CASE STUDY 95-04: Operator Certification: A Case Study in Operator Self-Inspection

Operator certification is the process where production workers are trained, authorized, and given the necessary resources to inspect their own work. This case study evaluated operator certification systems in the manufacturing process at three major aerospace companies during the Spring of 1995. Within the manufacturing area, operator certification was observed in such operations as high volume machining operations, certain processing operations-such as leak testing, balancing, and painting-and production of high volume detail parts. This case study was initiated as a result of the data from the human resources focus group’s survey in 1994. Prof. Jan Klein found that the airframe sector had a significantly lower percentage of plants where production workers perform inspection tasks as compared to the engine and electronics sectors. While operator certification is not a new concept, it appeared to be a best practice within two of the three sectors of the aerospace industry. This case study was performed to investigate these high potential payoffs

Factory Flow Benchmarking Report

The Lean Aircraft Initiative benchmarked representative part fabrications and some assembly operations within its member companies of the defense aircraft industry. This paper reports the results of this benchmarking effort. Comparisons are made using an efficiency metric called flow efficiency. Flow efficiency is defined as the ratio of the fabrication time to the cycle time. In addition, this report explores the major components of the cycle time: fabrication time, lot process delay, storage delay, and transportation delay. The report concludes that the major portion of the cycle time in this industry is storage delay and points out the opportunity to improve cycle time drastically by reducing the amount of storage delay being experienced in the fabrication of products

Lean Implementation Considerations in Factory Operations of Low Volume/High Complexity Production Systems

The researchers of the Lean Aircraft Initiative developed a hypothesized lean implementation model seeking to provide its members guidance on implementing lean transitions in factory operations of low volume/high complexity production systems. The model features four phases: (1) building a lean infrastructure to support lean behavior, (2) redesigning the flow of products in the factory, (3) revamping the operations management and (4) fostering process improvement. An order of implementation is discussed and each phase has implementation steps as well. Following the development of the hypothesized lean implementation model, twelve case studies were used to test the model. This report details the model and analyzes the case studies using the model as a framework

Effects of A17924G Genotypes Associated with Thioesterase Domain of Fatty Acid Synthase and K232A Genotypes of Diacylglycerol Acyltransferase-1 on Milk Fatty Acid Composition in Holstein Dairy Cows

The objective of this study was to determine if variations in single nucleotide polymorphism (SNP) in thioesterase domain of the fatty acid synthase (g.17924 A\u3eG Threonine\u3eAlanine) and in diacylglycerol acyltransferase-1 (g.10433/10434 GC/AA Alanine\u3eLysine) genes would explain variations in milk fatty acid composition among Holstein dairy cattle. About 200 cows participated in the study. Milk samples were collected monthly throughout the first ten months of lactation and analyzed for milk fatty acid composition by gas chromatography. Blood samples were used to obtain a DNA sample for each animal. Milk from cows with g.17924GG genotype had lower atherogenic index [AI; (12:0 + 4(14:0) + 16:0)/(MUFA + PUFA)] compared with milk from cows of g.17924AG genotype (P=0.007). Likewise, milk from cows with p.232AA genotype had lower AI compared with that from cows of p.232KK genotype (P\u3c0.016). The decrease in AI for cows with g.17924GG and p.232AA genotypes was achieved by the decrease in the concentration of palmitic acid (P=0.06 and P\u3c0.0001, respectively) and by the increase in the concentration of mono- and polyunsaturated fatty acids in milk for both genotypes. The results of this study indicate the potential of using earlier mentioned SNPs as DNA markers to select breeding animals that produce progeny with a healthier milk fatty acid composition

Development and preliminary results of an Electronic Medical Record (EMR)-integrated smartphone telemedicine program to deliver asthma care remotely

Background: Technology-based interventions that can function within real-world practice and improve outcomes without increasing provider burden are needed, yet few successfully cross the research-to-practice divide. This paper describes the process of developing a clinically-integrated smartphone-telemedicine program for adults with asthma and results from proof-of-concept testing. Methods: To ensure integration with practice, we used a contextually-grounded intervention development approach and May\u27s implementation theory to design the intervention, with emphasis on systems capabilities and stakeholder needs. The intervention incorporated symptom monitoring by smart phone, smartphone telemedicine visits and self-management training with a nurse, and clinical decision support software, which provided automated calculations of asthma severity, control, and step-wise therapy. Seven adults (aged 18-40) engaged in a 3-month beta-test. Asthma outcomes (control, quality of life, FEV1) and healthcare utilization patterns were measured at baseline and end-of-study. Results: Each participant received an average of 4 telemedicine visits with 94% patient satisfaction. All participants had uncontrolled asthma at baseline; by end-of-study 5/7 classified as well controlled. Mean asthma control improved 1.55 points (CI=0.59-2.51); quality of life improved 1.91 points CI=0.50-3.31), and FEV1 percent predicted increased 14.86% (CI=-3.09-32.80) with effect sizes of d=1.16, 1.09, and 0.96, respectively. Preventive healthcare utilization increased significantly (1.86 visits/year vs. 0.28/year prior, CI 0.67-2.47) as did prescriptions for controller medications (9.29 refills/year vs. 1.57 refills/year, CI 4.85-10.58) Conclusion: Smartphone telemedicine may be an effective means to improve outcomes and deliver asthma care remotely. However, careful attention to systems capabilities and stakeholder acceptability is needed to ensure successful integration with practice

A mixed‐methods analysis of younger adults\u27 perceptions of asthma, self‐management, and preventive care: This isn\u27t helping me none

Background: Young adults (ages 18‐44) have increased emergency department use for asthma and poor adherence to medications. The objective of this mixed‐methods study was to understand experiences with and approaches to managing asthma, of which little is known in this age group. Methods: Surveys (Asthma Control Questionnaire, Asthma Quality of Life Questionnaire) and 1:1 semi‐structured interviews were used to explore experiences with asthma, symptoms, self‐management behaviors, and relationship to asthma control and quality of life. Qualitative data were analyzed using content analysis techniques. Descriptive statistics and bivariate correlations were used to examine distributive characteristics and associations between variables. Results: Forty urban adults participated (mean age 32.7 ± 6.2, 1σ). Coughing was reported nearly 46% more often than wheezing, with 42.5% (17/40) coughing until the point of vomiting most days. Most participants delayed using medication for symptoms due to misperceptions about inhalers. Higher symptom frequency and worse asthma control were associated with greater use of non‐pharmacologic symptom management strategies (r=0.645, p\u3c0.001; r=0.360, p=0.022, respectively). Five themes were identified regarding young adults experiences with asthma: (1) having asthma means being limited and missing out on life; (2) healthcare for asthma is burdensome and other things are more important; (3) there is not enough personal benefit in medical interactions to make preventive care worthwhile; (4) there is insufficient support and education about asthma for adults; and (5) people normalize chronic symptoms over time and find ways of coping that fit with their lifestyle. Conclusions & Clinical Relevance: Young adults may tolerate symptoms without using quick‐relief medication or seeking preventive care. Increasing engagement with preventive services will require decreasing perceived burdens and increasing the personal benefits of care. Evaluating for non‐pharmacologic approaches to managing symptoms and asthma‐related coughing may identify uncontrolled asthma. Enhanced training for clinicians in patient‐centric asthma care may be needed