Networking to boost lean six sigma potential

At the beginning of 2008 three SMEs in a small town in Sweden started a network project inspired by the Six Sigma programme, and hired a full-time Black Belt to lead the improvement activities. Three months into the project, we interviewed the top management of the participating companies and the Black Belt, to pinpoint success factors as well as risks of the cooperation project. Results show that statistical methods were unused in favour of methods associated with lean manufacturing such as 5S. Accordingly, the expectations of the CEOs were related to production improvements and flow rather than quality. Both the Black Belt and the CEOs stated that management commitment was vital for the success of the partnership, but also that the visibility of this commitment could be improved. Despite this, all interviewees agreed that the project had gotten a good start and the managers had high expectations for its progress.Godkänd; 2008; 20081106 (bjarne_b

Testing for motivation to engage in improvements : a conceptual framework and an initial empirical test

This paper aims to develop a conceptual framework for testing the motivation to engage in improvement work. The framework is based on Ajzen's theory of planned behavior (TPB), that we suggest can be used to facilitate the implementation of improvement programmes. By using the model and probing intentions, attitudes, norms and perceived ability related to improvement work, we believe hindrances for implementation of improvement programmes will be exposed. When operationalising the framework we developed a survey instrument based on TPB and then made an initial empirical test by distributing it to 124 employees (response rate 67%) of three manufacturing small- and medium-sized enterprises. Factor analysis and regression were used to analyse the survey and follow-up interviews with employees and managers were used to validate the results. This initial test of the instrument showed that it has sound measurement properties, indicated by clear factor structure and good internal consistency. Interview data also validated that the instrument was able to capture important aspects related to implementation of improvement work. Based on the result, we conclude that TPB may be useful for guiding management actions. However, since our study only draws on a limited empirical sample, future research is needed to test the contextual validity.Validerad; 2014; 20130514 (andbra)</p

Suicide-attempters having immunoglobulin G with affinity for doparnine in cerebrospinal fluid

Altered immunological functions and changes in the monoaminergic neurotransmitter systems are two important observations made previously in the study of possible etiological and pathophysiological factors for psychiatric disorders. In search of tentative autoimmune mechanisms involved in these disorders we studied the presence of immunoglobulin G (DA-IgG) with affinity for the monoamine dopamine (DA) in cerebrospinal fluid (CSF) using ELISA. In CSF from 49 suicide attempters the titer of DA-IgG was significantly higher (P<0.001) than in CSF obtained from control subjects undergoing neurological investigation, The results in the present study indicate that an autoimmune mechanism may be involved in the dopaminergic neurotransmitter system and may be of pathophysiological importance in psychiatric disorders connected to an attempt of suicide, (C) 2002 Published by Elsevier Science BV/ECNP

Pharmacokinetics of Intravenously (DIZ101), Subcutaneously (DIZ102), and Intestinally (LCIG) Infused Levodopa in Advanced Parkinson Disease

Background and Objectives Intestinal levodopa/carbidopa gel infusion (LCIG) is superior to oral treatment in advanced Parkinson disease. The primary objective of this trial was to investigate whether continuous subcutaneous or intravenous infusion with a continuously buffered acidic levodopa/carbidopa solution yields steady-state plasma concentrations of levodopa that are equivalent in magnitude, and noninferior in variability, to those obtained with LCIG in patients with advanced Parkinson disease. Methods A concentrated acidic levodopa/carbidopa (8:1) solution buffered continuously and administered intravenously (DIZ101) or subcutaneously (DIZ102) was compared with an approved LCIG in a randomized, 3-period crossover, open-label, multicenter trial. Formulations were infused for 16 hours to patients with Parkinson disease who were using LCIG as their regular treatment. Patients were recruited from several university neurology clinics but came to the same phase I unit for treatment. Pharmacokinetic variables and safety including dermal tolerance are reported. The primary outcomes were bioequivalence and noninferior variability of DIZ101 and DIZ102 vs LCIG with respect to levodopa plasma concentrations. Results With dosing adjusted to estimated bioavailability, DIZ101 and DIZ102 produced levodopa plasma levels within standard bioequivalence limits compared with LCIG in the 18 participants who received all treatments. Although the levodopa bioavailability for DIZ102 was complete, it was 80% for LCIG. Therapeutic concentrations of levodopa were reached as quickly with subcutaneous administration of DIZ102 as with LCIG and remained stable throughout the infusions. Owing to poor uptake of LCIG, carbidopa levels in plasma were higher with DIZ101 and DIZ102 than with the former. All individuals receiving any of the treatments (n = 20) were included in the evaluation of safety and tolerability. Reactions at the infusion sites were mild and transient. Discussion It is feasible to rapidly achieve high and stable levodopa concentrations by means of continuous buffering of a subcutaneously administered acidic levodopa/carbidopa-containing solution

A Multiplex Protein Panel Applied to Cerebrospinal Fluid Reveals Three New Biomarker Candidates in ALS but None in Neuropathic Pain Patients

The objective of this study was to develop and apply a novel multiplex panel of solid-phase proximity ligation assays (SP-PLA) requiring only 20 μL of samples, as a tool for discovering protein biomarkers for neurological disease and treatment thereof in cerebrospinal fluid (CSF). We applied the SP-PLA to samples from two sets of patients with poorly understood nervous system pathologies amyotrophic lateral sclerosis (ALS) and neuropathic pain, where patients were treated with spinal cord stimulation (SCS). Forty-seven inflammatory and neurotrophic proteins were measured in samples from 20 ALS patients and 15 neuropathic pain patients, and compared to normal concentrations in CSF from control individuals. Nineteen of the 47 proteins were detectable in more than 95% of the 72 controls. None of the 21 proteins detectable in CSF from neuropathic pain patients were significantly altered by SCS. The levels of the three proteins, follistatin, interleukin-1 alpha, and kallikrein-5 were all significantly reduced in the ALS group compared to age-matched controls. These results demonstrate the utility of purpose designed multiplex SP-PLA panels in CSF biomarker research for understanding neuropathological and neurotherapeutic mechanisms. The protein changes found in the CSF of ALS patients may be of diagnostic interest