Creating 'Partnership in iSupport program' to optimise family carers' impact on dementia care: a randomised controlled trial protocol

Background: The majority of people with dementia are cared for by their family members. However, family carers are often unprepared for their caring roles, receiving less education and support compared with professional carers. The consequences are their reduced mental and physical health and wellbeing, and that of care recipients. This study protocol introduces the ‘Partnership in iSupport program’ that includes five interventional components: managing transitions, managing dementia progression, psychoeducation, carer support group and feedback on services. This health services research is built on family carer and dementia care service provider partnerships. The aims of the study are to evaluate the effectiveness, cost-effectiveness and family carers’ experiences in the program. Methods: A multicentre randomised controlled trial will be conducted with family carers of people living with dementia from two tertiary hospitals and two community aged care providers across three Australian states. The estimated sample size is 185 family carers. They will be randomly assigned to either the intervention group or the usual care group. Outcomes are measurable improvements in quality of life for carers and people with dementia, caregiving self-efficacy, social support, dementia related symptoms, and health service use for carers and their care recipients. Data will be collected at three time points: baseline, 6 months and 12 months post-initiation of the intervention. Discussion: This is the first large randomised controlled trial of a complex intervention on health and social care services with carers of people living with dementia in real-world practice across hospital and community aged care settings in three Australian states to ascertain the effectiveness, cost-effectiveness and carers’ experiences of the innovative program. We expect that this study will address gaps in supporting dementia carers in health and social care systems while generating new knowledge of the mechanisms of change in the systems. Findings will strengthen proactive health management for both people living with dementia and their carers by embedding, scaling up and sustaining the ‘Partnership in iSupport program’ in the health and social care systems.Lily Xiao, Ying Yu, Julie Ratcliffe, Rachel Milte, Claudia Meyer, Michael Chapman, Langduo Chen, Shahid Ullah, Alison Kitson, Andre Queiroz De Andrade, Elizabeth Beattie, Henry Brodaty, Sue McKechnie, Lee, Fay Low, Tuan Anh Nguyen, Craig Whitehead, Bianca Brijnath, Ronald Sinclair, and Diana Vos

Assembly line productivity improvement as re-engineered by MOST

The purpose of this paper is to address and solve operational problems of an automotive industry in reaching production target by adopting Maynard Operation Sequence Technique (MOST) as lean and productivity improvement strategies. Design/methodology/approach: In the undertaken case of auto-car rear window assembly line, a recurring production shortfall in fulfilling the daily demand is seemingly due to inappropriate work method. Initial observation of the operations led to suspect certain lapses in initiatives to adopt the time standards, to reduce or eliminate non-value added motions, to design suitable aisle and to assign tasks among workstations in a balanced manner. Subsequently an attempt is made to pinpoint the causes of poor performance and the bottlenecks through process flow analysis and time study by applying MOST. The elemental tasks are closely examined for possible reduction of workstation times by choosing efficient work methods with ergonomic features. Thus appropriate hand tools, jigs and fixture with nominal investment are prescribed to incorporate in the assembly works. The operational changes as steered by the MOST application have enhanced the workflow with a shorter cycle time which led to a substantial increase in productivity. Findings: The productivity of the assembly line is increased by more than 29 percent from the earlier capacity through the MOST application which is deemed to meet the current level of demand. Originality/value: The adopted framework for recognizing the effectiveness of MOST to expose and rectify the flaws in work methods without much investment is expected to be beneficial for a manufacturer in securing the competitiveness

Transformations of dibenzo(γ-oxopiperidino)aza-14-crowns-4 upon acylation. Molecular structure of dibenzo-16-crown-3

The result of acylation of dibenzoaza-14-crowns-4 containing a 4-oxopiperidine fragment with acetic anhydride depends on the substituent on the nitrogen atom. The NH-substrates initially undergo acylation at the piperidine nitrogen atom, followed by enolization and O-acylation. The acylation of N-methyl derivatives is accompanied by cleavage of the piperidine ring at the C-N bond with formation of acetylamino-substituted dibenzo-16-crowns-3. The structure of the latter was determined by X-ray analysis. © 2008 MAIK Nauka

Throughput enhancement of car exhaust fabrication line by applying MOST

In the fiercely competitive world market of today, manufacturers are facing increasingly tougher challenges and are compelled to find ways for productivity enhancement wherever possible in the whole supply chain. Nevertheless there are many facets in business process which can be explored for possible improvement, an immediate focus goes for the involved processes to re-engineer the activities in different workstations for an efficient and balanced assembly or fabrication line. In this paper an industrial case on fabrication line of a car exhaust system is presented to illustrate the scope of improvement by applying the MOST (Maynard’s Operation Sequence Technique) in streamlining the activities followed by assembly line balancing (ALB). The whole process of conducting various tasks is investigated to find out the lapses or wastes, to search for better option and to set the standard times for the tasks. Then individual workstation time is worked out by summing up the standard times of the involved tasks or activities and the concept of ALB is attempted to balance the fabrication line. So by possible reduction or elimination of the identified wastes or lapses workstation times including the bottleneck station are lowered. As a result the throughput of car exhaust systems is enhanced. According to the current practice, the Takt time is set at 3 minutes. However, upon an analysis through use of the MOST, the bottleneck station time is found to be as low as 1.27 minutes. Thus an opportunity of meeting the current level of demand with significantly lower workforce (with 2 operators instead of 5) is revealed. Alternatively, if necessary, an increased workload can be assigned for the current level of workforce. Moreover, with proper distribution of activities among the workstations using the concept of ALB, the line efficiency is found to be improved. So the line balance loss in the current setup of production line is also possible to be largely reduced. Thus daily production of car exhaust, if modified with suggested changes with the current workforce, could be more than double compared to the current daily output. Hence, effectiveness of the MOST followed by ALB applications to expose and remove the operational wastes in the work flow is reiterated with enhanced throughput

Transformations of dibenzo(γ-oxopiperidino)aza-14-crowns-4 upon acylation. Molecular structure of dibenzo-16-crown-3

The result of acylation of dibenzoaza-14-crowns-4 containing a 4-oxopiperidine fragment with acetic anhydride depends on the substituent on the nitrogen atom. The NH-substrates initially undergo acylation at the piperidine nitrogen atom, followed by enolization and O-acylation. The acylation of N-methyl derivatives is accompanied by cleavage of the piperidine ring at the C-N bond with formation of acetylamino-substituted dibenzo-16-crowns-3. The structure of the latter was determined by X-ray analysis. © 2008 MAIK Nauka