primary research to substantiate findings. It argues that Lean principles need to be applied throughout the value chain in order to be successful , and suggests that these tools need to be aligned with culture and change management. Chapters examine issues including Lean cultures, impediments to Lean, Lean and performance measurement, and the impact of Lean. Viewing Lean as a never-ending journey, this book provides a valuable resource to practising Lean managers, and specialist researchers and students, and also offers an important reference for organizations embarking on their Lean voyage.

  19. Illusion or delusion--Lean management in the health sector.

    Science.gov (United States)

    McIntosh, Bryan; Sheppy, Bruce; Cohen, Ivan

    2014-01-01

    There has been considerable interest in the implementation of practices imported from manufacturing into healthcare as a solution to rising healthcare spending and disappointing patient safety indicators. One approach that has attracted particular interest is Lean management and the purpose of this paper is to engage with this topic. Secondary research. Despite widespread enthusiasm about the potential of Lean management processes, evidence about its contribution to higher organisational performance remains inconsistent. This paper engages with the major Lean concepts of operations management and human resource management, including just-in-time, total quality management, total productive maintenance and does not engage in-depth with concepts related to employee empowerment, and training This paper contributes to the organisational management literature in healthcare by showing that although Lean management seems to have the potential to improve organisational performance it is far from a panacea against under performing hospitals. It informs policy making by suggesting that a progressive managerial philosophy has a stronger impact on healthcare performance than the adoption of practices from any particular managerial approach. This paper provides a critical evaluation of the impact of Lean practices in informing healthcare policy. The paper contributes to the organisational management literature in healthcare by showing that even though Lean management in healthcare appears to have the potential to improve organisational performance; there remain problems with its application.

  20. Lean Startup and Lean Canvas Using for Innovative Product Development

    Directory of Open Access Journals (Sweden)

    Alena Buchalcevová

    2016-06-01

    Full Text Available Recently, new approaches to product development have emerged that focus on idea generation techniques and customer itself. One of them is the Lean Startup method that is described in this article along with the Lean Canvas method. The main goal of the article is to demonstrate the application of both methods to an innovative product development focused on providing interactive trips for families with children. The development of the product during individual phases is described and application of the Lean Startup and Lean Canvas principles is demonstrated. Finally, benefits of both methods contributing to the product success are discussed. Similar case studies start emerging worldwide, however in the Czech context are quite rare.

  1. Clinically lean; "cutting the crap".

    Science.gov (United States)

    Caldwell, G

    2012-01-01

    Proponents of Lean Philosophy believe that successful businesses must reduce waste in working time and resources to a minimum, and maximise their use in productive work. The productive work of the Acute Medical Unit is to provide effective clinical management to a daily cohort of acutely ill patients. Many Clinicians are cynical about Lean. In this article, Dr Caldwell discusses how many clinicians complain of too much crap in the workplace, which gets in the way of swift, safe high quality clinical care. He argues that "Cutting the Crap" in the Acute Medical Unit is entirely consistent with Lean approaches to management of complex systems.

  2. Improving healthcare using Lean processes.

    Science.gov (United States)

    Baker, G Ross

    2014-01-01

    For more than a decade, healthcare organizations across Canada have been using Lean management tools to improve care processes, reduce preventable adverse events, increase patient satisfaction and create better work environments. The largest system-wide effort in Canada, and perhaps anywhere, is currently under way in Saskatchewan. The jury is still out on whether Lean efforts in that province, or elsewhere in Canada, are robust enough to transform current delivery systems and sustain new levels of performance. This issue of Healthcare Quarterly features several articles that provide a perspective on Lean methods in healthcare. Copyright © 2014 Longwoods Publishing.

  3. LEGS data acquisition facility

    International Nuclear Information System (INIS)

    LeVine, M.J.

    1985-01-01

    The data acquisition facility for the LEGS medium energy photonuclear beam line is composed of an auxiliary crate controller (ACC) acting as a front-end processor, loosely coupled to a time-sharing host computer based on a UNIX-like environment. The ACC services all real-time demands in the CAMAC crate: it responds to LAMs generated by data acquisition modules, to keyboard commands, and it refreshes the graphics display at frequent intervals. The host processor is needed only for printing histograms and recording event buffers on magnetic tape. The host also provides the environment for software development. The CAMAC crate is interfaced by a VERSAbus CAMAC branch driver

  4. Protein-enriched diet, with the use of lean red meat, combined with progressive resistance training enhances lean tissue mass and muscle strength and reduces circulating IL-6 concentrations in elderly women: a cluster randomized controlled trial.

    Science.gov (United States)

    Daly, Robin M; O'Connell, Stella L; Mundell, Niamh L; Grimes, Carley A; Dunstan, David W; Nowson, Caryl A

    2014-04-01

    Physical inactivity, inadequate dietary protein, and low-grade systemic inflammation contribute to age-related muscle loss, impaired function, and disability. We assessed the effects of progressive resistance training (PRT) combined with a protein-enriched diet facilitated through lean red meat on lean tissue mass (LTM), muscle size, strength and function, circulating inflammatory markers, blood pressure, and lipids in elderly women. In a 4-mo cluster randomized controlled trial, 100 women aged 60-90 y who were residing in 15 retirement villages were allocated to receive PRT with lean red meat (∼160 g cooked) to be consumed 6 d/wk [resistance training plus lean red meat (RT+Meat) group; n = 53] or control PRT [1 serving pasta or rice/d; control resistance training (CRT) group; n = 47)]. All women undertook PRT 2 times/wk and received 1000 IU vitamin D3/d. The mean (± SD) protein intake was greater in the RT+Meat group than in the CRT group throughout the study (1.3 ± 0.3 compared with 1.1 ± 0.3 g · kg⁻¹ · d⁻¹, respectively; P < 0.05). The RT+Meat group experienced greater gains in total body LTM (0.45 kg; 95% CI: 0.07, 0.84 kg), leg LTM (0.22 kg; 95% CI: 0.02, 0.42 kg), and muscle strength (18%; 95% CI: 0.03, 0.34) than did the CRT group (all P < 0.05). The RT+Meat group also experienced a 10% greater increase in serum insulin-like growth factor I (P < 0.05) and a 16% greater reduction in the proinflammatory marker interleukin-6 (IL-6) (P < 0.05) after 4 mo. There were no between-group differences for the change in blood lipids or blood pressure. A protein-enriched diet equivalent to ∼1.3 g · kg⁻¹ · d⁻¹ achieved through lean red meat is safe and effective for enhancing the effects of PRT on LTM and muscle strength and reducing circulating IL-6 concentrations in elderly women. This trial was registered at the Australian Clinical Trials Registry as ACTRN12609000223235.

  5. Lean Manufacturing measurement: The relationships between Lean activities and Lean metrics

    Directory of Open Access Journals (Sweden)

    Diego Fernando Manotas Duque

    2007-01-01

    Full Text Available Medición en Lean Manufacturing: Relaciones entre Actividades Lean y Métricas Lean Lean Manufacturing fue desarrollada por Toyota para satisfacer sus necesidades específicas en un mercado restringido y en tiempos de estrechez económica. Estos conceptos han sido estudiados y se ha comprobado su aplicabilidad en una amplia variedad de industrias. El objetivo de este artículo es el de integrar un conjunto de métricas que han sido propuestas por diferentes autores, de tal manera que sean consistentes con las etapas y elementos de implementaciones de Lean Manufacturing. Para lograrlo se presentan dos marcos de referencia para implementaciones Lean y los principales factores de éxito se utilizan como base para proponer métricas que identifiquen el avance en estos factores. Posteriormente se propone una tabla que cruza el impacto de las “Actividades Lean” sobre las métricas, postulando que muchos de los supuestos a priori sobre estos impactos deberían ser precisos. Finalmente se proponen algunas ideas para proyectos de investigación hacia el futuro y posibles extensiones de las aplicaciones propuestas aquí.

  6. Researching Lean: Methodological Implications of Loose Definitions

    Directory of Open Access Journals (Sweden)

    Mikael Brännmark

    2012-12-01

    Full Text Available Recently, Lean Production (Lean has become a prevailing management concept in Sweden. However, previous research seems to show that the Lean concept and the impact of Lean vary considerably between organizations. This paper illustrates some key methodological issues that need to be considered when researching loosely defined management concepts such as Lean. The paper is based on a review of the literature and five comparative Swedish cases studies. Our study indicates that Lean has changed over time and that operationalization and interpretations of the concept vary considerably. This study concludes that future Lean studies should include a thorough assessment of the Lean interventions, study settings, and in particular non-Lean factors mediating the outcomes of Lean-inspired change programs.

  7. Value Stream Mapping to Improve Workplace to support Lean Environment

    Directory of Open Access Journals (Sweden)

    Ahmad Ahmad Nur Aizat

    2017-01-01

    Full Text Available In recent years, lean manufacturing is being followed by various sectors in order to keep their competitiveness in the global markets. Lean manufacturing plays a vital role in improving the efficiency of operation by eliminating or reducing wastes. Nonetheless, most of small and medium enterprises (SMEs lack sufficient knowledge or information on the benefits of implementing lean manufacturing. The main objective of this study is to apply value stream mapping, one of lean manufacturing tools, for improving the productivity in a SME by eliminating non-value added activities. In this study, lean manufacturing was adopted at a SME, particularly a food industry. Value stream mapping was served as main tool to identify the wastes and improvement opportunities in production line. Subsequently, different lean manufacturing tools such as Kaizen Burst, one piece flow, and 5S were applied to eliminate or reduce identified wastes. Based on the future state value stream mapping, final results showed that the total operation time and non-added value activities time were successfully decreased from 1993 seconds to 1719 seconds, and 234 seconds to 104 seconds, respectively. The findings of this study indicate that value stream mapping is an effective approach to eliminate the wastes and improve the productivity.

  8. Lean Design and Management for Manufactoring

    OpenAIRE

    NIU, Zhanwen

    2009-01-01

    Most enterprises inducting lean production were confined by the innate limitations of existing production systems, which make it difficult to fulfill lean production comprehensively. To solve this problem, the theory of lean design and management for the manufacturing enterprise lifecycle was proposed. First, the necessities of lean design were analyzed and its theoretical system was established; second, the principles, process, methods and tools for lean design was introduced. Techniques and...

  9. The evolution of Lean organizations

    OpenAIRE

    Serafinas, Dalius; Ruželė, Darius

    2014-01-01

    Remiantis evoliucijos tyrimų modeliais bei autorių sudarytu evoliucionuojančios organizacijos modeliu,straipsnyje analizuojama Lean vadybos metodologija ir tiriama, kaip evoliucionuoja ją įgyvendinančios Lietuvosgamybinės organizacijos. The purpose of this paper is to examine the evolution of Lean organizations.Design/methodology/approach: a conceptual literature on the evolution of species, organisms and organizations was reviewed and an original model (framework) of the evolution of orga...

  10. Buildings Lean Maintenance Implementation Model

    Science.gov (United States)

    Abreu, Antonio; Calado, João; Requeijo, José

    2016-11-01

    Nowadays, companies in global markets have to achieve high levels of performance and competitiveness to stay "alive".Within this assumption, the building maintenance cannot be done in a casual and improvised way due to the costs related. Starting with some discussion about lean management and building maintenance, this paper introduces a model to support the Lean Building Maintenance (LBM) approach. Finally based on a real case study from a Portuguese company, the benefits, challenges and difficulties are presented and discussed.

  11. Lean Transformation of Multinational Concerns

    DEFF Research Database (Denmark)

    Matthiesen, Rikke Vestergaard; Johansen, John

    2008-01-01

    triggered. This paper reports on exploratory studies from a multinational company adopting centrally managed pilot projects as a transformation mechanism for continuous change towards a lean business system and an organizational culture of continuous improvements (CI). Competitive pressure demands...... from a multinational company adopting centrally managed pilot projects as a transformation mechanism for continuous change towards a lean business system and an organizational culture of continuous improvements (CI)....

  12. Serum betaine is inversely associated with low lean mass mainly in men in a Chinese middle-aged and elderly community-dwelling population.

    Science.gov (United States)

    Huang, Bi-Xia; Zhu, Ying-Ying; Tan, Xu-Ying; Lan, Qiu-Ye; Li, Chun-Lei; Chen, Yu-Ming; Zhu, Hui-Lian

    2016-06-01

    Previous studies have demonstrated that betaine supplements increase lean body mass in livestock and improve muscle performance in human beings, but evidence for its effect on human lean mass is limited. Our study assessed the association of circulating betaine with lean mass and its composition in Chinese adults. A community-based study was conducted on 1996 Guangzhou residents (weight/mass: 1381/615) aged 50-75 years between 2008 and 2010. An interviewer-administered questionnaire was used to collect general baseline information. Fasting serum betaine was assessed using HPLC-MS. A total of 1590 participants completed the body composition analysis performed using dual-energy X-ray absorptiometry during a mean of 3·2 years of follow-up. After adjustment for age, regression analyses demonstrated a positive association of serum betaine with percentage of lean mass (LM%) of the entire body, trunk and limbs in men (all Pwomen (P=0·016). Each sd increase in serum betaine was associated with increases in LM% of 0·609 (whole body), 0·811 (trunk), 0·422 (limbs), 0·632 (arms) and 0·346 (legs) in men and 0·350 (trunk) in women. Multiple logistic regression analysis revealed that the prevalence of lower LM% decreased by 17 % (whole body) and 14 % (trunk) in women and 23 % (whole body), 28 % (trunk), 22 % (arms) and 26 % (percentage skeletal muscle index) in men with each sd increment in serum betaine. Elevated circulating betaine was associated with a higher LM% and lower prevalence of lower LM% in middle-aged and elderly Chinese adults, particularly men.

  13. The effectiveness of lean manufacturing audits in measuring operational performance improvements

    Directory of Open Access Journals (Sweden)

    Taggart, P.

    2013-08-01

    Full Text Available The hypothesis that lean manufacturing audits are an effective way to measure improvements in operational performance was tested using 64 manufacturing sites owned by a FTSE 100 company. Commonly-used lean characteristics were evaluated: policy deployment, standardised work, visual management and housekeeping, quick changeover techniques, total productive maintenance, continuous improvement (kaizen, error proofing, cultural awareness, material control, and levelling (heijunka. Operational performance was assessed employing commonly-used operational performance measures: on-time-delivery, inventory turns, and direct labour utilisation. The findings are that lean manufacturing audits are effective in measuring improvements in operational performance provided that the audit scope and the lean characteristics are aligned up front.

  14. Lean manufacturing measurement: the relationship between lean activities and lean metrics

    Directory of Open Access Journals (Sweden)

    Manotas Duque Diego Fernando

    2007-10-01

    Full Text Available Lean Manufacturing was developed by Toyota Motor company to address their specific needs in a restricted market in times of economic trouble. These concepts have been studied and proven to be transferrable and applicable to a wide variety of industries. This paper aims to integrate a set of metrics that have been proposed by different authors in such a way that they are consistent with the different stages and elements of Lean Manufacturing implementations. To achieve this, two frameworks for Lean implementations are presented and then the main factors for success are used as the basis to propose metrics that measure the advance in these factors. A tabular display of the impact of “Lean activities” on the metrics is presented, proposing that many a priori assumptions about the benefits on many different levels of improvement should be accurate. Finally, some ideas for future research and extension of the applications proposed on this paper are presented as closing points.

  15. Estimation of lean and fat composition of pork ham using image processing measurements

    Science.gov (United States)

    Jia, Jiancheng; Schinckel, Allan P.; Forrest, John C.

    1995-01-01

    This paper presents a method of estimating the lean and fat composition in pork ham from cross-sectional area measurements using image processing technology. The relationship between the quantity of ham lean and fat mass with the ham lean and fat areas was studied. The prediction equations for pork ham composition based on the ham cross-sectional area measurements were developed. The results show that ham lean weight was related to the ham lean area (r equals .75, P lean weight was highly related to the product of ham total weight times percentage ham lean area (r equals .96, P product of ham total weight times percentage ham fat area (r equals .88, P lean weight was trimmed wholesale ham weight and percentage ham fat area with a coefficient of determination of 92%. The best combination of independent variables for estimating ham fat weight was trimmed wholesale ham weight and percentage ham fat area with a coefficient of determination of 78%. Prediction equations with either two or three independent variables did not significantly increase the accuracy of prediction. The results of this study indicate that the weight of ham lean and fat could be predicted from ham cross-sectional area measurements using image analysis in combination with wholesale ham weight.

  16. Bio-Inspired Design and Kinematic Analysis of Dung Beetle-Like Legs

    DEFF Research Database (Denmark)

    Aditya, Sai Krishna Venkata; Ignasov, Jevgeni; Filonenko, Konstantin

    2017-01-01

    The African dung beetle Scarabaeus galenus can use its front legs to walk and manipulate or form a dung ball. The interesting multifunctional legs have not been fully investigated or even used as inspiration for robot leg design. Thus, in this paper, we present the development of real dung beetle......-like front legs based on biological investigation. As a result, each leg consists of three main segments which were built using 3D printing. The segments were combined with in total four active DOFs in order to mimic locomotion and object manipulation of the beetle. Kinematics analysis of the leg was also...... performed to identify its workspace as well as to design its trajectory. To this end, the study contributes not only novel multifunctional robotic legs but also the methodology of the bio-inspired leg design....

  17. Lean versus Quick Response Manufacturing og andre koncepter - er Lean den eneste ene?

    DEFF Research Database (Denmark)

    Michelsen, Aage U

    2005-01-01

    Begrebet Lean har gennem de senere år vundet en enorm udbredelse. Antallet af publikationer om Lean har været eksplosivt stigende, og mange virksomheder har gennemført eller gennemfører Lean-projekter. Er Lean et nyt koncept? Er Lean den eneste løsning? Kan Lean kombineres med tankegange og princ...... løsning af en anden produktionsopgave. I fjerde afsnit skitseres kort relationerne mellem Lean og to andre begreber, Six Sigma og TPM, der begge har samme mål som Lean, men forskellige udgangspunkter og forskellige indfaldsvinkler....

  18. Activity Behaviours in Lean and Morbidly Obese Pregnant Women.

    Science.gov (United States)

    Fazzi, Caterina; Mohd-Shukri, Nor; Denison, Fiona C; Saunders, David H; Norman, Jane E; Reynolds, Rebecca M

    2018-05-17

    Interventions to increase physical activity in pregnancy are challenging for morbidly obese women. Targeting sedentary behaviours may be a suitable alternative to increase energy expenditure. We aimed to determine total energy expenditure, and energy expended in sedentary activities in morbidly obese and lean pregnant women. We administered the Pregnancy Physical Activity Questionnaire PPAQ (non-objective) and the Actical accelerometer (objective) to morbidly obese (BMI≥40kg/m²) and lean (BMI≤25Kg/M²) pregnant women recruited in early (lean pregnant women. No differences were observed in the proportion of energy expended sedentary between lean and morbidly obese pregnant women. The greater total energy expenditure in morbidly obese pregnant women was corroborated by Actical accelerometer in early (n=14 per group, obese 1167.7 (313.6) Kcal; lean 781.1 (210.1) Kcal, plean 893.7 (175.9) Kcal, plean pregnant. Further studies are needed to determine whether sedentary behaviours are a suitable target for intervention in morbidly obese pregnancy. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  19. Lean Production Applications in a Manufacturing Company

    OpenAIRE

    Ali Görener; Humeyra Baser; Ali Turkyilmaz

    2013-01-01

    Lean production is a production model which comes about the pursuit of companies to be able to meet competition and make effective production. The main purpose of lean production is to get control about the wastage. This study includes the requirements for the success of the lean production and how the lean production system can be established. In this paper, lean production techniques were applied to the electric water heater line. Measurements using lean initiatives were made, operation cyc...

  20. Prediction equation for lower limbs lean soft tissue in circumpubertal boys using anthropometry and biological maturation.

    Directory of Open Access Journals (Sweden)

    João Valente-dos-Santos

    Full Text Available Lean soft tissue (LST, a surrogate of skeletal muscle mass, is largely limited to appendicular body regions. Simple and accurate methods to estimate lower limbs LST are often used in attempts to partition out the influence of body size on performance outputs. The aim of the current study was to develop and cross-validate a new model to predict lower limbs LST in boys aged 10-13 years, using dual-energy X-ray absorptiometry (DXA as the reference method. Total body and segmental (lower limbs composition were assessed with a Hologic Explorer-W QDR DXA scanner in a cross-sectional sample of 75 Portuguese boys (144.8±6.4 cm; 40.2±9.0 kg. Skinfolds were measured at the anterior and posterior mid-thigh, and medial calf. Circumferences were measured at the proximal, mid and distal thigh. Leg length was estimated as stature minus sitting height. Current stature expressed as a percentage of attained predicted mature stature (PMS was used as an estimate of biological maturity status. Backward proportional allometric models were used to identify the model with the best statistical fit: ln (lower limbs LST  = 0.838× ln (body mass +0.476× ln (leg length - 0.135× ln (mid-thigh circumference - 0.053× ln (anterior mid-thigh skinfold - 0.098× ln (medial calf skinfold - 2.680+0.010× (percentage of attained PMS (R = 0.95. The obtained equation was cross-validated using the predicted residuals sum of squares statistics (PRESS method (R2PRESS = 0.90. Deming repression analysis between predicted and current lower limbs LST showed a standard error of estimation of 0.52 kg (95% limits of agreement: 0.77 to -1.27 kg. The new model accurately predicts lower limbs LST in circumpubertal boys.

  1. Lean computing for the cloud

    CERN Document Server

    Bauer, Eric

    2016-01-01

    Applies lean manufacturing principles across the cloud service delivery chain to enable application and infrastructure service providers to sustainably achieve the shortest lead time, best quality, and value This book focuses on lean in the context of cloud computing capacity management of applications and the physical and virtual cloud resources that support them. Lean Computing for the Cloud considers business, architectural and operational aspects of efficiently delivering valuable services to end users via cloud-based applications hosted on shared cloud infrastructure. The work also focuses on overall optimization of the service delivery chain to enable both application service and infrastructure service providers to adopt leaner, demand driven operations to serve end users more efficiently. The book’s early chapters analyze how capacity management morphs with cloud computing into interlocked physical infrastructure capacity management, virtual resou ce capacity management, and application capacity ma...

  2. Large meta-analysis of genome-wide association studies identifies five loci for lean body mass

    DEFF Research Database (Denmark)

    Zillikens, M Carola; Demissie, Serkalem; Hsu, Yi-Hsiang

    2017-01-01

    Lean body mass, consisting mostly of skeletal muscle, is important for healthy aging. We performed a genome-wide association study for whole body (20 cohorts of European ancestry with n = 38,292) and appendicular (arms and legs) lean body mass (n = 28,330) measured using dual energy X-ray absorpt...... a meta-analysis of genome-wide association studies for whole body lean body mass and find five novel genetic loci to be significantly associated.......-ray absorptiometry or bioelectrical impedance analysis, adjusted for sex, age, height, and fat mass. Twenty-one single-nucleotide polymorphisms were significantly associated with lean body mass either genome wide (p 

  3. Lean management in academic surgery.

    Science.gov (United States)

    Collar, Ryan M; Shuman, Andrew G; Feiner, Sandra; McGonegal, Amy K; Heidel, Natalie; Duck, Mary; McLean, Scott A; Billi, John E; Healy, David W; Bradford, Carol R

    2012-06-01

    Lean is a management system designed to enhance productivity by eliminating waste. Surgical practice offers many opportunities for improving efficiency. Our objective was to determine whether systematic implementation of lean thinking in an academic otolaryngology operating room improves efficiency and profitability and preserves team morale and educational opportunities. In an 18-month prospective quasi-experimental study, a multidisciplinary task force systematically implemented lean thinking within an otolaryngology operating room of an academic health system. Operating room turnover time and turnaround time were measured during a baseline period; an observer-effect period in which workers were made aware that their efficiency was being measured but before implementing lean changes; and an intervention period after redesign principles had been used. The impact on teamwork, morale, and surgical resident education were measured during the baseline and intervention periods through validated surveys. A profit model was applied to estimate the financial implications of the study. There was no difference between the baseline and observer-effect periods of the study for turnover time (p = 0.98) or turnaround time (p = 0.20). During the intervention period, the mean turnover time and turnaround time were significantly shorter than during the baseline period (29 vs 38 minutes; p improved morale after implementation (p = 0.011). Educational metrics were unchanged before and after implementation. The annual opportunity revenue for the involved operating room is $330,000; when extrapolated throughout the operating rooms, lean thinking could create 6,500 hours of capacity annually. Application of lean management techniques to a single operating room and surgical service improved operating room efficiency and morale, sustained resident education, and can provide considerable financial gains when scaled to an entire academic surgical suite. Copyright © 2012. Published by

  4. 'Lean' approach gives greater efficiency.

    Science.gov (United States)

    Call, Roger

    2014-02-01

    Adapting the 'Lean' methodologies used for many years by many manufacturers on the production line - such as in the automotive industry - and deploying them in healthcare 'spaces' can, Roger Call, an architect at Herman Miller Healthcare in the US, argues, 'easily remedy many of the inefficiencies' found within a healthcare facility. In an article that first appeared in the September 2013 issue of The Australian Hospital Engineer, he explains how 'Lean' approaches such as the 'Toyota production system', and 'Six Sigma', can be harnessed to good effect in the healthcare sphere.

  5. A Simulation of Lean Manufacturing: The Lean Lemonade Tycoon 2

    Science.gov (United States)

    Ncube, Lisa B.

    2010-01-01

    This article discusses the functions and effectiveness of games and simulations in the learning processes, in particular as an experiential learning methodology. The application of the game Lemonade Tycoon in the development of lean manufacturing concepts is described. This article addresses the use of the game to teach the principles of lean…

  6. Learning Lean: A Survey of Industry Lean Needs

    Science.gov (United States)

    Fliedner, Gene; Mathieson, Kieran

    2009-01-01

    The authors examined business practitioners' preferences for higher education curricula design in general and for what graduates should know about Lean, or waste-reduction efforts. The authors conducted a Web-based survey and found that practitioners are not as concerned about graduates' possessing specific technical skills as they are about them…

  7. Lean Application to Manufacturing Ramp-Up

    DEFF Research Database (Denmark)

    Christensen, Irene; Rymaszewska, Anna

    2016-01-01

    . Abstracting from the extant literature, the authors considered the competitiveness of manufacturing companies from two principal perspectives: the leanness of the ramp-up process and the new-value creation of quality managers. While much of the literature fails to acknowledge that the roots of lean actually......This article provides a theoretical overview of the concepts of lean and manufacturing ramp-up in an attempt to conceptualize the strategic areas in which lean philosophy and principles can be applied for continuous improvements. The application of lean principles during the final stage of a new...... product development process, that is, the ramp-up process, is a critical, early enabler of lean manufacturing. The manufacturing strategy literature conceptualizes a state of “leanness in operations,” which can consolidate both the concepts of lean and manufacturing ramp-up, providing a dual perspective...

  8. Leg mass characteristics of accurate and inaccurate kickers--an Australian football perspective.

    Science.gov (United States)

    Hart, Nicolas H; Nimphius, Sophia; Cochrane, Jodie L; Newton, Robert U

    2013-01-01

    Athletic profiling provides valuable information to sport scientists, assisting in the optimal design of strength and conditioning programmes. Understanding the influence these physical characteristics may have on the generation of kicking accuracy is advantageous. The aim of this study was to profile and compare the lower limb mass characteristics of accurate and inaccurate Australian footballers. Thirty-one players were recruited from the Western Australian Football League to perform ten drop punt kicks over 20 metres to a player target. Players were separated into accurate (n = 15) and inaccurate (n = 16) groups, with leg mass characteristics assessed using whole body dual energy x-ray absorptiometry (DXA) scans. Accurate kickers demonstrated significantly greater relative lean mass (P ≤ 0.004) and significantly lower relative fat mass (P ≤ 0.024) across all segments of the kicking and support limbs, while also exhibiting significantly higher intra-limb lean-to-fat mass ratios for all segments across both limbs (P ≤ 0.009). Inaccurate kickers also produced significantly larger asymmetries between limbs than accurate kickers (P ≤ 0.028), showing considerably lower lean mass in their support leg. These results illustrate a difference in leg mass characteristics between accurate and inaccurate kickers, highlighting the potential influence these may have on technical proficiency of the drop punt.

  9. Parametric study of turbine NGV blade lean and vortex design

    Directory of Open Access Journals (Sweden)

    Zhang Shaowen

    2016-02-01

    Full Text Available The effects of blade lean and vortex design on the aerodynamics of a turbine entry nozzle guide vane (NGV are considered using computational fluid dynamics. The aim of the work is to address some of the uncertainties which have arisen from previous studies where conflicting results have been reported for the effect on the NGV. The configuration was initially based on the energy efficient engine turbine which also served as the validation case for the computational method. A total of 17 NGV configurations were evaluated to study the effects of lean and vortex design on row efficiency and secondary kinetic energy. The distribution of mass flow ratio is introduced as an additional factor in the assessment of blade lean effects. The results show that in the turbine entry NGV, the secondary flow strength is not a dominant factor that determines NGV losses and therefore the changes of loading distribution due to blade lean and the associated loss mechanisms should be regarded as a key factor. Radial mass flow redistribution under different NGV lean and twist is demonstrated as an addition key factor influencing row efficiency.

  10. A Sand Cone Model of Lean Implementation

    OpenAIRE

    Yestemessov, Azamat

    2011-01-01

    Over the past 20 years Lean Production system has been a focus of researches by different academicians. A numerous works have been written in the field of Lean implementation in manufacturing companies. However, as shown, most of the academic topics relate to the issues of implementing Lean tools and techniques. Critical Success Factors have been also described widely; however, no efforts in systematization have been made. Only several works have a focus on integration of Lean implementation ...

  11. Training for successful lean manufacturing implementation

    OpenAIRE

    Ichimura, Maki; Jahankhani, Hamid; Arunachalam, Subramaniam

    2006-01-01

    Implementing lean manufacturing is a complex and everlasting task. The workers involving in production processes are the pivot of the lean manufacturing implementation. Training is known as a vehicle to assist the implementation process. Despite awareness of the training importance, so far, a little is available to assist to organise an efficient training. This paper summarises the overview of lean manufacturing and discuss the importance of human resource within lean implementation process. ...

  12. Sustainable cost reduction by lean management in metallurgical processes

    Directory of Open Access Journals (Sweden)

    A. V. Todorut

    2016-10-01

    Full Text Available This paper focuses on the need for sustainable cost reduction in the metallurgical industry by applying Lean Management (LM tools and concepts in metallurgical production processes leading to increased competitiveness of corporations in a global market. The paper highlights that Lean Management is a novel way of thinking, adapting to change, reducing waste and continuous improvement, leading to sustainable development of companies in the metallurgical industry. The authors outline the main Lean Management instruments based on recent scientific research and include a comparative analysis of other tools, such as Sort, Straighten, Shine, Standardize, Sustain (5S, Visual Management (VM, Kaizen, Total Productive Maintenance (TPM, Single-Minute Exchange of Dies (SMED, leading to a critical appraisal of their application in the metallurgical industry.

  13. Lean and psychosocial work environment in manufacturing

    DEFF Research Database (Denmark)

    Edwards, Kasper; Thye, Nina; Nielsen, Anders P.

    2011-01-01

    Lean is currently the rationalization method of choice in the Danish manufacturing industry. This paper reports finding from three lean implementation cases. All cases are manufacturing companies focusing on upmarket products produced in small series. Prior to lean production was organized as sel...

  14. Lean - set i et historisk perspektiv

    DEFF Research Database (Denmark)

    Michelsen, Aage U

    2006-01-01

    I kapitlet redegøres for, hvordan begrebet Lean opstod som en karakteristik af Toyota Production System (TPS), der igen har sin rod i scientific management. Gennem eksempler illustreres det, at centrale Lean-principper således har været anvendt i årtier. Der argumenteres for, at Lean i mange...

  15. Lean Six Sigma in financial services

    NARCIS (Netherlands)

    de Koning, H.; Does, R.J.M.M.; Bisgaard, S.

    2008-01-01

    Lean Thinking and Six Sigma are typically considered as separate approaches to process innovation, with complementary strengths. When combined as Lean Six Sigma, this approach provides a unified framework for systematically developing innovations. Lean Six Sigma can also bring about significant

  16. Assessing Children's Legs and Feet

    OpenAIRE

    Wedge, John H.

    1985-01-01

    Shoes are necessary for protection and warmth. Normal children do not require shoes for support. There is no scientific evidence that shoes—‘orthopedic’ or otherwise—influence or alter the growth or shape of the normal child's foot except, perhaps, adversely if they fit poorly. Family physicians must understand common variations of normal foot and leg development if they are to effectively advise and reassure parents about appropriate footwear. Flat feet, knock knees, bow legs, in-toeing, and...

  17. Improving venous leg ulcer management

    OpenAIRE

    Weller, Carolina Dragica

    2017-01-01

    This thesis reports several different methods to develop and evaluate complex interventions designed to improve venous leg ulcer management. Chronic venous leg ulcers (VLU) are the most common chronic wound problem in the community. Its health and economic burden is predicted to increase due to ageing of the community and increase in prevalence of diabetes and obesity. Although many patients seek health care for VLU, most do not receive the most effective management. Patients with this condi...

  18. Change management in lean enterprise

    Directory of Open Access Journals (Sweden)

    Furman Joanna

    2016-06-01

    Full Text Available The main purpose of the paper is the analysis of a process of change focusing particularly on the concept of slimmed production (Lean and its implementation in the enterprise. A case study method was chosen as a research tool because it offers wide array of techniques and means of gaining and analysing data.

  19. Analysis Of Lean Accounting JIT And Balance Scorecard In The Companys Lean Manufacturing

    OpenAIRE

    Irwan Sutirman Wahdiat

    2015-01-01

    This research purpose to analyze the concept of Lean Manufacturing which is influenced by the role of JIT. This research uses a theoretical approach. This study portrait thinking companies that have yet to implement lean manufacturing and after doing the concept of lean manufacturing. This study shows that the concept of lean manufacturing can make the company more efficient and effective. This paper shows some lean manufacturing dimensions of the researchers previous researchers. This study ...

  20. Comparative Analysis between Lean, Six Sigma and Lean Six Sigma Concepts

    OpenAIRE

    Alexandra Mirela Cristina MUNTEANU

    2017-01-01

    This paper analyzes the benefits of Lean Six Sigma in comparison with Lean and Six Sigma, traditional improvement methodologies. The introduction highlights the appearance of Lean Six Sigma, early 2000s, as well as the benefits brought by the integrated approach. The following parts of the study emphasize the main differences between methodologies and their commonalities based on their synergy. Finally the advantages of Lean Six Sigma versus Lean and Six Sigma are analyzed and systematized by...

  1. Cold leg condensation tests. Task C. Steam--water interaction tests

    International Nuclear Information System (INIS)

    Brodrick, J.R.; Loiselle, V.

    1974-03-01

    A report is presented of tests to determine the condensation efficiency of ECC water injected into a quality fluid mixture flowing through the cold leg. In particular, a specific objective was to determine if the mixture of ECC water and quality fluid reached thermodynamic equilibrium before exiting the cold leg. Further, the stability of the ECC water/quality fluid interaction would be assessed by interpretation of thermocouple records and utilization of a section of cold leg piping with view ports to film the interaction whenever possible. The cold leg condensation tests showed complete condensation of the 5 lbm/sec steam quality mixtures in the cold leg by the ECC water flows of the test matrix. The cold leg exit fluid temperature remained below the saturation temperature and had good agreement with the predicted cold leg outlet temperature, calculated assuming total condensation. (U.S.)

  2. Elimination of waste: creation of a successful Lean colonoscopy program at an academic medical center.

    Science.gov (United States)

    Damle, Aneel; Andrew, Nathan; Kaur, Shubjeet; Orquiola, Alan; Alavi, Karim; Steele, Scott R; Maykel, Justin

    2016-07-01

    Lean processes involve streamlining methods and maximizing efficiency. Well established in the manufacturing industry, they are increasingly being applied to health care. The objective of this study was to determine feasibility and effectiveness of applying Lean principles to an academic medical center colonoscopy unit. Lean process improvement involved training endoscopy personnel, observing patients, mapping the value stream, analyzing patient flow, designing and implementing new processes, and finally re-observing the process. Our primary endpoint was total colonoscopy time (minutes from check-in to discharge) with secondary endpoints of individual segment times and unit colonoscopy capacity. A total of 217 patients were included (November 2013-May 2014), with 107 pre-Lean and 110 post-Lean intervention. Pre-Lean total colonoscopy time was 134 min. After implementation of the Lean process, mean colonoscopy time decreased by 10 % to 121 min (p = 0.01). The three steps of the process affected by the Lean intervention (time to achieve adequate sedation, time to recovery, and time to discharge) decreased from 3.7 to 2.4 min (p Lean patient satisfaction surveys demonstrated an average score of 4.5/5.0 (n = 73) regarding waiting time, 4.9/5.0 (n = 60) regarding how favorably this experienced compared to prior colonoscopy experiences, and 4.9/5.0 (n = 74) regarding professionalism of staff. One hundred percentage of respondents (n = 69) stated they would recommend our institution to a friend for colonoscopy. With no additional utilization of resources, a single Lean process improvement cycle increased productivity and capacity of our colonoscopy unit. We expect this to result in increased patient access and revenue while maintaining patient satisfaction. We believe these results are widely generalizable to other colonoscopy units as well as other process-based interventions in health care.

  3. The relationship between objectively assessed physical activity and bone health in older adults differs by sex and is mediated by lean mass.

    Science.gov (United States)

    McMillan, L B; Aitken, D; Ebeling, P; Jones, G; Scott, D

    2018-03-12

    Relationships between objectively assessed free-living physical activity (PA) and changes in bone health over time are poorly understood in older adults. This study suggests these relationships are sex-specific and that body composition may influence the mechanical loading benefits of PA. To investigate associations of objectively assessed PA and bone health in community-dwelling older adults. This secondary analysis of a subset of the Tasmanian Older Adult Cohort study included participants with PA assessed utilising ActiGraph GT1M accelerometers over 7 days (N = 209 participants, 53% female; mean ± SD age 64.5 ± 7.2 years). Steps/day and PA intensity were estimated via established thresholds. Bone mineral content (BMC) was acquired at the total hip, lumbar spine, legs and whole body by DXA at baseline and approximately 2.2 years later. Relationships between PA and BMC were assessed by multivariable linear regression analyses adjusted for age, smoking status, height and total lean mass. Men with above-median total hip BMC completed significantly less steps per day, but there was no significant difference in PA intensity compared with those with below-median BMC. There were no significant differences in PA in women stratified by median BMC. In women, steps/day were positively associated with leg BMC (B = 0.178; P = 0.017), and sedentary behaviour was negatively associated with leg BMC (- 0.165; 0.016) at baseline. After adjustment for confounders including lean mass and height, higher sedentary behaviour at baseline was associated with declines in femoral neck BMC (- 0.286; 0.011) but also with increases in pelvic BMC (0.246; 0.030) in men and increases in total hip BMC (0.215; 0.032) in women, over 2.2 years. No other significant longitudinal associations were observed after adjustment for body composition. Associations of accelerometer-determined sedentary behaviour and PA with bone health in older adults differ by sex and anatomical

  4. Age, gender, and race/ethnic differences in total body and subregional bone density.

    Science.gov (United States)

    Looker, A C; Melton, L J; Harris, T; Borrud, L; Shepherd, J; McGowan, J

    2009-07-01

    Total body bone density of adults from National Health and Nutrition Examination Survey (NHANES) 1999-2004 differed as expected for some groups (men>women and blacks>whites) but not others (whites>Mexican Americans). Cross-sectional age patterns in bone mineral density (BMD) of older adults differed at skeletal sites that varied by degree of weight-bearing. Total body dual-energy X-ray absorptiometry (DXA) data offer the opportunity to compare bone density of demographic groups across the entire skeleton. The present study uses total body DXA data (Hologic QDR 4500A, Hologic, Bedford MA, USA) from the NHANES 1999-2004 to examine BMD of the total body and selected skeletal subregions in a wide age range of adult men and women from three race/ethnic groups. Total body, lumbar spine, pelvis, right leg, and left arm BMD and lean mass from 13,091 adults aged 20 years and older were used. The subregions were chosen to represent sites with different degrees of weight-bearing. Mean BMD varied in expected ways for some demographic characteristics (men>women and non-Hispanic blacks>non-Hispanic whites) but not others (non-Hispanic whites>Mexican Americans). Differences in age patterns in BMD also emerged for some characteristics (sex) but not others (race/ethnicity). Differences in cross-sectional age patterns in BMD and lean mass by degree of weight-bearing in older adults were observed for the pelvis, leg, and arm. This information may be useful for generating hypotheses about age, race, and sex differences in fracture risk in the population.

  5. Exploiting HRM in support of lean manufacturing

    DEFF Research Database (Denmark)

    Jørgensen, Frances; Matthiesen, Rikke

    The purpose of this paper is to investigate the ways in HRM practices are-and could potentially be-exploited to support lean manufacturing in practice. First, a review of the pertinent literature regarding HRM, SHRM, and lean manufacturing is presented to provide an understanding of the mechanisms...... by which HRM practices could, theoretically, be used to support a lean implementation. Data presented in the paper are derived from 1) a longitudinal case study on lean implementation and 2) from managers currently involved with lean manufacturing in a second company. The relevant literature and the data...... depicting the potential role in supporting HRM/lean integrated practices. The analysis of the model with respect to the theoretical background emphasizes a number of areas in which HRM could be more fully exploited in order to more successfully support lean implementation, for example, by stressing HRM...

  6. Lean manufacturing in Indian context: A survey

    Directory of Open Access Journals (Sweden)

    Rakesh Kumar

    2015-04-01

    Full Text Available This paper is an attempt to examine the implementation of Lean Manufacturing system in the Indian industries. Predominant elements of Lean Manufacturing, benefits gained after its implementation and obstacles observed by Indian Industry have been recognized. The results of this survey support the opinion that Lean Manufacturing had potential to improve the organizational performance of Indian industries. Nevertheless, Indian industries are required to be passionate to transform their manufacturing by adopting Lean manufacturing to gain the full benefits. A large numbers of literature papers are available on the better side of Lean manufacturing approach and its benefits gained by manufacturing organizations after implementation. But the adverse impacts of Lean manufacturing are not discussed to a great extent. Some drawbacks of Lean manufacturing are also highlighted in this paper.

  7. Lean Production Applications in a Manufacturing Company

    Directory of Open Access Journals (Sweden)

    Ali Görener

    2016-01-01

    Full Text Available Lean production is a production model which comes about the pursuit of companies to be able to meet competition and make effective production. The main purpose of lean production is to get control about the wastage. This study includes the requirements for the success of the lean production and how the lean production system can be established. In this paper, lean production techniques were applied to the electric water heater line. Measurements using lean initiatives were made, operation cycle times were determined, and Kaizen improvement methods and line balancing methods were applied according to the results. And the last section of study showed conclusion of lean implementation.

  8. Comparison between Unilateral and Bilateral Plyometric Training on Single and Double Leg Jumping Performance and Strength.

    Science.gov (United States)

    Bogdanis, Gregory C; Tsoukos, Athanasios; Kaloheri, Olga; Terzis, Gerasimos; Veligekas, Panagiotis; Brown, Lee E

    2017-04-18

    This study compared the effects of unilateral and bilateral plyometric training on single and double-leg jumping performance, maximal strength and rate of force development (RFD). Fifteen moderately trained subjects were randomly assigned to either a unilateral (U, n=7) or bilateral group (B, n=8). Both groups performed maximal effort plyometric leg exercises two times per week for 6 weeks. The B group performed all exercises with both legs, while the U group performed half the repetitions with each leg, so that total exercise volume was the same. Jumping performance was assessed by countermovement jumps (CMJ) and drop jumps (DJ), while maximal isometric leg press strength and RFD were measured before and after training for each leg separately and both legs together. CMJ improvement with both legs was not significantly different between U (12.1±7.2%) and B (11.0±5.5%) groups. However, the sum of right and left leg CMJ only improved in the U group (19.0±7.1%, pplyometric training was more effective at increasing both single and double-leg jumping performance, isometric leg press maximal force and RFD when compared to bilateral training.

  9. Green Lean TQM Human Resource Management Practices in Malaysian Automotive Companies

    OpenAIRE

    Noor Azlina Mohd Salleh; Salmiah Kasolang; Ahmed Jaffar

    2012-01-01

    Green Lean Total Quality Management (LTQM) Human Resource Management (HRM) System is a system comprises of HRM in Environmental Management System (EMS) practices which is integrated to TQM with Lean Manufacturing (LM) principles. HRM is essential especially in dealing with low motivation and less productive employees. The ultimate goal of this system is to focus on achieving total human resource development that is motivated and capable to optimize their creativity to be a part of Green and L...

  10. Pipe crawler with extendable legs

    International Nuclear Information System (INIS)

    Zollinger, W.T.

    1992-01-01

    A pipe crawler for moving through a pipe in inchworm fashion having front and rear leg assemblies separated by air cylinders to increase and decrease the spacing between assemblies. Each leg of the four legs of an assembly is moved between a wall-engaging, extended position and a retracted position by a separate air cylinder. The air cylinders of the leg assemblies are preferably arranged in pairs of oppositely directed cylinders with no pair lying in the same axial plane as another pair. Therefore, the cylinders can be as long as a leg assembly is wide and the crawler can crawl through sections of pipes where the diameter is twice that of other sections. The crawler carries a valving system, a manifold to distribute air supplied by a single umbilical air hose to the various air cylinders in a sequence controlled electrically by a controller. The crawler also utilizes a rolling mechanism, casters in this case, to reduce friction between the crawler and pipe wall thereby further extending the range of the pipe crawler. 8 figs

  11. Pipe crawler with extendable legs

    Science.gov (United States)

    Zollinger, W.T.

    1992-06-16

    A pipe crawler for moving through a pipe in inchworm fashion having front and rear leg assemblies separated by air cylinders to increase and decrease the spacing between assemblies. Each leg of the four legs of an assembly is moved between a wall-engaging, extended position and a retracted position by a separate air cylinder. The air cylinders of the leg assemblies are preferably arranged in pairs of oppositely directed cylinders with no pair lying in the same axial plane as another pair. Therefore, the cylinders can be as long as a leg assembly is wide and the crawler can crawl through sections of pipes where the diameter is twice that of other sections. The crawler carries a valving system, a manifold to distribute air supplied by a single umbilical air hose to the various air cylinders in a sequence controlled electrically by a controller. The crawler also utilizes a rolling mechanism, casters in this case, to reduce friction between the crawler and pipe wall thereby further extending the range of the pipe crawler. 8 figs.

  12. An economic analysis of a system wide Lean approach: cost estimations for the implementation of Lean in the Saskatchewan healthcare system for 2012-2014.

    Science.gov (United States)

    Sari, Nazmi; Rotter, Thomas; Goodridge, Donna; Harrison, Liz; Kinsman, Leigh

    2017-08-03

    The costs of investing in health care reform initiatives to improve quality and safety have been underreported and are often underestimated. This paper reports direct and indirect cost estimates for the initial phase of the province-wide implementation of Lean activities in Saskatchewan, Canada. In order to obtain detailed information about each type of Lean event, as well as the total number of corresponding Lean events, we used the Provincial Kaizen Promotion Office (PKPO) Kaizen database. While the indirect cost of Lean implementation has been estimated using the corresponding wage rate for the event participants, the direct cost has been estimated using the fees paid to the consultant and other relevant expenses. The total cost for implementation of Lean over two years (2012-2014), including consultants and new hires, ranged from $44 million CAD to $49.6 million CAD, depending upon the assumptions used. Consultant costs accounted for close to 50% of the total. The estimated cost of Lean events alone ranged from $16 million CAD to $19.5 million CAD, with Rapid Process Improvement Workshops requiring the highest input of resources. Recognizing the substantial financial and human investments required to undertake reforms designed to improve quality and contain cost, policy makers must carefully consider whether and how these efforts result in the desired transformations. Evaluation of the outcomes of these investments must be part of the accountability framework, even prior to implementation.

  13. Leaning in to "muddy" interviews

    DEFF Research Database (Denmark)

    Lippke, Lena; Tanggaard, Lene

    2014-01-01

    Over the last few decades, qualitative research has been acknowledged as a peopled practice in which subjectivities come into play. The main argument presented in this article is that qualitative research involves “muddy,” troublesome, interactional passages, because of a complex interplay between...... situated identities among the participants cross each other. We emphasize the value of daring to lean in to the muddiness of peopled research, use it as an analytical tool and present it in its imperfect form. This approach contributes to transparency in qualitative research, opens up the data in a new way...... subjectivities, situated identities, emotions, and conversational genres. Based on ethnographic fieldwork at a Danish Vocational Educational Training College, we introduce the concept of “leaning in” to provide an analytical grasp of the “muddy” interactional tension field in an interview situation, in which...

  14. Lean six sigma in healthcare.

    Science.gov (United States)

    de Koning, Henk; Verver, John P S; van den Heuvel, Jaap; Bisgaard, Soren; Does, Ronald J M M

    2006-01-01

    Healthcare, as with any other service operation, requires systematic innovation efforts to remain competitive, cost efficient, and up-to-date. This article outlines a methodology and presents examples to illustrate how principles of Lean Thinking and Six Sigma can be combined to provide an effective framework for producing systematic innovation efforts in healthcare. Controlling healthcare cost increases, improving quality, and providing better healthcare are some of the benefits of this approach.

  15. Leg ulcers due to hyperhomocysteinemia

    Directory of Open Access Journals (Sweden)

    Krupa Shankar D

    2006-01-01

    Full Text Available Chronic leg ulcers are rare in young adults and generally indicate a vascular cause. We report a case of a 26-year-old man with leg ulcers of eight months duration. Doppler study indicated venous incompetence and a postphlebitic limb. However, as the distribution and number of ulcers was not consistent with stasis alone and no features of collagen vascular disease were noted, a hyperviscosity state was considered and confirmed with significantly elevated homocysteine level in the serum. Administration of vitamins B1, B2, B6 and B12, trimethyl-glycine, mecobalamine, folic acid and povidone iodine dressings with culture-directed antibiotic therapy led to a satisfactory healing of ulcers over a period of one month. Hyperhomocysteinemia must be considered in the differential diagnosis of leg ulcers in young individuals.

  16. Promethus Hot Leg Piping Concept

    International Nuclear Information System (INIS)

    AM Girbik; PA Dilorenzo

    2006-01-01

    The Naval Reactors Prime Contractor Team (NRPCT) recommended the development of a gas cooled reactor directly coupled to a Brayton energy conversion system as the Space Nuclear Power Plant (SNPP) for NASA's Project Prometheus. The section of piping between the reactor outlet and turbine inlet, designated as the hot leg piping, required unique design features to allow the use of a nickel superalloy rather than a refractory metal as the pressure boundary. The NRPCT evaluated a variety of hot leg piping concepts for performance relative to SNPP system parameters, manufacturability, material considerations, and comparison to past high temperature gas reactor (HTGR) practice. Manufacturability challenges and the impact of pressure drop and turbine entrance temperature reduction on cycle efficiency were discriminators between the piping concepts. This paper summarizes the NRPCT hot leg piping evaluation, presents the concept recommended, and summarizes developmental issues for the recommended concept

  17. Comparative Analysis between Lean, Six Sigma and Lean Six Sigma Concepts

    Directory of Open Access Journals (Sweden)

    Alexandra Mirela Cristina MUNTEANU

    2017-06-01

    Full Text Available This paper analyzes the benefits of Lean Six Sigma in comparison with Lean and Six Sigma, traditional improvement methodologies. The introduction highlights the appearance of Lean Six Sigma, early 2000s, as well as the benefits brought by the integrated approach. The following parts of the study emphasize the main differences between methodologies and their commonalities based on their synergy. Finally the advantages of Lean Six Sigma versus Lean and Six Sigma are analyzed and systematized by author in order to reveal Lean Six Sigma’s benefits.

  18. Orthostatic leg blood volume changes assessed by near-infrared spectroscopy

    DEFF Research Database (Denmark)

    Truijen, J; Kim, Y S; Krediet, C T P

    2012-01-01

    posture, volume accumulation in small blood vessels contributes significantly to the total fluid volume accumulated in the legs. Considering that near-infrared spectroscopy (NIRS) tracks postural blood volume changes within the small blood vessels of the lower leg, we evaluated the NIRS-determined changes......-linear accumulation of blood volume in the small vessels of the leg, with an initial fast phase followed by a more gradual increase at least partly contributing to the relocation of fluid during orthostatic stress....

  19. Effect of obesity on oxygen uptake and cardiovascular dynamics during whole-body and leg exercise in adult males and females.

    LENUS (Irish Health Repository)

    Green, Simon

    2018-05-01

    Obesity has been associated with a slowing of V˙O2 dynamics in children and adolescents, but this problem has not been studied in adults. Cardiovascular mechanisms underlying this effect are not clear. In this study, 48 adults (18 males, 30 females) grouped according to body mass index (BMI) (lean < 25 kg·m-2 , overweight = 25-29.9 kg·m-2 , obese ≥30 kg·m-2 ) provided a fasting blood sample, completed a maximal graded exercise test and six bouts of submaximal exercise on a cycle ergometer, and performed two protocols of calf exercise. Dynamic response characteristics of V˙O2 and leg vascular conductance (LVC) were assessed during cycling (80% ventilatory threshold) and calf exercise (30% MVC), respectively. Dynamic responses of cardiac output, mean arterial pressure and total systemic vascular conductance were also assessed during cycling based on measurements at 30 and 240 sec. The time constant of the second phase of the V˙O2 response was significantly greater in obese than lean subjects (39.4 (9.2) vs. 29.1 (7.6) sec); whereas dynamic responses of cardiac output and systemic vascular conductance were not affected by BMI. For calf exercise, the time constant of the second growth phase of LVC was slowed significantly in obese subjects (22.1 (12.7) sec) compared with lean and overweight subjects (11.6 (4.5) sec and 13.4 (6.7) sec). These data show that obesity slows dynamic responses of V˙O2 during cycling and the slower phase of vasodilation in contracting muscles of male and female adults.

  20. The one-leg standing radiograph

    OpenAIRE

    Pinsornsak, P.; Naratrikun, K.; Kanitnate, S.; Sangkomkamhang, T.

    2016-01-01

    Objectives The purpose of this study was to compare the joint space width between one-leg and both-legs standing radiographs in order to diagnose a primary osteoarthritis of the knee. Methods Digital radiographs of 100 medial osteoarthritic knees in 50 patients were performed. The patients had undergone one-leg standing anteroposterior (AP) views by standing on the affected leg while a both-legs standing AP view was undertaken while standing on both legs. The severity of the osteoarthritis wa...

  1. Total body and regional bone mineral content in hemodialysis patients

    International Nuclear Information System (INIS)

    Hagiwara, Satoshi; Aratani, Hideyui; Miki, Takami; Nishizawa, Yoshiki; Okamura, Terue; Koizumi, Yoshiko; Ochi, Hironobu; Morii, Hirotoshi

    1994-01-01

    Bone mineral content (BMC) in the total body and lumbar spine was evaluated in 126 hemodialysis patients (60 males, 66 females) by dual photon absorptiometry with the Norland DBD 2600. Measurements of: 1) total body BMC divided by lean body mass (BMC TB /LBM), 2) bone mineral density (BMD) of total body, 3) BMD of four regional sections (head, trunk, pelvis, and legs), and 4) BMD of lumbar spine, generally showed a significant decrease in the hemodialysis patients compared to the reference population. However, arm BMD did not show a significant difference between patients and control populations. The z-score of BMC TB /LBM declined significantly throughout the duration of hemodialysis, although that of the lumbar spine BMD did not. It should be noted that the degree of decrease in BMC was more prominent in the total body measurement than in the lumbar spine measurement. There was preferential osteopenia of the total body in the hemodialysis patients. Although the lumbar spine BMD showed a lower value than the control population, the lumbar spine is not the recommended region to monitor the BMD change in hemodialysis patients. (author)

  2. Cultural Aspects when Implementing Lean Production and Lean Product Development – Experiences from a Swedish Perspective

    Directory of Open Access Journals (Sweden)

    Promporn Wangwacharakul

    2014-07-01

    Full Text Available Lean principles and methods, originating in a Japanese cultural context, have spread to a large number of companies throughout the world. The aim of this case study research is to identify and compare national cultural aspects that influence Lean Production and Lean Product Development implementation in Swedish companies. Data were collected through questionnaires, interviews and an industrial workshop with Swedish Lean practitioners. The study shows that some sub-areas in Lean, such as value definition, control systems, leadership, team development, knowledge management, and strategies, are highly dependent on contextual factors related to human, cultural and organizational aspects. These are related to the national culture and should be considered to a higher extent for successful sustainable implementation of Lean in different cultural contexts. As for implementing Lean in Sweden, national cultural characteristics, such as individualism, autonomy and supportive management style fit well with Lean thinking.

  3. Lean Construction Supply Chain : A Literature Review

    OpenAIRE

    Ren, Jiamei

    2012-01-01

    The aim of this thesis is to enhance the management of supply systems in construction industry using lean principles. This study is an attempt to identify what kind of activities causes’ construction process delay and how to perform lean concept into supply chain in practice. The objective is to assure on-time delivery of information and materials to construction sites at lowest cost and maximum value for the customer. These study problems have been analysed from a lean construction supply ch...

  4. Apply Lean Thinking in Project Management

    OpenAIRE

    Pham Ngoc, Lan

    2015-01-01

    The purpose of this thesis was to study the effects of Lean Thinking in Project Management and how applying Lean Project Management could enhance the productivity of project work. The study was carried using theoretical research and collecting empirical data from three interviews and one case study at a local company. At the end of the study, the major project management problems at the company were identified and analyzed following Lean Principles. It was also pointed out where there...

  5. Lean Six Sigma in financial services

    OpenAIRE

    de Koning, H.; Does, R.J.M.M.; Bisgaard, S.

    2008-01-01

    Lean Thinking and Six Sigma are typically considered as separate approaches to process innovation, with complementary strengths. When combined as Lean Six Sigma, this approach provides a unified framework for systematically developing innovations. Lean Six Sigma can also bring about significant results and breakthrough improvements in financial services, as demonstrated with four case studies from Dutch multinational insurance companies. These cases demonstrate the importance of incremental i...

  6. Increase in Leg Stiffness Reduces Joint Work During Backpack Carriage Running at Slow Velocities.

    Science.gov (United States)

    Liew, Bernard; Netto, Kevin; Morris, Susan

    2017-10-01

    Optimal tuning of leg stiffness has been associated with better running economy. Running with a load is energetically expensive, which could have a significant impact on athletic performance where backpack carriage is involved. The purpose of this study was to investigate the impact of load magnitude and velocity on leg stiffness. We also explored the relationship between leg stiffness and running joint work. Thirty-one healthy participants ran overground at 3 velocities (3.0, 4.0, 5.0 m·s -1 ), whilst carrying 3 load magnitudes (0%, 10%, 20% weight). Leg stiffness was derived using the direct kinetic-kinematic method. Joint work data was previously reported in a separate study. Linear models were used to establish relationships between leg stiffness and load magnitude, velocity, and joint work. Our results found that leg stiffness did not increase with load magnitude. Increased leg stiffness was associated with reduced total joint work at 3.0 m·s -1 , but not at faster velocities. The association between leg stiffness and joint work at slower velocities could be due to an optimal covariation between skeletal and muscular components of leg stiffness, and limb attack angle. When running at a relatively comfortable velocity, greater leg stiffness may reflect a more energy efficient running pattern.

  7. Effect of gender and lean body mass on kidney size in healthy 10-year-old children

    DEFF Research Database (Denmark)

    Schmidt, I. M.; Mølgaard, C.; Main, K. M.

    2001-01-01

    predictor of kidney volume was lean body mass, overruling height, weight, and surface area. When total kidney volume was related to lean body mass as a ratio, the gender difference in kidney size was no longer significant. A strong negative correlation was found between fat body mass and kidney volume...

  8. Lean and the quality of work

    DEFF Research Database (Denmark)

    Jensen, Per Langaa

    2008-01-01

    Lean has for the last decade developed as the dominating model for developing productions processes not only within industry but also in health care, administration and service industries in general. With this development a discussion on human factors aspects of lean has developed internationally....... Literature studies documents that it is not possible to establish a clear relation between lean and the psychosocial aspects of work. The studies also indicate that the context and the implementations process play a dominating role in how lean is experienced. This has been the basis for establishing...

  9. Lean education an overview of current issues

    CERN Document Server

    Flumerfelt, Shannon; Kahlen, Franz-Josef

    2017-01-01

    This edited volume presents a structured approach to a new lean education curriculum, implemented for the education of engineers, managers, administrators as well as human resources developers. The authorship comprises professors and lecturers, trainers and practitioners who educate future professionals in Lean Thinking principles and tools. This edited book provides a platform for authors to share their efforts in building a Body of Knowledge (BoK) for Lean Education. The topical spectrum is state-of-the-art in this field, but the book also includes a glimpse into future developments. This is a highly informative and carefully presented book, providing valuable insight for scholars with an interest in Lean Education.

  10. Doppler ultrasound exam of an arm or leg

    Science.gov (United States)

    Peripheral vascular disease - Doppler; PVD - Doppler; PAD - Doppler; Blockage of leg arteries - Doppler; Intermittent claudication - Doppler; Arterial insufficiency of the legs - Doppler; Leg pain and ...

  11. A Methodology for the Assessment of Experiential Learning Lean: The Lean Experience Factory Study

    Science.gov (United States)

    De Zan, Giovanni; De Toni, Alberto Felice; Fornasier, Andrea; Battistella, Cinzia

    2015-01-01

    Purpose: The purpose of this paper is to present a methodology to assess the experiential learning processes of learning lean in an innovative learning environment: the lean model factories. Design/methodology/approach: A literature review on learning and lean management literatures was carried out to design the methodology. Then, a case study…

  12. Lean programm as a method of managing lean changes in the company

    Directory of Open Access Journals (Sweden)

    Suetina Tatiana Aleksandrovna

    2012-12-01

    Full Text Available This article is about methods and ways of providing changes on enterprices which introduce instruments of lean production. The main accent is how to use metodology of the project management by providing lean-changes. Lean program is proposed as a program of strategic developement of enterprices.

  13. Lean and Green Hand Surgery.

    Science.gov (United States)

    Van Demark, Robert E; Smith, Vanessa J S; Fiegen, Anthony

    2018-02-01

    Health care in the United States is both expensive and wasteful. The cost of health care in the United States continues to increase every year. Health care spending for 2016 is estimated at $3.35 trillion. Per capita spending ($10,345 per person) is more than twice the average of other developed countries. The United States also leads the world in solid waste production (624,700 metric tons of waste in 2011). The health care industry is second only to the food industry in annual waste production. Each year, health care facilities in the United States produce 4 billion pounds of waste (660 tons per day), with as much as 70%, or around 2.8 billion pounds, produced directly by operating rooms. Waste disposal also accounts for up to 20% of a hospital's annual environmental services budget. Since 1992, waste production by hospitals has increased annually by a rate of at least 15%, due in part to the increased usage of disposables. Reduction in operating room waste would decrease both health care costs and potential environmental hazards. In 2015, the American Association for Hand Surgery along with the American Society for Surgery of the Hand, American Society for Peripheral Nerve Surgery, and the American Society of Reconstructive Microsurgery began the "Lean and Green" surgery project to reduce the amount of waste generated by hand surgery. We recently began our own "Lean and Green" project in our institution. Using "minor field sterility" surgical principles and Wide Awake Local Anesthesia No Tourniquet (WALANT), both surgical costs and surgical waste were decreased while maintaining patient safety and satisfaction. As the current reimbursement model changes from quantity to quality, "Lean and Green" surgery will play a role in the future health care system. Copyright © 2018 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

  14. Lean production of intensive cities

    DEFF Research Database (Denmark)

    Ratner, Helene Gad; Bojesen, Anders; Bramming, Pia

    2014-01-01

    turnover. This is analysed in terms of Italo Calvino's Invisible cities. It is argued that Calvino's themes and prose help us understand change as a multiplicity of temporal intensities producing ambivalence and affect. We describe this use of literary abstractions as a ‘hyperbolic social epistemology......’. Through the depiction of four intensifications of Lean Production, the metaphors of Calvino's cities show how reality and illusion; hope and poverty; dreams and death and utopia and dystopia are intricately mingled and produce temporary and equally ambivalent affects of alienation, hypocrisy, self...

  15. Increasing Production and Eliminating Waste through Lean Tools and Techniques for Halal Food Companies

    OpenAIRE

    Malihe Manzouri; Mohd Nizam Ab-Rahman; Che Rosmawati Che Mohd Zain; Ezad Azraai Jamsari

    2014-01-01

    Major businesses around the world have been trying to reduce the total cost and wastes across their supply chain to remain competitive in the expanding global market. Hence, a collection of reliable tools and techniques are vital for decreasing costs and wastes and for providing effective services for customer demands. Given that lean concept attempts to decrease costs and wastes, this study aims to identify the effective lean tools required for eliminating wastes in the supply chain. Because...

  16. Comparative study of lean practices between Japanese and Malaysia automotive service centres

    Science.gov (United States)

    Ahmad, Md Fauzi; Ting, Neo Yeong; Nor, Nik Hisyamudin Muhd; Wei, Chan Shiau; Hassan, Mohd Fahrul; Hamid, Nor Aziati Abdul

    2017-10-01

    Nowadays, lean practices are implemented in many manufacturing and services companies. Lean practices are implemented in order to minimize wastes while maximise the overall performances in an organisation. In service sector, lean practices are importance to ensure value added services can be delivered to customers. However, Malaysia automotive companies cannot compete with Japanese automotive companies in terms of their customer satisfaction. The purpose of this study is to compare the lean practice between Japanese and Malaysia automotive service centres. A total of 80 questionnaires out of 100 distributed questionnaires were responded and this represented as 80% of response rate. The Mann-Whitney test result shows that there were four out of five factors of lean practices have significant differences between Japanese and Malaysia automotive service centres, which are TPM, JIT, Kanban, and 5S. VSM has not significant difference between ownerships. In addition, TPM, JIT, Kanban, VSM and 5S were higher practices in Japanese companies against Malaysia companies. Many Malaysia companies are still in the journey of lean practices and they need recommendation guidance to compete with other long-term established companies. Based on the survey result, the significant differences are identified as weak points of Malaysia companies as an opportunity to improve. Moreover, the significance of this study can help researchers and industry players to improve lean practices in automotive service industry.

  17. TQM and lean strategy deployment in Italian hospitals.

    Science.gov (United States)

    Chiarini, Andrea; Baccarani, Claudio

    2016-10-03

    Purpose This paper aims to contribute to the debate concerning total quality management (TQM)-Lean strategy in public healthcare by analyzing the deployment path for implementation, the possible benefits that can be achieved and the encountered pitfalls. Design/methodology/approach Three case studies are drawn from three large Italian hospitals with more than 500 beds each and structured with many departments. The hospitals are located in Tuscany, Italy. These three hospitals have embraced TQM and Lean, starting from strategic objectives and their deployment. At the same time, they have also implemented many TQM-Lean tools. The case studies are based on interviews held with four managers in each of these three public hospitals. Findings Results from the interviews show that there is a specific deployment path for TQM-Lean implementation. The hospitals have also achieved benefits linked to patient satisfaction and improved organizational performances. Problems related to organizational and cultural issues, such as senior managers' commitment, staff management, manufacturing culture and tools adaptation, could affect the benefits. Research limitations/implications The research has been carried out in just three Italian public hospitals. Hence, similar investigations could be managed in other countries. Researchers could also use a larger sample and investigate these issues by means of quantitative inquiry. Practical implications Practitioners could try to apply the deployment path revealed by these case studies in other public and private hospitals. Originality/value The results of this research show that there is a specific, new deployment path for implementing TQM-Lean strategy in some public hospitals.

  18. Model Development and Process Analysis for Lean Cellular Design Planning in Aerospace Assembly and Manufacturing

    Science.gov (United States)

    Hilburn, Monty D.

    factors are critical inputs into the support staffing resources calculation used by the lean planning model. Null hypothesis related to functional support staff resources was rejected for most functional groups, indicating that the baseline site plan inadequately provided for cross-functional staff involvement to support the lean transformation plan. Null hypotheses related to total lean transformation staffing could not be rejected, indicating that while total staffing plans were not significantly different than plans developed during the on-site review and through the use of the lean planning model, the allocation of staffing among various functional groups such as engineering, production, and materials planning was an issue. The on-site review process and simple lean transformation plan developed was determined to be useful in identifying short-comings in lean transformation planning within aerospace manufacturing and assembly sites. It was concluded that the differences uncovered were likely contributing factors affecting the effectiveness of aerospace manufacturing sites' implementation of lean cellular manufacturing.

  19. The LEAN Payload Integration Process

    Science.gov (United States)

    Jordan, Lee P.; Young, Yancy; Rice, Amanda

    2011-01-01

    It is recognized that payload development and integration with the International Space Station (ISS) can be complex. This streamlined integration approach is a first step toward simplifying payload integration; making it easier to fly payloads on ISS, thereby increasing feasibility and interest for more research and commercial organizations to sponsor ISS payloads and take advantage of the ISS as a National Laboratory asset. The streamlined integration approach was addressed from the perspective of highly likely initial payload types to evolve from the National Lab Pathfinder program. Payloads to be accommodated by the Expedite the Processing of Experiments for Space Station (EXPRESS) Racks and Microgravity Sciences Glovebox (MSG) pressurized facilities have been addressed. It is hoped that the streamlined principles applied to these types of payloads will be analyzed and implemented in the future for other host facilities as well as unpressurized payloads to be accommodated by the EXPRESS Logistics Carrier (ELC). Further, a payload does not have to be classified as a National Lab payload in order to be processed according to the lean payload integration process; any payload that meets certain criteria can follow the lean payload integration process.

  20. Lean production and business performance: influences of ...

    African Journals Online (AJOL)

    Hence, this study aims to examine the influence of leadership style in the implementation of lean production. Data were gathered from randomly selected Malaysian manufacturing firms. Findings reveal a positive relationship between lean production and business performance. Specifically, democratic leadership style was ...

  1. Just-in-Time og Lean Manufacturing

    DEFF Research Database (Denmark)

    Michelsen, Aage U.

    2004-01-01

    Filosofi, principper og teknikker i JIT. Princip i Kanban-styring og dimensionering af et Kanban-system. Lean Thinking og Value Stream Mapping.......Filosofi, principper og teknikker i JIT. Princip i Kanban-styring og dimensionering af et Kanban-system. Lean Thinking og Value Stream Mapping....

  2. Indførelse af Lean principper

    DEFF Research Database (Denmark)

    Balmer, Christian; Michelsen, Aage U

    2004-01-01

    I artiklen beskrives, hvorledes lean-principper er indført i en forsikringsvirksomhed samt de opnåede resultater.......I artiklen beskrives, hvorledes lean-principper er indført i en forsikringsvirksomhed samt de opnåede resultater....

  3. Principles of lean planning and control

    NARCIS (Netherlands)

    Riezebos, J.

    2015-01-01

    Lean production systems use teams instead of functional departments as well as simple shop floor control methods to manage the flow of orders at the shop floor. Lean shop floor control focuses on robust and visual methods that are able to cope with variation in processing times, routing sequences,

  4. De praktijk van Lean Six Sigma

    NARCIS (Netherlands)

    Does, R.J.M.M.; de Koning, H.

    2008-01-01

    Zowel Lean als Six Sigma zijn benaderingen van kwaliteits- en efficiëntieverbetering die op dit moment sterk in de belangstelling staan van zowel de industrie als de dienstverlening. Lean Six Sigma integreert beide benaderingen. Ze wordt door sommigen gezien als panacee voor alle mogelijke

  5. Disturbing Practices: Training Workers to Be Lean

    Science.gov (United States)

    Yasukawa, Keiko; Brown, Tony; Black, Stephen

    2014-01-01

    Purpose: The purpose of this paper is to explore the possibilities for expansive learning during organisational change. It considers the introduction of "lean production" as a disturbance to the existing work practices. Design/methodology/approach: The paper considers two case studies of "lean production" training with…

  6. Advancing lean manufacturing, the role of IT

    NARCIS (Netherlands)

    Riezebos, J.; Klingenberg, W.

    This introduction to the special issue discusses the changing role of information technology (IT) in advancing lean production. Lean principles and techniques have been applied in a wide variety of organisations, from make-to-stock to engineer-to-order industries, and even in typical service

  7. Lean in healthcare from employees' perspectives.

    Science.gov (United States)

    Drotz, Erik; Poksinska, Bozena

    2014-01-01

    The purpose of this paper is to contribute toward a deeper understanding of the new roles, responsibilities, and job characteristics of employees in Lean healthcare organizations. The paper is based on three cases studies of healthcare organizations that are regarded as successful examples of Lean applications in the healthcare context. Data were collected by methods including interviews, observations, and document studies. The implementation of Lean in healthcare settings has had a great influence on the roles, responsibilities, and job characteristics of the employees. The focus has shifted from healthcare professionals, where clinical autonomy and professional skills have been the guarding principles of patient care, to process improvement and teamwork. Different job characteristics may make it difficult to implement certain Lean practices in healthcare. Teamwork and decentralization of authority are examples of Lean practices that could be considered countercultural because of the strong professional culture and uneven power distribution, with doctors as the dominant decision makers. Teamwork, value flow orientation, and company-wide involvement in CI were associated with positive effects on the organizations' working environment, staff development, and organizational performance. In order to succeed with Lean healthcare, it is important to understand and recognize the differences in job characteristics between Lean manufacturing and healthcare. This paper provides insights into how Lean implementation changes the roles, responsibilities, and job characteristics of healthcare staff and the challenges and implications that may follow from this.

  8. Lean Six Sigma in a hospital

    NARCIS (Netherlands)

    van den Heuvel, J.; Does, R.J.M.M.; de Koning, H.

    2006-01-01

    Abstract Hospitals today face major challenges. Patients demand quality of care to be improved continuously. Health insurance companies demand the lowest possible prices. Lean Six Sigma is a program that can help healthcare providers to achieve these (seemingly) conflicting goals. Lean Six Sigma is

  9. Genetic variation in efficiency to deposit fat and lean meat in Norwegian Landrace and Duroc pigs.

    Science.gov (United States)

    Martinsen, K H; Ødegård, J; Olsen, D; Meuwissen, T H E

    2015-08-01

    Feed costs amount to approximately 70% of the total costs in pork production, and feed efficiency is, therefore, an important trait for improving pork production efficiency. Production efficiency is generally improved by selection for high lean growth rate, reduced backfat, and low feed intake. These traits have given an effective slaughter pig but may cause problems in piglet production due to sows with limited body reserves. The aim of the present study was to develop a measure for feed efficiency that expressed the feed requirements per 1 kg deposited lean meat and fat, which is not improved by depositing less fat. Norwegian Landrace ( = 8,161) and Duroc ( = 7,202) boars from Topigs Norsvin's testing station were computed tomography scanned to determine their deposition of lean meat and fat. The trait was analyzed in a univariate animal model, where total feed intake in the test period was the dependent variable and fat and lean meat were included as random regression cofactors. These cofactors were measures for fat and lean meat efficiencies of individual boars. Estimation of fraction of total genetic variance due to lean meat or fat efficiency was calculated by the ratio between the genetic variance of the random regression cofactor and the total genetic variance in total feed intake during the test period. Genetic variance components suggested there was significant genetic variance among Norwegian Landrace and Duroc boars in efficiency for deposition of lean meat (0.23 ± 0.04 and 0.38 ± 0.06) and fat (0.26 ± 0.03 and 0.17 ± 0.03) during the test period. The fraction of the total genetic variance in feed intake explained by lean meat deposition was 12% for Norwegian Landrace and 15% for Duroc. Genetic fractions explained by fat deposition were 20% for Norwegian Landrace and 10% for Duroc. The results suggested a significant part of the total genetic variance in feed intake in the test period was explained by fat and lean meat efficiency. These new

  10. Restless legs syndrome in hemodialysis patients

    Directory of Open Access Journals (Sweden)

    Shahram Rafie

    2016-01-01

    Full Text Available Restless legs syndrome (RLS is a neurological disorder characterized by uncomfortable sensation of paresthesia in legs that subsequently causes involuntary and continuous movement of the lower limbs, especially at rest. Its prevalence in hemodialysis is more than that in the general population. Different risk factors have been suggested for RLS. We studied the prevalence and risk factors of RLS in 137 hemodialysis patients followed up at our center. The patients completed at least three months on dialysis and fulfilled four criteria for the diagnosis of RLS. We compared the patients with and without RLS, and the odds ratios (ORs were estimated by the logistic regression models. The prevalence of RLS was 36.5% in the study patients. Among the variables, diabetes was the only predicting factor for the development of RLS. The diabetic patients may be afflicted with RLS 2.25 times more than the non-diabetics. Women developed severe RLS 5.23 times more than men. Neurodegeneration, decrease in dopamine level, higher total oxidant status, and neuropathy in diabetic patients may explain the RLS symptoms.

  11. [Etiological diagnosis of leg ulcers].

    Science.gov (United States)

    Debure, Clélia

    2010-09-20

    Etiological diagnosis of leg ulcers must be the first step of treatment, even if we know that veinous disease is often present. We can build a clinical decisional diagram, which helps us to understand and not forget the other causes of chronic wounds and choose some basic examination, like ultrasound and histological findings. This diagnosis helps to choose the right treatment in order to cure even the oldest venous ulcers. Educational programs should be improved to prevent recurrence.

  12. Correlates of increased lean muscle mass in women with polycystic ovary syndrome.

    Science.gov (United States)

    Carmina, E; Guastella, E; Longo, R A; Rini, G B; Lobo, R A

    2009-10-01

    Muscle mass plays an important role in determining cardiovascular and metabolic risks in polycystic ovary syndrome (PCOS). In addition, whether lean mass influences carotid intima-media thickness (IMT) in PCOS has not been assessed. Prospective investigation. Ninety-five women with PCOS were age- and weight-matched to 90 ovulatory controls. All women had dual X-ray absorptiometry for lean, fat and bone mass, and bone mass density (BMD). Serum testosterone, sex hormone-binding globulin, insulin, and glucose and carotid IMT were determined. Free androgen index (FAI) and insulin resistance (by QUICKI) were calculated. In PCOS, waist circumference and insulin were higher and QUICKI lower than in controls (Plean mass were higher in PCOS compared to controls (PPCOS (PPCOS patients had abnormal (> or = 0.9 mm) values. Lean mass correlated with fat parameters, insulin, QUICKI, and FAI, but not with total testosterone; and after adjustments for insulin and QUICKI, lean mass still correlated with fat mass (PLean mass correlated with IMT (Plean mass independently of insulin. Bone mass correlated with lean and fat mass, but not with insulin or androgen. PCOS patients with 'pathological' IMT values had higher % trunk fat, lean mass, and insulin, lower QUICKI, and higher testosterone and FAI compared with those with normal IMT. Lean mass is increased in PCOS, while bone mass is similar to that of matched controls. The major correlates of lean mass are fat mass and insulin but not androgen. Lean mass also correlated with IMT, and although influenced by insulin, small changes in IMT may partially reflect changes in muscle mass, while clearly abnormal values relate to more severe abnormalities of PCOS.

  13. Skaber lean bedre arbejdsmiljø?

    DEFF Research Database (Denmark)

    Hansen, Nanette Juhler

    2007-01-01

    rationalization strategies, among others Lean, claim to improve working conditions. The aim of this thesis is to identify whether the application of Lean strategies leads to a reduction of the occupational health and safety problem repetitive work. Repetitive work is a problem created by the Taylorisation of work......, and therefore it is to be expected that a break with one or more of the Tayloristic principles can lead to a reduction of repetitive work. This thesis points out a number of areas within which Lean breaks with Tayloristic principles, whilst other principles are maintained. These breaks between Lean...... and Taylorism are also found in the study of the case company. By linking breaks with Taylorism with solutions for the reduction of repetitive work, I point out a number of openings in Lean that may lead to a reduction of repetitive work. By using the concept of openings I present the possibilities offered...

  14. Lean thinking for a maintenance process

    Directory of Open Access Journals (Sweden)

    Sherif Mostafa

    2015-01-01

    Full Text Available The maintenance process shares significant operating costs in an organisation. Lean thinking can be incorporated into maintenance activities through applying its principles and practices/tools. Lean maintenance (LM is a prerequisite for lean manufacturing systems. This research proposes a new structure for LM process based on a systematic literature review of a significant number of related articles that were published on LM. The process structure is designed based on the five lean principles to guide and support organisations to pursue maintenance excellence. This study establishes a scheme for LM tools that are structured into 2 level 4 bundles and 26 lean practices/tools and develops a House of Waste (HoW to demonstrate the association between maintenance wastes and the LM tools. With a successful accomplishment of the proposed scheme, the performance of a maintenance department can create more improvement opportunities over time to reach the maintenance excellence status.

  15. Transferring lean management infrastructure for increasing productivity

    Directory of Open Access Journals (Sweden)

    Ph.D.Daniel Georgescu

    2010-12-01

    Full Text Available These years, manufacturing function have been transferred rapidly and globally from matured countries to emerging countries. In this paper is about the critical elements for successful transfer of lean management among sites and countries. Based on this general descriptive analysis, current global transfer activity of Lean as well as its future direction is also described. According to the gradual progress of lean management transfer, necessity of its refinement/reinforcement is recognized and some research subjects are proposed for contributing further encouragement of its global activities. In this paper, based on this understanding, requisites for transfer of lean management are discussed through investigating global activity of Lean and specification of infrastructure enabling its smooth transfer is examined

  16. Modelling Lean and Green Supply Chain

    Science.gov (United States)

    Duarte, Susana Carla Vieira Lino Medina

    The success of an organization depends on the effective control of its supply chain. It is important to recognize new opportunities for organization and its supply chain. In the last few years the approach to lean, agile, resilient and green supply chain paradigms has been addressed in the scientific literature. Research in this field shows that the integration of these concepts revealed some contradictions among so many paradigms. This thesis is mainly focused on the lean and green approaches. Thirteen different management frameworks, embodied in awards, standards and tools were studied to understand if they could contribute for the modelling process of a lean and green approach. The study reveals a number of categories that are common in most management frameworks, providing adequate conditions for a lean and green supply chain transformation. A conceptual framework for the evaluation of a lean and green organization`s supply chain was proposed. The framework considers six key criteria, namely, leadership, people, strategic planning, stakeholders, processes and results. It was proposed an assessment method considering a criteria score for each criterion. The purpose is to understand how lean and green supply chain can be compatible, using principles, practices, techniques or tools (i.e. elements) that support both, a lean and a green approach, in all key criteria. A case study in the automotive upstream supply chain was performed to understand more deeply if the elements proposed for the conceptual framework could be implemented in a real-scenario. Based on the conceptual framework and the case study, a roadmap to achieve a lean-green transformation is presented. The proposed roadmap revealed its contribution to the understanding on how and when an organization`s supply chain should apply the lean and green elements. This study is relevant to practice, as it may assist managers in the adoption of a lean and green supply chain approach, giving insights for the

  17. Comparative study: TQ and Lean Production ownership models in health services.

    Science.gov (United States)

    Eiro, Natalia Yuri; Torres-Junior, Alvair Silveira

    2015-01-01

    compare the application of Total Quality (TQ) models used in processes of a health service, cases of lean healthcare and literature from another institution that has also applied this model. this is a qualitative research that was conducted through a descriptive case study. through critical analysis of the institutions studied it was possible to make a comparison between the traditional quality approach checked in one case and the theoretical and practice lean production approach used in another case and the specifications are described below. the research identified that the lean model was better suited for people that work systemically and generate the flow. It also pointed towards some potential challenges in the introduction and implementation of lean methods in health.

  18. An empirical review of lean manufacturing and their strategies

    Directory of Open Access Journals (Sweden)

    Virender Chahal

    2017-07-01

    Full Text Available The theory of lean manufacturing provides the quality of the products in minimum cost and pro-vides customer satisfaction. Today, the competition level is very high and every industry tries to supply high quality products in nominal cost, so lean is the latest tool to achieve. The objective of this paper is to study different lean concepts under various lean strategies. This study helps to find out the status of lean manufacturing and its ways of implementation. Also in this paper, there is a discussion about lean manufacturing concept, lean waste, lean strategies, lean barriers and cycle of lean implementation. This paper presents a literature review to clear the status of lean manufacturing and their strategies with help of collection of relevant papers.

  19. Mechanical Deformation Behavior of Lean Duplex 329LA Steel

    Energy Technology Data Exchange (ETDEWEB)

    Yoon, Byung-Jun [Research Institute of Industrial Science and Technology, Pohang (Korea, Republic of); Choi, Jeom-Yong [POSCO Technical Research Lab., Pohang (Korea, Republic of); Park, Kyung-Tae [Hanvat National University, Daejeon (Korea, Republic of); Lee, Ho Seong [Kyungpook National University, Daegu (Korea, Republic of)

    2015-09-15

    The tensile response of Lean Duplex 329LA stainless steel was investigated over various strain rates. It was observed that the mechanical response, including in particular the total elongation of the tested alloy, was strongly affected by the strain rate. As the strain rate decreased from 10-1 s-1 to 10-4 s-1, the elongation increased. As the strain rate increased, the deformation mode in an austenite phase was dominated by dislocation glide, resulting in deterioration of the elongation. The substructure of the ferritic phase showed a dislocation cell structure, independent of the applied strain rate. The optimum mechanical properties of lean duplex stainless steel thus can be obtained by controlling the deformation mode in the austenitic phase.

  20. Mechanical Deformation Behavior of Lean Duplex 329LA Steel

    International Nuclear Information System (INIS)

    Yoon, Byung-Jun; Choi, Jeom-Yong; Park, Kyung-Tae; Lee, Ho Seong

    2015-01-01

    The tensile response of Lean Duplex 329LA stainless steel was investigated over various strain rates. It was observed that the mechanical response, including in particular the total elongation of the tested alloy, was strongly affected by the strain rate. As the strain rate decreased from 10-1 s-1 to 10-4 s-1, the elongation increased. As the strain rate increased, the deformation mode in an austenite phase was dominated by dislocation glide, resulting in deterioration of the elongation. The substructure of the ferritic phase showed a dislocation cell structure, independent of the applied strain rate. The optimum mechanical properties of lean duplex stainless steel thus can be obtained by controlling the deformation mode in the austenitic phase.

  1. Adapting lean to histology laboratories.

    Science.gov (United States)

    Buesa, René J

    2009-10-01

    Histology laboratories (histolabs) can increase productivity and reduce turnaround time and errors by using any one of several available management tools. After a few years of operation, all histolabs develop workflow problems. Histology laboratories handling more than 20,000 cases per year benefit the most from implementing management tools, as occurred in the 25 facilities summarized in this article. Discontinuous workflow, lack of "pulling" between steps, accepting unavoidable waiting times while working with small batches within work cells, and a workflow with an uneven rate of completion, are some of the adaptations required by the Lean system when it is used in histology because 70% of the tasks are manual and the flow has to be interrupted to add value to the pieces of tissue during tissue processing, no matter how short that step is. After all these adaptations are incorporated, the histolab becomes as "Lean" as it can be, and the qualifier is also a recognition of the effort and personnel involvement in the implementation. Given its service nature, productivity increments do not expand the histolab customer base and could lead to staffing reductions. This is one of the causes of reluctance by some employees for implementing these techniques which are mostly driven by cost reductions sought by insurance companies and administrators, and not necessarily because of a real medical need to reduce the turnaround time. Finally, any histolab wanting to improve its workflow can follow some easy steps presented here as a guide to accomplish that objective. These steps stress the need for the supervisors to insure that the personnel in the histology laboratory are being paid at a comparable rate as other histolabs in the area.

  2. Overweight adult cats have significantly lower voluntary physical activity than adult lean cats.

    Science.gov (United States)

    de Godoy, Maria Rc; Shoveller, Anna K

    2017-12-01

    Objectives The objectives of the current pilot study were to evaluate whether body condition score (BCS) and body weight are significantly related to physical activity counts, and to evaluate potential interaction between BCS and voluntary physical activity measured over a 14 day period. Methods Ten (five lean, five overweight), neutered, adult American Shorthair cats were selected for this study (median age 4 ± 0.5 years). Cats with a BCS of ⩽3.0 were considered lean, whereas cats with a BCS >3.0 were considered overweight, using a 5-point scale. Cats were housed in a free-living environment with indoor/outdoor access and were individually fed once daily a commercially available dry extruded diet and allowed 1 h to eat. Voluntary physical activity was measured consecutively for 14 days using the Actical Activity Monitors that were worn parallel to the ribs and attached via a harness. Results Lean cats had a greater mean total daily voluntary physical activity ( P = 0.0059), and a greater voluntary physical activity during light ( P = 0.0023) and dark ( P = 0.0446) periods, with overweight cats having 60% of the physical activity of lean cats. Lean cats were more active before feeding and during animal care procedures. These data suggest that lean cats have a greater anticipatory physical activity prior to feeding and are more eager to have social interaction with humans than overweight cats. A significant interaction was observed between day of physical activity measurement and BCS for total daily voluntary physical activity ( P = 0.0133) and activity during the light period ( P = 0.0016) where lean cats were consistently more active than overweight cats. In general, cats were more active during weekdays vs weekends. Conclusions and relevance The results of this study suggest that overweight cats are less active than lean cats and that voluntary physical activity level appears to be influenced by social interaction with humans.

  3. Lean in healthcare: the unfilled promise?

    Science.gov (United States)

    Radnor, Zoe J; Holweg, Matthias; Waring, Justin

    2012-02-01

    In an effort to improve operational efficiency, healthcare services around the world have adopted process improvement methodologies from the manufacturing sector, such as Lean Production. In this paper we report on four multi-level case studies of the implementation of Lean in the English NHS. Our results show that this generally involves the application of specific Lean 'tools', such as 'kaizen blitz' and 'rapid improvement events', which tend to produce small-scale and localised productivity gains. Although this suggests that Lean might not currently deliver the efficiency improvements desired in policy, the evolution of Lean in the manufacturing sector also reveals this initial focus on the 'tool level'. In moving to a more system-wide approach, however, we identify significant contextual differences between healthcare and manufacturing that result in two critical breaches of the assumptions behind Lean. First, the customer and commissioner in the private sector are the one and the same, which is essential in determining 'customer value' that drives process improvement activities. Second, healthcare is predominantly designed to be capacity-led, and hence there is limited ability to influence demand or make full use of freed-up resources. What is different about this research is that these breaches can be regarded as not being primarily 'professional' in origin but actually more 'organisational' and 'managerial' and, if not addressed could severely constrain Lean's impact on healthcare productivity at the systems level. Copyright © 2011 Elsevier Ltd. All rights reserved.

  4. The human side of lean teams.

    Science.gov (United States)

    Wackerbarth, Sarah B; Strawser-Srinath, Jamie R; Conigliaro, Joseph C

    2015-05-01

    Organizations use lean principles to increase quality and decrease costs. Lean projects require an understanding of systems-wide processes and utilize interdisciplinary teams. Most lean tools are straightforward, and the biggest barrier to successful implementation is often development of the team aspect of the lean approach. The purpose of this article is to share challenges experienced by a lean team charged with improving a hospital discharge process. Reflection on the experience provides an opportunity to highlight lessons from The Team Handbook by Peter Scholtes and colleagues. To improve the likelihood that process improvement initiatives, including lean projects, will be successful, organizations should consider providing training in organizational change principles and team building. The authors' lean team learned these lessons the hard way. Despite the challenges, the team successfully implemented changes throughout the organization that have had a positive impact. Training to understand the psychology of change might have decreased the resistance faced in implementing these changes. © 2014 by the American College of Medical Quality.

  5. Leading Lean: a Canadian healthcare leader's guide.

    Science.gov (United States)

    Fine, Benjamin A; Golden, Brian; Hannam, Rosemary; Morra, Dante

    2009-01-01

    Canadian healthcare organizations are increasingly asked to do more with less, and too often this has resulted in demands on staff to simply work harder and longer. Lean methodologies, originating from Japanese industrial organizations and most notably Toyota, offer an alternative - tried and tested approaches to working smarter. Lean, with its systematic approaches to reducing waste, has found its way to Canadian healthcare organizations with promising results. This article reports on a study of five Canadian healthcare providers that have recently implemented Lean. We offer stories of success but also identify potential obstacles and ways by which they may be surmounted to provide better value for our healthcare investments.

  6. A Hydroxyurea-induced Leg Ulcer

    OpenAIRE

    Hwang, Seon-Wook; Hong, Soon-Kwon; Kim, Sang-Hyun; Seo, Jong-Keun; Lee, Deborah; Sung, Ho-Suk

    2009-01-01

    Hydroxyurea is a cytostatic agent that has recently become the drug of choice in the treatment of various myeloproliferative diseases. The cutaneous side effects of hydroxyurea include xerosis, hyperpigmentation, nail discoloration, and scaling. Leg ulcers have only rarely been reported in association with hydroxyurea treatment. A 75-year-old woman presented with leg ulcers, nail discoloration, and xerosis. The leg ulcers were refractory to conventional treatment. She had been taking oral hyd...

  7. Leg tissue composition and physico-chemical parameters of sheep meat fed annatto coproduct

    Directory of Open Access Journals (Sweden)

    Dorgival Morais de Lima Júnior

    2017-10-01

    Full Text Available Our objective was to evaluate leg tissue composition and physico-chemical quality parameters of sheep meat fed with increasing levels of annatto coproduct. 32 male uncastrated animals without a defined breed were randomized in four treatments (0, 100, 200 and 300 g kg-1 of annatto coproduct in the DM diet. After 78 days of confinement, the animals were slaughtered and body components were recorded. Reconstituted leg weight, total muscle weight, biceps weight and semitendinosus weight showed a negative linear behavior (P 0.05 were found for leg tissue composition (%, muscle:bone ratio, relative fat or leg muscle. Meat physico-chemical parameters (color, shear force, water retention capacity and cooking losses were not affected by the inclusion of the annatto coproduct in the diet. The annatto coproduct can be included in up to 300 g kg-1 of dietary dry matter without negative effects to the leg tissue composition (% and physical parameters of confined sheep meat.

  8. Lean Principles’Potential Measurement Framework for Service Organization

    Directory of Open Access Journals (Sweden)

    M. D. Vadhvani

    2016-06-01

    Full Text Available Role of service sector can be considered vital as these industries are accountable for accelerating the major functions of the secondary organizations. Hence it is a very important element of economy in enhancing competitive dimensions- quality, flexibility, cost and delivery. Improvement initiatives such as Total Quality Management, Lean Practices, and Leansigma focus on increasing the competitive dimensions. Among these Lean Practices are having the inherent principles of reducing the cost and increasing the quality by focusing the non value added activities from the value chain of the service or product. Lean Principles (LPs are being practiced since long by the organizations of secondary sectors and followed by that of the tertiary sectors. Albeit the reported improvement achieved are limited by the drawbacks such as lack of proper set of guidelines, partial features of measurable characteristics, lack of guideline for measurement. Present work proposes a measurement frame work with aids of flowchart and questionnaire for measuring the potential of LPs in service organization which help them to take accompanying initiatives to implement the LPs.

  9. Effects of Eating Fresh Lean Pork on Cardiometabolic Health Parameters

    Directory of Open Access Journals (Sweden)

    Peter R. C. Howe

    2012-07-01

    Full Text Available High protein meat-based diets are commonly promoted for weight loss, supposedly by increasing satiety and energy expenditure. Pork is a good source of protein however little information on the metabolic effects of pork consumption exists. This pilot study aimed to examine whether regular consumption of fresh lean pork could improve body composition and cardiovascular risk factors in a 6 month parallel intervention trial. 164 overweight adults (mean BMI 32 were randomly assigned to incorporate up to 1 kg pork/week by substituting for other foods or maintain their habitual diet (control. Plasma levels of lipids, glucose and insulin, BMI, waist/hip circumference, blood pressure, heart rate and arterial compliance were measured at baseline and 3 and 6 months. Body composition was determined using dual energy X-ray absorptiometry. A total of 144 volunteers completed and volunteers in the pork group increased their intake 10 fold by substituting pork for mainly beef and chicken. After 3 months, there were significant (p ≤ 0.01 reductions in weight, BMI, waist circumference, % body fat, fat mass and abdominal fat in the pork group relative to controls, which persisted for 6 months. There was no change in lean mass, indicating that the reduction in weight was due to loss of fat mass. There were no significant effects on other metabolic parameters. Regular consumption of lean fresh pork may improve body composition.

  10. Assessment of insulin resistance in lean women with polycystic ovary syndrome.

    Science.gov (United States)

    Morciano, Andrea; Romani, Federica; Sagnella, Francesca; Scarinci, Elisa; Palla, Carola; Moro, Francesca; Tropea, Anna; Policola, Caterina; Della Casa, Silvia; Guido, Maurizio; Lanzone, Antonio; Apa, Rosanna

    2014-07-01

    To develop and validate a specific simple measure of insulin sensitivity using oral glucose tolerance test (OGTT) values for lean polycystic ovary syndrome (PCOS) women. Retrospective study. Gynecologic Outpatient Clinic of University Hospital, affiliated with Unit of Gynecologic Endocrinology. Totals of 201 lean and 198 overweight/obese (ov-ob) nondiabetic PCOS patients were retrospectively selected. None. All patients underwent OGTT, euglycemic-hyperinsulinemic clamp, and androgenic and biochemical assays. The predictive performance of each insulin resistance (IR) index was analyzed with the use of receiver operating characteristic (ROC) curves. Higher correlation coefficients with clamp studies were obtained with the Belfiore Area (RS=0.579) and the homeostasis-model assessment (HOMA)-M120 (RS=-0.576) in lean PCOS patients and with the Sib (RS=0.697) in ov-ob PCOS patients. The best predictive index of IR in lean PCOS was a HOMA-M120 value of ≥12.8 or more (area under the ROC curve [AUC] 92.4%). In the ov-ob PCOS population, the best predictive performance was obtained by a Sib of ≤10.2 or less (AUC 85.7%). IR should be assessed in all PCOS women, both lean and ov-ob subjects. The HOMA-M120 resulted as a very simple tool, validated specifically for the lean PCOS woman whose cardiometabolic impairment is more frequently misunderstood. Copyright © 2014 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  11. The impact of Lean bundles on hospital performance: does size matter?

    Science.gov (United States)

    Al-Hyari, Khalil; Abu Hammour, Sewar; Abu Zaid, Mohammad Khair Saleem; Haffar, Mohamed

    2016-10-10

    Purpose The purpose of this paper is to study the effect of the implementation of Lean bundles on hospital performance in private hospitals in Jordan and evaluate how much the size of organization can affect the relationship between Lean bundles implementation and hospital performance. Design/methodology/approach The research is considered as quantitative method (descriptive and hypothesis testing). Three statistical techniques were adopted to analyse the data. Structural equation modeling techniques and multi-group analysis were used to examine the research's hypothesis, and to perform the required statistical analysis of the data from the survey. Reliability analysis and confirmatory factor analysis were used to test the construct validity, reliability and measurement loadings that were performed. Findings Lean bundles have been identified as an effective approach that can dramatically improve the organizational performance of private hospitals in Jordan. Main Lean bundles - just in time, human resource management, and total quality management are applicable to large, small and medium hospitals without significant differences in advantages that depend on size. Originality/value According to the researchers' best knowledge, this is the first research that studies the impact of Lean bundles implementation in healthcare sector in Jordan. This research also makes a significant contribution for decision makers in healthcare to increase their awareness of Lean bundles.

  12. Making it lean applying lean practices to the work of it

    CERN Document Server

    Williams, Howard

    2013-01-01

    Making IT Lean: Applying Lean Practices to the Work of IT presents Lean concepts and techniques for improving processes and eliminating waste in IT operations and IT Service Management, in a manner that is easy to understand. The authors provide a context for discussing several areas of application within this domain, allowing you to quickly gain insight into IT processes and Lean principles.The text reviews IT Service Management, with reference to the IT Infrastructure Library (ITIL®) as a framework for best practices-explaining how to use it to accommod

  13. LEAN SIX SIGMA – MULTIPLE CASE STUDY

    Directory of Open Access Journals (Sweden)

    Delvio Venanzi

    2017-12-01

    Full Text Available Lean Six Sigma é uma gestão focada na qualidade e desempenho produtivo em sistemas operacionais. Este artigo discute os fundamentos desta metodologia através de duas diferentes concepções de gestão, Lean Manufacturing e Six Sigma. Primeiro, o artigo explica o DMAIC (definir, medir, analisar, melhorar e controlar e suas respectivas fases, após a filosofia Lean com o sipoc e técnicas de mapeamento de fluxo de valor. O artigo pretende mostrar a integração destes dois conceitos e seus resultados. A metodologia consistiu em uma teoria baseada em uma pesquisa bibliográfica de pesquisa exploratória que consistiu de três estudos de caso em empresas de diferenças localizadas em Sorocaba, São Paulo. Neste artigo estuda a aplicação de Lean Seis Sigma e seus resultados.

  14. Lean Construction Applications for Bridge Inspection

    Science.gov (United States)

    2017-10-01

    Lean philosophy was used to analyze the efficiency of bridge inspection. Emphasis was put on identifying activities that add value to the final output, an owner approved bridge inspection report. 26 bridge inspections were shadowed. Time spent on bri...

  15. Lean in service industries: A literature review

    Science.gov (United States)

    V, Vignesh; Suresh, M.; Aramvalarthan, S.

    2016-09-01

    Lean service is an amalgamation of tools and practices which, if applied appropriately, would definitely improve the existing quality of operations and ensure the generation of a large amount of favourable financial and economic outcomes and improve the behaviour of the workforce. As a result, it assumes of great significance in the fiercely competitive modern world. This article presents a comprehensive bibliographic study about the various lean service practices through a variety of approaches like service improvement, manufacturing, supply chain, market and retailing approaches, etc. Thus it gives a clear view on how the lean services are implemented in various sectors and the contribution of lean service towards improving the quality in the services provided while reducing the costs.

  16. Implementation of Lean Manufacturing in Romanian Organisations

    Directory of Open Access Journals (Sweden)

    Ucenic Camelia Ioana

    2017-01-01

    Full Text Available The implementation of lean manufacturing is one of the main tools for attaining a higher performance level in the Romanian organisations. The study uses data collected at middle management level from organisations located in Transylvania. The organisations come from different fields of activity and are in different stages of lean implementation. The article makes use of quantitative and qualitative instruments for the evaluation of lean in the above mentioned companies. Characteristics as waste reduction, cost, quality, product design have different approaches in the companies. Their way of approach gives useful information regarding the type of company from the point of view of lean manufacturing implementation. This knowledge provides a useful support at different managerial levels in the process of decision making.

  17. Lean six sigma application to transportation logistics

    Directory of Open Access Journals (Sweden)

    Simone Tavares Fernandes

    2012-06-01

    Full Text Available This work presents the application of Lean Six Sigma in a case study of a metallurgic industry. The Six Sigma and the Lean are two processes used by enterprises in Brazil and worldwide. Currently the integration of these processes is a challenge for these companies, which search a way more efficient to reduce their wastes and to adapt to the needs of their markets. The paper had as purpose to demonstrate the applicability of the Lean Six Sigma in a real logistical problem related to the transportation of goods among units of a metallurgic industry. The stages used for the solution of the problem follow the DMAIC cycle – Define, Measure, Analyze, Improve and Control. The paper presents in details the integrated approach of the improvement processes Lean and Six Sigma, their tools set, as well the excellent results obtained in the case study.

  18. LEAN Tools in the IT Sector

    Directory of Open Access Journals (Sweden)

    Zoltan VAJNA

    2015-05-01

    Full Text Available Nowadays the LEAN tools with their proven efficiency are indispensable parts of the production management. I think there is no producing enterprise that cannot utilize a wide variety of these LEAN tools. The question now is how these tools can support companies in increasing the efficiency of their supporting IT processes. In this study I will demonstrate how these well-known LEAN tools from production management can be used in IT management to create more cost-effective, efficient and transparent solutions during the IT system development and IT operation activities. I will show respectively without attempting to be comprehensive the most important tools of the LEAN management and I will analyse how these tools can be used in the IT sector. At the end of this study I will demonstrate what the IT managers think about the practical use of these tools.

  19. A case study of lean, sustainable manufacturing

    Directory of Open Access Journals (Sweden)

    Geoff Miller

    2010-06-01

    Full Text Available A small furniture production company has integrated lean tools and sustainability concepts with discrete event simulation modeling and analysis as well as mathematical optimization to make a positive impact on the environment, society and its own financial success. The principles of lean manufacturing that aid in the elimination of waste have helped the company meet ever increasing customer demands while preserving valuable resources for future generations. The implementation of lean and sustainable manufacturing was aided by the use of discrete event simulation and optimization to overcome deficits in lean’s traditional implementation strategies. Lean and green manufacturing can have a more significant, positive impact on multiple measures of operational performance when implemented concurrently rather than separately. These ideas are demonstrated by three applications.

  20. A Web-Based Lean Simulation Game for Office Operations: Training the Other Side of a Lean Enterprise

    Science.gov (United States)

    Kuriger, Glenn W.; Wan, Huang-da; Mirehei, S. Moussa; Tamma, Saumya; Chen, F. Frank

    2010-01-01

    This research proposes a Web-based version of a lean office simulation game (WeBLOG). The game is designed to be used to train lean concepts to office and administrative personnel. This group belongs to the frequently forgotten side of a lean enterprise. Over four phases, the game presents the following seven lean tools: one-piece flow,…

  1. The Finnish healthcare services lean management.

    Science.gov (United States)

    Hihnala, Susanna; Kettunen, Lilja; Suhonen, Marjo; Tiirinki, Hanna

    2018-02-05

    Purpose The purpose of this paper is to discuss health services managers' experiences of management in a special health-care unit and development efforts from the point of view of the Lean method. Additionally, the aim is to deepen the knowledge of the managers' work and nature of the Lean method development processes in the workplace. The research focuses on those aspects and results of Lean method that are currently being used in health-care environments. Design/methodology/approach These data were collected through a number of thematic interviews. The participants were nurse managers ( n = 7) and medical managers ( n = 7) who applied Lean management in their work at the University Hospital in the Northern Ostrobothnia Health Care District. The data were analysed with a qualitative content analysis. Findings A common set of values in specialized health-care services, development of activities and challenges for management in the use of the Lean manager development model to improve personal management skills. Practical implications Managers in specialized health-care services can develop and systematically manage with the help of the Lean method. This emphasizes assumptions, from the point of view of management, about systems development when the organization uses the Lean method. The research outcomes originate from specialized health-care settings in Finland in which the Lean method and its associated management principles have been implemented and applied to the delivery of health care. Originality/value The study shows that the research results and in-depth knowledge on Lean method principles can be applied to health-care management and development processes. The research also describes health services managers' experiences of using the Lean method. In the future, these results can be used to improve Lean management skills, identify personal professional competencies and develop skills required in development processes. Also, the research findings can be used

  2. Lean Implementation : the significance of people and dualism

    OpenAIRE

    Bengt, Halling

    2013-01-01

    Lean, with its origins at the Toyota Motor Company, is a concept that is known to increase effectiveness in manufacturing. The Lean concept is now argued to be relevant not only in manufacturing but in service and health-care delivery as well. The reported results of Lean implementation efforts are divided. There are reports that most of the Lean implementation efforts are not reaching the goal; on the other hand, there are reports of promising results. The divided results from Lean implement...

  3. Lean in the supply chain : research and practice

    OpenAIRE

    Ugochukwu, Paschal

    2012-01-01

    Lean is a management philosophy that enhances customer value through waste elimination and continuous improvement in a system by applying lean principles, practices, and techniques. The focus on lean implementations and research had been typically a single company without extension to the entire supply chain. When the concept of lean is implemented across the entire supply chain, however, it is referred to as lean supply chain. The purpose of this thesis is to create a structure from theory a...

  4. Lean in healthcare: A comprehensive review.

    Science.gov (United States)

    D'Andreamatteo, Antonio; Ianni, Luca; Lega, Federico; Sargiacomo, Massimo

    2015-09-01

    Lean seems to be the next revolution for a better, improved, value-based healhcare. In the last 15 years Lean has been increasingly adapted and adopted in healthcare. Accordingly, Lean healthcare has been developing into a major strand of research since the early 2000s. The aim of this work is to present a comprehensive overview of the main issues highlighted by research on implementation of Lean in a complex contest such as the healthcare one. Comprehensive literature review was conducted in order to identify empirical and theoretical articles published up to September 2013. Thematic analysis was performed in order to extract and synthesis data. 243 articles were selected for analysis. Lean is best understood as a means to increase productivity. Hospital is the more explored setting, with emergency and surgery as the pioneer departments. USA appears to be the leading country for number of applications. The theoretical works have been focused mainly on barriers, challenges and success factors. Sustainability, framework for measurement and critical appraisal remain underestimated themes. Evaluations of "system wide approach" are still low in number. Even though Lean results appear to be promising, findings so far do not allow to draw a final word on its positive impacts or challenges when introduced in the healthcare sector. Scholars are called to explore further the potentiality and the weaknesses of Lean, above all as for the magnitude of investments required and for the engagement of the whole organization it represents increasingly strategic choice, whilst health professionals, managers and policy makers could and should learn from research how to play a pivotal role for a more effective implementation of lean in different health contexts. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  5. Lean tool used in the automotive industry

    Directory of Open Access Journals (Sweden)

    Manuela Ingaldi

    2014-10-01

    Full Text Available In the paper basic concepts of Lean Manufacturing were presented. A company specializing in the development of vehicle dynamics, driver assistance systems, brake systems, seat belt sand electronics technology was characterized. The company is engaged in designing and manufacturing world-class products for the automotive market. The Lean tools used in the production hall, such as Yamazumi chart, machine motion analysis, MTM method and timing, were presented.

  6. Lean tool used in the automotive industry

    OpenAIRE

    Manuela Ingaldi; Marta Jagusiak-Kocik

    2014-01-01

    In the paper basic concepts of Lean Manufacturing were presented. A company specializing in the development of vehicle dynamics, driver assistance systems, brake systems, seat belt sand electronics technology was characterized. The company is engaged in designing and manufacturing world-class products for the automotive market. The Lean tools used in the production hall, such as Yamazumi chart, machine motion analysis, MTM method and timing, were presented.

  7. Implementing lean manufacturing system: ISM approach

    Directory of Open Access Journals (Sweden)

    Naveen Kumar

    2013-09-01

    Full Text Available Purpose: Lean Manufacturing System has emerged as an important area of research in Indian context. The requirement of Lean Manufacturing has increased due to defects in products (semi finished and finished and subsequent increase in cost. In this context, this study is an attempt to develop a structural model of the variables, important to implement Lean Manufacturing System in Indian automobile industry. Design/Methodology/Approach: Various variables of lean manufacturing system implementation have been identified from literature review and experts’ opinions. Contextual relationship among these identified variables has been set after carrying out brainstorming session. Further, classification of the variables has been carried out based upon the driving power and dependence. In addition to this, a structural model of variables to implement lean concept in Indian automobile industry has also been developed using Interpretive Structural Modeling (ISM technique. Questionnaire based survey has also been conducted to rank these variables. Findings: Eighteen variables have been identified from the literature and subsequent discussions with experts. Out of which, nine variables have been identified as dependent and nine variables have been identified as driver. No variable has been identified as linkage variable and autonomous variable. From the model developed, ‘Relative cost benefits’ has been identified as top level dependent variable and top management commitment as bottom level most independent variable. Research limitations/Implications: The model so developed is a hypothetical model based upon experts’ opinions. The conclusions so drawn may be further modified to apply in real situation. Practical implication: Clear understanding of interactions among these variables will help organizations to prioritize and manage these variables more effectively and efficiently to draw advantage from lean manufacturing system implementation

  8. INNOVATION LEAN PRINCIPLES IN AUTOMOTIVE GREEN MANUFACTURING

    Directory of Open Access Journals (Sweden)

    Dušan Sabadka

    2014-12-01

    Full Text Available Today, industries such as automotive and manufacturing industries deal with a lot of environmental regulations. Lean is a production strategy whose fundamental principles drive the industry towards a more effective production of goods and services. The eco-efficiency concept is primary to sustainable development and intends to provide more value with less environmental impact. The aim of this study is to identify and explore the contributions of Lean to reduce environmental impacts that naturally result from industrial activity.

  9. Data report for ROSA-IV LSTF 10% hot leg break experiment Run SB-HL-02

    International Nuclear Information System (INIS)

    Kukita, Yutaka; Hirata, Kazuo; Gotou, Hiroki

    1990-03-01

    Experimental data for the 10% hot leg break test, Run SB-HL-02, conducted at the ROSA-IV Large Scale Test Facility (LSTF) on June 30, 1987, are presented. This test assumed total failure of both high pressure injection (HPI) and auxiliary feedwater (AFW) systems. The test results were characterized by asymmetric loop responses, flashing in the cold legs and upper downcomer, as well as condensation depressurization in the cold legs following injection of emergency core coolant (ECC) from accumulators. (author)

  10. The promise of Lean in health care.

    Science.gov (United States)

    Toussaint, John S; Berry, Leonard L

    2013-01-01

    An urgent need in American health care is improving quality and efficiency while controlling costs. One promising management approach implemented by some leading health care institutions is Lean, a quality improvement philosophy and set of principles originated by the Toyota Motor Company. Health care cases reveal that Lean is as applicable in complex knowledge work as it is in assembly-line manufacturing. When well executed, Lean transforms how an organization works and creates an insatiable quest for improvement. In this article, we define Lean and present 6 principles that constitute the essential dynamic of Lean management: attitude of continuous improvement, value creation, unity of purpose, respect for front-line workers, visual tracking, and flexible regimentation. Health care case studies illustrate each principle. The goal of this article is to provide a template for health care leaders to use in considering the implementation of the Lean management system or in assessing the current state of implementation in their organizations. Copyright © 2013 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.

  11. Lean healthcare from a change management perspective.

    Science.gov (United States)

    van Rossum, Lisa; Aij, Kjeld Harald; Simons, Frederique Elisabeth; van der Eng, Niels; Ten Have, Wouter Dirk

    2016-05-16

    Purpose - Lean healthcare is used in a growing number of hospitals to increase efficiency and quality of care. However, healthcare organizations encounter problems with the implementation of change initiatives due to an implementation gap: the gap between strategy and execution. From a change management perspective, the purpose of this paper is to increase scientific knowledge regarding factors that diminish the implementation gap and make the transition from the "toolbox lean" toward an actual transformation to lean healthcare. Design/methodology/approach - A cross-sectional study was executed in an operating theatre of a Dutch University Medical Centre. Transformational leadership was expected to ensure the required top-down commitment, whereas team leadership creates the required active, bottom-up behavior of employees. Furthermore, professional and functional silos and a hierarchical structure were expected to impede the workforce flexibility in adapting organizational elements and optimize the entire process flow. Findings - The correlation and regression analyses showed positive relations between the transformational leadership and team leadership styles and lean healthcare implementation. The results also indicated a strong relation between workforce flexibility and the implementation of lean healthcare. Originality/value - With the use of a recently developed change management model, the Change Competence Model, the authors suggest leadership and workforce flexibility to be part of an organization's change capacity as crucial success factor for a sustainable transformation to lean healthcare.

  12. Implementing Lean Health Reforms in Saskatchewan

    Directory of Open Access Journals (Sweden)

    Greg Marchildon

    2013-07-01

    Full Text Available Saskatchewan has gone further than any other Canadian province in implementing health system process improvements using Lean, a production line discipline that originated with the automobile industry. The goal of the Lean reform is to reduce waste and improve quality and overall health system performance by long-term changes in behaviour. Lean enjoys a privileged position on the provincial government’s agenda because of the policy’s championing by the Deputy Minister of Health and the policy’s fit with the government’s patient-centred care agenda. The implementation of reform depends on a major investment of time in the training and Lean-certification of key leaders and managers in the provincial health system. The Saskatchewan Union of Nurses, the union representing the single largest group of health workers in the province, has agreed to co-operate with the provincial government in implementing Lean-type reforms. Thus far, the government has had limited independent evaluation of Lean while internal evaluations claim some successes.

  13. Visual communication in lean organizations

    Directory of Open Access Journals (Sweden)

    Iuga Maria Virginia

    2017-01-01

    Full Text Available Many researchers have studied the role and importance of communication and communication types for organizations and their work force. The topic of organizational communication is a constantly changing one. The thing that remains stable throughout this very wide topic is its purpose: communication is vital for the effectiveness and success of organizations of all sizes, types and cultures. In terms of type, one could split up topic by type as followed: verbal, visual and written. This research paper focuses on the visual component at shop floor within automotive organizations. It aims at giving the reader a structured overview on the most appropriate but also lean visual communication practices. In order to establish these methods at shop floor, a survey was conducted among nine big automotive companies in Romania. It was then followed up by a second survey dedicated to check the effectiveness of implementation of these methods in a big automotive organization. The paper presents the analyses, results and the conclusions of this surveys.

  14. Epilepsy and restless legs syndrome.

    Science.gov (United States)

    Geyer, James D; Geyer, Emery E; Fetterman, Zachary; Carney, Paul R

    2017-03-01

    Restless legs syndrome (RLS) is a common neurological movement disorder occurring in approximately 10% of the general population. The prevalence of moderately severe RLS is 2.7% overall (3.7% for women and 1.7% for men). Epilepsy is also a common neurological disorder with significant associated morbidity and impact on quality of life. We evaluated the severity and frequency of primary RLS in patients with localization-related temporal lobe epilepsy (TLE) and investigated the role of prodromal RLS symptoms as a warning sign and lateralizing indicator. All epilepsy patients seen in the outpatient clinic were screened for movement disorders from 2005 to 2015. Ninety-eight consecutive patients with localization-related TLE (50 right TLE and 48 left TLE) who met inclusion criteria were seen in the outpatient clinic. The control group consisted of 50 individuals with no history or immediate family history of epilepsy. Each patient was evaluated with the International Restless Legs Study Group (IRLSSG) questionnaire, NIH RLS diagnostic criteria, ferritin level, and comprehensive sleep screening including polysomnography. Furthermore, patients with obstructive sleep apnea or a definite cause of secondary restless legs syndrome such as low serum ferritin or serum iron levels were also excluded from the study. There was a significant association between the type of epilepsy and whether or not patients had RLS χ 2 (1)=10.17, p<.01, using the χ 2 Goodness of Fit Test. Based on the odds ratio, the odds of patients having RLS were 4.60 times higher if they had right temporal epilepsy than if they had left temporal epilepsy, serving as a potential lateralizing indicator. A prodromal sensation of worsening RLS occurred in some patients providing the opportunity to intervene at an earlier stage in this subgroup. We identified frequent moderate to severe RLS in patients with epilepsy. The frequency of RLS was much more common than would typically be seen in patients of similar

  15. The Relationship among Leg Strength, Leg Power and Alpine Skiing Success.

    Science.gov (United States)

    Gettman, Larry R.; Huckel, Jack R.

    The purpose of this study was to relate leg strength and power to alpine skiing success as measured by FIS points. Isometric leg strength was represented by the knee extension test described by Clarke. Leg power was measured by the vertical jump test and the Margaria-Kalamen stair run. Results in the strength and power tests were correlated with…

  16. Leg ischemia post-varicocelectomy

    Directory of Open Access Journals (Sweden)

    Al-Wahbi AM

    2016-03-01

    Full Text Available Abdullah M Al-Wahbi1, Shaza Elmoukaied2 1Division of Vascular Surgery, Department of Surgery, King Abdulaziz Medical City, Riyadh, Saudi Arabia; 2Department of Surgery, Dr Sulaiman Al Habib Hospital, Riyadh, Saudi Arabia Abstract: Varicocelectomy is the most commonly performed operation for the treatment of male infertility. Many surgical approaches are used as each of them has advantages over the other and is preferred by surgeons. Vascular injury has never been reported as a complication of varicocelectomy apart from testicular artery injury. We present a 36-year-old male who developed leg ischemia post-varicocelectomy due to common femoral artery injury. He was successfully treated by using a vein graft. Keywords: varicocele, varicocelectomy, complications, vascular injuries

  17. Lean i Norge : opplever norske bedrifter som er mer lean, større økning i kundetilfredshet enn de som er mindre lean?

    OpenAIRE

    Fagereng, Hanne Eline; Askevold, Elisabeth Cathrine

    2010-01-01

    Vi ønsker å måle i hvor stor grad norske bedrifter har implementert lean, og for å måle grad av lean har vi utviklet et rammeverk basert på lean teori. Hovedformålet med lean er å øke kundeverdi med minst mulig ressursbruk, anstrengelse, energi, utstyr, tid, plass, material og kapital (Womack, Roos and Jones 2007). Vi vil utforske om høyere grad av lean fører til mer tilfredse kunder enn de som har lavere grad av lean. Altså om hovedformålet med lean blir oppnådd hvis man implementerer lean i...

  18. Intensive treatment of leg lymphedema

    Directory of Open Access Journals (Sweden)

    Pereira de Godoy Jose

    2010-01-01

    Full Text Available Background: Despite of all the problems caused by lymphedema, this disease continues to affect millions of people worldwide. Thus, the identification of the most efficacious forms of treatment is necessary. Aim: The aim of this study was to evaluate a novel intensive outpatient treatment for leg lymphedema. Methods: Twenty-three legs of 19 patients were evaluated in a prospective randomized study. The inclusion criteria were patients with Grade II and III lymphedema, where the difference, measured by volumetry, between the affected limb below the knee and the healthy limb was greater than 1.5 kg. Intensive treatment was carried out for 6- to 8-h sessions in the outpatient clinic. Analysis of variance was utilized for statistical analysis with an alpha error of 5% (P-value < 0.05 being considered significant. Results: All limbs had significant reductions in size with the final mean loss being 81.1% of the volume of edema. The greatest losses occurred in the first week (P-value < 0.001. Losses of more than 90% of the lymphedema occurred in 9 (39.13% patients; losses of more than 80% in 13 (56.52%, losses of more than 70% in 17 (73.91% and losses of more than 50% were recorded for 95.65% of the patients; only 1 patient lost less than 50% (37.9% of the edema. Conclusion: The intensive treatment of lymphedema in the outpatient clinic can produce significant reductions in the volume of edema over a short period of time and can be recommended for any grade of lymphedema, in particular the more advanced degrees.

  19. Børns leg og eksperimenterende virksomhed

    DEFF Research Database (Denmark)

    Damgaard Warrer, Sarah; Broström, Stig

    Børns leg og eksperimenterende virksomhed er et rigt felt med mange perspektiver, indgangsvinkler og nuancer. I denne bog kædes leg og det eksperimenterende og skabende sammen som to gensidigt forbundne fænomener og belyses i pædagogisk og didaktisk perspektiv. Desuden beskrives potentialet i båd...

  20. Clinical quality indicators of venous leg ulcers

    DEFF Research Database (Denmark)

    Kjaer, Monica L; Mainz, Jan; Soernsen, Lars T

    2005-01-01

    In the clinical setting, diagnosis and treatment of venous leg ulcers can vary considerably from patient to patient. The first step to reducing this variation is to document venous leg ulcer care through use of quantitative scientific documentation principles. This requires the development of val...

  1. Using Dynamic Value Stream Mapping and Lean Accounting Box Scores to Support Lean Implementation

    Science.gov (United States)

    Woehrle, Stephen L.; Abou-Shady, Louay

    2010-01-01

    Lean has proven to be an effective management philosophy for improving businesses in a competitive market by eliminating waste and improving operations. An impact of implementing lean projects is the rapid reduction in inventory levels, which gives management the false impression that profits are decreasing while workers on the shop floor observe…

  2. The relationships between Lean manufacturing, management accounting and firm performance

    DEFF Research Database (Denmark)

    Kristensen, Thomas Borup; Nielsen, Henrik; Grasso, Lawrency

    2016-01-01

    with management accounting practices. Specifically, we document that Lean manufacturing is positively associated with Value Stream Costing, Lean visual controls and, more importantly, measures of labor and materials efficiency. Lean manufacturing is positively related to Lean thinking and both are positively...... associated with operational performance and so are Lean visual controls. We also document that the management accounting practices intervene affecting operational performance and they intervene with Lean thinking as well. Lastly, the relationship between Lean manufacturing and measures of labor and materials......Lean manufacturing has been adopted by numerous western companies as an answer to an increasing competitive environment. Lean manufacturing is seen as an enterprise-wide strategy encompassing a transformation of manufacturing practices, affecting companies’ management accounting practices and...

  3. Optimization of large scale food production using Lean Manufacturing principles

    DEFF Research Database (Denmark)

    Engelund, Eva Høy; Friis, Alan; Breum, Gitte

    2009-01-01

    This paper discusses how the production principles of Lean Manufacturing (Lean) can be applied in a large-scale meal production. Lean principles are briefly presented, followed by a field study of how a kitchen at a Danish hospital has implemented Lean in the daily production. In the kitchen...... not be negatively affected by the rationalisation of production procedures. The field study shows that Lean principles can be applied in meal production and can result in increased production efficiency and systematic improvement of product quality without negative effects on the working environment. The results...... show that Lean can be applied and used to manage the production of meals in the kitchen....

  4. Lean Manufacturing Auto Cluster at Chennai

    Science.gov (United States)

    Bhaskaran, E.

    2012-10-01

    Due the presence of lot of automotive Industry, Chennai is known as Detroit of India, that producing over 40 % of the Indian vehicle and components. Lean manufacturing concepts have been widely recognized as an important tool in improving the competitiveness of industries. This is a continuous process involving everyone, starting from management to the shop floor. Automotive Component Industries (ACIs) in Ambattur Industrial Estate, Chennai has formed special purpose vehicle (SPV) society namely Ambattur Industrial Estate Manufacturers Association (AIEMA) Technology Centre (ATC) lean manufacturing cluster (ATC-LMC) during July 2010 under lean manufacturing competitiveness scheme, that comes under National Manufacturing Competitiveness Programme of Government of India. The Tripartite Agreement is taken place between National Productivity Council, consultants and cluster (ATC-LMC). The objective is to conduct diagnostic study, study on training and application of various lean manufacturing techniques and auditing in ten ACIs. The methodology adopted is collection of primary data/details from ten ACIs. In the first phase, diagnostic study is done and the areas for improvement in each of the cluster member companies are identified. In the second phase, training programs and implementation is done on 5S and other areas. In the third phase auditing is done and found that the lean manufacturing techniques implementation in ATC-LMC is sustainable and successful in every cluster companies, which will not only enhance competitiveness but also decrease cost, time and increase productivity. The technical efficiency of LMC companies also increases significantly.

  5. Lean oncology: a new model for oncologists

    Directory of Open Access Journals (Sweden)

    Montesarchio Vincenzo

    2012-04-01

    Full Text Available Abstract The history of the term Lean is relatively recent and originates from the Toyota Production System (TPS. The term "Lean" means "thin", which refers to a mental process, operational, productive, no-frills, quick but not hasty, consequential to the previous event. The Lean process flows seamlessly into the result, eliminates unnecessary complications to the effect, prevents unnecessary equipment processes. The idea is to 'do more with less', like using the (few available resources in the most productive way possible, through the elimination of all types of waste that inevitably accompanies every stage of a production process. Lean management is primarily a management philosophy, a system of values and behaviors that goes beyond the mere application of the instrument and that, once internalized, will form the nucleus of the corporate culture. "Lean Oncology" is a term coined to identify a methodology of care and treatment to cancer patients, consisting on process simplification, streamlining of the organizational and routes of drug treatment, detection and elimination of waste. Its main objective is the centrality of the patient.

  6. Lean oncology: a new model for oncologists.

    Science.gov (United States)

    Montesarchio, Vincenzo; Grimaldi, Antonio Maria; Fox, Bernard A; Rea, Antonio; Marincola, Francesco M; Ascierto, Paolo A

    2012-04-25

    The history of the term Lean is relatively recent and originates from the Toyota Production System (TPS). The term "Lean" means "thin", which refers to a mental process, operational, productive, no-frills, quick but not hasty, consequential to the previous event. The Lean process flows seamlessly into the result, eliminates unnecessary complications to the effect, prevents unnecessary equipment processes. The idea is to 'do more with less', like using the (few) available resources in the most productive way possible, through the elimination of all types of waste that inevitably accompanies every stage of a production process. Lean management is primarily a management philosophy, a system of values and behaviors that goes beyond the mere application of the instrument and that, once internalized, will form the nucleus of the corporate culture. "Lean Oncology" is a term coined to identify a methodology of care and treatment to cancer patients, consisting on process simplification, streamlining of the organizational and routes of drug treatment, detection and elimination of waste. Its main objective is the centrality of the patient.

  7. LEAN PRACTICES FOR PRODUCT DEVELOPMENT PROCESS

    Directory of Open Access Journals (Sweden)

    Guilherme Luz Tortorella

    2015-06-01

    Full Text Available Lean product development (LPD is an approach that comprises lean principles and management practices that aim to reduce waste and improve operational effectiveness throughout the entire value stream in continuous improvement endless journey. Due to that, the ability to innovate, change and learn continuously is a key element in order to minimize product development problems. Several LPD techniques are presented in the literature as possible enablers for lean implementation. However, little has been known about the impact of these enablers on the problems related to product development processes. Thus, this paper aims to examine the relationship between five LPD practices’ constructs and the occurrence frequency of eleven LPD problems’ constructs in companies that are implementing lean. Moreover, the identification of relevant relationships between LPD practices’ and problems’ constructs may contribute to specify the contexts in which problems are expected to occur. The study sample comprises sixty four companies already undergoing lean implementation both in shop floor and offices area. The results indicate that the same practices’ constructs, which are deemed as influential for minimizing LPD problems, present different relationship intensities among them.

  8. Using Lean to Advance Quality Improvement Research.

    Science.gov (United States)

    Blackmore, Christopher Craig; Williams, Barbara L; Ching, Joan M; Chafetz, Lynne A; Kaplan, Gary S

    2016-01-01

    Quality improvement research skills are not commonplace among quality improvement practitioners, and research on the effectiveness of quality improvement has not always kept pace with improvement innovation. However, the Lean tools applied to quality improvement should be equally relevant to the advancement of quality improvement research. We applied the Lean methods to develop a simplified quality improvement publication pathway enabling a small research methodology group to increase quality improvement research throughout the institution. The key innovations of the pathway are horizontal integration of the quality improvement research methods group across the institution, implementation of a Lean quality improvement research pathway, and application of a just-in-time quality improvement research toolkit. This work provides a road map and tools for the acceleration of quality improvement research. At our institution, the Lean quality improvement research approach was associated with statistically significant increases in the number (annual mean increase from 3.0 to 8.5, p = .03) and breadth of published quality improvement research articles, and in the number of quality improvement research projects currently in process. Application of Lean methods to the quality improvement research process can aid in increasing publication of quality improvement articles from across the institution.

  9. Bevezetés a lean menedzsmentbe – a lean stratégiai alapjai = Introduction to lean management – basic strategic elements of lean

    OpenAIRE

    Losonci, Dávid

    2010-01-01

    A lean menedzsment az értékteremtő folyamatok stratégiai és operatív szintjének meghatározó formálójává vált az elmúlt évtizedekben. Jelen tanulmány stratégiai nézőpontból tárgyalja a lean menedzsment teljes bevezetését. Részletes áttekintést ad a Womack és Jones (2003) által lefektetett lean alapelvekről. Az operatív teljesítményjavulásból származó vevői értékteremtés mellett foglalkozik a tulajdonosi értékteremtéssel, az MRP és a lean szinergikus összekapcsolásával, valamint a lean ideális ...

  10. Hot Leg Piping Materials Issues

    International Nuclear Information System (INIS)

    V. Munne

    2006-01-01

    With Naval Reactors (NR) approval of the Naval Reactors Prime Contractor Team (NRPCT) recommendation to develop a gas cooled reactor directly coupled to a Brayton power conversion system as the space nuclear power plant (SNPP) for Project Prometheus (References a and b) the reactor outlet piping was recognized to require a design that utilizes internal insulation (Reference c). The initial pipe design suggested ceramic fiber blanket as the insulation material based on requirements associated with service temperature capability within the expected range, very low thermal conductivity, and low density. Nevertheless, it was not considered to be well suited for internal insulation use because its very high surface area and proclivity for holding adsorbed gases, especially water, would make outgassing a source of contaminant gases in the He-Xe working fluid. Additionally, ceramic fiber blanket insulating materials become very friable after relatively short service periods at working temperatures and small pieces of fiber could be dislodged and contaminate the system. Consequently, alternative insulation materials were sought that would have comparable thermal properties and density but superior structural integrity and greatly reduced outgassing. This letter provides technical information regarding insulation and materials issues for the Hot Leg Piping preconceptual design developed for the Project Prometheus space nuclear power plant (SNPP)

  11. The Development Of A Theoretical Lean Culture Causal Framework To Support The Effective Implementation Of Lean In Automotive Component Manufacturers

    Directory of Open Access Journals (Sweden)

    Van der Merwe, Karl Robert

    2014-05-01

    Full Text Available Although it is generally accepted that lean manufacturing improves operational performance, many organisations are struggling to adapt to the lean philosophy. The purpose of this study is to contribute to a more effective strategy for implementing the lean manufacturing improvement philosophy. The study sets out both to integrate well-researched findings and theories related to generic organisational culture with more recent research and experience related to lean culture, and to examine the role that culture plays in the effective implementation of lean manufacturing principles and techniques. The ultimate aim of this exercise is to develop a theoretical lean culture causal framework.

  12. Lean for Government: Eliminating the Seven Wastes

    Science.gov (United States)

    Shepherd, Christena C.

    2012-01-01

    With shrinking budgets and a slow economy, it is becoming increasingly important for all government agencies to become more efficient. Citizens expect and deserve efficient and effective services from federal, state and local government agencies. One of the best methods to improve efficiency and eliminate waste is to institute the business process improvement methodologies known collectively as Lean; however, with reduced budgets, it may not be possible to train everyone in Lean or to engage the services of a trained consultant. It is possible, however, to raise awareness of the "Seven Wastes" of Lean in each employee, and encourage them to identify areas for improvement. Management commitment is vital to the success of these initiatives, and it is also important to develop the right metrics that will track the success of these changes.

  13. Contribution of Lean Management to Excellence

    Directory of Open Access Journals (Sweden)

    López-Fresno Palmira

    2014-11-01

    Full Text Available To continuously and systematically improve efficiency and efficacy of processes, organizations need the implication of all employees in continuous improvement and innovation through suitable Quality Management Programs (QMPs. Effectiveness of these programs is directly linked to the requirement employees understand the methodologies and tools used for QM and the benefits that will derivate from their implementation, individually and collectively, so they can commit and implicate. Lean Management is a friendly methodology to continuously and systematically achieve process improvement, so helping the organization seeking operational excellence that contributes to overall excellence. This paper identifies Critical Success Factors (CSFs for an effective implementation of QMPs, suggests Lean Management as an easy-to-understand, powerful and friendly methodology for operational excellence and overall excellence, and presents a case experience of implementation of Lean Management in a health care organization that applies the EFQM model, and the lessons learnt.

  14. Lean Start-up in Established Companies

    DEFF Research Database (Denmark)

    Goduscheit, René Chester

    2018-01-01

    Lean start-up is an emergent perspective on how entrepreneurs can bring new products and services to the market. This approach challenges the dominant role of lengthy business plans, linear product development processes, and seeking complete overview of the potential of the new products....../services before market launch. Instead it suggests that start-ups could benefit from a ‘minimum-viable product’ approach where products and services are launched when they contain critical features. The emphasis in the lean start-up approach is on business models rather than the elaborate business plan...... at the companies (strategy meetings, development workshops etc.). The aim is to shed light on the implications for companies that seek to employ lean start-up. These implications will be aimed at aspects like innovation management, organizational structure, customer relations etc....

  15. Theories of lean management: an empirical evaluation.

    Science.gov (United States)

    Handel, Michael J

    2014-03-01

    Debates within organization theory traditionally argued the relative merits of bureaucracy but today there is broad agreement across different perspectives that bureaucratic organization is inefficient and outmoded. Despite their differences, post-bureaucratic and neo-liberal theories argue that organizations with relatively flat hierarchies and low management overhead are better adapted to current market requirements. Post-bureaucratic theory also argues that employees, as well as firms, benefit from leaner management structures. This paper investigates trends in managerial leanness, proposed explanations for such trends, and the consequences of leanness for firms and employees. Although there is a trend toward flatter management hierarchies, there is only weak support for current claims regarding both the causes and consequences of lean management. Copyright © 2013 Elsevier Inc. All rights reserved.

  16. Quantifying Leg Movement Activity During Sleep.

    Science.gov (United States)

    Ferri, Raffaele; Fulda, Stephany

    2016-12-01

    Currently, 2 sets of similar rules for recording and scoring leg movement (LM) exist, including periodic LM during sleep (PLMS) and periodic LM during wakefulness. The former were published in 2006 by a task force of the International Restless Legs Syndrome Study Group, and the second in 2007 by the American Academy of Sleep Medicine. This article reviews the basic recording methods, scoring rules, and computer-based programs for PLMS. Less frequent LM activities, such as alternating leg muscle activation, hypnagogic foot tremor, high-frequency LMs, and excessive fragmentary myoclonus are briefly described. Copyright © 2016 Elsevier Inc. All rights reserved.

  17. A Novel Perforator Flap Training Model Using a Chicken Leg.

    Science.gov (United States)

    Cifuentes, Ignacio J; Yañez, Ricardo A; Salisbury, Maria C; Rodriguez, José R; Varas, Julian E; Dagnino, Bruno L

    2016-04-01

    Living animal models are frequently used for perforator flap dissection training, but no ex vivo models have been described. The aim of this study is to present a novel nonliving model for perforator flap training based on a constant perforator in the chicken leg. A total of 15 chicken legs were used in this study. Anatomical dissection of the perforator was performed after its identification using ink injection, and in four of these specimens a perforator-based flap was raised. The anatomical dissection revealed a constant intramuscular perforator with a median length of 5.7 cm. Median proximal and distal vessel diameters were 0.93 and 0.4 mm, respectively. The median dissection time was 77.5 minutes. This study introduces a novel, affordable, and reproducible model for the intramuscular dissection of a perforator-based flap using an ex vivo animal model. Its consistent perforator and appropriate-sized vessels make it useful for training.

  18. Waste Measurement Techniques For Lean Companies

    Directory of Open Access Journals (Sweden)

    Maciej Pieńkowski

    2014-12-01

    Full Text Available The paper is dedicated to answer the problem of measuring waste in companies, which are implementing Lean Manufacturing concept. Lack of complex identification, quantification an visualization of waste significantly impedes Lean transformation efforts. This problem can be solved by a careful investigation of Muda, Muri and Mura, which represent the essence of waste in the Toyota Production System. Measuring them facilitates complete and permanent elimination of waste in processes. The paper introduces a suggestion of methodology, which should enable company to quantify and visualize waste at a shop floor level.

  19. A Lean Six Sigma journey in radiology.

    Science.gov (United States)

    Bucci, Ronald V; Musitano, Anne

    2011-01-01

    The department of radiology at Akron Children's Hospital embarked on a Lean Six Sigma mission as part of a hospital wide initiative to show increased customer satisfaction, reduce employee dissatisfaction and frustration, and decrease costs. Three processes that were addressed were reducing the MRI scheduling back-log, reconciling discrepancies in billing radiology procedures, and implementing a daily management system. Keys to success is that managers provide opportunities to openly communicate between department sections to break down barriers. Executive leaders must be engaged in Lean Six Sigma for the company to be successful.

  20. The Lean and Global Start-up

    DEFF Research Database (Denmark)

    Tanev, Stoyan; Rasmussen, Erik Stavnsager

    For several decades researchers have studied start-up companies with a focus on international markets, suppliers and networks from their inception and on companies that are establishing new, agile business models. This has resulted in two streams of research: The Born Global and International New...... Ventures research and research with a focus on the Lean Start-up company. It is our intention in this paper to give a short presentation of the two research streams and show how they can be merged into one with a focus on newly established technology oriented firms that are lean and global from...

  1. Lower Limb Symmetry: Comparison of Muscular Power Between Dominant and Nondominant Legs in Healthy Young Adults Associated With Single-Leg-Dominant Sports.

    Science.gov (United States)

    Vaisman, Alex; Guiloff, Rodrigo; Rojas, Juan; Delgado, Iris; Figueroa, David; Calvo, Rafael

    2017-12-01

    Achieving a symmetrical power performance (difference power between the dominant and nondominant legs in healthy young adults, (2) evaluate the effect of a single-leg-dominant sport activity performed at the professional level, and (3) propose a parameter of normality for maximal power difference in the lower limbs of this young adult population. Controlled laboratory study. A total of 78 healthy, male, young adults were divided into 2 groups according to sport activity level. Group 1 consisted of 51 nonathletes (mean ± SD age, 20.8 ± 1.5 years; weight, 71.9 ± 10.5 kg) who participated in less than 8 hours a week of recreational physical activity with nonspecific training; group 2 consisted of 27 single-leg-dominant professional soccer players (age, 18.4 ± 0.6 years; weight, 70.1 ± 7.5 kg) who specifically trained and competed at their particular activity 8 hours or more a week. For assessment of maximal leg power, both groups completed the single-leg squat jump test. Dominance was determined when participants completed 2 of 3 specific tests with the same extremity. Statistical analysis included the Student t test. No statistical difference was found for maximal power between dominant and nondominant legs for nonathletes ( t = -1.01, P = .316) or single-leg-dominant professional soccer players ( t = -1.10, P = .281). A majority (95%) of participants studied showed a power difference of less than 15% between their lower extremities. Among young healthy adults, symmetrical power performance is expected between lower extremities independent of the existence of dominance and difference in sport activity level. A less than 15% difference in power seems to be a proper parameter to define symmetrical power performance assessed by vertical single-leg jump tests.

  2. Does a crouched leg posture enhance running stability and robustness?

    Science.gov (United States)

    Blum, Yvonne; Birn-Jeffery, Aleksandra; Daley, Monica A; Seyfarth, Andre

    2011-07-21

    Humans and birds both walk and run bipedally on compliant legs. However, differences in leg architecture may result in species-specific leg control strategies as indicated by the observed gait patterns. In this work, control strategies for stable running are derived based on a conceptual model and compared with experimental data on running humans and pheasants (Phasianus colchicus). From a model perspective, running with compliant legs can be represented by the planar spring mass model and stabilized by applying swing leg control. Here, linear adaptations of the three leg parameters, leg angle, leg length and leg stiffness during late swing phase are assumed. Experimentally observed kinematic control parameters (leg rotation and leg length change) of human and avian running are compared, and interpreted within the context of this model, with specific focus on stability and robustness characteristics. The results suggest differences in stability characteristics and applied control strategies of human and avian running, which may relate to differences in leg posture (straight leg posture in humans, and crouched leg posture in birds). It has been suggested that crouched leg postures may improve stability. However, as the system of control strategies is overdetermined, our model findings suggest that a crouched leg posture does not necessarily enhance running stability. The model also predicts different leg stiffness adaptation rates for human and avian running, and suggests that a crouched avian leg posture, which is capable of both leg shortening and lengthening, allows for stable running without adjusting leg stiffness. In contrast, in straight-legged human running, the preparation of the ground contact seems to be more critical, requiring leg stiffness adjustment to remain stable. Finally, analysis of a simple robustness measure, the normalized maximum drop, suggests that the crouched leg posture may provide greater robustness to changes in terrain height

  3. Reproducibility and day time bias correction of optoelectronic leg volumetry: a prospective cohort study.

    Science.gov (United States)

    Engelberger, Rolf P; Blazek, Claudia; Amsler, Felix; Keo, Hong H; Baumann, Frédéric; Blättler, Werner; Baumgartner, Iris; Willenberg, Torsten

    2011-10-05

    Leg edema is a common manifestation of various underlying pathologies. Reliable measurement tools are required to quantify edema and monitor therapeutic interventions. Aim of the present work was to investigate the reproducibility of optoelectronic leg volumetry over 3 weeks' time period and to eliminate daytime related within-individual variability. Optoelectronic leg volumetry was performed in 63 hairdressers (mean age 45 ± 16 years, 85.7% female) in standing position twice within a minute for each leg and repeated after 3 weeks. Both lower leg (legBD) and whole limb (limbBF) volumetry were analysed. Reproducibility was expressed as analytical and within-individual coefficients of variance (CVA, CVW), and as intra-class correlation coefficients (ICC). A total of 492 leg volume measurements were analysed. Both legBD and limbBF volumetry were highly reproducible with CVA of 0.5% and 0.7%, respectively. Within-individual reproducibility of legBD and limbBF volumetry over a three weeks' period was high (CVW 1.3% for both; ICC 0.99 for both). At both visits, the second measurement revealed a significantly higher volume compared to the first measurement with a mean increase of 7.3 ml ± 14.1 (0.33% ± 0.58%) for legBD and 30.1 ml ± 48.5 ml (0.52% ± 0.79%) for limbBF volume. A significant linear correlation between absolute and relative leg volume differences and the difference of exact day time of measurement between the two study visits was found (P correction formula permitted further improvement of CVW. Leg volume changes can be reliably assessed by optoelectronic leg volumetry at a single time point and over a 3 weeks' time period. However, volumetry results are biased by orthostatic and daytime-related volume changes. The bias for day-time related volume changes can be minimized by a time-correction formula.

  4. Genetic correlations between claw health and feet and leg conformation in Norwegian Red cows.

    Science.gov (United States)

    Ødegård, C; Svendsen, M; Heringstad, B

    2014-07-01

    The aim of this study was to estimate genetic correlations between claw disorders and feet and leg conformation traits in Norwegian Red cows. A total of 188,928 cows with claw health status recorded at claw trimming from 2004 to September 2013 and 210,789 first-lactation cows with feet and leg conformation scores from 2001 to September 2013 were included in the analyses. Traits describing claw health were corkscrew claw, infectious claw disorders (dermatitis, heel horn erosion, and interdigital phlegmon), and laminitis-related claw disorders (sole ulcer, white line disorder, and hemorrhage of sole and white line). The feet and leg conformation traits were rear leg rear view (new and old definition), rear leg side view, foot angle, and hoof quality. Feet and leg conformation traits were scored linearly from 1 to 9, with optimum scores depending on the trait. Claw disorders were defined as binary (0/1) traits for each lactation. Threshold sire models were used to model claw disorders, whereas the feet and leg conformation traits were described by linear sire models. Three multivariate analyses were performed, each including the 5 feet and leg conformation traits and 1 of the 3 claw disorders at a time. Posterior means of heritability of liability of claw disorders ranged from 0.10 to 0.20 and heritabilities of feet and leg conformation traits ranged from 0.04 to 0.11. Posterior standard deviation of heritability was ≤0.01 for all traits. Genetic correlations between claw disorders and feet and leg conformation traits were all low or moderate, except between corkscrew claw and hoof quality (-0.86), which are supposed to measure the same trait. The genetic correlations between rear leg rear view (new) and infectious claw disorders (-0.20) and laminitis-related claw disorders (0.26), and between hoof quality and laminitis-related claw disorders (-0.33) were moderate. Eight of the 15 genetic correlations between claw disorders and feet and leg conformation traits had 0

  5. Reproducibility and day time bias correction of optoelectronic leg volumetry: a prospective cohort study

    Directory of Open Access Journals (Sweden)

    Baumgartner Iris

    2011-10-01

    Full Text Available Abstract Background Leg edema is a common manifestation of various underlying pathologies. Reliable measurement tools are required to quantify edema and monitor therapeutic interventions. Aim of the present work was to investigate the reproducibility of optoelectronic leg volumetry over 3 weeks' time period and to eliminate daytime related within-individual variability. Methods Optoelectronic leg volumetry was performed in 63 hairdressers (mean age 45 ± 16 years, 85.7% female in standing position twice within a minute for each leg and repeated after 3 weeks. Both lower leg (legBD and whole limb (limbBF volumetry were analysed. Reproducibility was expressed as analytical and within-individual coefficients of variance (CVA, CVW, and as intra-class correlation coefficients (ICC. Results A total of 492 leg volume measurements were analysed. Both legBD and limbBF volumetry were highly reproducible with CVA of 0.5% and 0.7%, respectively. Within-individual reproducibility of legBD and limbBF volumetry over a three weeks' period was high (CVW 1.3% for both; ICC 0.99 for both. At both visits, the second measurement revealed a significantly higher volume compared to the first measurement with a mean increase of 7.3 ml ± 14.1 (0.33% ± 0.58% for legBD and 30.1 ml ± 48.5 ml (0.52% ± 0.79% for limbBF volume. A significant linear correlation between absolute and relative leg volume differences and the difference of exact day time of measurement between the two study visits was found (P W. Conclusions Leg volume changes can be reliably assessed by optoelectronic leg volumetry at a single time point and over a 3 weeks' time period. However, volumetry results are biased by orthostatic and daytime-related volume changes. The bias for day-time related volume changes can be minimized by a time-correction formula.

  6. Lean Transformation Guidance: Why Organizations Fail To Achieve and Sustain Excellence Through Lean Improvement

    OpenAIRE

    Mohammed Hamed Ahmed

    2013-01-01

    Many companies are complaining that lean didn’t achieve their long-term goals, and the improvement impact was very short-lived. 7 out of each 10 lean projects fail as companies try to use lean like a toolkit, copying and pasting the techniques without trying to adapt the employee’s culture, manage the improvement process, sustain the results, and develop their leaders. When the Toyota production system was created, the main goal was to remove wastes from the shop floor us...

  7. Peripheral Dopamine in Restless Legs Syndrome

    Directory of Open Access Journals (Sweden)

    Ulrike H. Mitchell

    2018-03-01

    Full Text Available Objective/BackgroundRestless Legs Syndrome (RLS is a dopamine-dependent disorder characterized by a strong urge to move. The objective of this study was to evalulate blood levels of dopamine and other catecholamines and blood D2-subtype dopamine receptors (D2Rs in RLS.Patients/MethodsDopamine levels in blood samples from age-matched unmedicated RLS subjects, medicated RLS subjects and Controls were evaluated with high performance liquid chromatography and dopamine D2R white blood cell (WBC expression levels were determined with fluorescence-activated cell sorting and immunocytochemistry.ResultsBlood plasma dopamine levels, but not norepinepherine or epinephrine levels, were significantly increased in medicated RLS subjects vs unmedicated RLS subjects and Controls. The percentage of lymphocytes and monocytes expressing D2Rs differed between Control, RLS medicated and RLS unmedicated subjects. Total D2R expression in lymphocytes, but not monocytes, differed between Control, RLS medicated and RLS unmedicated subjects. D2Rs in lymphocytes, but not monocytes, were sensitive to dopamine in Controls only.ConclusionDownregulation of WBCs D2Rs occurs in RLS. This downregulation is not reversed by medication, although commonly used RLS medications increase plasma dopamine levels. The insensitivity of monocytes to dopamine levels, but their downregulation in RLS, may reflect their utility as a biomarker for RLS and perhaps brain dopamine homeostasis.

  8. Development of framework for sustainable Lean implementation: an ISM approach

    Science.gov (United States)

    Jadhav, Jagdish Rajaram; Mantha, S. S.; Rane, Santosh B.

    2014-07-01

    The survival of any organization depends upon its competitive edge. Even though Lean is one of the most powerful quality improvement methodologies, nearly two-thirds of the Lean implementations results in failures and less than one-fifth of those implemented have sustained results. One of the most significant tasks of top management is to identify, understand and deploy the significant Lean practices like quality circle, Kanban, Just-in-time purchasing, etc. The term `bundle' is used to make groups of inter-related and internally consistent Lean practices. Eight significant Lean practice bundles have been identified based on literature reviewed and opinion of the experts. The order of execution of Lean practice bundles is very important. Lean practitioners must be able to understand the interrelationship between these practice bundles. The objective of this paper is to develop framework for sustainable Lean implementation using interpretive structural modelling approach.

  9. Lean Production and information technology : Connection or contradiction?

    NARCIS (Netherlands)

    Riezebos, Jan; Klingenberg, Warse; Hicks, Christian

    The principles of Lean Production have enabled organisations in the manufacturing and service sectors to significantly improve their competitiveness. The application of Lean principles, derived from the Toyota Production System has enabled many organisations to Simultaneously improve productivity,

  10. IBIS UvA: research and consultancy in Lean Six Sigma

    NARCIS (Netherlands)

    Kemper, B.; de Mast, J.

    2008-01-01

    Lean Six Sigma is an advanced process improvement methodology. Initially, Six Sigma focused on the reduction of the number of defects in manufacturing. It was introduced at Motorola in 1986, and it incorporates previous methodologies, such as Statistical Process Control, Total Quality Management,

  11. Dietary B vitamin needs of strains of pigs with high and moderate lean growth.

    Science.gov (United States)

    Stahly, T S; Williams, N H; Lutz, T R; Ewan, R C; Swenson, S G

    2007-01-01

    Ten sets of 5 littermate pigs from each of 2 genetic strains were utilized to determine the impact of the dietary concentration of 5 B vitamins (riboflavin, niacin, pantothenic acid, cobalamin, and folacin) on growth from 9 to 28 kg of BW in pigs with high or moderate capacity for lean growth. All pigs (penned individually) were reared via a segregated, early weaning scheme, so that the lean growth potential of each strain could be expressed. The basal diet provided the 5 test vitamins at concentrations of total and estimated bioavailability equivalent to a minimum of 100 and 70%, respectively, of their estimated requirements (NRC, 1998) for 5- to 10-kg pigs. At a BW of 9 +/- 0.9 kg, pigs within each litter were allotted to the basal diet supplemented with sources of the 5 test vitamins equivalent to an additional 0, 100, 200, 300, or 400% (bioavailable) of the NRC requirements. Pigs from the high lean strain consumed less feed (P vitamin concentrations were increased. However, the dietary B vitamin concentrations needed to optimize G:F were greater (P 470% of NRC, 1998) vs. moderate (270%) lean strain. Based on these data, the dietary needs for 1 or more of the 5 B vitamins are greater than current NRC (1998) estimates, particularly in pigs expressing a high rate of lean tissue growth. The greater need for these vitamins is not associated with greater dietary energy intake or body energy accretion rate but is potentially due to shifts in the predominant metabolic pathways.

  12. Buoyant Unstable Behavior of Initially Spherical Lean Hydrogen-Air Premixed Flames

    Directory of Open Access Journals (Sweden)

    Zuo-Yu Sun

    2014-07-01

    Full Text Available Buoyant unstable behavior in initially spherical lean hydrogen-air premixed flames within a center-ignited combustion vessel have been studied experimentally under a wide range of pressures (including reduced, normal, and elevated pressures. The experimental observations show that the flame front of lean hydrogen-air premixed flames will not give rise to the phenomenon of cellular instability when the equivalence ratio has been reduced to a certain value, which is totally different from the traditional understanding of the instability characteristics of lean hydrogen premixed flames. Accompanied by the smoothened flame front, the propagation mode of lean hydrogen premixed flames transitions from initially spherical outwardly towards upwardly when the flames expand to certain sizes. To quantitatively investigate such buoyant instability behaviors, two parameters, “float rate (ψ” and “critical flame radius (Rcr”, have been proposed in the present article. The quantitative results demonstrate that the influences of initial pressure (Pint on buoyant unstable behaviors are different. Based on the effects of variation of density difference and stretch rate on the flame front, the mechanism of such buoyant unstable behaviors has been explained by the competition between the stretch force and the results of gravity and buoyancy, and lean hydrogen premixed flames will display buoyant unstable behavior when the stretch effects on the flame front are weaker than the effects of gravity and buoyancy.

  13. The Impact of Lean Six Sigma on the Overall Results of Companies

    Directory of Open Access Journals (Sweden)

    Corina DUMITRESCU

    2011-12-01

    Full Text Available Lean Six Sigma represents a management approach for driving innovating processes inside a company in order to achieve superior results. It involves a practical analysis based on facts, aiming the innovation and growth, not only the efficiency of processes. It is a long term process of gradual and continuous improvement. The application of Lean Six Sigma in companies led to attaining superior financial performance by addressing new needs, by differentiating the products and services or by adjusting the business lines to new processes. Quality is more than making things without errors. It is about making a product or service meet the individual perception of a customer about the quality or value. Therefore, in what regards Lean Six Sigma, the concern is not only to "do the things right" but also to "do the right things right". We focus on the impact of implementing the Lean Six Sigma approach on companies, seeking for what changes and benefits it brings. The key elements it aims at are achieving the best quality, the lowest cost, getting the shortest lead-time, stressing on waste elimination. The requirements of a company for its implementation and the strategy to obtain the maximum practical outcome are investigated. Furthermore, we conduct a comparison analysis with the other methods of the total quality management and see why Lean Six Sigma is a more desirable approach.

  14. Implementation of lean construction techniques for minimizing the risks effect on project construction time

    Directory of Open Access Journals (Sweden)

    Usama Hamed Issa

    2013-12-01

    Full Text Available The construction projects involve various risk factors which have various impacts on time objective that may lead to time-overrun. This study suggests and applies a new technique for minimizing risk factors effect on time using lean construction principles. The lean construction is implemented in this study using the last planner system through execution of an industrial project in Egypt. Evaluating the effect of using the new tool is described in terms of two measurements: Percent Expected Time-overrun (PET and Percent Plan Completed (PPC. The most important risk factors are identified and assessed, while PET is quantified at the project start and during the project execution using a model for time-overrun quantification. The results showed that total project time is reduced by 15.57% due to decreasing PET values, while PPC values improved. This is due to minimizing and mitigating the effect of most of the risk factors in this project due to implementing lean construction techniques. The results proved that the quantification model is suitable for evaluating the effect of using lean construction techniques. In addition, the results showed that average value of PET due to factors affected by lean techniques represents 67% from PET values due to all minimized risk factors.

  15. Weight-adjusted lean body mass and calf circumference are protective against obesity-associated insulin resistance and metabolic abnormalities.

    Science.gov (United States)

    Takamura, Toshinari; Kita, Yuki; Nakagen, Masatoshi; Sakurai, Masaru; Isobe, Yuki; Takeshita, Yumie; Kawai, Kohzo; Urabe, Takeshi; Kaneko, Shuichi

    2017-07-01

    To test the hypothesis that preserved muscle mass is protective against obesity-associated insulin resistance and metabolic abnormalities, we analyzed the relationship of lean body mass and computed tomography-assessed sectional areas of specific skeletal muscles with insulin resistance and metabolic abnormalities in a healthy cohort. A total of 195 subjects without diabetes who had completed a medical examination were included in this study. Various anthropometric indices such as circumferences of the arm, waist, hip, thigh, and calf were measured. Body composition (fat and lean body mass) was determined by bioelectrical impedance analysis. Sectional areas of specific skeletal muscles (iliopsoas, erector spinae, gluteus, femoris, and rectus abdominis muscles) were measured using computed tomography. Fat and lean body mass were significantly correlated with metabolic abnormalities and insulin resistance indices. When adjusted by weight, relationships of fat and lean body mass with metabolic parameters were mirror images of each other. The weight-adjusted lean body mass negatively correlated with systolic and diastolic blood pressures; fasting plasma glucose, HbA1c, alanine aminotransferase, and triglyceride, and insulin levels; and hepatic insulin resistance indices, and positively correlated with HDL-cholesterol levels and muscle insulin sensitivity indices. Compared with weight-adjusted lean body mass, weight-adjusted sectional areas of specific skeletal muscles showed similar, but not as strong, correlations with metabolic parameters. Among anthropometric measures, the calf circumference best reflected lean body mass, and weight-adjusted calf circumference negatively correlated with metabolic abnormalities and insulin resistance indices. Weight-adjusted lean body mass and skeletal muscle area are protective against weight-associated insulin resistance and metabolic abnormalities. The calf circumference reflects lean body mass and may be useful as a protective

  16. Acupuncture for restless legs syndrome.

    Science.gov (United States)

    Cui, Ye; Wang, Yin; Liu, Zhishun

    2008-10-08

    Restless legs syndrome (RLS) is a common movement disorder for which patients may seek treatment with acupuncture. However, the benefits of acupuncture in the treatment of RLS are unclear and have not been evaluated in a systematic review until now. To evaluate the efficacy and safety of acupuncture therapy in patients with RLS. We searched the Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library, Issue 1, 2007), MEDLINE (January 1950 to February 2007), EMBASE (January 1980 to 2007 Week 8), Chinese Biomedical Database (CBM) (1978 to February 2007), China National Knowledge Infrastructure (CNKI) (1979 to February 2007), VIP Database (1989 to February 2007), Japana Centra Revuo Medicina (1983 to 2007) and Korean Medical Database (1986 to 2007). Four Chinese journals, relevant academic conference proceedings and reference lists of articles were handsearched. Randomized controlled trials and quasi-randomized trials comparing acupuncture with no intervention, placebo acupuncture, sham acupuncture, pharmacological treatments, or other non-acupuncture interventions for primary RLS were included. Trials comparing acupuncture plus non-acupuncture treatment with the same non-acupuncture treatment were also included. Trials that only compared different forms of acupuncture or different acupoints were excluded. Two authors independently identified potential articles, assessed methodological quality and extracted data. Relative risk (RR) was used for binary outcomes and weighted mean difference for continuous variables. Results were combined only in the absence of clinical heterogeneity. Fourteen potentially relevant trials were identified initially, but twelve of them did not meet the selection criteria and were excluded. Only two trials with 170 patients met the inclusion criteria. No data could be combined due to clinical heterogeneity between trials. Both trials had methodological and/or reporting shortcomings. No significant difference was detected

  17. Lean Accounting - An Ingenious Solution for Cost Optimization

    OpenAIRE

    Dimi Ofileanu; Dan Ioan Topor

    2014-01-01

    The aim of this work is to present a new concept in accounting management: Lean Accounting. This work explains the way the lean concept was born; its benefits for the production system of the factories and the necessity of applying lean accounting in the factories which have implemented lean production, taking into account both its advantages and the boundaries of the other cost management methods in those factories.

  18. TH-C-9A-01: Lean Tools and Methods

    International Nuclear Information System (INIS)

    Rangaraj, D; Chan, K; Boddu, S; Pawlicki, T; Dieterich, S

    2014-01-01

    Lean thinking has revolutionized the manufacturing industry. Toyota has pioneered and leveraged this aspect of Lean thinking. Application of Lean thinking and Lean Six Sigma techniques into Healthcare and in particular in Radiation Oncology has its merits and challenges. To improve quality, safety and patient satisfaction with available resources or reducing cost in terms of time, staff and resources is demands of today's healthcare. Radiation oncology treatment involves many processes and steps, identifying and removing the non-value added steps in a process can significantly improve the efficiency. Real projects undertaken in radiation oncology department in cutting down the procedure time for MRI guided brachytherapy to 40% less using lean thinking will be narrated. Simple Lean tools and techniques such as Gemba walk, visual control, daily huddles, standard work, value stream mapping, error-proofing, etc. can be applied with existing resources and how that improved the operation in a Radiation Oncology department's two year experience will be discussed. Lean thinking focuses on identifying and solving the root-cause of a problem by asking “Why” and not “Who” and this requires a culture change of no blame. Role of leadership in building lean culture, employee empowerment and trains and develops lean thinkers will be presented. Why Lean initiatives fail and how to implement lean successfully in your clinic will be discussed. Learning Objectives: Concepts of lean management or lean thinking. Lean tools and techniques applied in Radiation Oncology. Implement no blame culture and focus on system and processes. Leadership role in implementing lean culture. Challenges for Lean thinking in healthcare

  19. Investigating employee resistance to Lean transformation: UK case study.

    OpenAIRE

    Bruce, J.; Scott, Philip; Roberts, Martyn

    2011-01-01

    Lean is a business process transformation approach that eliminates ‘wastes’ – activities that generate no value for the customer. Lean originated from the production line but is widely implemented in the service sector. This study investigates human and social factors in a Lean transformation in a ‘knowledge worker’ environment. We identify a paradox: a successful Lean programme in the service sector develops staff who are educated and empowered and thus potential opponents to future business...

  20. TH-C-9A-01: Lean Tools and Methods

    Energy Technology Data Exchange (ETDEWEB)

    Rangaraj, D [Baylor Scott and White Health, Temple, TX (United States); Chan, K [Princess Margaret Hospital, Toronto (Canada); Boddu, S [Temple, TX (United States); Pawlicki, T [UC San Diego, La Jolla, CA (United States); Dieterich, S [UC Davis Medical Center, Sacramento, CA (United States)

    2014-06-15

    Lean thinking has revolutionized the manufacturing industry. Toyota has pioneered and leveraged this aspect of Lean thinking. Application of Lean thinking and Lean Six Sigma techniques into Healthcare and in particular in Radiation Oncology has its merits and challenges. To improve quality, safety and patient satisfaction with available resources or reducing cost in terms of time, staff and resources is demands of today's healthcare. Radiation oncology treatment involves many processes and steps, identifying and removing the non-value added steps in a process can significantly improve the efficiency. Real projects undertaken in radiation oncology department in cutting down the procedure time for MRI guided brachytherapy to 40% less using lean thinking will be narrated. Simple Lean tools and techniques such as Gemba walk, visual control, daily huddles, standard work, value stream mapping, error-proofing, etc. can be applied with existing resources and how that improved the operation in a Radiation Oncology department's two year experience will be discussed. Lean thinking focuses on identifying and solving the root-cause of a problem by asking “Why” and not “Who” and this requires a culture change of no blame. Role of leadership in building lean culture, employee empowerment and trains and develops lean thinkers will be presented. Why Lean initiatives fail and how to implement lean successfully in your clinic will be discussed. Learning Objectives: Concepts of lean management or lean thinking. Lean tools and techniques applied in Radiation Oncology. Implement no blame culture and focus on system and processes. Leadership role in implementing lean culture. Challenges for Lean thinking in healthcare.

  1. Lean management in a non-manufacturing organization

    Directory of Open Access Journals (Sweden)

    Mladen Žvorc

    2013-12-01

    Full Text Available This paper examines the possibilities of a lean approach to non-manufacturing functions, i.e. a market-oriented organization. This refers to purchasing, shipment, storage, sale and delivery of goods; marketing, etc. A lean approach to business operations is discussed and several lean business methods are developed on the basis of which lean management can be used not only in manufacturing, but also in non-manufacturing organizations.

  2. Flexural characteristics of a stack leg

    International Nuclear Information System (INIS)

    Cook, J.

    1979-06-01

    A 30 MV tandem Van de Graaff accelerator is at present under construction at Daresbury Laboratory. The insulating stack of the machine is of modular construction, each module being 860 mm in length. Each live section stack module contains 8 insulating legs mounted between bulkhead rings. The design, fabrication (from glass discs bonded to stainless steel discs using an epoxy film adhesive) and testing of the stack legs is described. (U.K.)

  3. Effect of selection for lean growth on gonadal development of ...

    African Journals Online (AJOL)

    A primary objective of commercial pig production is lean meat yield in order to satisfy consumer needs. The majority of the commercial pig breeds in South Africa have been selected for high lean growth potential and reduced backfat thickness. There are indications that selection for high lean meat yield may affect the ...

  4. Using Simulation to Explore Lean Manufacturing Implementation Strategies

    Science.gov (United States)

    Shannon, Patrick W.; Krumwiede, Kip R.; Street, Jeffrey N.

    2010-01-01

    Lean manufacturing, an outgrowth of the Toyota Production System, has spread far beyond the automobile industry and is seen by many leaders as a key management philosophy in the battle to compete on an international scale. Successful implementation of lean requires that managers and employees be educated in the proper application of lean tools and…

  5. Når lean organiserer på hospitalet

    DEFF Research Database (Denmark)

    Hauge, Amalie Martinus

    Lean er kendt og anvendt af mange offentlige organisationer i Danmark. Selv om Leans anvendelighed de fleste steder er slået fast, bliver Lean imidlertid ved med at udfordre og skabe konflikt. Hvorfor det? Dette spørgsmål – og mange andre – bliver belyst i denne rapport, som er baseret på en Ph...

  6. Reducing waste in administrative services with lean principles

    NARCIS (Netherlands)

    Wijnhoven, Alphonsus B.J.M.; Beckers, David; Amrit, Chintan Amrit

    2016-01-01

    In the last few decades, lean techniques have been developed for removing with waste in manufacturing. More recently, lean is used outside the manufacturing context as well. This article focuses on using lean thinking for reducing waste in administrative services, i.e., business services with

  7. Teaching Special Decisions in a Lean Accounting Environment

    Science.gov (United States)

    Haskin, Daniel

    2010-01-01

    Lean accounting has become increasingly important as more and more companies adopt the lean enterprise model or some variation of it. Cost and managerial accounting textbooks continue to use, almost exclusively, models based on standard overhead absorption, which if used in a lean environment will not accurately reflect the benefits from the…

  8. Application of lean thinking to health care: issues and observations

    Science.gov (United States)

    Joosten, Tom; Bongers, Inge; Janssen, Richard

    2009-01-01

    Background Incidents and quality problems are a prime cause why health care leaders are calling to redesign health care delivery. One of the concepts used is lean thinking. Yet, lean often leads to resistance. Also, there is a lack of high quality evidence supporting lean premises. In this paper, we present an overview of lean thinking and its application to health care. Development, theory and application of lean thinking to health care Lean thinking evolved from a tool designed to improve operational shop-floor performance at an automotive manufacturer to a management approach with both operational and sociotechnical aspects. Sociotechnical dynamics have until recently not received much attention. At the same time a balanced approach might lead to a situation where operational and sociotechnial improvements are mutually reinforcing. Application to health care has been limited and focussed mainly on operational aspects using original lean tools. A more integrative approach would be to pay more attention to sociotechnical dynamics of lean implementation efforts. Also, the need to use the original lean tools may be limited, because health care may have different instruments and tools already in use that are in line with lean thinking principles. Discussion We believe lean thinking has the potential to improve health care delivery. At the same time, there are methodological and practical considerations that need to be taken into account. Otherwise, lean implementation will be superficial and fail, adding to existing resistance and making it more difficult to improve health care in the long term. PMID:19696048

  9. Lean-team effectiveness through leader values and members’ informing

    NARCIS (Netherlands)

    van Dun, Desirée Hermina; Wilderom, Celeste P.M.

    2016-01-01

    Purpose Although empirical tests of effective lean-team leadership are scarce, leaders are often blamed when lean work-floor initiatives fail. In the present study, a lean-team leader’s work values are assumed to affect his or her team members’ behaviors and, through them, to attain team

  10. Cull sow knife-separable lean content evaluation at harvest and lean mass content prediction equation development.

    Science.gov (United States)

    Abell, Caitlyn E; Stalder, Kenneth J; Hendricks, Haven B; Fitzgerald, Robert F

    2012-07-01

    The objectives of this study were to develop a prediction equation for carcass knife-separable lean within and across USDA cull sow market weight classes (MWC) and to determine carcass and individual primal cut knife separable lean content from cull sows. There were significant percent lean and fat differences in the primal cuts across USDA MWC. The two lighter USDA MWC had a greater percent carcass lean and lower percent fat compared to the two heavier MWC. In general, hot carcass weight explained the majority of carcass lean variation. Additionally, backfat was a significant variation source when predicting cull sow carcass lean. The findings support using a single lean prediction equation across MWC to assist processors when making cull sow purchasing decisions and determine the mix of animals from various USDA MWC that will meet their needs when making pork products with defined lean:fat content. Copyright © 2012 Elsevier Ltd. All rights reserved.

  11. Industrial Ecology and Environmental Lean Management: Lights and Shadows

    Directory of Open Access Journals (Sweden)

    Giuseppe Ioppolo

    2014-09-01

    Full Text Available Current industrial production is driven by increasing globalization, which has led to a steady increase in production volumes and complexity of products aimed at the pursuit of meeting the needs of customers. In this context, one of the main tools in the management of customer value is Lean Manufacturing or Production, though it is considered primarily as a set of tools to reduce the total cost of the resources needed to achieve such needs. This philosophy has recently been enriched in the literature with case studies that link Lean Management (LM with the improvement of environmental sustainability. The consequence is an expansion of the Computer Integrated Manufacturing (CIM; indeed, CIM, currently, combining and integrating the key business functions (e.g., business, engineering, manufacturing, and information management with a view of the life cycle, does not highlight the strategic role of the environmental aspects. In order to deal with the increasingly rapid environmental degradation that is reflected in society, in terms of both economy and quality of life, Industrial Ecology (IE introduced a new paradigm of principles and instruments of analysis and decision support (e.g., Life Cycle Assessment—LCA, Social Life Cycle Assessment -SLCA, Material Flow Account—MFA, etc. that can be considered as the main basis for integrating the environmental aspects in each strategy, design, production, final product, and end of life management, through the re-engineering of processes and activities towards the development of an eco-industrial system. This paper presents the preliminary observations based on a analysis of both theories (LM-IE and provides a possible assessment of the key factors relevant to their integration in a “lean environmental management”, highlighting both positives (lights and possible barriers (shadows.

  12. The impact of insulin resistance on clinical, hormonal and metabolic parameters in lean women with polycystic ovary syndrome.

    Science.gov (United States)

    Yildizhan, Begum; Anik Ilhan, Gokce; Pekin, Tanju

    2016-10-01

    This study was performed to assess insulin resistance (IR) in lean women with polycystic ovary syndrome (PCOS). Retrospective analysis of 100 consecutive lean (body mass index PCOS subjects was performed. Subjects were divided into two groups according to homeostasis model assessment IR index (HOMA-IR), as IR + and IR-. A HOMA-IR value >2.5 was used to indicate IR. A total of 100 lean PCOS subjects were enrolled in the study, of which 47% were insulin resistant. Comparison of group means showed significantly higher values for waist-to-hip ratio (WHR), diastolic blood pressure and Ferriman-Gallwey score (FGS) in IR + group. HOMA-IR values were found to be positively correlated with WHR (r = 0.500, p PCOS subjects, the insulin resistant group should be separated as unique and IR should also be evaluated in lean women with PCOS.

  13. Investigation of the prominent barriers to lean manufacturing implementation in Malaysian food and beverages industry using Rasch Model

    Science.gov (United States)

    Khusaini, N. S.; Ismail, A.; Rashid, A. A.

    2016-02-01

    This paper presents a preliminary study on the prominent barriers to lean manufacturing implementation in Malaysian Food and Beverages Industry. A survey was carried out to determine the most prominent barriers of lean manufacturing implementation that are currently being faced in this industry. The amount of barriers identified for this study is twenty seven. Out of 1309 available organizations, a total of 300 organizations have been randomly selected as respondents, and 53 organizations responded. From the variable map, the analysis shows that, the negative perception towards lean manufacturing top the list as the most agreeable barrier, while the technical barriers came after it. It can also be seen from the variable map that averagely, lack of vision and direction is the barrier that is being faced. Finally, this is perhaps the first attempt in investigating the prominent barriers to Lean Manufacturing implementation in Malaysian food and beverages industry using Rasch Model.

  14. Lean Transformation Guidance: Why Organizations Fail To Achieve and Sustain Excellence Through Lean Improvement

    Directory of Open Access Journals (Sweden)

    Mohammed Hamed Ahmed

    2013-06-01

    Full Text Available Many companies are complaining that lean didn’t achieve their long-term goals, and the improvement impact was very short-lived. 7 out of each 10 lean projects fail as companies try to use lean like a toolkit, copying and pasting the techniques without trying to adapt the employee’s culture, manage the improvement process, sustain the results, and develop their leaders. When the Toyota production system was created, the main goal was to remove wastes from the shop floor using some lean techniques and tools. What was not clear is that this required from Toyota a long process of leadership development, and a high commitment to training and coaching their employee. A Failure to achieve and sustain the improvement is a problem of both management and leadership as well as the improper understanding of the human behavior, and the required culture to success.

  15. Genetic parameters for claw and leg health, foot and leg conformation, and locomotion in Danish Holsteins

    DEFF Research Database (Denmark)

    Laursen, M. V.; Boelling, D.; Mark, Thomas

    2009-01-01

    was defined as absence of hock infection, swollen hock, and bruising. The potential indicators were locomotion and foot and leg conformation, represented by rear leg side view, rear leg rear view, foot angle, and apparent hock quality and bone structure. The study was conducted using records from 429......,877 Danish Holstein cows in first lactation. Binary health traits were divided into 3 subcategories: claw health, leg health, and absence of all claw and leg disorders. Genetic (r(g)) and phenotypic correlations were estimated using a bivariate linear sire model and REML. Estimated heritabilities were 0.......01 for all 3 combined claw and leg health traits (on the observed binary scale), 0.09 for locomotion, 0.14 for rear leg rear view, 0.19 for rear leg side view, 0.13 for foot angle, 0.22 for apparent hock quality, and 0.27 for apparent bone structure. Heritabilities were 0.06 and 0.01 for claw health and leg...

  16. Systems Thinking, Lean Production and Action Learning

    Science.gov (United States)

    Seddon, John; Caulkin, Simon

    2007-01-01

    Systems thinking underpins "lean" management and is best understood through action-learning as the ideas are counter-intuitive. The Toyota Production System is just that--a system; the failure to appreciate that starting-place and the advocacy of "tools" leads many to fail to grasp what is, without doubt, a significant…

  17. Lean leiderschap voor (nog) betere teamprestaties

    NARCIS (Netherlands)

    van Dun, Desirée Hermina; Wilderom, Celeste P.M.

    2016-01-01

    Veel managers en teams hebben moeite om continu te blijven verbeteren. Recent onderzoek van de Universiteit Twente laat zien dat er bij het toepassen van lean meer aandacht nodig is voor gedragsontwikkeling van zowel medewerkers als leidinggevenden. Managers met bepaalde gedragskenmerken creëren een

  18. Simulation of lean premixed turbulent combustion

    International Nuclear Information System (INIS)

    Bell, J; Day, M; Almgren, A; Lijewski, M; Rendleman, C; Cheng, R; Shepherd, I

    2006-01-01

    There is considerable technological interest in developing new fuel-flexible combustion systems that can burn fuels such as hydrogen or syngas. Lean premixed systems have the potential to burn these types of fuels with high efficiency and low NOx emissions due to reduced burnt gas temperatures. Although traditional Scientific approaches based on theory and laboratory experiment have played essential roles in developing our current understanding of premixed combustion, they are unable to meet the challenges of designing fuel-flexible lean premixed combustion devices. Computation, with its ability to deal with complexity and its unlimited access to data, has the potential for addressing these challenges. Realizing this potential requires the ability to perform high fidelity simulations of turbulent lean premixed flames under realistic conditions. In this paper, we examine the specialized mathematical structure of these combustion problems and discuss simulation approaches that exploit this structure. Using these ideas we can dramatically reduce computational cost, making it possible to perform high-fidelity simulations of realistic flames. We illustrate this methodology by considering ultra-lean hydrogen flames and discuss how this type of simulation is changing the way researchers study combustion

  19. Ares Launch Vehicles Lean Practices Case Study

    Science.gov (United States)

    Doreswamy, Rajiv; Self, Timothy A.

    2007-01-01

    The Ares launch vehicles team, managed by the Ares Projects Office (APO) at NASA Marshall Space Flight Center, has completed the Ares I Crew Launch Vehicle System Requirements Review and System Definition Review and early design work for the Ares V Cargo Launch Vehicle. This paper provides examples of how Lean Manufacturing, Kaizen events, and Six Sigma practices are helping APO deliver a new space transportation capability on time and within budget, while still meeting stringent technical requirements. For example, Lean philosophies have been applied to numerous process definition efforts and existing process improvement activities, including the Ares I-X test flight Certificate of Flight Readiness (CoFR) process, risk management process, and review board organization and processes. Ares executives learned Lean practices firsthand, making the team "smart buyers" during proposal reviews and instilling the team with a sense of what is meant by "value-added" activities. Since the goal of the APO is to field launch vehicles at a reasonable cost and on an ambitious schedule, adopting Lean philosophies and practices will be crucial to the Ares Project's long-term SUCCESS.

  20. Lean Six Sigma: Stap voor stap

    NARCIS (Netherlands)

    Does, R.J.M.M.; de Koning, H.; de Mast, J.

    2008-01-01

    Lean Six Sigma is de culminatie van ontwikkelingen in kwaliteitsverbetering in de 20ste eeuw. Het combineert belangrijke principes en technieken in een goed gestructureerde en geïntegreerde benadering. Het belichaamt wetenschappelijke inzichten over onderzoeksmethodologie, management en economie. In

  1. Lean leadership and change management skills

    NARCIS (Netherlands)

    Frank Willems

    2013-01-01

    Gastcollege Masteropleiding MIM Tilburg University/TiasNimbas Business School op 17 & 18 mei 2013. • Basic principles of Change Management • Group practice • TheoryU and Social Networking theory as framework for Leadership • Theory about Lean thinking as a method for improving Leadership skills and

  2. Lean approaches in a knowledge worker environment

    CSIR Research Space (South Africa)

    Christelis, L

    2012-08-01

    Full Text Available Most of us are familiar with the concept of Lean (a way to do more and more with less and less). The principles have been applied by the Japanese as part of the Toyota Production System from as early as the 1950's. Subsequently many have applied...

  3. Lean and Agile: An Epistemological Reflection

    Science.gov (United States)

    Browaeys, Marie-Joelle; Fisser, Sandra

    2012-01-01

    Purpose: The aim of the paper is to contribute to the discussion of treating the concepts of lean and agile in isolation or combination by presenting an alternative view from complexity thinking on these concepts, considering an epistemological approach to this topic. Design/methodology/approach: The paper adopts an epistemological approach, using…

  4. Implementing Lean Six Sigma in organizations

    NARCIS (Netherlands)

    Lameijer, B.A.

    2017-01-01

    This thesis focuses on operational excellence following the Lean Six Sigma (LSS) method. As the popularity of implementing LSS grows, questions about implementing LSS in organizations arise, and this is where we aim to contribute. We study key questions about implementing LSS in organizations at two

  5. Modelling green and lean supply chains

    DEFF Research Database (Denmark)

    Govindan, Kannan; Carvalho, Helena; Azevedo, Susana G.

    2017-01-01

    This manuscript proposes a model to support decision making and to help managers identify the best set of green and lean supply chain management practices to improve their eco-efficiency. To attain this objective, a mathematical model based on eco-efficiency concepts is suggested to overcome...... a strategic framework to support the design of eco-efficient supply chains....

  6. Implementing lean in a surgical ward

    DEFF Research Database (Denmark)

    Edwards, Kasper; Nielsen, Anders Paarup; Jacobsen, Peter

    be planned (in detail) in advance. The remaining operating rooms are allocated to this flow and there have been no significant changes to the organization of work in these theaters. Lean management is derived from the Toyota production system and is a comprehensive system of tools and techniques...

  7. Performance management practices in lean manufacturing organizations

    NARCIS (Netherlands)

    Bellisario, Andrea; Pavlov, Andrey

    2018-01-01

    This paper provides the first systematic look into the existing research on performance management (PM) practices employed in lean manufacturing organisations (LMOs). It adopts a systematic review method to examine the evidence generated in the period 2004 – 2015 and uses a comprehensive PM

  8. Lean planning and control : principles and practice

    NARCIS (Netherlands)

    Riezebos, Jan; Suer, Gursel; Gen, Mitsuo

    2018-01-01

    A basic characteristic of lean, agile, and responsive production systems are the use of teams instead of functional departments. Another characteristic is the use of rather simple shop floor control methods to manage the flow of orders. The shop floor control methods provide robust and visual

  9. Personality characteristics of excellent lean managers

    DEFF Research Database (Denmark)

    Steendahl Nielsen, Jacob; Boer, Harry; Lindgren, Peter

    2016-01-01

    Today many Danish companies are implementing Lean and hereby trying to implement a continuous improvement (CI) program and culture. We have observed that companies can easily implement the artifacts of CI, such as Kaizen boards, Kaizen meetings, Performance management (KPI), A3 and PDCA reports...

  10. Lowlands sociotechnical design theory and lean production

    NARCIS (Netherlands)

    Christis, Jac; Soepenberg, Erik; Mohr, Bernard J.; van Amelsvoort, Pierre

    2015-01-01

    Lean Production (LP) can be regarded as a design approach in search of a theoretical foundation. In this paper we show that Lowlands’ Sociotechnical Design Theory (STSL) could function as such a foundation. To reach this goal, we first describe STSL as a system theoretical reformulation of Original

  11. Measuring lean implementation for maintenance service companies

    NARCIS (Netherlands)

    de Jong, Stephan J.; Beelaerts van Blokland, W.W.A.

    2016-01-01

    Purpose – Implementation of lean manufacturing is currently performed in the production industry; however, for the airline maintenance service industry, it is still in its infancy. Indicators such as work in process, cycle time, on-time performance and inventory are useful indicators to measure

  12. The Scientific Underpinning of Lean Six Sigma

    NARCIS (Netherlands)

    Does, R.J.M.M.; de Mast, J.; de Koning, H.; Bisgaard, S.

    2007-01-01

    The twentieth century saw an incredible development of professional organizations. The impact of technological advances is obvious, but besides these, innovations in management structures and methods have resulted in the highly productive organizations of today. Lean Six Sigma is not revolutionary.

  13. Lean Six Sigma for Service and Healthcare

    NARCIS (Netherlands)

    de Mast, J.; Does, R.J.M.M.; de Koning, H.

    2006-01-01

    Lean Six Sigma is built on principles and methods that have proven themselves over the twentieth century. It has incorporated the most effective approaches and integrated them into a full programme. It offers a management structure for organizing continuous improvement of routine tasks, such as

  14. Lean Sygehuset - del I: En patienthistorie

    DEFF Research Database (Denmark)

    Laursen, Martin Lindgaard; Gertsen, Frank

    Denne forskningsrapport introducerer et forskningsprojekt baseret på case studier af Lean principper anvendt på Skejby sygehus. Operationelle udfordringer i sygehusets arbejdsgange illustreres gennem et observeret patientforløb. Disse udfordringer, et oprids af sygehusenes vilkår, og gennemgang af...

  15. Lean automation development : applying lean principles to the automation development process

    OpenAIRE

    Granlund, Anna; Wiktorsson, Magnus; Grahn, Sten; Friedler, Niklas

    2014-01-01

    By a broad empirical study it is indicated that automation development show potential of improvement. In the paper, 13 lean product development principles are contrasted to the automation development process and it is suggested why and how these principles can facilitate, support and improve the automation development process. The paper summarises a description of what characterises a lean automation development process and what consequences it entails. Main differences compared to current pr...

  16. Leveraging lean in the office: Lean office needs a novel and differentiated approach

    OpenAIRE

    Rüttimann, Bruno G.; Fischer, Urs P.; Stöckli, Martin T.

    2014-01-01

    Lean Six Sigma tools have been increasingly employed also in the service industry, however with different success as field studies have shown. The reason not only has to be attributed to a poor Change Management, but can also be attributed to the intrinsic characteristics of the Lean techniques, which have been tailored to sustain a stable customer-takted pull-manufacturing principle. An office workplace shows significant differences to a procedural shop floor environment, as it comprises bot...

  17. TOWARDS GREEN THROUGH LEAN/LEAN SIX SIGMA APPROACHES: A LITERATURE REVIEW AT SERVICE INDUSTRY

    Directory of Open Access Journals (Sweden)

    RODRIGO GOYANNES GUSMÃO CAIADO

    2017-08-01

    Full Text Available In the last decades, sustainable development have increasingly gained importance to service industry and lean/Six Sigma approaches are becoming more and more outstanding in order to improve sustainability performance. In the post-modern era the integration between those approaches are necessary in order to aid organisations to balance the need for operational efficiency in their production and service systems with environmental commitment and social fairness. Because of that, Lean Six Sigma practices are progressively becoming widespread in studies about service, as way to improve quality, efficiency, effectiveness and sustainability of services. The purpose of this paper is to critically review the Lean and Lean Six Sigma (L6σ methodologies and highlight their importance to achieve sustainable development in service industry. To do this, a systematic literature review (SLR of the subjects under investigation was conducted. We examine the compatibility and divergences of the green, lean and Six Sigma concepts and implications regarding its sustainable implementation in service industry. The study has two major contributions. First, it is one of the first researches that investigate the potential benefits of integrating green, lean and Six Sigma in service sector. Second, it supports and expands current literature, providing both academicians and practitioners a better panorama to understand the present status of L6σ for achieving sustainability in service sector.

  18. [Sustainable process improvement with application of 'lean philosophy'].

    Science.gov (United States)

    Rouppe van der Voort, Marc B V; van Merode, G G Frits; Veraart, Henricus G N

    2013-01-01

    Process improvement is increasingly being implemented, particularly with the aid of 'lean philosophy'. This management philosophy aims to improve quality by reducing 'wastage'. Local improvements can produce negative effects elsewhere due to interdependence of processes. An 'integrated system approach' is required to prevent this. Some hospitals claim that this has been successful. Research into process improvement with the application of lean philosophy has reported many positive effects, defined as improved safety, quality and efficiency. Due to methodological shortcomings and lack of rigorous evaluations it is, however, not yet possible to determine the impact of this approach. It is, however, obvious that the investigated applications are fragmentary, with a dominant focus on the instrumental aspect of the philosophy and a lack of integration in a total system, and with insufficient attention to human aspects. Process improvement is required to achieve better and more goal-oriented healthcare. To achieve this, hospitals must develop integrated system approaches that combine methods for process design with continuous improvement of processes and with personnel management. It is crucial that doctors take the initiative to guide and improve processes in an integral manner.

  19. Six sigma and lean production adoption in a manufacturing company

    Directory of Open Access Journals (Sweden)

    Alisson Christian Scheller

    2014-11-01

    Full Text Available The connection among Lean Production with Six Sigma originated the Lean Six Sigma methodology, focused on processes variation and waste reduction. This methodology was developed on different ways in the companies and there is no consensus over its structure and its implementation. In this context, this paper aims to identify and analyze the main characteristics on the adoption and integration of Lean Six Sigma methodology through a case study conducted in a manufacturing company that adopts lean production and six sigma. The results show two important aspects of the Lean Six Sigma methodology. One of them is the adoption of the value stream mapping as a central tool on Lean Six Sigma. The other is the use of DMAIC for improvements actions. The study indicates that despite the difficulties on Lean Six Sigma implementation, the methodology offers benefits to the company that adopts it in the suitable way.

  20. The Hybrid Lean System to Improve Manufacturing Environment

    Directory of Open Access Journals (Sweden)

    Ahmad Ahmad Nur Aizat

    2017-01-01

    Full Text Available Lean manufacturing is a systematic approch could increase manufacturing competitiveness by identifying and elminating waste through lean tools. However, these tools are often categorized into different groups, continues to be difficult for companies to select the most appropriate lean tool to be adopted, especially in respect of the SMEs whose knowledge of lean tools and associated principles are limited. This study is to propose solution on how to implement appropriate lean tools in food manufacturing industry located at Rengit, Johor. Qualitative method is used as a methodology to see the changes after the implementation of lean tools. Interview session also a part of method to collect data from respondents. The finding from this paper shows that implementation of an appropriate lean tool will help to eliminate waste in industry sector, maintain and control the inventory, improve quality of the product and improve overall operational process.

  1. Single-leg squats can predict leg alignment in dancers performing ballet movements in "turnout".

    Science.gov (United States)

    Hopper, Luke S; Sato, Nahoko; Weidemann, Andries L

    2016-01-01

    The physical assessments used in dance injury surveillance programs are often adapted from the sports and exercise domain. Bespoke physical assessments may be required for dance, particularly when ballet movements involve "turning out" or external rotation of the legs beyond that typically used in sports. This study evaluated the ability of the traditional single-leg squat to predict the leg alignment of dancers performing ballet movements with turnout. Three-dimensional kinematic data of dancers performing the single-leg squat and five ballet movements were recorded and analyzed. Reduction of the three-dimensional data into a one-dimensional variable incorporating the ankle, knee, and hip joint center positions provided the strongest predictive model between the single-leg squat and the ballet movements. The single-leg squat can predict leg alignment in dancers performing ballet movements, even in "turned out" postures. Clinicians should pay careful attention to observational positioning and rating criteria when assessing dancers performing the single-leg squat.

  2. Developing A Strategy to Enact Lean

    Directory of Open Access Journals (Sweden)

    Nicola Morrey

    2013-01-01

    Full Text Available This paper explains the strategy employed by a case study company to implement lean across the business, and to reflect on the success of this approach so other companies may consider this learning and how it might be useful to them. The strategy to enact lean in the case study company was based on creating a number of standard tools/ways of working. These tools can be considered to be standardised work for key aspects of the construction process that the company undertakes. The aim of the tools was to ensure that critical tasks would be carried out to the correct standard (quality, time, cost, health and safety every time, across the business. Achievement of this is expected to lead to improved performance and elimination of variation (waste. To implement this strategy of using standardised work to eliminate variation and lead to improved performance, a step-by-step process was developed to create the tools/standardised work. The paper describes the process that was undertaken and how it aimed to not only produce a number of tools/standardised work, but also to involve people and managers from across the business such that lean philosophy and thinking might also begin to become embedded. The paper will firstly explain, with reference to the relevant literature, how and why the strategy to implement standardised work was chosen, the process that was defined to develop the standardised work, and what happened when that process was put into practice. The findings of the paper show that whilst the completed tools delivered business benefits, the development of the tools did not follow the planned process. The paper discusses how people within the business responded to this strategy and how the process had to be continuously adapted to cope with the current business environment and path dependencies, further evidencing that lean implementations need to be tailored to suit the needs of the individual firm, rather than there being a one size fits all

  3. The role of lean body mass and physical activity in bone health in children.

    Science.gov (United States)

    Baptista, Fátima; Barrigas, Carlos; Vieira, Filomena; Santa-Clara, Helena; Homens, Pedro Mil; Fragoso, Isabel; Teixeira, Pedro J; Sardinha, Luís B

    2012-01-01

    In the context of physical education curricula, markers of physical fitness (e.g., aerobic capacity, muscular strength, flexibility, and body mass index or body fat) are usually evaluated in reference to health standards. Despite their possible mediating role in the relationship between weight-bearing or muscle forces and features of bone tissue, these attributes of fitness may not be the most relevant to predict skeletal health. It is therefore important to analyze the relative contribution of these factors to the variability in bone tissue of different parts of the skeleton, and to analyze it by gender, as sensitivity to mechanical loading can diverge for boys and girls. We compared the effects of habitual physical activity (PA) and lean mass, as surrogates of weight-bearing and muscle forces, and of physical fitness (aerobic and muscle capacity of lower and upper limbs) on bone mineral content (BMC) and size of total body, lumbar spine, femoral neck, and 1/3 radius in 53 girls and 64 boys from 7.9 to 9.7 years of age. After controlling for bone age, body mass, body height, and calcium intake, lean mass was the most important predictor of bone size and/or mineral in both genders (p  608 counts/min/day (~105 min/day of moderate and vigorous intensity) showed 13-20% more BMC than those with less physical activity, and girls with a lean mass >19 kg showed 12-19% more BMC than those with less lean mass. These findings suggest that lean mass was the most important predictor of bone size and/or mineralization in both genders, while habitual weight-bearing PA appears to positively impact on bone mineral in prepubertal boys and that both lean mass and PA need to be considered in physical education curricula and other health-enhancing programs.

  4. Oxidative stress and inflammation in lean and obese subjects with polycystic ovary syndrome.

    Science.gov (United States)

    Blair, Sarah A; Kyaw-Tun, Tommy; Young, Ian S; Phelan, Niamh A; Gibney, James; McEneny, Jane

    2013-01-01

    To determine whether polycystic ovary syndrome (PCOS) independently influences oxidative stress and inflammation or if the culprit is the comorbidities of obesity and/or insulin resistance common to this condition. Thirty women with PCOS were matched for age, body mass index and insulin resistance with 30 control subjects. Oxidative stress was examined by measuring the total oxidant status (TOS) and total antioxidant capacity (TAC) by spectrophotometric assay. The inflammatory biomarkers, C-reactive protein, plasminogen activator inhibitor-1, myeloperoxidase, neopterin, and serum amyloid A were measured by ELISA methodologies. Oxidative status was increased in the PCOS subjects relative to their weight-matched controls (TOS: obese PCOS patients vs. obese controls, 42.42 +/- 4.49 vs. 32.57 +/- 1.97, plean PCOS patients vs. lean controls, 33.69 +/- 1.59 vs. 28.69 +/- 1.18 micromol H2O2 Equiv/L, p lean PCOS group relative to their weight-matched controls (TAC: lean PCOS patients vs. lean controls, 1.10 +/- 0.09 vs. 1.49 +/- 0.03 nmol Trolox Equiv/L, p PCOS independently influenced oxidative stress. Overall, the presence of PCOS may increase cardiovascular risk.

  5. Development of a Framework for a Lean based Water and Energy Efficiency Assessment Tool

    Directory of Open Access Journals (Sweden)

    Edward Davies

    2015-07-01

    Full Text Available The manufacturing industry of South Africa is the sector consuming the largest portion of the total energy consumption and second largest portion of total water consumption per annum nationally. With a significant increase in electrical energy cost in recent years, together with the reserve energy margin dropping below the minimum level required for sustainable operation of energy utilities, energy efficiency improvement is becoming imperative for organisational success as well as national economical sustainability. This paper explores selected Lean manufacturing principles and its positive effect on energy and water efficiency. Although the implementation of Lean manufacturing techniques naturally leads to the improvement of energy and water intensity, the author believes that there is even greater potential in the development of a Lean based tool which will specifically focus on the improvement of energy and water efficiency. For this purpose the value stream mapping tool was chosen as the foundation. This paper continues to explain the process undergone to develop standardised energy and water specific waste categories to be used in conjunction with the traditional Lean wastes. The study concludes by detailing the development of the tool, together with its framework for implementation and a brief discussion on the forecasting model incorporated.

  6. Increasing trunk flexion transforms human leg function into that of birds despite different leg morphology.

    Science.gov (United States)

    Aminiaghdam, Soran; Rode, Christian; Müller, Roy; Blickhan, Reinhard

    2017-02-01

    Pronograde trunk orientation in small birds causes prominent intra-limb asymmetries in the leg function. As yet, it is not clear whether these asymmetries induced by the trunk reflect general constraints on the leg function regardless of the specific leg architecture or size of the species. To address this, we instructed 12 human volunteers to walk at a self-selected velocity with four postures: regular erect, or with 30 deg, 50 deg and maximal trunk flexion. In addition, we simulated the axial leg force (along the line connecting hip and centre of pressure) using two simple models: spring and damper in series, and parallel spring and damper. As trunk flexion increases, lower limb joints become more flexed during stance. Similar to birds, the associated posterior shift of the hip relative to the centre of mass leads to a shorter leg at toe-off than at touchdown, and to a flatter angle of attack and a steeper leg angle at toe-off. Furthermore, walking with maximal trunk flexion induces right-skewed vertical and horizontal ground reaction force profiles comparable to those in birds. Interestingly, the spring and damper in series model provides a superior prediction of the axial leg force across trunk-flexed gaits compared with the parallel spring and damper model; in regular erect gait, the damper does not substantially improve the reproduction of the human axial leg force. In conclusion, mimicking the pronograde locomotion of birds by bending the trunk forward in humans causes a leg function similar to that of birds despite the different morphology of the segmented legs. © 2017. Published by The Company of Biologists Ltd.

  7. Effect of fat mass and lean mass on bone mineral density in postmenopausal and perimenopausal Thai women

    Directory of Open Access Journals (Sweden)

    Namwongprom S

    2013-02-01

    Full Text Available Sirianong Namwongprom,1 Sattaya Rojanasthien,2 Ampica Mangklabruks,3 Supasil Soontrapa,4 Chanpen Wongboontan,5 Boonsong Ongphiphadhanakul61Clinical Epidemiology Program and Department of Radiology, 2Department of Orthopaedics, 3Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, 4Department of Orthopaedics, Faculty of Medicine, Khon Kaen University, Khon Kaen, 5Department of Radiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, 6Department of Internal Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, ThailandBackground: The purpose of this study was to investigate the association between fat mass, lean mass, and bone mineral density (BMD in postmenopausal and perimenopausal Thai women.Methods: A cross-sectional study was conducted in 1579 healthy Thai women aged 40–90 years. Total body, lumbar spine, total femur, and femoral neck BMD and body composition were measured by dual x-ray absorptiometry. To evaluate the associations between fat mass and lean mass and various measures of BMD, multivariable linear regression models were used to estimate the regression coefficients for fat mass and lean mass, first in separate equations and then with both fat mass and lean mass in the same equation.Results: Among the study population, 1448 subjects (91.7% were postmenopausal and 131 (8.3% were perimenopausal. In postmenopausal women, after controlling for age, height, and duration of menopause, both fat mass and lean mass were positively correlated with BMD when they were analyzed independently of each other. When included in the same equation, both fat mass and lean mass continued to show a positive effect, but lean mass had a significantly greater impact on BMD than fat mass at all regions except for total body. Lean mass but not fat mass had a positive effect on BMD at all skeletal sites except the lumbar spine, after controlling for age and height in perimenopausal

  8. Leg stiffness during phases of countermovement and take-off in vertical jump.

    Science.gov (United States)

    Struzik, Artur; Zawadzki, Jerzy

    2013-01-01

    With respect to cyclic movements such as human gait, running or hopping, leg stiffness is a little variable parameter. The aim of this study was to investigate changes in leg stiffness during the phase of countermovement and take-off when performing a single maximum counter-movement jump. Kistler force plates and a BTS SMART system for comprehensive motion analysis were employed in the study. The study covered a group of 12 athletes from university basketball teams. Leg stiffness was calculated in those parts of countermovement and take-off phases where its level is relatively constant and the relationship F(Δl) is similar to linear one. Mean total stiffness (±SD) in both legs in the countermovement phase amounted to 6.5 ± 1.5 kN/m, whereas during the take-off phase this value was 6.9 ± 1 kN/m. No statistically significant differences were found between leg stiffness during the countermovement phase and takeoff phase in the study group at the level of significance set at α = 0.05. This suggests that the leg stiffness in phase of countermovement and phase of take-off are much similar to each other, despite different function of both phases. Similar to cyclic movements, leg stiffness turned out relatively constant when performing a single vertical jump. There are also reported statistically significant correlations between body mass, body height, length of lower limbs and leg stiffness. The stiffness analysed by the authors should be understood as quasi-stiffness because the measurements of ΔF(Δl) were made during transient states where inertia and dumping forces are likely to affect the final result.

  9. Lean Strategies in the Operating Room.

    Science.gov (United States)

    Robinson, Stephen T; Kirsch, Jeffrey R

    2015-12-01

    Lean strategies can be readily applied to health care in general and operating rooms specifically. The emphasis is on the patient as the customer, respect and engagement of all providers, and leadership from management. The strategy of lean is to use continuous improvement to eliminate waste from the care process, leaving only value-added activities. This iterative process progressively adds the steps of identifying the 7 common forms of waste (transportation, inventory, motion, waiting, overproduction, overprocessing, and defects), 5S (sort, simplify, sweep, standardize, sustain), visual controls, just-in-time processing, level-loaded work, and built-in quality to achieve the highest quality of patient care. Copyright © 2015 Elsevier Inc. All rights reserved.

  10. Network model of project "Lean Production"

    Science.gov (United States)

    Khisamova, E. D.

    2018-05-01

    Economical production implies primarily new approaches to culture of management and organization of production and offers a set of tools and techniques that allows reducing losses significantly and making the process cheaper and faster. Economical production tools are simple solutions that allow one to see opportunities for improvement of all aspects of the business, to reduce losses significantly, to constantly improve the whole spectrum of business processes, to increase significantly the transparency and manageability of the organization, to take advantage of the potential of each employee of the company, to increase competitiveness, and to obtain significant economic benefits without making large financial expenditures. Each of economical production tools solves a specific part of the problems, and only application of their combination will allow one to solve the problem or minimize it to acceptable values. The research of the governance process project "Lean Production" permitted studying the methods and tools of lean production and developing measures for their improvement.

  11. ["Lean management" in hospitals: potentials and limitations].

    Science.gov (United States)

    Glossmann, J P; Schliebusch, O; Diehl, V; Walshe, R

    2000-08-15

    Little attention has yet been payed on establishing modern and competitive organizational structures in German hospitals. In this paper, we attempt to apply elements of lean management to the work of physicians working in an inpatient setting. Traditional ways of communication and their disadvantages are discussed. These include loss of motivation, bureaucratic structures and a lack of interdisciplinary cooperation. Using Maslow's theory of motivation, possible improvements are discussed, such as the reduction of restrictive job characteristics, an increase of physicians' spheres of competence and the use of their innovative potentials. These suggestions are explained using practical examples. The aim of the study is to contribute to quality management in hospitals by increasing personal responsibilities according to lean management.

  12. [Physical treatment modalities for chronic leg ulcers].

    Science.gov (United States)

    Dissemond, J

    2010-05-01

    An increasing numbers of physical treatment options are available for chronic leg ulcer. In this review article, compression therapy, therapeutic ultrasound, negative pressure therapy, extracorporeal shock wave therapy, electrostimulation therapy, electromagnetic therapy, photodynamic therapy, water-filtered infrared-A-radiation and hydrotherapy are discussed in terms of their practical applications and the underlying evidence. With the exception of compression therapy for most of these treatments, good scientific data are not available. However this is a widespread problem in the treatment of chronic wounds. Nevertheless, several of the described methods such as negative pressure therapy represent one of the gold standards in practical treatment of patients with chronic leg ulcers. Although the use of physical treatment modalities may improve healing in patients with chronic leg ulcers, the diagnosis and treatment of the underlying causes are essential for long-lasting success.

  13. Conjoined legs: Sirenomelia or caudal regression syndrome?

    Directory of Open Access Journals (Sweden)

    Sakti Prasad Das

    2013-01-01

    Full Text Available Presence of single umbilical persistent vitelline artery distinguishes sirenomelia from caudal regression syndrome. We report a case of a12-year-old boy who had bilateral umbilical arteries presented with fusion of both legs in the lower one third of leg. Both feet were rudimentary. The right foot had a valgus rocker-bottom deformity. All toes were present but rudimentary. The left foot showed absence of all toes. Physical examination showed left tibia vara. The chest evaluation in sitting revealed pigeon chest and elevated right shoulder. Posterior examination of the trunk showed thoracic scoliosis with convexity to right. The patient was operated and at 1 year followup the boy had two separate legs with a good aesthetic and functional results.

  14. Conjoined legs: Sirenomelia or caudal regression syndrome?

    Science.gov (United States)

    Das, Sakti Prasad; Ojha, Niranjan; Ganesh, G Shankar; Mohanty, Ram Narayan

    2013-07-01

    Presence of single umbilical persistent vitelline artery distinguishes sirenomelia from caudal regression syndrome. We report a case of a12-year-old boy who had bilateral umbilical arteries presented with fusion of both legs in the lower one third of leg. Both feet were rudimentary. The right foot had a valgus rocker-bottom deformity. All toes were present but rudimentary. The left foot showed absence of all toes. Physical examination showed left tibia vara. The chest evaluation in sitting revealed pigeon chest and elevated right shoulder. Posterior examination of the trunk showed thoracic scoliosis with convexity to right. The patient was operated and at 1 year followup the boy had two separate legs with a good aesthetic and functional results.

  15. Simulation-enhanced lean design process

    Directory of Open Access Journals (Sweden)

    Jon H. Marvel

    2009-07-01

    Full Text Available 72 Normal 0 false false false EN-US X-NONE X-NONE /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin:0in; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:"Times New Roman"; mso-bidi-theme-font:minor-bidi;} A traditional lean transformation process does not validate the future state before implementation, relying instead on a series of iterations to modify the system until performance is satisfactory. An enhanced lean process that includes future state validation before implementation is presented.  Simulation modeling and experimentation is proposed as the primary validation tool.  Simulation modeling and experimentation extends value stream mapping to include time, the behavior of individual entities, structural variability, random variability, and component interaction effects. Experiments to analyze the model and draw conclusions about whether the lean transformation effectively addresses the current state gap can be conducted.  Industrial applications of the enhanced lean process show it effectiveness.

  16. Where lean construction and value management meet

    OpenAIRE

    Musa, MM; Pasquire, C; Hurst, A

    2016-01-01

    The lean construction (LC) community’s key vision and goal is to provide value, yet they are increasingly challenged with understanding and dealing with the concept of value, with reports that value is one of the weakest points. Regardless of the previous studies and contributions already made on the concept of value in LC, the absence of a consistent understanding of value has resulted in misperceptions and indistinct boundaries with other construction value-related disciplines. Without a co...

  17. The effect of starting or stopping skin cooling on the thermoregulatory responses during leg exercise in humans.

    Science.gov (United States)

    Demachi, K; Yoshida, T; Kume, M; Tsuneoka, H

    2012-07-01

    To assess the effects of starting or stopping leg cooling on the thermoregulatory responses during exercise, 60 min of cycling exercise at 30% of maximal oxygen uptake was performed under 4 conditions using tube trouser perfused with water at 10 °C; no leg cooling (NC), starting of leg cooling after 30 min of exercise (delayed cooling, DC), continuous leg cooling (CC), and stopping of continuous leg cooling after 30 min of exercise (SC) at an environmental temperature of 28.5 °C. During exercise under the DC conditions, an instantaneous increase in the esophageal temperature (Tes), a suppression of the cutaneous vascular conductance at the forearm (%CVC), and a decrease in the mean skin temperature (Tsk) were observed after leg cooling. The total sweat loss (Δm sw,tot) was lower under the DC than the NC condition. In the SC study, however, the Tes remained constant, while the %CVC increased gradually after leg cooling was stopped, and the Δm sw,tot was greater than that under the CC condition. These results suggest that during exercise, rapid skin cooling of the leg may cause an increase in core temperature, while also enhancing thermal stress. However, stopping skin cooling did not significantly affect the core temperature long-term, because the skin blood flow and sweat rate subsequently increased. © Georg Thieme Verlag KG Stuttgart · New York.

  18. Lean Production Practices to Enhance Organisational Performance

    Directory of Open Access Journals (Sweden)

    Shah Satya

    2017-01-01

    Full Text Available Service sector organisations are constantly overcoming the challenges facing the over-production and waste reduction within their environments. Industries are also becoming very competitive thus forcing them to seek suitable production organisation strategies with the aim towards enhancing their competitiveness and efficiency. The aim of this research study is to investigate the impact of lean production practices on the performance of service based businesses through the case study of a local baked goods supplier. The research framework adopted consists of questionnaire survey method implemented with different end users, thus covering the overall production – retail – customer cycle. The research results and analysis justify the objective of the research that lean production practices enhance the performance of the supplier company and the common tool identified were JIT (Just in Time, Value Steam Mapping (VSP and the 5S methods. The results also suggest that JIT method has a higher impact towards improvement on performance relating to quality, speed, dependability, flexibility and cost of the supplier. However, the research study also identifies that one of the major challenges faced by the organisation while adopting lean practices was the lack of commitment from top management, continuous training and employee engagement measures.

  19. Managing Waste Throughout Lean-Green Perspective

    Directory of Open Access Journals (Sweden)

    Lamyaa Mohammed Dawood

    2017-11-01

    Full Text Available Managing waste has been known as a crucial need as it may reduce resource consumption, rigid regulations regarded to the environment and occupational health and safety. Lean and green management are two approaches of management that validate waste. Since performance measures are crucial to improve waste management as its  goals of  to promote the performance of organizations .In this research four primary KPIs have been employed that are significant to lean-green management; operational, environmental, economic and social performance factors, subdivided further into sixteen as (Value stream mapping, life cycle assessment,---etc. Also in this research   determination and ranking of these performance measures and their influence on waste minimization is conducted. Interpretive Structural Modeling (ISM methodology is applied to the classification of Key Performance Indicators (KPIs according to the priority of their importance and the correlation between them and their impact to waste minimization. Cronbach’s Alpha coefficient is employed  to assess the reliability of performance measures to minimize waste, and increase customer  satisfaction.  Results showed that Al-Kufa Cement plant has bad overall performance toward lean green waste management perspective. The highest individual score is for operational performance (6.6 rated as medium. But  the lowest individual score is for economic performance [very bad (2.0].   

  20. Dipoles on a Two-leg Ladder

    DEFF Research Database (Denmark)

    Gammelmark, Søren; Zinner, Nikolaj Thomas

    2013-01-01

    We study polar molecules with long-range dipole-dipole interactions confined to move on a two-leg ladder for different orientations of the molecular dipole moments with respect to the ladder. Matrix product states are employed to calculate the many-body ground state of the system as function...... that there is a critical angle at which ordering disappears. This angle is slightly larger than the angle at which the dipoles are non-interacting along a single leg. This behavior should be observable using current experimental techniques....

  1. Task driven optimal leg trajectories in insect-scale legged microrobots

    Science.gov (United States)

    Doshi, Neel; Goldberg, Benjamin; Jayaram, Kaushik; Wood, Robert

    Origami inspired layered manufacturing techniques and 3D-printing have enabled the development of highly articulated legged robots at the insect-scale, including the 1.43g Harvard Ambulatory MicroRobot (HAMR). Research on these platforms has expanded its focus from manufacturing aspects to include design optimization and control for application-driven tasks. Consequently, the choice of gait selection, body morphology, leg trajectory, foot design, etc. have become areas of active research. HAMR has two controlled degrees-of-freedom per leg, making it an ideal candidate for exploring leg trajectory. We will discuss our work towards optimizing HAMR's leg trajectories for two different tasks: climbing using electroadhesives and level ground running (5-10 BL/s). These tasks demonstrate the ability of single platform to adapt to vastly different locomotive scenarios: quasi-static climbing with controlled ground contact, and dynamic running with un-controlled ground contact. We will utilize trajectory optimization methods informed by existing models and experimental studies to determine leg trajectories for each task. We also plan to discuss how task specifications and choice of objective function have contributed to the shape of these optimal leg trajectories.

  2. THE EFFECTS OF SINGLE LEG HOP PROGRESSION AND DOUBLE LEGS HOP PROGRESSION EXERCISE TO INCREASE SPEED AND EXPLOSIVE POWER OF LEG MUSCLE

    Directory of Open Access Journals (Sweden)

    Nining W. Kusnanik

    2015-05-01

    Full Text Available The main purpose of this study was to determine the effect of single leg hop progression and double legs hop progression exercise to increase speed and explosive power of leg muscles. Plyometric is one of the training methods that can increase explosive power. There are many models of plyometric training including single leg hop progression and double leg hop progression. This research was experimental using match subject design techniques. The subjects of this study were 39 students who joined basketball school club. There were 3 groups in this study: Group 1 were 13 students who given sin¬gle leg hop progression exercise, Group 2 were 13 students who given double legs hop progression exercise, Group 3 were 13 students who given conventional exercise. The data was collected during pre test and post test by testing 30m speed running and vertical jump. The data was analyzed using Analysis of Varians (Anova. It was found that there were significantly increased on speed and explosive power of leg muscles of Group 1 and Group 2. It can be stated that single leg hop progression exercise was more effective than double leg hop progression exercise. The recent findings supported the hypothesis that single leg hop progression and double legs hop progression exercise can increase speed and explosive power of leg muscles. These finding were supported by some previous studies (Singh, et al, 2011; Shallaby, H.K., 2010. The single leg hop progression is more effective than double legs hop progression. This finding was consistent with some previous evidences (McCurdy, et al, 2005; Makaruk et al, 2011.

  3. The effect of boron supplementation on lean body mass, plasma testosterone levels, and strength in male bodybuilders

    Science.gov (United States)

    Ferrando, A. A.; Green, N. R.

    1993-01-01

    The effect of boron supplementation was investigated in 19 male bodybuilders ages 20-27 years. Ten were given a 2.5-mg boron supplement while 9 were given a placebo every day for 7 weeks. Plasma total and free testosterone, plasma boron, lean body mass, and strength measurements were determined on Days 1 and 49 of the study. Plasma boron values were significantly (p bodybuilding can increase total testosterone, lean body mass, and strength in lesser trained bodybuilders, and that boron supplementation had no effect on these measures.

  4. LEAN MANUFACTURING IN TWO SERBIAN FOOD COMPANIES - CASE STUDIES

    Directory of Open Access Journals (Sweden)

    Ilija Đekić

    2012-06-01

    Full Text Available This paper gives an overview of a 9 month experience in implementing lean manufacturing tools in two Serbian food companies. Both companies have certified quality and food safety management systems and are food exporters. One of them is a big producer with more than 1000 employees with a three shift serial production while the other is a small producer with one shift and batch oriented production. Results showed that six tools were chosen by both companies - Total productive maintenance, Poka yoke, batch reduction, layout improvement, standardization of work and visual management. The big company implemented also cellular and flow, Jidoka, quick changeovers and 5S. None of the companies expressed interest at implementing Just-In-Time, Kanban, Self-inspection and Value stream mapping at this stage of the project.

  5. Assessment of the vibration on the foam legged and sheet metal-legged passenger seat

    Directory of Open Access Journals (Sweden)

    L. Dahil

    2015-10-01

    Full Text Available In this study, it was aim ed to decrease the vibration reaching to passenger from the legs of vehicle seats. In order to determine the levels of vibrations reaching at passengers, a test pad placed under the passenger seat was used, and HVM100 device was used for digitizing the information obtained. By transferring the vibration data to system by using HVM100 device, the acceleration graphics were prepared with Blaze software. As a result, it was determined that the acceleration values of seat legs made of foam material were lower than that of seat legs made of 2 mm thick sheet metal, so they damped the vibration better.

  6. Industry 4.0 implies lean manufacturing: Research activities in industry 4.0 function as enablers for lean manufacturing

    Directory of Open Access Journals (Sweden)

    Adam Sanders

    2016-09-01

    Full Text Available Purpose: Lean Manufacturing is widely regarded as a potential methodology to improve productivity and decrease costs in manufacturing organisations. The success of lean manufacturing demands consistent and conscious efforts from the organisation, and has to overcome several hindrances. Industry 4.0 makes a factory smart by applying advanced information and communication systems and future-oriented technologies. This paper analyses the incompletely perceived link between Industry 4.0 and lean manufacturing, and investigates whether Industry 4.0 is capable of implementing lean. Executing Industry 4.0 is a cost-intensive operation, and is met with reluctance from several manufacturers. This research also provides an important insight into manufacturers’ dilemma as to whether they can commit into Industry 4.0, considering the investment required and unperceived benefits. Design/methodology/approach: Lean manufacturing is first defined and different dimensions of lean are presented. Then Industry 4.0 is defined followed by representing its current status in Germany. The barriers for implementation of lean are analysed from the perspective of integration of resources. Literatures associated with Industry 4.0 are studied and suitable solution principles are identified to solve the abovementioned barriers of implementing lean. Findings: It is identified that researches and publications in the field of Industry 4.0 held answers to overcome the barriers of implementation of lean manufacturing. These potential solution principles prove the hypothesis that Industry 4.0 is indeed capable of implementing lean. It uncovers the fact that committing into Industry 4.0 makes a factory lean besides being smart. Originality/value: Individual researches have been done in various technologies allied with Industry 4.0, but the potential to execute lean manufacturing was not completely perceived. This paper bridges the gap between these two realms, and identifies

  7. Lean-Prinzipien für verbesserte Kosteneffizienz: Instandhaltungseffizienz durch Lean Maintenance

    OpenAIRE

    Bandow, G.; Schmidt, A.

    2008-01-01

    Die Bedeutung der Instandhaltung nimmt weiter zu. In einem Lean Umfeld mit einer immer verschwendungsärmeren Produktion stehen nicht nur die Kosteneffizienz und Verfügbarkeit der Produktionsmittel im Fokus. Unplanmäßige Stillstände kosten Geld und gefährden häufig auch Personal und Produkt. Lean Maintenance vermeidet Verschwendung und optimiert so die Effektivität und Effizienz der Instandhaltung. Das zielgerichtete Zusammenspiel von Menschen, Prozessen und Technik garantiert dabei den Erfolg...

  8. Lean Thinking and Transferring Lean Management - The Best Defence against an Economic Recession?

    Directory of Open Access Journals (Sweden)

    Daniel D. GEORGESCU

    2011-06-01

    Full Text Available Productivity growth is a fundamental means for society to improve its living standards. Productivity growth comes from technological change (new ways of producing goods and services and better organisation of production (better ways of using available resources given available technology. Both processes operate simultaneously and, in practice, it is difficult to distinguish between the effects of each process. The processes are dynamic and affect individual activities differently over time. These years, manufacturing functions have been transferred rapidly and globally from mature countries to emerging countries. This paper is about the lean philosophy and the critical elements for successful transfer of lean management among sites and countries.

  9. Quality improvement in basic histotechnology: the lean approach.

    Science.gov (United States)

    Clark, David

    2016-01-01

    Lean is a comprehensive system of management based on the Toyota production system (TPS), encompassing all the activities of an organization. It focuses management activity on creating value for the end-user by continuously improving operational effectiveness and removing waste. Lean management creates a culture of continuous quality improvement with a strong emphasis on developing the problem-solving capability of staff using the scientific method (Deming's Plan, Do, Check, Act cycle). Lean management systems have been adopted by a number of histopathology departments throughout the world to simultaneously improve quality (reducing errors and shortening turnround times) and lower costs (by increasing efficiency). This article describes the key concepts that make up a lean management system, and how these concepts have been adapted from manufacturing industry and applied to histopathology using a case study of lean implementation and evidence from the literature. It discusses the benefits, limitations, and pitfalls encountered when implementing lean management systems.

  10. Performance effect of multiple control forms in a Lean organization

    DEFF Research Database (Denmark)

    Kristensen, Thomas Borup; Israelsen, Poul

    2012-01-01

    Over the last decades Lean has developed into a prominent management philosophy reaching beyond shop floor tools. However, substantial support of performance effects from Lean is still scarce and at best with mixed results. Recently, research has turned its focus towards perceiving Lean...... as a control package. In this paper we present statistical support for enhanced performance coming from Lean. Furthermore, our results strongly support the perception of Lean as a set of multiple control forms (output, behavioral, and social controls) that complement each other. Therefore, performance...... is increased if the average level of control forms is increased, and performance is further increased if the control forms are balanced at the same level representing a complementary effect between them. Our data are archival data spanning multiple years in a strong Lean organization. The dependent performance...

  11. Lean Management Systems in Radiology: Elements for Success.

    Science.gov (United States)

    Schultz, Stacy R; Ruter, Royce L; Tibor, Laura C

    2016-01-01

    This article is a review of the literature on Lean and Lean Management Systems and how they have been implemented in healthcare organizations and particularly in radiology departments. The review focuses on the elements required for a successful implementation of Lean by applying the principles of a Lean Management System instead of a Lean tools-only approach. This review shares the successes and failures from healthcare organizations' efforts to improve the quality and safety of the services they provide. There are a limited number of healthcare organizations in the literature who have shared their experiences and additional research is necessary to determine whether a Lean Management System is a viable alternative to the current management structure in healthcare.

  12. Transcutaneous laser treatment of leg veins

    NARCIS (Netherlands)

    Meesters, Arne A.; Pitassi, Luiza H. U.; Campos, Valeria; Wolkerstorfer, Albert; Dierickx, Christine C.

    2014-01-01

    Leg telangiectasias and reticular veins are a common complaint affecting more than 80% of the population to some extent. To date, the gold standard remains sclerotherapy for most patients. However, there may be some specific situations, where sclerotherapy is contraindicated such as needle phobia,

  13. Leg og læring

    DEFF Research Database (Denmark)

    Pedersen, Annette

    2008-01-01

    Leg synes at have et potentiale som metode til at fremme læring. Men hvordan? Legen har en vis grad af parallelitet med den virkelige verden i dens interaktive og relationelle strukturer. Det bliver muligt at finde nye meninger i interaktioner, som refererer til vante interaktionsformer, men...

  14. An automatic hinge system for leg orthoses

    NARCIS (Netherlands)

    Rietman, J. S.; Goudsmit, J.; Meulemans, D.; Halbertsma, J. P. K.; Geertzen, J. H. B.

    2004-01-01

    This paper describes a new automatic hinge system for leg orthoses, which provides knee stability in stance, and allows knee-flexion during swing. Indications for the hinge system are a paresis or paralysis of the quadriceps muscles. Instrumented gait analysis was performed in three patients, fitted

  15. An automatic hinge system for leg orthoses

    NARCIS (Netherlands)

    Rietman, J.S.; Goudsmit, J.; Meulemans, D.; Halbertsma, J.P.K.; Geertzen, J.H.B.

    This paper describes a new, automatic hinge system for leg orthoses, which provides knee stability in stance, and allows knee-flexion during swing. Indications for the hinge system are a paresis or paralysis of the quadriceps muscles. Instrumented gait analysis was performed in three patients,

  16. Parallel kinematics robot with five legs

    NARCIS (Netherlands)

    Lambert, P.

    2011-01-01

    Robot with multiple degrees of freedom comprising five legs (2) linked at a first of their ends to a base ( 3), and at a second of their ends opposite to the first ends to a mobile platform (4), which platform carries at least one tool (5, 6, 121, 12 "), and wherein the robot further comprises an

  17. Omnidirectional Wheel-Legged Hybrid Mobile Robot

    Directory of Open Access Journals (Sweden)

    István Vilikó

    2015-06-01

    Full Text Available The purpose of developing hybrid locomotion systems is to merge the advantages and to eliminate the disadvantages of different type of locomotion. The proposed solution combines wheeled and legged locomotion methods. This paper presents the mechatronic design approach and the development stages of the prototype.

  18. Clinical aspects of lower leg compartment syndrome

    NARCIS (Netherlands)

    Brand, Johan Gerard Henric van den

    2004-01-01

    A compartment syndrome is a condition in which increased pressure within a limited space compromises the circulation and function of tissues within that space. Although pathofysiology is roughly similar in chronic exertional and acute compartment syndrome of the lower leg, the clinical

  19. X-Ray Exam: Femur (Upper Leg)

    Science.gov (United States)

    ... Staying Safe Videos for Educators Search English Español X-Ray Exam: Femur (Upper Leg) KidsHealth / For Parents / X- ... Muscles, and Joints Broken Bones Getting an X-ray (Video) X-Ray (Video) View more Partner Message About Us ...

  20. Parental smoking during pregnancy shortens offspring's legs.

    Science.gov (United States)

    Żądzińska, E; Kozieł, S; Borowska-Strugińska, B; Rosset, I; Sitek, A; Lorkiewicz, W

    2016-12-01

    One of the most severe detrimental environmental factors acting during pregnancy is foetal smoke exposure. The aim of this study was to assess the effect of maternal, paternal and parental smoking during pregnancy on relative leg length in 7- to 10-year-old children. The research conducted in the years 2001-2002 included 978 term-born children, 348 boys and 630 girls, at the age of 7-10 years. Information concerning the birth weight of a child was obtained from the health records of the women. Information about the mother's and the father's smoking habits during pregnancy and about the mothers' education level was obtained from a questionnaire. The influence of parental smoking on relative leg length, controlled for age, sex, birth weight and the mother's education, as a proxy measure of socioeconomic status, and controlled for an interaction between sex and birth weight, was assessed by an analysis of covariance, where relative leg length was the dependent variable, smoking and sex were the independent variables, and birth weight as well as the mother's education were the covariates. Three separate analyses were run for the three models of smoking habits during pregnancy: the mother's smoking, the father's smoking and both parents' smoking. Only both parents' smoking showed a significant effect on relative leg length of offspring. It is probable that foetal hypoxia caused by carbon monoxide contained in smoke decelerated the growth of the long bones of foetuses. Copyright © 2016 Elsevier GmbH. All rights reserved.

  1. Chronic leg ulcer caused by Mycobacterium immunogenum

    NARCIS (Netherlands)

    Loots, Miriam A. M.; de Jong, Menno D.; van Soolingen, Dick; Wetsteyn, José C. F. M.; Faber, William R.

    2005-01-01

    Rare tropical skin diseases are seen more frequently in Western countries because of the increased popularity of visiting tropical regions. A 55-year-old white man developed a painless leg ulcer after traveling in Guatemala and Belize. A mycobacterium was cultured from a biopsy specimen and was

  2. Age-related differences in lean mass, protein synthesis and skeletal muscle markers of proteolysis after bed rest and exercise rehabilitation.

    Science.gov (United States)

    Tanner, Ruth E; Brunker, Lucille B; Agergaard, Jakob; Barrows, Katherine M; Briggs, Robert A; Kwon, Oh Sung; Young, Laura M; Hopkins, Paul N; Volpi, Elena; Marcus, Robin L; LaStayo, Paul C; Drummond, Micah J

    2015-09-15

    Bed rest-induced muscle loss and impaired muscle recovery may contribute to age-related sarcopenia. It is unknown if there are age-related differences in muscle mass and muscle anabolic and catabolic responses to bed rest. A secondary objective was to determine if rehabilitation could reverse bed rest responses. Nine older and fourteen young adults participated in a 5-day bed rest challenge (BED REST). This was followed by 8 weeks of high intensity resistance exercise (REHAB). Leg lean mass (via dual-energy X-ray absorptiometry; DXA) and strength were determined. Muscle biopsies were collected during a constant stable isotope infusion in the postabsorptive state and after essential amino acid (EAA) ingestion on three occasions: before (PRE), after bed rest and after rehabilitation. Samples were assessed for protein synthesis, mTORC1 signalling, REDD1/2 expression and molecular markers related to muscle proteolysis (MURF1, MAFBX, AMPKα, LC3II/I, Beclin1). We found that leg lean mass and strength decreased in older but not younger adults after bedrest (P protein synthesis increased before bed rest in both age groups (P protein synthesis rates and increased MAFBX mRNA, p-AMPKα and the LC3II/I ratio (P protein synthesis and a marginal increase in proteolytic markers. Finally, rehabilitation restored bed rest-induced deficits in lean mass and strength in older adults. © 2015 The Authors. The Journal of Physiology © 2015 The Physiological Society.

  3. Adiponectin and leptin in overweight/obese and lean women with polycystic ovary syndrome.

    Science.gov (United States)

    Chen, Chin-I; Hsu, Ming-I; Lin, Shyh-Hsiang; Chang, Yuan-Chin I; Hsu, Chun-Sen; Tzeng, Chii-Ruey

    2015-04-01

    The objective of this study was to evaluate the adiponectin and leptin levels in overweight/obese and lean women with polycystic ovary syndrome (PCOS). This was a retrospective study. Of the 422 studied patients, 224 women with PCOS and 198 women without PCOS were evaluated. Insulin resistance and the metabolic components were assessed. The adiponectin and leptin levels were also evaluated. Adiponectin was negatively correlated with insulin resistance, body mass index (BMI), and total testosterone, triglyceride, and low-density lipoprotein (LDL) levels; conversely, leptin reversed the aforementioned reaction and was negatively correlated with adiponectin levels. The adiponectin to leptin ratios were significantly lower in PCOS women than in those without PCOS. Compared to women with non-PCOS, overweight/obese women with PCOS had lower serum adiponectin levels than women without PCOS, which was not the case for lean women. Conversely, lean women with PCOS had higher serum leptin levels than those without PCOS, which was not the case for overweight/obese women. Adipose tissue might play an important role in the metabolic complications in women with PCOS. To study the impact of obesity biomarkers in women with PCOS, overweight/obese and lean women should be considered separately.

  4. Application of lean six sigma to waste minimization in cigarette paper industry

    Science.gov (United States)

    Syahputri, K.; Sari, R. M.; Anizar; Tarigan, I. R.; Siregar, I.

    2018-02-01

    The cigarette paper industry is one of the industry that is always experiencing increasing demand from consumers. Consumer expectations for the products produced also increased both in terms of quality and quantity. The company continuously improves the quality of its products by trying to minimize nonconformity, waste and improve the efficiency of the whole production process of the company. In this cigarette industry, there is a disability whose value is above the company’s defect tolerance that is 10% of the production amount per month. Another problem also occurs in the production time is too long due to the many activities that are not value added (non value added activities) on the production floor. To overcome this problem, it is necessary to improve the production process of cigarette paper and minimize production time by reducing non value added activities. Repairs done with Lean Six Sigma. Lean Six Sigma is a combination of Lean and Six Sigma concept with DMAIC method (Define, Measure, Analyze, Improve, Control). With this Lean approach, obtained total production time of 1479.13 minutes proposal with cycle efficiency process increased by 12.64%.

  5. Lean six sigma methodologies improve clinical laboratory efficiency and reduce turnaround times.

    Science.gov (United States)

    Inal, Tamer C; Goruroglu Ozturk, Ozlem; Kibar, Filiz; Cetiner, Salih; Matyar, Selcuk; Daglioglu, Gulcin; Yaman, Akgun

    2018-01-01

    Organizing work flow is a major task of laboratory management. Recently, clinical laboratories have started to adopt methodologies such as Lean Six Sigma and some successful implementations have been reported. This study used Lean Six Sigma to simplify the laboratory work process and decrease the turnaround time by eliminating non-value-adding steps. The five-stage Six Sigma system known as define, measure, analyze, improve, and control (DMAIC) is used to identify and solve problems. The laboratory turnaround time for individual tests, total delay time in the sample reception area, and percentage of steps involving risks of medical errors and biological hazards in the overall process are measured. The pre-analytical process in the reception area was improved by eliminating 3 h and 22.5 min of non-value-adding work. Turnaround time also improved for stat samples from 68 to 59 min after applying Lean. Steps prone to medical errors and posing potential biological hazards to receptionists were reduced from 30% to 3%. Successful implementation of Lean Six Sigma significantly improved all of the selected performance metrics. This quality-improvement methodology has the potential to significantly improve clinical laboratories. © 2017 Wiley Periodicals, Inc.

  6. Lean Six Sigma: a new approach to the management of patients undergoing prosthetic hip replacement surgery.

    Science.gov (United States)

    Improta, Giovanni; Balato, Giovanni; Romano, Maria; Carpentieri, Francesco; Bifulco, Paolo; Alessandro Russo, Mario; Rosa, Donato; Triassi, Maria; Cesarelli, Mario

    2015-08-01

    In 2012, health care spending in Italy reached €114.5 billion, accounting for 7.2% of the Gross Domestic Product (GDP) and 14.2% of total public spending. Therefore, reducing waste in health facilities could generate substantial cost savings. The objective of this study is to show that Lean Six Sigma represents an appropriate methodology for the development of a clinical pathway which allows to improve quality and to reduce costs in prosthetic hip replacement surgery. The methodology used for the development of a new clinical pathway was Lean Six Sigma. Problem solving in Lean Six Sigma is the DMAIC (Define, Measure, Analyse, Improve, Control) roadmap, characterized by five operational phases which make possible to reach fixed goals through a rigorous process of defining, measuring, analysing, improving and controlling business problems. The following project indicated several variables influencing the inappropriate prolongation of the length of stay for inpatient treatment and corrective actions were performed to improve the effectiveness and efficiency of the process of care. The average length of stay was reduced from 18.9 to 10.6 days (-44%). This article shows there is no trade-off between quality and costs: Lean Six Sigma improves quality and, at the same time, reduces costs. © 2015 John Wiley & Sons, Ltd.

  7. Application of Lean-Six Sigma Approach in a Laboratory Experimental Case Study

    Directory of Open Access Journals (Sweden)

    Hashim Raza Rizvi

    2013-12-01

    Full Text Available Laboratory experiments are a conventional activity performed at academic institutions, government and private organizations. These experimental studies provide the basis for new inventions in the field of science and engineering. Laboratory experiments are conducted on the basis of provided guidelines, already established by different standard organizations like ASTM, AASHTO etc. This article is based on a case study in which the process of an experiment is examined on the basis of Value Stream Maps (VSM and potential improvement possibilities have been identified. After determining the potential waste, appropriate Lean tools are selected to implement and observe the improvements. The process is examined after application of the Lean tools and a comparison is performed. University laboratory environment can be improved considerably by applying Lean Tools. MUDA application reduced the total work time from 90.75 hours and 10-CD to 63.75 hours and 7-CD hence saving, 27 hours and 3-CD for one experiment. This is remarkable achievement of this application. Heijunka application provided the students equal workload and they performed explicitly better than they used to. 5-S tool provided the students the opportunity to manage the laboratory in an effective and clean way. Safety of the students is a very major concern at university laboratory environment. 5-S not only upgraded the laboratory overall performance, but it significantly raised the safety standards of the laboratory. More application of the Lean Tools should be exercised explored to have more effective and efficient university laboratory experimental environment.

  8. Analysis The Leanness of The Supply Chain By Fuzzy QFD

    OpenAIRE

    Mukesh Singh Baghel; Pavan Agrawal

    2014-01-01

    The new systems of doing business in manufacturing have evolved in recent decades Lean production. Lean production can be traced to the 1960s in Japan, when Toyota Motors started innovating changes in mass production to deal with its domestic automotive market. The term “Lean production” was coined around 1989 with the popularity of the book, the machine that can change the world written by researchers at the Massachusetts Institute of Technology (MIT). The term itself was coined ...

  9. Application of lean manufacturing techniques in the Emergency Department.

    Science.gov (United States)

    Dickson, Eric W; Singh, Sabi; Cheung, Dickson S; Wyatt, Christopher C; Nugent, Andrew S

    2009-08-01

    "Lean" is a set of principles and techniques that drive organizations to continually add value to the product they deliver by enhancing process steps that are necessary, relevant, and valuable while eliminating those that fail to add value. Lean has been used in manufacturing for decades and has been associated with enhanced product quality and overall corporate success. To evaluate whether the adoption of Lean principles by an Emergency Department (ED) improves the value of emergency care delivered. Beginning in December 2005, we implemented a variety of Lean techniques in an effort to enhance patient and staff satisfaction. The implementation followed a six-step process of Lean education, ED observation, patient flow analysis, process redesign, new process testing, and full implementation. Process redesign focused on generating improvement ideas from frontline workers across all departmental units. Value-based and operational outcome measures, including patient satisfaction, expense per patient, ED length of stay (LOS), and patient volume were compared for calendar year 2005 (pre-Lean) and periodically after 2006 (post-Lean). Patient visits increased by 9.23% in 2006. Despite this increase, LOS decreased slightly and patient satisfaction increased significantly without raising the inflation adjusted cost per patient. Lean improved the value of the care we delivered to our patients. Generating and instituting ideas from our frontline providers have been the key to the success of our Lean program. Although Lean represents a fundamental change in the way we think of delivering care, the specific process changes we employed tended to be simple, small procedure modifications specific to our unique people, process, and place. We, therefore, believe that institutions or departments aspiring to adopt Lean should focus on the core principles of Lean rather than on emulating specific process changes made at other institutions.

  10. A new lean change methodology for small & medium sized enterprises

    OpenAIRE

    April, Joris; Powell, Daryl; Bart, Schanssema

    2010-01-01

    SMEs find it difficult to implement productivity improvement tools, particularly those associated with Lean Manufacturing. Larger companies have more success due to greater access to resources. To provide the SMEs with a way to implement Lean sustainably, the European project ERIP develops a new lean change methodology for SMEs. In this paper the methodology is explained and three test cases show the strength of the methodology. The method is a sequence of achieving management and company sup...

  11. Lean and Efficient Software: Whole-Program Optimization of Executables

    Science.gov (United States)

    2015-09-30

    Lean and Efficient Software: Whole-Program Optimization of Executables” Project Summary Report #5 (Report Period: 7/1/2015 to 9/30/2015...TYPE 3. DATES COVERED 00-00-2015 to 00-00-2015 4. TITLE AND SUBTITLE Lean and Efficient Software: Whole-Program Optimization of Executables 5a...unclassified c. THIS PAGE unclassified Standard Form 298 (Rev. 8-98) Prescribed by ANSI Std Z39-18 Lean and Efficient Software: Whole-Program

  12. A Model to align the organizational culture to Lean

    Directory of Open Access Journals (Sweden)

    Mehrsa Taherimashhadi

    2018-04-01

    Full Text Available Purpose: Since the emergence of Lean Manufacturing many organizations strived to implement it. Nonetheless, sustainable Lean transformation is not as easy as to be simply achieved. Several aspects need to be taken into account before Lean implementation which national and organizational culture are important. By considering influences of national culture on the organizational culture, this paper aims at proposing an evaluation model to determine the cultural weaknesses of an organization and give some recommendations to manage people before implementing Lean. Design/methodology/approach: This research has been conducted based on literature review survey and semi-structured interviews. Research papers, conference proceedings, books, and official websites regarding Lean philosophy were reviewed to find the influence of national culture in Lean implementation. Different databases were scrutinized, from 2015 to 2017, containing Scopus and Web of Science with the time period of 1996-2016. A set of key terms and their combinations were used including: Toyota Production system, Lean production, Lean manufacturing, Lean management, Transformation, Implementation, Barriers/ Impediments/Challenges/Difficulties, Human resources, Success factors, Organizational culture, and National culture. Findings: The proposed evaluation model is a guide for organizations to determine cultural misalignments between the corporate culture and the Lean culture before its implementation and gives some managerial recommendations to correct them. Originality/value: This study is the first attempt to integrate the national models   with Lean culture to provide an evaluation model and some recommendations to help the organization to align its culture to Lean culture before its implementation.

  13. Implementing lean office: a successful case in public sector

    OpenAIRE

    Monteiro, Mónica F. J. R.; Pacheco, Claudia C. L.; Dinis-Carvalho, José; Paiva, Francisco C.

    2015-01-01

    Applying lean approaches in office areas can lead to performance improvements and other benefits as achieved in traditional manufacturing environments. The intangibility of office operations may appear as a major difficulty for lean implementations but in fact the benefits achievable are as important as the ones achieved in manufacturing environments. This paper reports a successful case of lean office implementation in a public sector organization giving emphasis to its major performance imp...

  14. Identification of Lean Implementation Hurdles in Indian Industries

    OpenAIRE

    Bhim Singh

    2016-01-01

    Due to increased pressure from global competitors, manufacturing organizations are switching over to lean philosophies from traditional mass production. Lean manufacturing is a manufacturing philosophy which focuses on elimination of various types of wastes and creates maximum value for the end customers. Lean thinking aims to produce high quality products and services at the lowest possible cost with maximum customer responsiveness. Indian Industry is facing lot of problems in this transform...

  15. Lean mass and fat mass predict bone mineral density in middle-aged individuals with noninsulin-requiring type 2 diabetes mellitus.

    Science.gov (United States)

    Moseley, Kendall F; Dobrosielski, Devon A; Stewart, Kerry J; De Beur, Suzanne M Jan; Sellmeyer, Deborah E

    2011-05-01

    Despite high bone mineral density (BMD), persons with type 2 diabetes are at greater risk of fracture. The relationship between body composition and BMD in noninsulin-requiring diabetes is unclear. The aim was to examine how fat and lean mass independently affect the skeleton in this population. Subjects for this cross-sectional analysis were men (n = 78) and women (n = 56) aged 40-65 years (56 ± 6 years) with uncomplicated, noninsulin-requiring type 2 diabetes. Total body fat and lean mass, total body, hip and lumbar spine BMD were measured with dual energy X-ray absorptiometry. Magnetic resonance imaging measured total abdominal, visceral and subcutaneous (SQ) fat. Subjects had normal all-site BMD and were obese to overweight (body mass index 29-41 kg/m(2)) with controlled diabetes (HbA1c women 6·6 ± 1·2%, men 6·7 ± 1·6%). Lean mass was positively associated with total body, hip, femoral neck and hip BMD in both sexes. Fat mass, abdominal total and SQ fat were associated with total body and hip BMD in women. In multivariate analyses adjusted for sex, lean mass significantly predicted total, hip and femoral neck BMD in men and women. In unadjusted models, lean mass continued to predict BMD at these sites in men; fat mass also predicted total body, femoral and hip BMD in women. In men and women with uncomplicated, noninsulin-requiring diabetes, lean mass significantly predicted BMD at the total body, hip and femoral neck. Further research is needed to determine whether acquisition or maintenance of lean mass in T2DM can prevent hip fracture in this at-risk population. © 2011 Blackwell Publishing Ltd.

  16. Getting 'Lean': hardwiring process excellence into Northeast Health.

    Science.gov (United States)

    Brown, Tricia; Duthe, Robert

    2009-01-01

    Many healthcare organizations are turning to the "Lean" Toyota Production System as a means to hardwire process excellence into their organizations. Northeast Health, an integrated delivery system in New York's capital region, introduced the Lean concept into its culture in 2004. After four years, the organization is beginning to see its staff hardwire Lean thinking into day-to-day behaviors. This paper focuses on the approach used by Northeast Health to introduce Lean concepts into its culture, challenges faced, lessons learned and the factors critical to success.

  17. Application of a mathematical model for ergonomics in lean manufacturing.

    Science.gov (United States)

    Botti, Lucia; Mora, Cristina; Regattieri, Alberto

    2017-10-01

    The data presented in this article are related to the research article "Integrating ergonomics and lean manufacturing principles in a hybrid assembly line" (Botti et al., 2017) [1]. The results refer to the application of the mathematical model for the design of lean processes in hybrid assembly lines, meeting both the lean principles and the ergonomic requirements for safe assembly work. Data show that the success of a lean strategy is possible when ergonomics of workers is a parameter of the assembly process design.

  18. Lean leadership attributes: a systematic review of the literature.

    Science.gov (United States)

    Aij, Kjeld Harald; Teunissen, Maurits

    2017-10-09

    Purpose Emphasis on quality and reducing costs has led many health-care organizations to reconfigure their management, process, and quality control infrastructures. Many are lean, a management philosophy with roots in manufacturing industries that emphasizes elimination of waste. Successful lean implementation requires systemic change and strong leadership. Despite the importance of leadership to successful lean implementation, few researchers have probed the question of ideal leadership attributes to achieve lean thinking in health care. The purpose of this paper is to provide insight into applicable attributes for lean leaders in health care. Design/methodology/approach The authors systematically reviewed the literature on principles of leadership and, using Dombrowski and Mielke's (2013) conceptual model of lean leadership, developed a parallel theoretical model for lean leadership in health care. Findings This work contributes to the development of a new framework for describing leadership attributes within lean management of health care. Originality/value The summary of attributes can provide a model for health-care leaders to apply lean in their organizations.

  19. LEAN ACCOUNTING: SUATU ALTERNATIF TEKNIK AKUNTANSI MANAJEMEN DALAM INDUSTRI MANUFAKTUR

    Directory of Open Access Journals (Sweden)

    Eka Ardhani Sisdyani

    2010-07-01

    Full Text Available Manufacturing techniques have been developed to embrace theaims of continuous improvement. Continuous improvement would leadcompanies to win business competition. One technique that gains moreand more followers is lean manufacturing. Lean manufacturing hastwo main purposes, which are eliminating wastes and creating valuesto customers. It focuses on customer values, value stream, productionflows, demand-pull, and perfection. Lean accounting is needed tosupport and encourage the development of lean manufacturing, forinstances in product costing system, external reporting, and otherdecision making processes that need accounting data.

  20. Why Lean doesn't work for everyone.

    Science.gov (United States)

    Kaplan, Gary S; Patterson, Sarah H; Ching, Joan M; Blackmore, C Craig

    2014-12-01

    Popularisation of Lean in healthcare has led to emphasis on Lean quality improvement tools in isolation, with inconsistent results. We argue that delivery of safer, more efficient, and higher quality-patient focused care requires organisational transformation of which the Lean toolkit is only one component. To successfully facilitate system transformation toward higher quality care at lower cost, Lean tools must be part of a comprehensive management system, within a supportive institutional culture, and with committed leadership. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  1. Prevalence and hemodynamic effects of leaning during CPR

    Science.gov (United States)

    Niles, Dana E.; Sutton, Robert M.; Nadkarni, Vinay M.; Glatz, Andrew; Zuercher, Mathias; Maltese, Matthew R.; Eilevstjønn, Joar; Abella, Benjamin S.; Becker, Lance B.; Berg, Robert A.

    2013-01-01

    Background Cardiopulmonary resuscitation (CPR) guidelines recommend complete release between chest compressions (CC). Objective Evaluate the hemodynamic effects of leaning (incomplete chest wall release) during CPR and the prevalence of leaning during CPR. Results In piglet ventricular fibrillation cardiac arrests, 10% and 20% (1.8 kg and 3.6 kg, respectively), leaning during CPR increased right atrial pressures, decreased coronary perfusion pressures, and decreased cardiac index and left ventricular myocardial blood flow by nearly 50%. In contrast, residual leaning of a 260 g accelerometer/ force feedback device did not adversely affect cardiac index or myocardial blood flow. Among 108 adult in-hospital CPR events, leaning ≥2.5 kg was demonstrable in 91% of the events and 12% of the evaluated CC. For 12 children with in-hospital CPR, 28% of CC had residual leaning ≥2.5 kg and 89% had residual leaning ≥0.5 kg. Conclusions Leaning during CPR increases intrathoracic pressure, decreases coronary perfusion pressure, and decreases cardiac output and myocardial blood flow. Leaning is common during CPR. PMID:22208173

  2. What Determines Lean Manufacturing Implementation? A CB-SEM Model

    Directory of Open Access Journals (Sweden)

    Tan Ching Ng

    2018-02-01

    Full Text Available This research aims to ascertain the determinants of effective Lean Manufacturing (LM. In this research, Covariance-based Structural Equation Modeling (CB-SEM analysis will be used in order to analyze the determinants. Through CB-SEM analysis, the significant key determinants can be determined and the direct relationships among determinants can be analyzed. Thus, the findings of this research can act as guidelines for achievement of LM effectiveness, not only providing necessary steps for successful implementation of lean, but also helping lean companies to achieve higher level of lean cost and time savings.

  3. Experienced Barriers to Lean in Swedish Manufacturing and Health Care

    Directory of Open Access Journals (Sweden)

    Bengt Halling

    2013-12-01

    Full Text Available The purpose is to compare similarities and divergences in how the concepts of Lean and barriers to Lean are described by key informants at a production unit in a large manufacturing company and two emergency health care units in Sweden. Data was collected via semi-structured interviews and analyzed with the constant comparative method (CCM and Porras and Robertson’s (1992 change model. : In both organizations, the view of Lean changed from a toolbox to a human behavior view. Eight barriers were experienced in both organizations. Three barriers were unique to manufacturing or to health care, respectively. Nine barriers were elements of social factors; five were elements of organizing arrangements. Only people practically involved and responsible for the implementation at the two organizations participated in the study. Persons responsible for implementing Lean should consider organizational arrangements and social factors in order to limit barriers to successful implementation. Most research on Lean has been about successful Lean implementations. This study focuses on how Lean is viewed and what barriers personnel in manufacturing and health care have experienced. In comparing the barriers to Lean experienced in the two groups, common, archetypical, and unique barriers for manufacturing and health care can be identified, thus contributing to knowledge about barriers to Lean implementation.

  4. Product innovation and commercialization in lean global start-ups

    DEFF Research Database (Denmark)

    Tanev, Stoyan; Rasmussen, Erik Stavnsager; Zijdemans, Erik

    2015-01-01

    The paper examines the distinctive characteristics of product innovation and commercialization in Lean Global Start-up (LGS) – new technology firms which have adopted a lean and global path from or near to their inception. It suggests an uncertainty vs risk framework which allows integrating two...... research streams – Born Global (BG) firms and lean start-ups. In addition to its integrative theoretical value, the paper offers insights for lean start-up managers dealing with the challenges of a global start....

  5. Lean principles adoption in environmental management system (EMS - ISO 14001

    Directory of Open Access Journals (Sweden)

    Perumal Puvanasvaran

    2012-12-01

    Full Text Available Purpose: The purpose of this study is to examine the characteristic of the lean principles into ISO 14001 and to propose linkage of the lean principles and ISO 14001.Design/methodology/approach: To achieve the objective of the study, literature survey and quantitative research method using questionnaires survey are used.Findings and Originality/value: The findings of this study confirm that ISO 14001 certified company adopted lean production practices.  The study also proves that lean principles have positive and significant relationship with ISO 14001 EMS and the linkage can be made between lean principles and ISO 14001 to achieve Continual Improvement.Research limitations/implications: The small sizes of the sample of the participating companies are the main limitations of this study and this research mainly focuses on the manufacturing environment and services industry.Practical implications: This research show that all ISO 14001 companies do adopt at least one lean production practices and the main findings are lean principles has positive and highly significant relationship with ISO 14001 requirements.  This is because the integration of lean principles into ISO 14001 will serve practical methods for ISO14001 EMS to achieve the continual improvement.Originality/value: This research is amongst the first to study the combined lean principles with ISO 1400.  Based on the current situation, there is no integration within this two management system. 

  6. Multi-Axis Prosthetic Knee Resembles Alpine Skiing Movements of an Intact Leg

    Science.gov (United States)

    Demšar, Ivan; Duhovnik, Jože; Lešnik, Blaž; Supej, Matej

    2015-01-01

    intact leg and smaller than that of the control group. The total knee flexions in the laboratory measurements were comparable with field measurements. Additional load affects the RoM of the ski boot, ankle and knee joints for the amputated skier in both legs. No significant influence from the additional load was found on the RoM in the control group of healthy subjects. The above-knee prosthesis with a multiple-axis prosthetic knee reproduces the alpine skiing kinematics of an intact leg. PMID:26664282

  7. Lean management - an effective way to arrange maintenance?; Lean Management - ein effektiver Weg zur Gestaltung der Instandhaltung?

    Energy Technology Data Exchange (ETDEWEB)

    Tschuschke, W. [Inst. fuer Instandhaltung gGmbH, Iserlohn (Germany)

    1996-08-01

    Lean management/lean production wishes to attain more through intelligent operation system/production at less expense (personnel, materials, energy, costs). The object is not harder but more intelligent and production work; we do not need to run faster but to find shorter routes. The idea of lean management`s effects and changes have consequences for the field of maintenance as an equivalent and legitimate business area which are discussed in this paper. (orig.) [Deutsch] Lean Management/Lean Production will durch ein intelligentes Arbeitssystem/Produzieren mit weniger Aufwand (Personal, Material, Energie, Kosten) mehr erreichen. Ziel ist nicht das haertere, sondern das intelligentere und produktivere Arbeiten; wir sollen nicht schneller laufen, sondern kuerzere Wege finden. Fuer den Bereich Instandhaltung als gleichwertiger und gleichberechtigter Unternehmensbereich haben die Gedanken des Lean Managements Auswirkungen und Veraenderungen zur Folge, die im Beitrag genannt werden. (orig.)

  8. Restless Legs Syndrome -- Self-Tests and Diagnosis

    Science.gov (United States)

    ... legs syndrome Diagnosis Talk to a board certified sleep medicine physician if you think you have restless legs ... He or she can refer you to a sleep medicine physician if necessary. The sleep physician may ask ...

  9. Six-legged walking robot for service operations

    OpenAIRE

    Ihme, T.; Schneider, A.; Schmucker, U.

    1998-01-01

    This paper presents the control system of a six-legged vehicle including force control. Considered control schemes are control of forces and control of body motion. The experimental result with a six-legged robot is presented.

  10. Myocutaneous revascularization following graded ischemia in lean and obese mice

    Directory of Open Access Journals (Sweden)

    Clark RM

    2016-09-01

    Full Text Available Ross M Clark,1 Brittany Coffman,2 Paul G McGuire,3 Thomas R Howdieshell1,3 1Department of Surgery, 2Department of Pathology, 3Department of Cell Biology and Vascular Physiology, University of New Mexico Health Sciences Center, Albuquerque, NM, USA Background: Murine models of diabetes and obesity have provided insight into the pathogenesis of impaired epithelialization of excisional skin wounds. However, knowledge of postischemic myocutaneous revascularization in these models is limited. Materials and methods: A myocutaneous flap was created on the dorsum of wild type (C57BL/6, genetically obese and diabetic (ob/ob, db/db, complementary heterozygous (ob+/ob− , db+/db−, and diet-induced obese (DIO mice (n=48 total; five operative mice per strain and three unoperated mice per strain as controls. Flap perfusion was documented by laser speckle contrast imaging. Local gene expression in control and postoperative flap tissue specimens was determined by quantitative reverse transcription polymerase chain reaction (RT-PCR. Image analysis of immunochemically stained histologic sections confirmed microvascular density and macrophage presence. Results: Day 10 planimetric analysis revealed mean flap surface area necrosis values of 10.8%, 12.9%, 9.9%, 0.4%, 1.4%, and 23.0% for wild type, db+/db−, ob+/ob−, db/db, ob/ob, and DIO flaps, respectively. Over 10 days, laser speckle imaging documented increased perfusion at all time points with revascularization to supranormal perfusion in db/db and ob/ob flaps. In contrast, wild type, heterozygous, and DIO flaps displayed expected graded ischemia with failure of perfusion to return to baseline values. RT-PCR demonstrated statistically significant differences in angiogenic gene expression between lean and obese mice at baseline (unoperated and at day 10. Conclusion: Unexpected increased baseline skin perfusion and augmented myocutaneous revascularization accompanied by a control proangiogenic transcriptional

  11. Application of the Lean Methodology in a company from the pharmaceutical and food industry

    Directory of Open Access Journals (Sweden)

    Juliana Keiko Sagawa

    2016-06-01

    Full Text Available The main goal of Lean Manufacturing is the reduction of waste and consequently the improvement of manufacturing efficiency and quality. This paper presents a case study in a company from the pharmaceutical, health and food industry. The value stream was mapped, aiming to identify waste and the possible ways of reducing it, according to the lean principles. Among the proposed solutions is the implementation of Kanban cards and the implementation of a panel for stock control and production leveling (heijunka. A 70% reduction of the total lead time was estimated as a potential result (from 71 to 19 days. The proposed improvements sought to provide a balance given the trade-off between more flexible production with smaller batches, and the lower total set up time of larger batches.

  12. Leaning on lean: the reception of a management fashion in Germany

    NARCIS (Netherlands)

    Benders, J.G.J.M.; Bijsterveld, M.J.L. van

    2000-01-01

    The ‘fashionable’ concept of lean production has been discussed more intensively in Germany than elsewhere in Europe but has resulted not only in rationalisation measures such as downsizing and delayering but also in implementing ‘Gruppenarbeit’. Through interpretation processes at different levels,

  13. "The largest Lean transformation in the world": the implementation and evaluation of lean in Saskatchewan healthcare.

    Science.gov (United States)

    Kinsman, Leigh; Rotter, Thomas; Stevenson, Katherine; Bath, Brenna; Goodridge, Donna; Harrison, Liz; Dobson, Roy; Sari, Nazmi; Jeffery, Cathy; Bourassa, Carrie; Westhorp, Gill

    2014-01-01

    The Saskatchewan Ministry of Health has committed to a multi-million dollar investment toward the implementation of Lean methodology across the province's healthcare system. Originating as a production line discipline (the Toyota Production System), Lean has evolved to encompass process improvements including inventory management, waste reduction and quality improvement techniques. With an initial focus on leadership, strategic alignment, training and the creation of a supportive infrastructure (Lean promotion offices), the goal in Saskatchewan is a whole health system transformation that produces "better health, better value, better care, and better teams." Given the scope and scale of the initiative and the commitment of resources, it is vital that a comprehensive, longitudinal evaluation plan be implemented to support ongoing decision-making and program design. The nature of the initiative also offers a unique opportunity to contribute to health quality improvement science by advancing our understanding of the implementation and evaluation of complex, large-scale healthcare interventions. The purpose of this article is to summarize the background to Lean in Saskatchewan and the proposed evaluation methods. Copyright © 2014 Longwoods Publishing.

  14. Lean Architecture for Agile Software Development

    CERN Document Server

    Coplien, James O

    2010-01-01

    More and more Agile projects are seeking architectural roots as they struggle with complexity and scale - and they're seeking lightweight ways to do it: Still seeking? In this book the authors help you to find your own path; Taking cues from Lean development, they can help steer your project toward practices with longstanding track records; Up-front architecture? Sure. You can deliver an architecture as code that compiles and that concretely guides development without bogging it down in a mass of documents and guesses about the implementation; Documentation? Even a whiteboard diagram, or a CRC

  15. Application of force-length curve for determination of leg stiffness during a vertical jump.

    Science.gov (United States)

    Struzik, Artur; Zawadzki, Jerzy

    2016-01-01

    The aim of this study was to present the methodology for estimation of a leg stiffness during a countermovement jump. The question was asked whether leg stiffness in the countermovement and take-off phases are similar to each other as demonstrated in previous reports. It was also examined whether the stiffness in left lower limb is similar to the one in right lower limb. The research was conducted on 35 basketball players. Each participant performed three countermovement jumps with arm swing to the maximum height. Measurements employed a Kistlerforce plate and a BTS SMART system for motion analysis. Leg stiffness (understood as an inclination of the curve of ground reaction forces vs. length) was computed for these parts of countermovement and take-off phases where its value was relatively constant and F(Δl) relationship was similar to linear. Mean value (±SD) of total stiffness of both lower limbs in the countermovement phase was 7.1 ± 2.3 kN/m, whereas this value in the take-off phase was 7.5 ± 1 kN/m. No statistically significant differences were found between the leg stiffness in the countermovement and the take-off phases. No statistically significant differences were found during the comparison of the stiffness in the right and left lower limb. The calculation methodology allows us to estimate the value of leg stiffness based on the actual shape of F(Δl) curve rather than on extreme values of ΔF and Δl. Despite different tasks of the countermovement and the take-off phases, leg stiffness in these phases is very similar. Leg stiffness during a single vertical jump maintains a relatively constant value in the parts with a small value of acceleration.

  16. Leg intravenous pressure during head-up tilt.

    NARCIS (Netherlands)

    Groothuis, J.T.; Poelkens, F.; Wouters, C.W.; Kooijman, H.M.; Hopman, M.T.E.

    2008-01-01

    Leg vascular resistance is calculated as the arterial-venous pressure gradient divided by blood flow. During orthostatic challenges it is assumed that the hydrostatic pressure contributes equally to leg arterial, as well as to leg venous pressure. Because of venous valves, one may question whether,

  17. Spider diffraction: a comparison of curved and straight legs

    International Nuclear Information System (INIS)

    Richter, J.L.

    1984-01-01

    It has been known for some time that, if curved legs rather than the usual straight ones are used in the spider that supports the secondary optics in certain telescopes, the visible diffraction effect is reduced. Fraunhofer theory is used to calculate the diffraction effects due to the curved leg spider. Calculated and photographic diffraction patterns are compared for straight and curved leg spiders

  18. Project LEAN--lessons learned from a national social marketing campaign.

    OpenAIRE

    Samuels, S E

    1993-01-01

    The Henry J. Kaiser Family Foundation initiated a social marketing campaign in 1987 to reduce the nation's risk for heart disease and some cancers. Consensus on recommendations for dietary change have stimulated the development of a variety of social marketing campaigns to promote behavior change. Project LEAN (Low-Fat Eating for America Now) is a national campaign whose goal is to reduce dietary fat consumption to 30 percent of total calories through public service advertising, publicity, an...

  19. Investigation on the lean combustion performance of a hydrogen-enriched n-butanol engine

    International Nuclear Information System (INIS)

    Zhang, Bo; Ji, Changwei; Wang, Shuofeng

    2017-01-01

    Highlights: • H_2 addition avails improving thermal efficiency of n-butanol engines. • Lean burn limit of n-butanol engine is extended by H_2 addition. • H_2 addition shortens the n-butanol engine combustion duration. • HC and CO from the n-butanol engine are decreased by H_2 addition. - Abstract: n-Butanol is a feasible fuel candidate for spark-ignition engines. The current paper carried out an experiment to explore effects of hydrogen addition on further improving the performance of a n-butanol engine under the part load and lean conditions. Within the test, the engine intake pressure and speed were respectively kept at 61.5 kPa and 1400 rpm. The volumetric fractions of hydrogen in the total intake gas (hydrogen + air) were constrained at 0 and 3%, respectively. Under a certain hydrogen blending level, the global excess air ratio of in-cylinder charge which was changed from the stoichiometric to near the lean burn limit was adjusted by varying the n-butanol injection duration. The experimental results confirmed that the brake thermal efficiency was heightened and the lean burn limit was extended after the hydrogen addition. Besides, compared with the pure n-butanol combustion, the hydrogen enrichment enables the engine to gain dropped ignition delay and rapid combustion duration. Moreover, CO and HC from the pure n-butanol engine were reduced by the hydrogen addition. NOx were generally reduced when the excess air ratio was raised. This suggested that NOx from the hydrogen-enriched butanol engine could also be controlled by lean combustion.

  20. In vivo and in vitro studies of hepatic lipid metabolism in lean and reobese fetal pigs

    International Nuclear Information System (INIS)

    Hausman, G.J.; Trusty, C.D.; Martin, R.J.

    1986-01-01

    Fetuses were removed from pregnant (110 days of gestation) sows and 80 to 120 mg liver slices were prepared for two hour incubations with 14 C-palmitate (1 μCi/ml) or 3 H 2 O (1 mCi/ml). In vivo studies were conducted by injecting a single bolus of 0.5 or 10 ml of Liposyn (a 10% safflower oil emulsion) into fetuses (umbilical vein). One hour post injection (Liposyn) fetuses were removed from the uterus. Subsequently liver lipids were extracted and gas chromatographic analysis for 16:0, 18:0, 18:1, 18:2 and 20:4 were performed. Incorporation of C 14 -palmitate into total lipids was higher in lean livers whereas incorporation into CO 2 was independent of fetal strain. Incorporation of 3 H 2 O into triglyceride fatty acids was similar in lean and obese livers. Fatty acid composition of livers indicated strain differences (obese versus lean for 16:0 = 52 vs 27.8%; 18:0 = 20 vs 16.8%; 18:1 = 16.3 vs 32.6%; 20:4 = 8.8 vs 17.6%). There was a similar Liposyn dose dependent increase in the amount of 18:2 in chromatographs of lean (n = 7) and obese (n = 7) livers. Administration of Liposyn caused a significant increase in the amount of 18:1 and 20:4 in lean livers (least squares means +/- SEM, 0 vs 0.5 ml for 20:4 = .31 +/- .03 vs .48 +/- .04) but no increase in preobese livers. These studies illustrate significant alterations in hepatic lipid metabolism in the preobese state

  1. Relative contributions of lean and fat mass to bone strength in young Hispanic and non-Hispanic girls.

    Science.gov (United States)

    Hetherington-Rauth, Megan; Bea, Jennifer W; Blew, Robert M; Funk, Janet L; Hingle, Melanie D; Lee, Vinson R; Roe, Denise J; Wheeler, Mark D; Lohman, Timothy G; Going, Scott B

    2018-05-22

    With the high prevalence of childhood obesity, especially among Hispanic children, understanding how body weight and its components of lean and fat mass affect bone development is important, given that the amount of bone mineral accrued during childhood can determine osteoporosis risk later in life. The aim of this study was to assess the independent contributions of lean and fat mass on volumetric bone mineral density (vBMD), geometry, and strength in both weight-bearing and non-weight-bearing bones of Hispanic and non-Hispanic girls. Bone vBMD, geometry, and strength were assessed at the 20% distal femur, the 4% and 66% distal tibia, and the 66% distal radius of the non-dominant limb of 326, 9- to 12-year-old girls using peripheral quantitative computed tomography (pQCT). Total body lean and fat mass were measured by dual-energy x-ray absorptiometry (DXA). Multiple linear regression was used to assess the independent relationships of fat and lean mass with pQCT bone measures while adjusting for relevant confounders. Potential interactions between ethnicity and both fat and lean mass were also tested. Lean mass was a significant positive contributor to all bone outcomes (p Lean mass is the main determinant of bone strength for appendicular skeletal sites. Fat mass contributes to bone strength in the weight-bearing skeleton but does not add to bone strength in non-weight-bearing locations and may potentially be detrimental. Bone vBMD, geometry, and strength did not differ between Hispanic and non-Hispanic girls; fat mass may be a stronger contributor to bone strength in weight-bearing bones of Hispanic girls compared to non-Hispanic. Copyright © 2018. Published by Elsevier Inc.

  2. Immediate effects of the trunk stabilizing exercise on static balance parameters in double-leg and one-leg stances

    OpenAIRE

    Kim, Jwa-jun; Park, Se-yeon

    2016-01-01

    [Purpose] The purpose of this study was to evaluate the immediate effect of stabilizing exercise using the PNF technique on standing balance in one-leg and double-leg stances. [Subjects and Methods] The present study recruited 34 healthy participants from a local university. The Participants performed four balance tests (double-leg stance with and without vision, one-leg stance with and without vision), before and after exercise. The exercise consisted of exercises performed using PNF techniq...

  3. Pictorial essay: Ultrasonography in 'tennis leg'.

    Science.gov (United States)

    Shah, Jeshil R; Shah, Bipin R; Shah, Ankit B

    2010-11-01

    Tennis leg is caused by a rupture of the medial head of the gastrocnemius muscle, usually at its distal musculotendinous junction region. However, tears in this muscle and its tendon are also included under the term 'tennis leg'. It is seen regularly in practice and is an important cause of a painful calf. The common USG findings include: disruption of the pinnate pattern of the distal medial gastrocnemius, usually near the junction of the triceps surae (which is the echogenic line between the gastrocnemius, the soleus, and the plantaris muscles), fluid tracking along the fascia, adjacent hematoma, and intramuscular tears as well as hematomas. USG is useful for confirming the diagnosis, excluding other causes of a painful calf, for assessing the severity of the disease, and in follow-up.

  4. Faecal microbiota in lean and obese dogs.

    Science.gov (United States)

    Handl, Stefanie; German, Alexander J; Holden, Shelley L; Dowd, Scot E; Steiner, Jörg M; Heilmann, Romy M; Grant, Ryan W; Swanson, Kelly S; Suchodolski, Jan S

    2013-05-01

    Previous work has shown obesity to be associated with changes in intestinal microbiota. While obesity is common in dogs, limited information is available about the role of the intestinal microbiota. The aim of this study was to investigate whether alterations in the intestinal microbiota may be associated with canine obesity. Using 16S rRNA gene pyrosequencing and quantitative real-time PCR, we evaluated the composition of the faecal microbiota in 22 lean and 21 obese pet dogs, as well as in five research dogs fed ad libitum and four research dogs serving as lean controls. Firmicutes, Fusobacteria and Actinobacteria were the predominant bacterial phyla. The phylum Actinobacteria and the genus Roseburia were significantly more abundant in the obese pet dogs. The order Clostridiales significantly increased under ad libitum feeding in the research dogs. Canine intestinal microbiota is highly diverse and shows considerable interindividual variation. In the pet dogs, influence on the intestinal microbiota besides body condition, like age, breed, diet or lifestyle, might have masked the effect of obesity. The study population of research dogs was small, and further work is required before the role of the intestinal microbiota in canine obesity is clarified. © 2013 Federation of European Microbiological Societies. Published by Blackwell Publishing Ltd. All rights reserved.

  5. Experimental research on pedestrian lower leg impact

    Science.gov (United States)

    Constantin, B. A.; Iozsa, D. M.; Stan, C.

    2017-10-01

    The present paper is centred on the research of deceleration measured at the level of the lower leg during a pedestrian impact in multiple load cases. Basically, the used methodology for physical test setup is similar to EuroNCAP and European Union regulatory requirements. Due cost reduction reasons, it was not used a pneumatic system in order to launch the lower leg impactor in the direction of the vehicle front-end. During the test it was used an opposite solution, namely the vehicle being in motion, aiming the standstill lower leg impactor. The impactor has similar specifications to those at EU level, i.e. dimensions, materials, and principle of measurement of the deceleration magnitude. Therefore, all the results obtained during the study comply with the requirements of both EU regulation and EuroNCAP. As a limitation, due to unavailability of proper sensors in the equipment of the lower leg impactor, that could provide precise results, the bending angle, the shearing and the detailed data at the level of knee ligaments were not evaluated. The knee joint should be improved for future studies as some bending angles observed during the post processing of several impact video files were too high comparing to other studies. The paper highlights the first pedestrian impact physical test conducted by the author, following an extensive research in the field. Deceleration at the level of pedestrian knee can be substantially improved by providing enough volume between the bumper fascia and the front-end structure and by using pedestrian friendly materials for shock absorbers, such as foams.

  6. Dynamic legged locomotion in robots and animals

    Science.gov (United States)

    Raibert, Marc; Playter, Robert; Ringrose, Robert; Bailey, Dave; Leeser, Karl

    1995-01-01

    This report documents our study of active legged systems that balance actively and move dynamically. The purpose of this research is to build a foundation of knowledge that can lead both to the construction of useful legged vehicles and to a better understanding of how animal locomotion works. In this report we provide an update on progress during the past year. Here are the topics covered in this report: (1) Is cockroach locomotion dynamic? To address this question we created three models of cockroaches, each abstracted at a different level. We provided each model with a control system and computer simulation. One set of results suggests that 'Groucho Running,' a type of dynamic walking, seems feasible at cockroach scale. (2) How do bipeds shift weight between the legs? We built a simple planar biped robot specifically to explore this question. It shifts its weight from one curved foot to the other, using a toe-off and toe-on strategy, in conjunction with dynamic tipping. (3) 3D biped gymnastics: The 3D biped robot has done front somersaults in the laboratory. The robot changes its leg length in flight to control rotation rate. This in turn provides a mechanism for controlling the landing attitude of the robot once airborne. (4) Passively stabilized layout somersault: We have found that the passive structure of a gymnast, the configuration of masses and compliances, can stabilize inherently unstable maneuvers. This means that body biomechanics could play a larger role in controlling behavior than is generally thought. We used a physical 'doll' model and computer simulation to illustrate the point. (5) Twisting: Some gymnastic maneuvers require twisting. We are studying how to couple the biomechanics of the system to its control to produce efficient, stable twisting maneuvers.

  7. Asymptomatic Petechial Eruption on the Lower Legs

    OpenAIRE

    Mendese, Gary; Grande, Donald

    2013-01-01

    The authors report an unusual case of Rocky Mountain spotted fever that presented as an asymptomatic petechial eruption on the lower legs. Rocky Mountain spotted fever is rare in New England and, as such, is typically not on the differential diagnosis when presented with such patients. What began as an asymptomatic eruption progressed to more classic signs of the disease, including a positive Rocky Mountain spotted fever titer. The patient was successfully treated with doxycydine and within a...

  8. Chemical structures and theoretical models of lean premixed ...

    African Journals Online (AJOL)

    To better understand the chemistry involved in the lean-fuel combustion, the chemical structure of lean premixed propene-oxygen-nitrogen flames stabilized on a flat-flame burner at atmospheric pressure was determined experimentally. The species mole fraction profiles were also computed by the Premix code and three ...

  9. Lean Supply Chain Planning: A Performance Evaluation through Simulation

    Directory of Open Access Journals (Sweden)

    Rossini Matteo

    2016-01-01

    Full Text Available Nowadays companies look more and more for improving their efficiency to excel in the market. At the same time, the competition has moved from firm level to whole supply chain level. Supply chain are very complex systems and lacks of coordination among their members leads to inefficiency. Supply chain planning task is to improve coordination among supply chain members. Which is the best planning solution to improve efficiency is an open issue. On the other hand, Lean approach is becoming more and more popular among managers. Lean approach is recognize as efficiency engine for production systems, but effects of Lean implementation out of single firm boundaries is not clear. This paper aims at providing a theoretical and practical starting point for Lean implementation in supply chain planning issue. To reach it, a DES simulation model of a three-echelon and multi-product supply chain has been set. Lean management is a very broad topic and this paper focuses on two principles of “pull” and “create the flow”. Kanban system and setup-time and batch-size reductions are implemented in the lean-configured supply chain to apply “pull” and “create the flow” respectively. Lean principles implementations have been analyzed and compared with other supply chain planning policies: EOQ and information sharing (Visibility. Supported by the simulation study, this paper points Lean supply chain planning is a competitive planning policies to increase efficiency.

  10. Benchmarking performance measurement and lean manufacturing in the rough mill

    Science.gov (United States)

    Dan Cumbo; D. Earl Kline; Matthew S. Bumgardner

    2006-01-01

    Lean manufacturing represents a set of tools and a stepwise strategy for achieving smooth, predictable product flow, maximum product flexibility, and minimum system waste. While lean manufacturing principles have been successfully applied to some components of the secondary wood products value stream (e.g., moulding, turning, assembly, and finishing), the rough mill is...

  11. Inspanning om Lean Six Sigma op kaart te zetten beloond

    NARCIS (Netherlands)

    Does, R.J.M.M.

    2008-01-01

    Prof.dr. R.J.M.M. Does is al jarenlang een fervent voorvechter voor het gebruik van statistiek. En meer recent is hij zo’n beetje de belichaming van (Lean) Six Sigma in Europa. Tal van grote organisaties hebben hem te hulp geroepen bij de invoering van (Lean) Six Sigma. Het is dan ook niet meer dan

  12. Lean Six Sigma in het ziekenhuis: De beschikbaarheid van infuuspompen

    NARCIS (Netherlands)

    Does, R.J.M.M.; Kemper, B.P.H.; Koopmans, M.

    2011-01-01

    In het topklinisch ziekenhuis Medisch Spectrum Twente werd in 2008 een Lean Six Sigma-project gestart. Het doel was vermindering van operationele kosten van infuuspompen. Het is een interessant voorbeeld van Lean Six Sigma in de gezondheidszorg, omdat het laat zien dat kostenbesparing niet hoeft te

  13. Lean and the Learning Organization in Higher Education

    Science.gov (United States)

    Francis, David E.

    2014-01-01

    Canadian post-secondary institutions are seeking enhanced efficiencies due to ongoing funding shortfalls and expanding teaching, research, and service mandates. These institutions have considered or enacted Lean methodology based on results reported by public service and healthcare organizations worldwide. Lean requires a high level of…

  14. The productive operating theatre and lean thinking systems.

    Science.gov (United States)

    Kasivisvanathan, R; Chekairi, A

    2014-11-01

    The concept of 'lean thinking' first originated in the manufacturing industry as a means of improving productivity whilst maintaining quality through eliminating wasteful processes. The purpose of this article is to demonstrate how the principles of 'lean thinking' are relevant to healthcare and the operating theatre, with reference to our own institutional experience.

  15. Lean Thinking in Systems with Non-Negligible Process Variability

    DEFF Research Database (Denmark)

    Nielsen, Erland Hejn; Simons, David

    2000-01-01

    Lean Thinking (Womack and Jones) improves quality, cost and delivery through the relentless elimination of the wastes. For example, the exemplar of Lean, the Toyota Production system, focuses on improvement through the continual elimination of seven categorised wastes (Ohno). Time compression (St...

  16. Lean Thinking in systems with non-negligible process variability

    DEFF Research Database (Denmark)

    Nielsen, Erland Hejn; Simons, David

    2000-01-01

    Lean Thinking (Womack and Jones) improves quality, cost and delivery through the relentless elimination of wastes. For example, the exemplar of Lean, the Toyota Production system, focuses on improvement through the continual elimination of seven categorised wastes (Ohno). Time compression (Stalk ...

  17. Model reduction of a lean NOx trap catalyst model

    NARCIS (Netherlands)

    Nauta, K.M.

    2008-01-01

    The desire to increase fuel efficiency and reduce carbon dioxide emissions of vehicles has led to an increased use of vehicles equipped with lean-burn engines, such as diesel and lean-burn gasoline engines. This type of engine uses excess oxygen when compared to the amount required to

  18. Lang vej endnu før bilindustrien er Lean

    DEFF Research Database (Denmark)

    Christiansen, Thomas Bøhm

    2005-01-01

    Anmeldelse og diskussion af bogen "The Second Century: Reconnecting Customer and Value Chain through Build-to-order - Moving beyond Mass and Lean Production in the Auto Industry......Anmeldelse og diskussion af bogen "The Second Century: Reconnecting Customer and Value Chain through Build-to-order - Moving beyond Mass and Lean Production in the Auto Industry...

  19. Logistics services and Lean Six Sigma implementation: a case study

    NARCIS (Netherlands)

    Gutierrez Gutierrez, L.; de Leeuw, S.L.J.M.; Dubbers, R.

    2016-01-01

    Purpose: This paper aims to analyze the application of Lean Six Sigma (LSS) framework for supporting continuous improvement (CI) in logistics services. Both the lean philosophy and the Six Sigma methodology have become two of the most important initiatives for CI in organizations. The combination of

  20. An application of Lean Six Sigma in a hospital

    NARCIS (Netherlands)

    van den Heuvel, J.; Does, R.J.M.M.; de Koning, H.; Anthony, J.; Kumar, M.

    2007-01-01

    Abstract Healthcare today faces major challenges. Patients demand quality of care to be improved continuously. Insurance companies demand the lowest possible prices. Lean Six Sigma is a tool that can help healthcare providers to achieve these at least partly conflicting goals. Lean Six Sigma is an

  1. Agile and lean principles and systems engineering: a synergy?

    CSIR Research Space (South Africa)

    Joseph-Malherbe, SM

    2011-09-01

    Full Text Available not efficient and effective enough to support rapid fielding of products. The objective of this piece of work is multi-fold: (1) to explore and present fundamental Systems Engineering, Agile and Lean principles (2) the evolution or lack of Lean and Agile...

  2. Proprioceptive Actuation Design for Dynamic Legged locomotion

    Science.gov (United States)

    Kim, Sangbae; Wensing, Patrick; Biomimetic Robotics Lab Team

    Designing an actuator system for highly-dynamic legged locomotion exhibited by animals has been one of the grand challenges in robotics research. Conventional actuators designed for manufacturing applications have difficulty satisfying challenging requirements for high-speed locomotion, such as the need for high torque density and the ability to manage dynamic physical interactions. It is critical to introduce a new actuator design paradigm and provide guidelines for its incorporation in future mobile robots for research and industry. To this end, we suggest a paradigm called proprioceptive actuation, which enables highly- dynamic operation in legged machines. Proprioceptive actuation uses collocated force control at the joints to effectively control contact interactions at the feet under dynamic conditions. In the realm of legged machines, this paradigm provides a unique combination of high torque density, high-bandwidth force control, and the ability to mitigate impacts through backdrivability. Results show that the proposed design provides an impact mitigation factor that is comparable to other quadruped designs with series springs to handle impact. The paradigm is shown to enable the MIT Cheetah to manage the application of contact forces during dynamic bounding, with results given down to contact times of 85ms and peak forces over 450N. As a result, the MIT Cheetah achieves high-speed 3D running up to 13mph and jumping over an 18-inch high obstacle. The project is sponsored by DARPA M3 program.

  3. Sleep board review question: restless legs

    Directory of Open Access Journals (Sweden)

    Omobomi O

    2018-02-01

    Full Text Available No abstract available. Article truncated after 150 words. Ms. Jones (not her real name is a 63-year-old woman who states that she gets very fidgety when sitting in a theater, watching a movie or when flying long distances on a plane. She is unable to find words to describe the sensation but she states that moving her legs make them feel better. Lately, she has been getting this feeling almost every night. She reports no leg discomfort in the daytime. She denies muscle cramps her legs. She had some recent investigations done by her primary care physician because of complaints of fatigue. Which of the following will be helpful in the diagnosis and management in this patient? 1. An overnight polysomnogram showing apnea hypopnea index of 1.6 events per hour and no periodic limb movements (PLMs 2. Ferritin level of 18 ng/ml (normal range 20-200 ng/ml 3. Serum Bicarbonate of 29 mEq/L (normal range 23-29 mEq/L 4. Thyroid …

  4. Duplex sonography of the near-surface leg veins

    International Nuclear Information System (INIS)

    Mendoza, E.

    2007-01-01

    The book contains the following contributions: The ultrasonograph, selection of the ultrasonic transducer, anatomy of the near-surface vein system, physiology of the near-surface vein system, varicose status classification, systematics of the duplex sonography of near-surface leg veins, provocational maneuver for the duplex sonographic varicose diagnostics, exploration of vena saphena parva, perforans veins, side branches, phlebitis, sonography for varicose therapy, postsurgical sonography, deep leg veins, examination of near-surface leg veins for the pathology of the deep vein system, differential diagnostic clarification of leg oedema from the phlebologic-lymphological view, diagnostic side features along the near-surface leg veins

  5. Yalın düşünce ve Muhasebe (Lean Thinking and Accounting

    Directory of Open Access Journals (Sweden)

    Baki Rıza BALCI

    2011-01-01

    Full Text Available The aim of this article is to introduce the relationship between Lean Thinking and Accounting. It is explained in detail the kinds of reports generated when Lean Thinking implemented in accounting.It is identified that accounting, which could not keep pace with Lean Transformation and remain traditional, shares the failures of companies, who went Lean. This article emphasize that the companies that want to transform themselves into Lean, have to generate proper reports that suit Lean transformation. The types of reports are explained.Literature was scanned and some sample reports are submitted to the Turkish companies that want to go Lean and successful in their Lean efforts.

  6. Total protein

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/article/003483.htm Total protein To use the sharing features on this page, please enable JavaScript. The total protein test measures the total amount of two classes ...

  7. Lean manufacturing: A better way for enhancement in productivity

    Science.gov (United States)

    Kumar Ahir, Pankaj; Kumar Yadav, Lalit; Singh Chandrawat, Saurabh

    2012-03-01

    Productivity is the impact of peoples working together. Machines are merely an extended way of collective imagination and energy. Lean Manufacturing is the most used method for continues improvement of business. Organization management philosophy focusing on the reduction of wastage to improve overall customer value. "Lean" operating principles began in manufacturing environments and are known by a variety of synonyms; Lean Manufacturing, Lean Production, Toyota Production System, etc. It is commonly believed that Lean started in Japan "The notable activities in keeping the price of Ford products low is the steady restriction of the production cycle. The longer an article is in the process of manufacture and the more it is moved about, the greater is its ultimate cost." "A systematic approach to identifying and eliminating waste through continuous improvement, flowing the product at the pull of the customer in pursuit of perfection."

  8. Is there a lean future for global startups?

    DEFF Research Database (Denmark)

    Tanev, Stoyan

    2017-01-01

    This article integrates insights from the latest research on the lean startup entrepreneurial method, born-global firms, and global startups. It contributes to the clarification of terminology referring to the global aspects of startups, summarizes insights from previous literature focusing on gl......-based global startup research and practice. The analysis should benefit both researchers and practitioners in technology entrepreneurship, international entrepreneurship, and global innovation management.......This article integrates insights from the latest research on the lean startup entrepreneurial method, born-global firms, and global startups. It contributes to the clarification of terminology referring to the global aspects of startups, summarizes insights from previous literature focusing...... on global startups, and further substantiates the articulation of the need for considering the lean global startup as a new type of firm. The main message is that the lessons learned from the emergence of lean startup entrepreneurship offer a basis for promoting a similar lean phase in technology...

  9. Lean principles applied to software development – avoiding waste

    Directory of Open Access Journals (Sweden)

    Ionel NAFTANAILA

    2009-12-01

    Full Text Available Under the current economic conditions many organizations strive to continue the trend towards adopting better software development processes, in order to take advantage of the numerous benefits that these can offer. Those benefits include quicker return on investment, better software quality, and higher customer satisfaction. To date, however, there is little body of research that can guide organizations in adopting modern software development practices, especially when it comes to Lean thinking and principles. To address this situation, the current paper identifies and structures the main wastes (or muda in Lean terms in software development as described by Lean principles, in an attempt to bring into researchers’ and practitioners’ attention Lean Software Development, a modern development methodology based on well-established practices such as Lean Manufacturing or Toyota Production System.

  10. The lean product design and development journey a practical view

    CERN Document Server

    Pessôa, Marcus Vinicius Pereira

    2017-01-01

    This book presents a series of high performance product design (PD) and development best practices that can create or improve product development organization. In contrast to other books that focus only on Toyota or other individual companies applying lean IPD, this book explains the lean philosophy more broadly and includes discussions of systems engineering, design for X (DFX), agile development, integrated product development, and project management. The “Lean Journey” proposed here takes a value-centric approach, where the lean principles are applied to PD to allow the tools and methods selected to emerge from observation of the individual characteristics of each enterprise. This means that understanding lean product development (LPD) is not about knowing which tools are available but knowing how to apply the philosophy. The book comes with an accompanying manual with problems and solutions available on Springer Extras.

  11. LEAN THINKING IN HEALTHCARE: REVIEW OF IMPLEMENTATION RESULTS

    Directory of Open Access Journals (Sweden)

    Marija Kovacevic

    2016-03-01

    Full Text Available For over decade, automotive industry originated lean concept has been successfully implemented in healthcare systems as a management method and philosophy with main focus on elimination of all types of wastes and looses in all tasks and processes so that time, materials, resources and medical procedures could be realized as effectively as it is possible. As main result lean concept implementation ensured to healthcare organizations to focus on their main core function and dedicate more time and efforts to patients without additional costs for them or healthcare system. However, lean implementation in healthcare could be much more difficult than in standard industrial environment and there are significant number of examples of lean in healthcare projects that failed to gain any measurable results and sustainable benefits from it. This paper presents review of some of the most successful implementations of lean tools and principles in healthcare organizations.

  12. Individualisation of Lean Concept in Companies Dealing with Mass Production

    Science.gov (United States)

    Bednár, Roman

    2012-12-01

    The methods of lean manufacturing primarily designed for businesses dealing with serial production, are also used in other types of production. However the concept of lean production was not designed for these types of businesses, they are utilized only partially. Paper focuses on applying methods of lean concept in companies which are dealing with mass production and their options of exchange for other methods in the event of disagreement. Basis of the article is a list of lean methods with its description and its utilization in practice. The questionnaire was utilized to identify information from the practice. Based on this survey were identified the critical methods that are no longer appropriate for companies dealing with mass production. However, there are alternative methods of describing the problem. It is possible to say that companies are trying to get closer to their goal by modification of the basic concepts. And the concept of Lean Enterprise serves as a standard.

  13. The application of lean principles in product development

    DEFF Research Database (Denmark)

    Bjarnø, Ole-Christian

    2007-01-01

    Although Lean Manufacturing has been a megatrend for several years, its principles have not been broadly applied in product development processes. We have therefore found it useful to look into the theories of lean manufacturing and to discuss how and to what extent they could be applied in the p......Although Lean Manufacturing has been a megatrend for several years, its principles have not been broadly applied in product development processes. We have therefore found it useful to look into the theories of lean manufacturing and to discuss how and to what extent they could be applied...... in the product development processes, and this study is compared with industrial practices in several front running companies in Denmark. From this research a suggestion for a framework and a tool-box for lean product development is created and discussed from a HR management, an implementation, an operational...

  14. Lean IT partnering : How partners create value by developing a lean culture for IT supply and management

    NARCIS (Netherlands)

    Zee, van der J.T.M.; Blijleven, V.B; Gong, Y.

    2015-01-01

    Lean, as a philosophy, has been around for quite some time, predominantly in the manufacturing domain. Since the 1990s Lean management provides organizations with a way to achieve superior performance by focusing on customer value, innovation and productivity. In 2011 Steven Bell and Michael Orzen

  15. Age-related differences in lean mass, protein synthesis and skeletal muscle markers of proteolysis after bed rest and exercise rehabilitation

    DEFF Research Database (Denmark)

    Tanner, Ruth E; Brunker, Lucille B; Agergaard, Jakob

    2015-01-01

    during a constant stable isotope infusion in the postabsorptive state and after essential amino acid (EAA) ingestion on three occasions: before (PRE), after bed rest and after rehabilitation. Samples were assessed for protein synthesis, mTORC1 signalling, REDD1/2 expression and molecular markers related...... to muscle proteolysis (MURF1, MAFBX, AMPKα, LC3II/I, Beclin1). We found that leg lean mass and strength decreased in older but not younger adults after bedrest (P protein synthesis increased before bed rest in both age groups...... (P protein synthesis rates and increased MAFBX mRNA, p-AMPKα and the LC3II/I ratio (P

  16. Plasma visfatin level in lean women with PCOS: relation to proinflammatory markers and insulin resistance.

    Science.gov (United States)

    Gen, Ramazan; Akbay, Esen; Muslu, Necati; Sezer, Kerem; Cayan, Filiz

    2009-04-01

    The present study was undertaken to investigate the association between plasma visfatin concentrations and inflammatory markers such as interleukin-6 (IL-6) and high-sensitive C-reactive protein (hsCRP) in company with several metabolic parameters in lean women with polycystic ovary syndrome (PCOS). The study group consisted of 21 lean women with PCOS (BMI 20.74 +/- 1.74 kg/m(2)) and 15 healthy, normally menstruating women (BMI 20.85 +/- 2.08 kg/m(2) control group). PCOS was defined according to the Rotterdam criteria. Visfatin, IL-6, hsCRP, hyperandrogenism markers and metabolic markers were examined in all PCOS and control women. Plasma visfatin level in the PCOS group was higher than that in the control group. Plasma hsCRP and IL-6 levels in PCOS group were similar with the control group. Plasma visfatin levels were positively associated with total cholesterol, high density lipoprotein, hirsutism score, total testosterone and FAI. Plasma visfatin level was negatively associated with SHBG. However, there were no correlation between plasma visfatin level and IL-6 and hsCRP. In multivariate regression analyses, only FAI and high density lipoprotein-cholesterol (HDL-C) showed a significant association with serum visfatin. Our data indicates that plasma visfatin levels are associated with HDL-C and markers of hyperandrogenism, but it is not associated with proinflammatory markers and insulin resistance in lean women with PCOS.

  17. PERBAIKAN SISTEM DIVISI PENGOLAHAN DAN PENGADAAN PERPUSTAKAAN UK. PETRA DENGAN FILOSOFI LEAN SIX SIGMA

    Directory of Open Access Journals (Sweden)

    Jani Rahardjo

    2007-01-01

    Full Text Available The responsibility of Acquisition and Processing Unit in Petra Christian University Library is to handle books purchasing, processing the books, then hand them over to the circulation unit. To improve the unit performance, a new system was proposed using Lean Six Sigma philosophy. We employ the common tools of Six Sigma i.e. DMAIC (Define, Measure, Analyze, Improve, and Control. The results are a new procedure, a better software design, and a better workplace lay out. We believe that the results could reduce the book processing time, eliminate non value added activities, reduce defects, and decrease the total distance taken by books when being processed. Abstract in Bahasa Indonesia : Tanggung jawab divisi Pengadaan dan Pengolahan Perpustakaan U.K. Petra adalah menangani pembelian buku, memprosesnya lalu menyerahkan ke bagian sirkulasi. Untuk meningkatkan performa divisi ini, maka dilakukan perbaikan sistem dengan menggunakan metode Lean Six Sigma dengan salah satu tool yaitu DMAIC (Define, Measure, Analyze, Improve dan Control. Hasil akhir dari metode tersebut adalah prosedur baru, desain software baru, dan tata letak baru yang jika diimplementasikan dapat mengurangi waktu pemrosesan buku, non value added activity, jumlah kecacatan buku, dan jarak total yang ditempuh buku selama pemrosesan. Kata kunci: Lean Six Sigma, Perpustakaan U.K. Petra, Perbaikan Sistem

  18. Lean practices for quality results: a case illustration.

    Science.gov (United States)

    Hwang, Pauline; Hwang, David; Hong, Paul

    2014-01-01

    Increasingly, healthcare providers are implementing lean practices to achieve quality results. Implementing lean healthcare practices is unique compared to manufacturing and other service industries. The purpose of this paper is to present a model that identifies and defines the lean implementation key success factors in healthcare organisations. The model is based on an extant literature review and a case illustration that explores actual lean implementation in a major USA hospital located in a Midwestern city (approximately 300,000 people). An exploratory/descriptive study using observation and follow-up interviews was conducted to identify lean practices in the hospital. Lean practice key drivers include growing elderly populations, rising medical expenses, decreasing insurance coverage and decreasing management support. Effectively implementing lean practices to increase bottom-line results and improve organisational integrity requires sharing goals and processes among healthcare managers and professionals. An illustration explains the model and the study provides a sound foundation for empirical work. Practical implications are included. Lean practices minimise waste and unnecessary hospital stays while simultaneously enhancing customer values and deploying resources in supply systems. Leadership requires clear project targets based on sound front-end planning because initial implementation steps involve uncertainty and ambiguity (i.e. fuzzy front-end planning). Since top management support is crucial for implementing lean practices successfully, a heavyweight manager, who communicates well both with top managers and project team members, is an important success factor when implementing lean practices. Increasingly, green orientation and sustainability initiatives are phrases that replaced lean practices. Effective results; e.g. waste reduction, employee satisfaction and customer values are applicable to bigger competitive challenges arising both in specific

  19. Lean process management implementation through enhanced problem solving capabilities

    Directory of Open Access Journals (Sweden)

    Perumal Puvanasvaran

    2010-12-01

    Full Text Available All Original Equipment Manufacturers (OEM organizations in Aerospace, Automotive and Electronics industries had to upgrade their functions. These organizations including suppliers and solutions providers are duty bound to improve their functions through strategic initiatives. One such initiative is Lean Process Management. Lean Process Management has proven to aid organizations in developing manufacturing and administrative management solutions and make the organization a leaner at the same time a ‘fitter’ one, achieving World Class standards in terms of production, quality, marketing, etc, etc. The issue or problem is, although a number of authors, experts, researchers have discussed the lean process management as part organization centric issues, they failed to provide an effective lean process management system. Besides the need to formulate an effective lean process as suggested by some authors, another important reason suggested is the employee’s development aspect regarding how to unlock the infinite potential of their workforce. This employee’s development is basically the problem solving capabilities of the employees while implementing the Lean through clear cutting protocols or processes of Lean Process Management. The employees need to be developed and equipped to contribute optimally to the process. Because of this scenario, the main objective of this study is to develop an employees development system which the author has acronym or trademark it as People Development System (PDS to enhance problem solving capability among its employees while implementing the lean process management there. Although, the PDS can be implemented throughout the organization, if it is implemented in a particular department in an organization, it will be feasible to study and analyze its effectiveness in-depth. So, this study documents and analyzes the implementation of Lean process in the Kitting Department of the aerospace company, ABC Company

  20. Social Network Analysis on Lean Production and World Class Manufacturing: how are associated in the literature?

    Directory of Open Access Journals (Sweden)

    Gustavo Antiqueira Goes

    2017-06-01

    Full Text Available This paper aims to conduct a Systematic Literature Review (SLR to identify how to configure the publications that relate WCM and Lean Production issues. Therefore, a search on the Brazilian metasearch portal called CAPES Periodicals was conducted focusing on articles of the last five years. They were identified after screening and filtering a total of 42 articles, which were analyzed. The construction of the network analysis has identified that the issues are still in an initial phase of association, with the characteristic part of decentralizes networks, with some points of greatest association. It was also identified that the theme Lean Production has greater representation between the two topics due its higher use by authors.

  1. Lean and global technology start-ups

    DEFF Research Database (Denmark)

    Tanev, Stoyan; Rasmussen, Erik Stavnsager; Zijdemans, Erik

    2015-01-01

    In this paper the authors introduce the concept of Lean Global Start-up (LGS) as a way of emphasizing the impossibility for new technology start-ups to deal separately with business development, innovation and early internationalization. For a newly established technology firm the task of being...... global and innovative at the same time should be seen as one process. The paper has two components – an introductory conceptual part and an empirical part that should be considered as basis for the preliminary validation of the conceptual insights. The research sample includes six firms – three from...... Canada and three from Denmark. The firms have had significant problems with the complexity, uncertainties and risks of being innovative on a global scale. They have however found ways of addressing these problems by a disciplined knowledge sharing and IP protection strategy and the efficient use...

  2. Lean construction management the Toyota way

    CERN Document Server

    Gao, Shang

    2014-01-01

    The book presents a mixed research method adopted to assess and present the Toyota Way practices within construction firms in general and for firms in China specifically. The results of an extensive structured questionnaire survey based on the Toyota Way-styled attributes identified were developed, and data collected from building professionals working in construction firms is presented. The quantitative data presented in the book explains the status quo of the Toyota Way-styled practices implemented in the construction industry, as well as the extent to which these attributes were perceived for lean construction management. The book highlights all the actionable attributes derived from the Toyota Way model appreciated by the building professionals, but alerts the readers that some attributes felled short of implementation. Further findings from in-depth interviews and case studies are also presented in the book to provide to readers an understanding how these Toyota Way practices can be implemented in real-l...

  3. The role of outsourcing in Lean Manufacturing

    DEFF Research Database (Denmark)

    Bjarnø, Ole-Christian

    2003-01-01

    In this article a longitudinal study performed at a medium-sized producer of electronics is reported during which we studied the company’s manufacturing change process. Based on theories of outsourcing, reengineering and explorative case research a series of findings is identified which demonstra......In this article a longitudinal study performed at a medium-sized producer of electronics is reported during which we studied the company’s manufacturing change process. Based on theories of outsourcing, reengineering and explorative case research a series of findings is identified which...... degree of complexity by introducing many new product lines, without phasing out very many of the old products could be changed into a far less complex organisation through reengineering and outsourcing. This again opened up for the application of the tool kit in Lean Manufacturing, and through...

  4. Robust and efficient walking with spring-like legs

    Energy Technology Data Exchange (ETDEWEB)

    Rummel, J; Blum, Y; Seyfarth, A, E-mail: juergen.rummel@uni-jena.d, E-mail: andre.seyfarth@uni-jena.d [Lauflabor Locomotion Laboratory, University of Jena, Dornburger Strasse 23, 07743 Jena (Germany)

    2010-12-15

    The development of bipedal walking robots is inspired by human walking. A way of implementing walking could be performed by mimicking human leg dynamics. A fundamental model, representing human leg dynamics during walking and running, is the bipedal spring-mass model which is the basis for this paper. The aim of this study is the identification of leg parameters leading to a compromise between robustness and energy efficiency in walking. It is found that, compared to asymmetric walking, symmetric walking with flatter angles of attack reveals such a compromise. With increasing leg stiffness, energy efficiency increases continuously. However, robustness is the maximum at moderate leg stiffness and decreases slightly with increasing stiffness. Hence, an adjustable leg compliance would be preferred, which is adaptable to the environment. If the ground is even, a high leg stiffness leads to energy efficient walking. However, if external perturbations are expected, e.g. when the robot walks on uneven terrain, the leg should be softer and the angle of attack flatter. In the case of underactuated robots with constant physical springs, the leg stiffness should be larger than k-tilde = 14 in order to use the most robust gait. Soft legs, however, lack in both robustness and efficiency.

  5. Robust and efficient walking with spring-like legs

    International Nuclear Information System (INIS)

    Rummel, J; Blum, Y; Seyfarth, A

    2010-01-01

    The development of bipedal walking robots is inspired by human walking. A way of implementing walking could be performed by mimicking human leg dynamics. A fundamental model, representing human leg dynamics during walking and running, is the bipedal spring-mass model which is the basis for this paper. The aim of this study is the identification of leg parameters leading to a compromise between robustness and energy efficiency in walking. It is found that, compared to asymmetric walking, symmetric walking with flatter angles of attack reveals such a compromise. With increasing leg stiffness, energy efficiency increases continuously. However, robustness is the maximum at moderate leg stiffness and decreases slightly with increasing stiffness. Hence, an adjustable leg compliance would be preferred, which is adaptable to the environment. If the ground is even, a high leg stiffness leads to energy efficient walking. However, if external perturbations are expected, e.g. when the robot walks on uneven terrain, the leg should be softer and the angle of attack flatter. In the case of underactuated robots with constant physical springs, the leg stiffness should be larger than k-tilde = 14 in order to use the most robust gait. Soft legs, however, lack in both robustness and efficiency.

  6. The challenges of lean manufacturing implementation in kitting assembly

    Science.gov (United States)

    Fansuri, A. F. H.; Rose, A. N. M.; Nik Mohamed, N. M. Z.; Ahmad, H.

    2017-10-01

    Literature studies shows that lean manufacturing goes way back with the original founder Eli Whitney in year 1799. The main purpose of lean manufacturing is to identify and eliminate waste in production. The application of lean manufacturing can be carried out in any industrial processes with regards to the understanding of lean principles, theories and practices. Kitting is one of the important aspects in a successful production. The continuous supply of materials from store to production has to be systematic and able to achieve lean standard for it to be successful. The objective of this paper is to review the implementation of lean manufacturing in kitting assembly. Previous papers show that, the implementation of lean manufacturing in kitting assembly may be beneficial to the organization such as reduce in space occupancy, part shortages, lead time and manpower. Based on previous research, some industries may tend to change between kitting and line stocking which are due to lack of understanding when implementing kitting and causes longer lead time and materials overflow in store. With a proper understanding on what to kit, where to kit, how to kit, why to kit and who kits the material with a standardised process flow may ensure the success of kitting.

  7. Lean implementation strategies: how are the Toyota way principles addressed?

    Directory of Open Access Journals (Sweden)

    Coetzee, Rojanette

    2016-11-01

    Full Text Available Lean manufacturing is widely considered to be a proven organisational improvement philosophy, yet the success rate of lean implementation in industry remains relatively low. Neglect of the human aspect of lean manufacturing is often cited as the leading reason for this, despite the emphasis so clearly placed upon this aspect by the creators of the lean philosophy. This article reviews the extent to which the human dimensions of the lean philosophy, as described in the Toyota Way management principles, have been incorporated in lean implementation strategies. It is found that few of the principles feature prominently in these strategies. Notably absent are those linked to the ‘respect for people’ pillar , which forms half of the T oyota Way’s foundation. This conclusion indicates that the adoption of the lean philosophy runs contrary to the oft-repeated message from its creators that no tenet of the philosophy should be favoured at the expense of another. This may provide valuable insight into the reasons for the high implementation failure rate.

  8. Medical and scientific writing: Time to go lean and mean

    Directory of Open Access Journals (Sweden)

    Payal Bhardwaj

    2017-01-01

    Full Text Available The Lean Six Sigma methodology for process improvements and driving efficiency is old, but lean writing was adopted late by the pharmaceutical world in terms of size of the documents. The documents were lean earlier, and then became voluminous, and now we are about to complete a full circle in this regard, i.e., coming back to the lean documents again using e-formats and hyperlinking. Furthermore, writing has become more and more precise over time. The need for this lean and mean medical and scientific writing arose from voluminous research globally, both industry and academia which are abuzz with skyrocketing regulatory and scientific submission volumes. The quantum of literature is so much that reviewers or information seekers firmly believe that going through even selected and relevant literature has become highly challenging. Considering this, there has been much insistence on downsizing the medical writing documents, which could be tempting enough to be leveraged for scientific publications as well. Here, we present the need for lean and mean medical writing, discuss this concept in relation to the pharmaceutical industry, and how to apply this to key documents. Furthermore, presented is the proposed algorithm for lean and mean clinical study reports and manuscripts. These thoughts are aligned to the recently established concept of data transparency, and can be easily achieved by web links between the protocols and clinical trial results disclosed publicly, and the corresponding manuscripts.

  9. Improvement of emergency department patient flow using lean thinking.

    Science.gov (United States)

    Sánchez, Miquel; Suárez, Montse; Asenjo, María; Bragulat, Ernest

    2018-05-01

    To apply lean thinking in triage acuity level-3 patients in order to improve emergency department (ED) throughtput and waiting time. A prospective interventional study. An ED of a tertiary care hospital. Triage acuity level-3 patients. To apply lean techniques such as value stream mapping, workplace organization, reduction of wastes and standardization by the frontline staff. Two periods were compared: (i) pre-lean: April-September, 2015; and (ii) post-lean: April-September, 2016. Variables included: median process time (time from beginning of nurse preparation to the end of nurse finalization after doctor disposition) of both discharged and transferred to observation patients; median length of stay; median waiting time; left without being seen, 72-h revisit and mortality rates, and daily number of visits. There was no additional staff or bed after lean implementation. Despite an increment in the daily number of visits (+8.3%, P lean implementation. No significant differences were registered in left without being seen rate (5.23% vs 4.95%), 72-h revisit rate (3.41% vs 3.93%), and mortality rate (0.23% vs 0.15%). Lean thinking is a methodology that can improve triage acuity level-3 patient flow in the ED, resulting in better throughput along with reduced waiting time.

  10. Lean og professionel autonomi på hospitaler

    DEFF Research Database (Denmark)

    Hasle, Peter

    2014-01-01

    Hospitaler står overfor store udfordringer fra voksende krav fra både patienter og samfund samtidig med begrænsede budgetter og stadig flere medicinske muligheder. Hospitalsledelserne anvender lean som en af de væsentligste metoder til at løse disse udfordringer. Lean stammer imidlertid fra...... industrien, og det er spørgsmålet, hvordan lean bliver tilpasset i til en hospitalssammenhæng, og hvilke konsekvenser lean får for medarbejderne. Dette spørgsmål er undersøgt i forbindelse med introduktion af lean i en kræftafdeling på et universitetshospital. Det viste sig vanskeligere end forventet...... at implementere lean, og konsekvenserne for henholdsvis laboranter og sygeplejersker viste sig at være meget forskelligartede. Laboranterne oplevede et forbedret arbejdsmiljø, mens det modsatte var tilfældet for sygeplejerskerne. En mulig forklaring er, at lean øgede kontrollen over eget arbejde for laboranterne...

  11. Quality of life psychosocial characteristics in Greek patients with leg ulcers: a case control study.

    Science.gov (United States)

    Kouris, Anargyros; Armyra, Kalliopi; Christodoulou, Christos; Sgontzou, Themis; Karypidis, Dimitrios; Kontochristopoulos, George; Liordou, Fotini; Zakopoulou, Nikoletta; Zouridaki, Eftychia

    2016-10-01

    Chronic leg ulcers are a public health problem that can have a significant impact on the patient's physical, socioeconomic and psychological status. The aim of this study is to evaluate the quality of life, anxiety and depression, self-esteem and loneliness in patients suffering from leg ulcers. A total of 102 patients were enrolled in the study. The quality of life, anxiety and depression, self-esteem and loneliness of the patient were assessed using the Dermatology Life Quality Index (DLQI), Hospital Anxiety and Depression Scale (HADS), Rosenberg's Self-esteem Scale (RSES) and the UCLA Loneliness Scale (UCLA-Version 3), respectively. The mean DLQI score was 13·38 ± 2·59, suggesting a serious effect on the quality of life of patients. Those with leg ulcers had statistically significant higher scores according to the HADS-total scale (P = 0·031) and HADS-anxiety subscale (P = 0·015) compared with healthy volunteers. Moreover, a statistically significant difference was found between the two groups concerning the UCLA-scale (P = 0·029). Female patients presented with a higher score of anxiety (P = 0·027) and social isolation (P = 0·048), and worse quality of life (P = 0·018) than male patients. A severe quality of life impairment was documented, reflecting a significant psychosocial impact on patients with leg ulcers. © 2014 The Authors. International Wound Journal © 2014 Medicalhelplines.com Inc and John Wiley & Sons Ltd.

  12. Sleep disturbances in restless legs syndrome

    Directory of Open Access Journals (Sweden)

    Jović Jasmina

    2018-01-01

    Full Text Available Background/Aim. Resteless legs syndrome (RLS is chronical neurological disorder characterized by urge to move legs that is usually accompanied by unpleasant sensations in the lower extremities. Sleep disturbance is one of the main accompanying symptoms of RLS which exists in approximatelly 90% of patients. Impairment of sleep is related to daily sleepiness, depressive and anxiety disorders. The aim of this study was to detect frequency and characterisitics of sleep-related symptoms in patients with RLS, and its impairrment to daily sleepiness, fatique, anxiety and depression. Methods. We have examinated 94 patients with RLS. The diagnose of RLS was based on questionnaire with 4 specific questions according to the International Restless Legs Syndrome Study Group (IRLSSG criteria updated in 2003. Severity of symptoms was astimated with IRLSSG Rating Scale, depression and anxiety with Hamilton Depression Rating Scale (HDRS and Hamilton Anxiety Rating Scale (HARS and sleepiness with Epworth Sleepiness scale (ESS. We astimated sleep characteristics and disturbances with specific questionnaire. Results. In our study 79.9% of patients had sleep-related symptoms. Average sleep duration was 6.50 ± 1.42 hours, with average frequency of awakening 2.34 ± 1.69 times per night. Average ESS score was 5.12 ± 4.08 (0–17. Patients with more severe symptoms had higher degree of sleepiness (p = 0.005. Patients with higher symptoms frequency, significantly more often had sleep disturbance (p = 0.016, tiredness and daily sleepiness (p = 0.001. Daily sleepiness (ESS also significantly correlates with depression (p < 0.05 and anxiety (p = 0.012. Conclusion. Our results confirm that sleep disturbances are one of the key accompanying symptoms of RLS which cause daily sleepiness, tiredness, depression and anxiety. Therefore, their early recognition and appropriate treatment must be a priority in RLS patients.

  13. Comparison of thermoregulatory responses to heat between Malaysian and Japanese males during leg immersion

    Science.gov (United States)

    Wijayanto, Titis; Wakabayashi, Hitoshi; Lee, Joo-Young; Hashiguchi, Nobuko; Saat, Mohamed; Tochihara, Yutaka

    2011-07-01

    The objective of this study was to investigate thermoregulatory responses to heat in tropical (Malaysian) and temperate (Japanese) natives, during 60 min of passive heating. Ten Japanese (mean ages: 20.8 ± 0.9 years) and ten Malaysian males (mean ages: 22.3 ± 1.6 years) with matched morphological characteristics and physical fitness participated in this study. Passive heating was induced through leg immersion in hot water (42°C) for 60 min under conditions of 28°C air temperature and 50% RH. Local sweat rate on the forehead and thigh were significantly lower in Malaysians during leg immersion, but no significant differences in total sweat rate were observed between Malaysians (86.3 ± 11.8 g m-2 h-1) and Japanese (83.2 ± 6.4 g m-2 h-1) after leg immersion. In addition, Malaysians displayed a smaller rise in rectal temperature (0.3 ± 0.1°C) than Japanese (0.7 ± 0.1°C) during leg immersion, with a greater increase in hand skin temperature. Skin blood flow was significantly lower on the forehead and forearm in Malaysians during leg immersion. No significant different in mean skin temperature during leg immersion was observed between the two groups. These findings indicated that regional differences in body sweating distribution might exist between Malaysians and Japanese during heat exposure, with more uniform distribution of local sweat rate over the whole body among tropical Malaysians. Altogether, Malaysians appear to display enhanced efficiency of thermal sweating and thermoregulatory responses in dissipating heat loss during heat loading. Thermoregulatory differences between tropical and temperate natives in this study can be interpreted as a result of heat adaptations to physiological function.

  14. Painful legs and moving toes syndrome

    Directory of Open Access Journals (Sweden)

    Qiu-ying Ma

    2015-10-01

    Full Text Available Painful legs and moving toes syndrome (PLMT is a rare movement disorder with low diagnostic rate, which is characterized by lower limb pain with involuntary movements of feet or toes. Etiology and pathogenesis of this disease is still unclear. Patients have different clinical manifestations, so the diagnosis is difficult. Treatment methods for PLMT are numerous, but so far the treatment of this disease is still a major challenge for clinicians. Further research is still needed to guide clinical work. DOI: 10.3969/j.issn.1672-6731.2015.10.013

  15. Optimal powering schemes for legged robotics

    Science.gov (United States)

    Muench, Paul; Bednarz, David; Czerniak, Gregory P.; Cheok, Ka C.

    2010-04-01

    Legged Robots have tremendous mobility, but they can also be very inefficient. These inefficiencies can be due to suboptimal control schemes, among other things. If your goal is to get from point A to point B in the least amount of time, your control scheme will be different from if your goal is to get there using the least amount of energy. In this paper, we seek a balance between these extremes by looking at both efficiency and speed. We model a walking robot as a rimless wheel, and, using Pontryagin's Maximum Principle (PMP), we find an "on-off" control for the model, and describe the switching curve between these control extremes.

  16. Asymptomatic petechial eruption on the lower legs.

    Science.gov (United States)

    Mendese, Gary; Grande, Donald

    2013-09-01

    The authors report an unusual case of Rocky Mountain spotted fever that presented as an asymptomatic petechial eruption on the lower legs. Rocky Mountain spotted fever is rare in New England and, as such, is typically not on the differential diagnosis when presented with such patients. What began as an asymptomatic eruption progressed to more classic signs of the disease, including a positive Rocky Mountain spotted fever titer. The patient was successfully treated with doxycydine and within a short period of time, was completely back at baseline.

  17. Acceptance of lean redesigns in primary care: A contextual analysis.

    Science.gov (United States)

    Hung, Dorothy; Gray, Caroline; Martinez, Meghan; Schmittdiel, Julie; Harrison, Michael I

    Lean is a leading change strategy used in health care to achieve short-term efficiency and quality improvement while promising longer-term system transformation. Most research examines Lean intervention to address isolated problems, rather than to achieve broader systemic changes to care delivery. Moreover, no studies examine contextual influences on system-wide Lean implementation efforts in primary care. The aim of this study was to identify contextual factors most critical to implementing and scaling Lean redesigns across all primary care clinics in a large, ambulatory care delivery system. Over 100 interviews and focus groups were conducted with frontline physicians, clinical staff, and operational leaders. Data analysis was guided by a modified Consolidated Framework for Implementation Research (CFIR), a popular implementation science framework. On the basis of expert recommendations, the modified framework targets factors influencing the implementation of process redesigns. This modified framework, the CFIR-PR, informed our identification of contextual factors that most impacted Lean acceptance among frontline physicians and staff. Several domains identified by the CFIR-PR were critical to acceptance of Lean redesigns. Regarding the implementation process acceptance was influenced by time and intensity of exposure to changes, "top-down" versus "bottom-up" implementation styles, and degrees of employee engagement in developing new workflows. Important factors in the inner setting were the clinic's culture and style of leadership, along with availability of information about Lean's effectiveness. Last, implementation efforts were impacted by individual and team characteristics regarding changed work roles and related issues of professional identity, authority, and autonomy. This study underscores the need for change leaders to consider the contextual factors that surround efforts to implement Lean in primary care. As Lean redesigns are scaled across a system

  18. Intrinsic factors rather than vitamin D deficiency are related to insulin resistance in lean women with polycystic ovary syndrome.

    Science.gov (United States)

    Sahin, S; Eroglu, M; Selcuk, S; Turkgeldi, L; Kozali, S; Davutoglu, S; Muhcu, M

    2014-10-01

    To investigate the correlation between insulin resistance (IR) and serum 25-OH-Vit D concentrations and hormonal parameters in lean women with polycystic ovary syndrome (PCOS). 50 lean women with PCOS and 40 body mass index (BMI) matched controls were compared in terms of fasting insulin and glucose, homeostatic model assessment insulin resistance (HOMA-IR), 25-OH-Vit D, high sensitivity C-reactive protein (hs-CRP), luteinizing hormone (LH), follicle-stimulating hormone (FSH), total testosterone, dehydroepiandrosterone sulfate (DHEA-S), total cholesterol, high density lipoprotein (HDL), low density lipoprotein (LDL), triglycerides and Ferriman-Gallway (FG) scores. Correlation analyses were performed between HOMA-IR and metabolic and endocrine parameters. 30% of patients with PCOS demonstrated IR. Levels of 25-OH-Vit D, hsCRP, cholesterol, HDL, LDL, triglyceride and fasting glucose did not differ between the study and control groups. Fasting insulin, HOMA-IR, LH, total testosterone, and DHEA-S levels were higher in PCOS group. HOMA-IR was found to correlate with hs-CRP and total testosterone but not with 25-OH-Vit D levels in lean patients with PCOS. An association between 25-OH-Vit D levels and IR is not evident in lean women with PCOS. hs-CRP levels do not indicate to an increased risk of cardiovascular disease in this population of patients. Because a strong association between hyperinsulinemia and hyperandrogenism exists in lean women with PCOS, it is advisable for this population of patients to be screened for metabolic disturbances, especially in whom chronic anovulation and hyperandrogenism are observed together.

  19. Lean production teams and health in garment manufacture.

    Science.gov (United States)

    Jackson, P R; Mullarkey, S

    2000-04-01

    The impact of lean production on psychological health was assessed by comparing lean production teams in garment manufacture with a traditional system for making similar garments. Work design characteristics were examined as mediators of the impact of work organization on health. Findings indicate both positive and negative direct effects of teamworking on aspects of autonomy, work demands, and social climate. In turn, both positive and negative direct effects of work design on psychological health were found, which combine to give no overall difference between the groups. This study suggests that the balance between positive and negative effects of lean production teamworking depends on management choices in the form of work design.

  20. Implementation analysis of lean enablers for managing engineering programs

    DEFF Research Database (Denmark)

    von Arnim, Joachim; Oehmen, Josef; Rebentisch, Eric

    2014-01-01

    This paper presents research to improve the applicability of the Lean Enablers and consists of two parts. The first is a case study of a very successful project management maturity improvement initiative at Siemens Industry Sector’s Industry Automation division in the US. It views the initiative...... from the perspective of the Lean Enablers [Oehmen 2012] and is based on information from [Sopko 2012a], [Sopko 2012b], [Sopko 2010], [Sopko 2009], interviews, internal documentation, and the used MSP program management methodology [UK 2011]. The analysis of Lean Enablers incorporated in the MSP...

  1. Lean Manufacturing Implementation: an Approach to Reduce Production Cost

    Directory of Open Access Journals (Sweden)

    Iraswari

    2012-04-01

    Full Text Available Abstract: Lean Manufacturing Implementation: An Approach To Reduce Production Cost. Opportunities to improve production processes and reduce production cost through the implementation of lean manufacturing in small medium garment manufacturing are presented in this research. This research shows that there is a possibility of decrease in production cost and increase in return on sales. Lean manufacturing implementation can eliminate waste in the production process. This is a set of techniques for identification and elimination of waste gathered from The Ford Production, Statistical Process Control and other techniques. Improvement of quality could be carried out while time and cost of production are being reduced.

  2. Lean Management as an Instrument of Sustainable Development of Enterprises

    Science.gov (United States)

    Sikora, Marcin; Kwiatkowski, Maciej; Prosół, Hanna; Nowicka, Daria; Lorenc, Karolina; Pham, Laurena

    2016-03-01

    The aim of the paper is to present the philosophy of Lean Management as an instrument of improving sustainable management of enterprises. The article presents the origins, characteristics of the broadly understood concept of Lean Management and describes the idea of Sustainable Development (SD). At the same time implications for the application and development of the instruments which operationalize the assumptions of SD at the level of enterprises are discussed. The paper specifies those areas of functioning of contemporary companies in which Lean Management can be implemented and compares them with the features of traditional management in particular subjects.

  3. Total algorithms

    NARCIS (Netherlands)

    Tel, G.

    We define the notion of total algorithms for networks of processes. A total algorithm enforces that a "decision" is taken by a subset of the processes, and that participation of all processes is required to reach this decision. Total algorithms are an important building block in the design of

  4. Postprandial response of ghrelin and PYY and indices of low-grade chronic inflammation in lean young women with polycystic ovary syndrome.

    Science.gov (United States)

    Zwirska-Korczala, K; Sodowski, K; Konturek, S J; Kuka, D; Kukla, M; Brzozowski, T; Cnota, W; Woźniak-Grygiel, E; Jaworek, J; Bułdak, R; Rybus-Kalinowska, B; Fryczowski, M

    2008-08-01

    The aim of the study were to answer the question 1.) Whether circulating pro-inflammatory markers of endothelial dysfunction and due to chronic low-grade inflammation of obesity, are altered in untreated lean, young relatively healthy polycystic ovary syndrome (PCOS) patients in comparison with healthy controls; 2.) Whether postprandial plasma concentration pattern of ghrelin and PYY can be predictable as risk factors for atherosclerosis and depend of obesity. Forty young women with PCOS were divided in two groups: 19 lean and 21 obese. The control group included 20 lean, healthy volunteers. Plasma total and active ghrelin, total PYY and PYY(3-36), serum adiponectin and insulin were measured using RIA technique, serum sCD40L, visfatin, sP-, sE-selectins, resistin by EIA. Composition of test meal was: 527 kcal total and consisted of 24.1% fat, 54.4% carbohydrate and 21.5% protein. Total and active ghrelin and total PYY were significantly lower in obese PCOS women, whereas active ghrelin was also significantly lower in lean PCOS women compared to controls. Postprandial plasma total ghrelin levels decrease were blunted in lean and obese compared to controls (12.8 % and 18.2% vs 28.2 %). Postprandial plasma active ghrelin decreased in lean and obese PCOS groups (49.9 % and 44.1 %) and controls (63.8 %). PCOS subjects exhibited smaller rises in postprandial levels of total PYY. Postprandial plasma PYY(3-36) levels increased in obese PCOS women (30.9 %) and controls (41%), whereas lean PCOS women exhibited blunted increase (11.5%). sCD40L levels increased, whereas adiponectin decreased in PCOS groups independently, whereas rise in visfatin, sE- and sP-selectin and the fall in adiponectin was associated with obesity. sP- and sE -selectins correlated positively with obesity. In summary, our study provides the first evidence that lean untreated young PCOS women contribute to the so called "pancreatic islet adaptation to insulin resistance" because of ghrelin and PYY

  5. Are the hamstrings from the drive leg or landing leg more active in baseball pitchers? An electromyographic study.

    Science.gov (United States)

    Erickson, Brandon J; Zaferiou, Antonia; Chalmers, Peter N; Ruby, Deana; Malloy, Phillip; Luchetti, Timothy J; Verma, Nikhil N; Romeo, Anthony A

    2017-11-01

    Ulnar collateral ligament reconstruction (UCLR) has become a common procedure among baseball players of all levels. There are several graft choices in performing UCLR, one of which is a hamstring (gracilis or semitendinosus) autograft. It is unclear whether the hamstring muscle from a pitcher's drive leg (ipsilateral side of the UCLR) or landing leg (contralateral side of the UCLR) is more active during the pitching motion. We hypothesized that the landing leg semitendinosus will be more electromyographically active than the drive leg. Healthy, elite male pitchers aged 16-21 years were recruited. Sixteen pitchers (average age, 17.6 ± 1.6 years; 67% threw right handed) underwent electromyographic analysis. Pitchers threw 5 fastballs at 100% effort from the wind-up with electromyographic analysis of every pitch. Activation of the semitendinosus and biceps femoris in both legs was compared within pitchers and between pitchers. Hamstring activity was higher in the drive leg than in the landing leg during each phase and in sum, although the difference was significant only during the double support phase (P = .021). On within-pitcher analysis, 10 of 16 pitchers had significantly more sum hamstring activity in the drive leg than in the landing leg, while only 4 of 16 had more activity in the landing leg (P = .043). During the baseball pitch, muscle activity of the semitendinosus was higher in the drive leg than in the landing leg in most pitchers. Surgeons performing UCLR using hamstring autograft should consider harvesting the graft from the pitcher's landing leg to minimize disruption to the athlete's pitching motion. Copyright © 2017 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

  6. An Ultralightweight and Living Legged Robot.

    Science.gov (United States)

    Vo Doan, Tat Thang; Tan, Melvin Y W; Bui, Xuan Hien; Sato, Hirotaka

    2018-02-01

    In this study, we describe the most ultralightweight living legged robot to date that makes it a strong candidate for a search and rescue mission. The robot is a living beetle with a wireless electronic backpack stimulator mounted on its thorax. Inheriting from the living insect, the robot employs a compliant body made of soft actuators, rigid exoskeletons, and flexure hinges. Such structure would allow the robot to easily adapt to any complex terrain due to the benefit of soft interface, self-balance, and self-adaptation of the insect without any complex controller. The antenna stimulation enables the robot to perform not only left/right turning but also backward walking and even cessation of walking. We were also able to grade the turning and backward walking speeds by changing the stimulation frequency. The power required to drive the robot is low as the power consumption of the antenna stimulation is in the order of hundreds of microwatts. In contrast to the traditional legged robots, this robot is of low cost, easy to construct, simple to control, and has ultralow power consumption.

  7. Restless Legs Syndrome with Current Diagnostic Criteria

    Directory of Open Access Journals (Sweden)

    Meral Bilgilisoy Filiz

    2015-08-01

    Full Text Available Restless legs syndrome (RLS, also known as Willis-Ekbom disease, is a chronic movement disorder, characterized by an urge to move legs usually accompanied by uncomfortable sensations and sleep disorders. The prevalence of the syndrome ranges from 1% to 15% in the general population, and about 2% during childhood. RLS is the most common movement disorder in pregnancy. However RLS still remains underdiagnosed probably due to lack of accurate information about the disease. Family history is positive in 50-70% of the primary RLS patients. The secondary form of the syndrome is associated with iron deficiency, renal failure, pregnancy, diabetes mellitus and many rheumatologic disorders. Secondary forms generally manifest at older ages and have a rapid progression with a poorer prognosis. The pathophysiology of RLS is focused on the dopaminergic system, reduced central nervous system iron levels and genetic linkages. Diagnosis is based on clinical features and the diagnostic criteria suggested by International RLS Study Group. Secondary causes must be carefully investigated before the treatment. In mild forms of the disease non-pharmacologic therapies might be useful, while in moderate or severe forms of the disease generally pharmacologic therapies such as dopamine agonists, anticonvulsants, opioids and benzodiazepines are required. (Turkish Journal of Osteoporosis 2015;21: 87-95

  8. Bioinspired template-based control of legged locomotion

    OpenAIRE

    Ahmad Sharbafi, Maziar

    2018-01-01

    cient and robust locomotion is a crucial condition for the more extensive use of legged robots in real world applications. In that respect, robots can learn from animals, if the principles underlying locomotion in biological legged systems can be transferred to their artificial counterparts. However, legged locomotion in biological systems is a complex and not fully understood problem. A great progress to simplify understanding locomotion dynamics and control was made by introducing simple mo...

  9. Frequency and predisposing factors of leg cramps in pregnancy: a prospective clinical trial

    Directory of Open Access Journals (Sweden)

    Sohrabvand F

    2009-12-01

    Full Text Available "n Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin:0in; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:Arial; mso-bidi-theme-font:minor-bidi;} Background: Leg cramp is the painful contraction of the muscles that often occurs at night. Pregnancy is the most common cause of muscle cramps that usually occur in the second trimester of pregnancy. Although the reasons of the spasms had not been determined, the imbalance between the absorption and elimination of serum electrolytes such as Ca, Mg and potassium and also insufficiency of some vitamins and probably the changes in activities of motor neurons of spinal cord, can be the source of these problems. The aim of this study was the evaluation of frequency and predisposing factors of leg cramps."n"nMethods: In a cross sectional descriptive analytic study, a group of 400 women in the third trimester of pregnancy were asked to record the symptoms of leg cramp. Their education level and job recorded and their total serum level of Ca and Mg was measured in the first visit. Exclusion criteria included systemic medical conditions such as thyroid disease, diabetes, osteoporosis and prenatal disorders such as gestational diabetes mellitus and preeclampsia and patient cooperation."n"nResults: In our study the prevalence of leg cramp was 54.75%. There was a statistically significant relationship between leg cramp and serum

  10. Lean Manufacturing e Lean Accounting Cost: um enfoque no real desempenho em empresas de capital aberto na BOVESPA

    OpenAIRE

    Teixeira, Hipólito Francisco

    2016-01-01

    Esta pesquisa teve por alvo o campo de estudo denominado Lean Accounting (LA) aplicado as empresas que adotam os procedimentos de Produção Enxuta (PE). As empresas neste ambiente competitivo e muito imprevisivel têm procuradoadotar decisões e procedimentos voltadosa valorizar sua própria continuidade e diferencial para se expor perante ao mercado. Neste sentido novas tecnologias de produção e controles contábeis são necessários. Lean Accounting (LA) ou Contabilidade Lean ou “enxuta” pode s...

  11. Protection against high intravascular pressure in giraffe legs

    DEFF Research Database (Denmark)

    Petersen, Karin K; Hørlyck, Arne; Østergaard, Kristine Hovkjær

    2013-01-01

    The high blood pressure in giraffe leg arteries renders giraffes vulnerable to edema. We investigated in 11 giraffes whether large and small arteries in the legs and the tight fascia protect leg capillaries. Ultrasound imaging of foreleg arteries in anesthetized giraffes and ex vivo examination....... All three findings can contribute to protection of the capillaries in giraffe legs from a high arterial pressure....... revealed abrupt thickening of the arterial wall and a reduction of its internal diameter just below the elbow. At and distal to this narrowing, the artery constricted spontaneously and in response to norepinephrine and intravascular pressure recordings revealed a dynamic, viscous pressure drop along...

  12. APPLICATION OF LEAN CONCEPT TO SHIP SAFETY INSPECTION: A CASE STUDY AT PORT OF SURABAYA

    Directory of Open Access Journals (Sweden)

    F. Cahyadi

    2012-06-01

    Full Text Available The Lean Concept is a mindset widely used in various industries seeking for efficiency and effectiveness through improvement of process flow and elimination of waste. This research applies lean thinking to ship safety inspection at Port of Surabaya to investigate the existing procedure and to identify the wastes and non-value-add (NVA activity. It used a combination of literature review, examination on the data of 520 inspections that have been carried out to 201 ships in the last two years (2009 - 2011, investigation on related regulations and guidelines, observation on the actual conduct of inspection, and interview with 59 marine inspectors and ship officers. Analysis is conducted using Value Stream Mapping (VSM. It is found that the existing procedure lacks significant impact in terms of imposing a reduction in the total number of detected deficiency between the earlier and subsequent inspections. Only 37% of the ships experience a reduction, indicating that the performance of inspection is currently at the level of 37 on a 100-point scale. It was mainly due to severe violation of the regulations, which is demonstrated by the issuance of ship certificate regardless of corrective action undertaken relating to the detected deficiency. Keywords: Lean concept, ship safety inspection, value stream mapping.

  13. Lean Methodology Reduces Inappropriate Use of Antipsychotics for Agitation at a Psychiatric Hospital.

    Science.gov (United States)

    Goga, Joshana K; Depaolo, Antonio; Khushalani, Sunil; Walters, J Ken; Roca, Robert; Zisselman, Marc; Borleis, Christopher

    2017-01-01

    To Evaluate the Effects of Applying Lean Methodology-Improving Quality Increasing Efficiency by Eliminating Waste and Reducing Costs-An Approach To Decrease the Prescribing Frequency of Antipsychotics for The Indication of Agitation. Historically Controlled Study. Bheppard Pratt Health System is the Largest Private Provider of Psychiatric Care in Maryland With a Total Bed Capacity of 300. There Were 4 337 Patient Days From November 1 2012 to October 31 2013 on the Dementia Unit. All Patients Admitted on the Dementia Unit Were 65 Years of Age and Older with a Primary Diagnosis of Dementia. our Multidisciplinary Team Used Lean Methodology to Identify the Root Causes and Interventions Necessary to Reduce Inappropriate Antipsychotic Use. The Primary Outcome Was Rate of Inappropriately Indicating Agitation as the Rationale When Prescribing Antipsychotic Medications. There Was a 90% (P Agitation. The Lean Methodology Interventions Led To A 90% (P Agitation and a 10% Rate Reduction in Overall Antipsychotic Prescribing. Key Words: Agitation Alzheimer's Antipsychotics Behavioral and Psychological Symptoms of Dementia Centers For Medicare & Medicaid Services Dementia Root-cause Analysis. BPSD = Behavioral and Psychological Symptoms of Dementia CATIE-AD = Clinical Antipsychotic Trials of Intervention Effectiveness in Alzheimer's Disease EMR = Electronic Medical Records GAO = Government Accountability Office GNCIS = Geriatric Neuropsychiatric Clinical Indicator Scale.

  14. Increasing Production and Eliminating Waste through Lean Tools and Techniques for Halal Food Companies

    Directory of Open Access Journals (Sweden)

    Malihe Manzouri

    2014-12-01

    Full Text Available Major businesses around the world have been trying to reduce the total cost and wastes across their supply chain to remain competitive in the expanding global market. Hence, a collection of reliable tools and techniques are vital for decreasing costs and wastes and for providing effective services for customer demands. Given that lean concept attempts to decrease costs and wastes, this study aims to identify the effective lean tools required for eliminating wastes in the supply chain. Because of the large number of consumers and the global market of Halal products, this study focuses on Halal food supply chains. Out of the questionnaires distributed to 300 Halal food firms in Malaysia, only 61 usable replies were obtained. The results showed that demand collaboration, continuous improvement, and inventory management practices are the most important tools in Lean Supply Chain (LSC implementation. In addition, the results indicated that only a small percentage of Halal food companies are implementing LSC. Malaysia is an important Halal food producer in the word, but has low level of LSC implementation among its Halal food producers. LSC is a new concept that needs more effort to be understood and implemented.

  15. Effect of engine-based thermal aging on surface morphology and performance of Lean NOx Traps

    International Nuclear Information System (INIS)

    Toops, Todd J.; Bunting, Bruce G.; Nguyen, Ke; Gopinath, Ajit

    2007-01-01

    A small single-cylinder diesel engine is used to thermally age model (Pt + Rh/Ba/γ-Al 2 O 3 ) lean NO x traps (LNTs) under lean/rich cycling at target temperatures of 600 C, 700 C, and 800 C. During an aging cycle, fuel is injected into the exhaust to achieve reproducible exotherms under lean and rich conditions with the average temperature approximating the target temperature. Aging is performed until the cycle-average NO x conversion measured at 400 C is approximately constant. Engine-based NO x conversion decreased by 42% after 60 cycles at 600 C, 36% after 76 cycles at 700 C and 57% after 46 cycles at 800 C. The catalyst samples were removed and characterized by XRD and using a microreactor that allowed controlled measurements of surface area, precious metal size, NO x storage, and reaction rates. Three aging mechanisms responsible for the deactivation of LNTs have been identified: (1) loss of dispersion of the precious metals, (2) phase transitions in the washcoat materials, and (3) loss of surface area of the storage component and support. These three mechanisms are accelerated when the aging temperature exceeds 850 C - the γ to (delta) transition temperature of Al 2 O 3 . Normalization of rates of NO reacted at 400 C to total surface area demonstrates the biggest impact on performance stems from surface area losses rather than from precious metal sintering. (author)

  16. Reliability of Single-Leg Balance and Landing Tests in Rugby Union; Prospect of Using Postural Control to Monitor Fatigue.

    Science.gov (United States)

    Troester, Jordan C; Jasmin, Jason G; Duffield, Rob

    2018-06-01

    The present study examined the inter-trial (within test) and inter-test (between test) reliability of single-leg balance and single-leg landing measures performed on a force plate in professional rugby union players using commercially available software (SpartaMARS, Menlo Park, USA). Twenty-four players undertook test - re-test measures on two occasions (7 days apart) on the first training day of two respective pre-season weeks following 48h rest and similar weekly training loads. Two 20s single-leg balance trials were performed on a force plate with eyes closed. Three single-leg landing trials were performed by jumping off two feet and landing on one foot in the middle of a force plate 1m from the starting position. Single-leg balance results demonstrated acceptable inter-trial reliability (ICC = 0.60-0.81, CV = 11-13%) for sway velocity, anterior-posterior sway velocity, and mediolateral sway velocity variables. Acceptable inter-test reliability (ICC = 0.61-0.89, CV = 7-13%) was evident for all variables except mediolateral sway velocity on the dominant leg (ICC = 0.41, CV = 15%). Single-leg landing results only demonstrated acceptable inter-trial reliability for force based measures of relative peak landing force and impulse (ICC = 0.54-0.72, CV = 9-15%). Inter-test results indicate improved reliability through the averaging of three trials with force based measures again demonstrating acceptable reliability (ICC = 0.58-0.71, CV = 7-14%). Of the variables investigated here, total sway velocity and relative landing impulse are the most reliable measures of single-leg balance and landing performance, respectively. These measures should be considered for monitoring potential changes in postural control in professional rugby union.

  17. Comparative morphology of the prothoracic leg in heliconian butterflies: Tracing size allometry, podite fusions and losses in ontogeny and phylogeny.

    Science.gov (United States)

    Moreira, Gilson R P; Silva, Denis S; Gonçalves, Gislene L

    2017-07-01

    Prothoracic legs of heliconian butterflies (Nymphalidae, Heliconiinae, Heliconiini) are reduced in size compared to mesothoracic and metathoracic legs. They have no apparent function in males, but are used by females for drumming on host plants, a behavior related to oviposition site selection. Here, taking into account all recognized lineages of heliconian butterflies, we described their tarsi using optical and scanning electron microscopy and searched for podite fusions and losses, and analyzed allometry at the static, ontogenetic and phylogenetic levels. Female tarsi were similar, club-shaped, showing from four to five tarsomeres, each bearing sensilla chaetica and trichodea. Male tarsi were cylindrical, formed from five (early diverging lineages) to one (descendant lineages) either partially or totally fused tarsomeres, all deprived of sensilla. Pretarsi were reduced in both sexes, in some species being either vestigial or absent. Tarsal lengths were smaller for males in almost all species. An abrupt decrease in size was detected for the prothoracic legs during molting to the last larval instar at both histological and morphometric levels. In both sexes, most allometric coefficients found at the population level for the prothoracic legs were negative compared to the mesothoracic leg and also to wings. Prothoracic tarsi decreased proportionally in size over evolutionary time; the largest and smallest values being found for nodes of the oldest and youngest lineages, respectively. Our results demonstrate that evolution of the prothoracic leg in heliconian butterflies has been based on losses and fusions of podites, in association with negative size allometry at static, ontogenetic and phylogenetic levels. These processes have been more pronounced in males. Our study provided further support to the hypothesis that evolution of these leg structures is driven by females, by changing their use from walking to drumming during oviposition site selection. In males the

  18. Reliability of Single-Leg Balance and Landing Tests in Rugby Union; Prospect of Using Postural Control to Monitor Fatigue

    Directory of Open Access Journals (Sweden)

    Jordan C. Troester, Jason G. Jasmin, Rob Duffield

    2018-06-01

    Full Text Available The present study examined the inter-trial (within test and inter-test (between test reliability of single-leg balance and single-leg landing measures performed on a force plate in professional rugby union players using commercially available software (SpartaMARS, Menlo Park, USA. Twenty-four players undertook test – re-test measures on two occasions (7 days apart on the first training day of two respective pre-season weeks following 48h rest and similar weekly training loads. Two 20s single-leg balance trials were performed on a force plate with eyes closed. Three single-leg landing trials were performed by jumping off two feet and landing on one foot in the middle of a force plate 1m from the starting position. Single-leg balance results demonstrated acceptable inter-trial reliability (ICC = 0.60-0.81, CV = 11-13% for sway velocity, anterior-posterior sway velocity, and mediolateral sway velocity variables. Acceptable inter-test reliability (ICC = 0.61-0.89, CV = 7-13% was evident for all variables except mediolateral sway velocity on the dominant leg (ICC = 0.41, CV = 15%. Single-leg landing results only demonstrated acceptable inter-trial reliability for force based measures of relative peak landing force and impulse (ICC = 0.54-0.72, CV = 9-15%. Inter-test results indicate improved reliability through the averaging of three trials with force based measures again demonstrating acceptable reliability (ICC = 0.58-0.71, CV = 7-14%. Of the variables investigated here, total sway velocity and relative landing impulse are the most reliable measures of single-leg balance and landing performance, respectively. These measures should be considered for monitoring potential changes in postural control in professional rugby union.

  19. Lean and the working environment: a review of the literature

    DEFF Research Database (Denmark)

    Hasle, Peter; Bojesen, Anders; Jensen, Per Langaa

    2012-01-01

    for the negative impact of lean on both the working environment and employee health and well-being in cases of manual work with low complexity. However, since examples of positive effects were also found in the literature, it is important to move from a simple cause-and-effect model to a more comprehensive model...... of manufacturing industry. The literature reflects, only to a limited extent, on the significance of implementation strategy and production context. Practical implications - Organizations working with lean should make efforts to avoid an impaired working environment for manual employees. Involvement of employees......Purpose - The effects of lean on employees have been debated ever since the concept was introduced. The purpose of this paper is to review the scientific literature on the effects of lean on the working environment and employee health and well-being. Design/methodology/approach - Relevant databases...

  20. The Effects of Application of Lean Concept in Retail

    Directory of Open Access Journals (Sweden)

    Radojko LUKIC

    2012-06-01

    Full Text Available Lean principles and techniques can be successfully applied in the retail sector. In the retail sector, lean approach improves operational flows. Lean retail encourages manufacturers to produce standard products in accordance with the created (placed orders from retailers pursuant to the demand of their consumers. Characteristics of the retail market are: strong competition, shorter product life cycle, longer product development time and high sensitivity of demand. In order to be more competitive and profitable today's retailers operate strategically oriented to lower prices and gain exemption from holding unnecessary stocks. Lean retail is an example of best practices of successful operational strategies which management need to accept - to maximize the operating efficiency of the retail process.