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- Assarlind, Marcus, 1983, et al.
(författare)
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Multi-faceted views on a Lean Six Sigma application
- 2013
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Ingår i: International Journal of Quality and Reliability Management. - : Emerald. - 0265-671X. ; 30:4, s. 387-402
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Tidskriftsartikel (refereegranskat)abstract
- Purpose – Lean and Six Sigma observers, researchers and managers are awaiting the next step, which many feel could take the form of a combination of the two concepts, known as Lean Six Sigma. The purpose of this paper is to explore an application of Lean Six Sigma in practical improvement work, as a way of identifying factors of importance for improving future Lean Six Sigma applications.Design/methodology/approach – The empirical study was conducted through interviews, meetings, document analysis and observations over a period of four months.Findings – The findings of this study suggest it is unfeasible to apply one standardised approach to improvements in one company. Continuous smaller improvements and larger improvement projects demand different formulas. It is appropriate to use Lean and Six Sigma in parallel but this should be done through clever cross-fertilisation, such as taking variations in project complexity into consideration.Research limitations/implications – This paper shows one way of working with an improvement initiative in one particular company. It does not propose that this is the only way to combine Lean and Six Sigma nor does it suggest universal applicability. Further research on other possible combinations would be valuable.Practical implications – This paper provides an outline of how to structure a combination of Lean and Six Sigma. This could provide valuable insights to managers who wish to structure their improvement processes depending on the type of problem at hand.Originality/value – This paper expands the theoretical foundation for combining Lean and Six Sigma by studying and analysing a practical application of the concept. As a result, it provides new factors of importance for successful Lean Six Sigma applications, such as having a clear structure that guides the company in terms of what components of Lean Six Sigma to apply and what competences to involve in various projects, depending on the scope and complexity.
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- Assarlind, Marcus, 1983, et al.
(författare)
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Multi-faceted views on a Lean Six Sigma application
- 2012
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Ingår i: International Journal of Quality and Reliability Management. - : Emerald. - 0265-671X. ; 29:1, s. 21-30
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Tidskriftsartikel (refereegranskat)abstract
- Purpose – As Lean and Six Sigma have become established as influential concepts in the process improvement area, observers, researchers and managers are awaiting the next step, which many feel could take the form of a combination of the two concepts, known as Lean Six Sigma. A considerable amount of literature has been produced regarding the possible benefits of combining Lean and Six Sigma, which has led to greater support for the idea. The purpose of this paper is to explore an application of Lean Six Sigma in practical improvement work. Design/methodology/approach – The empirical study was conducted through interviews, meetings, document analysis and observations over a period of four months. Findings – Based on this paper, it seems unfeasible to apply one standardised approach to improvements in one company. Continuous smaller improvements and larger improvement projects demand different formulas. It seems that using both Lean and Six Sigma in parallel is appropriate but this should be done through clever cross-fertilisation. Research limitations/implications – This paper shows one possible way of working with one improvement concept in one company. It does not claim to present the only possible way of combining Lean and Six Sigma nor does it suggest universal applicability. Further research on other possible combinations would therefore be valuable. Practical implications – This paper provides an outline of how to structure a combination of Lean and Six Sigma. It can provide valuable insights to managers who wish to structure their improvement processes. Originality/value – This paper expands the theoretical foundation for combining Lean and Six Sigma by studying and analysing a practical application of the concept. Apart from the paper's value for managers, it can also help researchers understand the compatibility of Lean and Six Sigma.
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- Bäckman, Kristoffer, 1979, et al.
(författare)
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37 years of body mass index and dementia: observations from the prospective population study of women in Gothenburg, Sweden.
- 2012
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Ingår i: Journal of Alzheimer's disease : JAD. - 1875-8908. ; 28:1, s. 163-71
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Tidskriftsartikel (refereegranskat)abstract
- Level of adiposity is linked to dementia in epidemiological studies. Overweight and obesity in mid- and late-life may increase risk for dementia, whereas decline in body weight or body mass index (BMI) and underweight in years preceding and at the time of a dementia diagnosis may also relate to dementia. Longitudinal studies with sufficient follow-up are necessary to estimate trajectories that allow better understanding of the relationship between adiposity indices and dementia over the life course. We evaluated the natural history of BMI in relationship to clinical dementia over 37 years in the Prospective Population Study of Women (PPSW) in Sweden. PPSW is a systematic sample of 1462 women born 1908, 1914, 1918, 1922, and 1930 and aged 38-60 years at baseline. Examinations occurred in 1968, 1974, 1980, 1992, 2000, and 2005. Statistical analyses were conducted using mixed effects regression models. Trajectories of BMI over 37 years as a function of age differed between women who did versus did not develop dementia. Women developing dementia evidenced a lesser increase in BMI from age 38 to 70 years. After age 70, the BMI slope decreased similarly (no "accelerated decline") irrespective of dementia status. A lower BMI before and during dementia onset was observed. Women with similar BMI at mid-life exhibited a different pattern of BMI change as they approached late-life that was related to dementia onset. BMI may be a potential marker of dementia-related neuropathologies in the brain. Dementia is related to a common risk factor, BMI, from mid-to late-life.
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- Bäckman, Kristoffer, 1979, et al.
(författare)
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Changes in the Lethality of Frailty Over 30 Years: Evidence From Two Cohorts of 70-Year-Olds in Gothenburg Sweden.
- 2017
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Ingår i: The journals of gerontology. Series A, Biological sciences and medical sciences. - : Oxford University Press (OUP). - 1079-5006 .- 1758-535X. ; 72:7, s. 945-950
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Tidskriftsartikel (refereegranskat)abstract
- With aging, health deficits accumulate: people with few deficits for their age are fit, and those with more are frail. Despite recent reports of improved health in old age, how deficit accumulation is changing is not clear. Our objectives were to evaluate changes over 30years in the degree of deficit accumulation and in the relationship between frailty and mortality in older adults. Methods: We analyzed data from two population based, prospective longitudinal cohorts, assembled in 1971–1972 and 2000–2001, respectively. Residents of Gothenburg Sweden, systematically drawn from the Swedish population registry. The 1901–1902 cohort (N=973) had a response rate of 84.8%; the 1930 cohort (N=500) had a response rate of 65.1%. Afrailty index using 36 deficits was calculated using data from physical examinations, assessments of physical activity, daily, sensory and social function, and laboratory tests. We evaluated mortality over 12.5years in relation to the frailty index. Results: Mean frailty levels were the same (x =0.20, p=.37) in the 1901–1902 cohort as in the 1930 cohort. Although the frailty index was linked to the risk of death in both cohorts, the hazards ratio decreased from 1.67 per 0.1 increment in the frailty index for the first cohort to 1.32 for the second cohort (interaction term p=.005). Discussion: Although frailty was as common at age 70 as before, its lethality appears to be less. Just why this is so should be explored further.
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- Joas, Erik, 1983, et al.
(författare)
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Blood Pressure Trajectories From Midlife to Late Life in Relation to Dementia in Women Followed for 37 Years
- 2012
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Ingår i: Hypertension. - 0194-911X .- 1524-4563. ; 59:4, s. 796-801
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Tidskriftsartikel (refereegranskat)abstract
- Abstract. Higher midlife blood pressure increases risk for dementia. To further understand the relation between blood pressure and dementia, it is necessary to examine evolution of blood pressure from midlife to late life. We examined blood pressure trajectories using linear mixed models in a representative sample of middle aged women (N1462) who were followed from 1968–1969 until 2005–2006 with comprehensive medical and neuropsychiatric examinations. Dementia was diagnosed according to established criteria. Among those not treated with antihypertensives, higher systolic blood pressure at baseline but not blood pressure trajectories from 1968 to 1992 was associated with dementia and Alzheimer disease. Those with history of antihypertensive treatment had higher baseline systolic blood pressure than those who were never treated. In this group, those who developed dementia and Alzheimer disease had lower baseline systolic blood pressure and steeper increase in systolic blood pressure from 1968 to 1992 than those who did not. A steeper decline in systolic blood pressure during the later part of the study was observed in those who developed dementia regardless of antihypertensive treatment. The latter association was attenuated or disappeared when adjusting for body mass index. The association between blood pressure and dementia is complex and influenced by antihypertensive treatment. The findings emphasize the importance of detecting increased blood pressure in midlife and controlling blood pressure in those treated. Whether the trajectory of blood pressure is a risk factor or part of the clinical course of dementia needs to be elucidated.
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- Joas, Erik, 1983, et al.
(författare)
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Psychoeducation for bipolar disorder and risk of recurrence and hospitalization - a within-individual analysis using registry data.
- 2020
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Ingår i: Psychological medicine. - 1469-8978. ; 50:6, s. 1043-1049
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Tidskriftsartikel (refereegranskat)abstract
- The efficacy of psychoeducation for bipolar disorder has been demonstrated in clinical trials, but it is not known if the results translate into effectiveness in routine clinical practice. The aim was to determine the effectiveness of psychoeducation for bipolar disorder in a routine clinical setting.We identified 2819 patients with at least three registrations in the Swedish Quality Assurance Register for Bipolar Disorder. Among those, 402 had not been exposed to psychoeducation at the first visit, but received psychoeducation during any of the following registrations. Using within-individual analyses, the risk of recurrence after having received psychoeducation was compared with the risk prior to psychoeducation.In adjusted within-individuals comparisons, periods after psychoeducation was associated with decreased risks of any recurrence [odds ratio (OR) 0.57, 95% CI 0.42-0.78], (hypo-)manic or mixed episodes (OR 0.54, 95% CI 0.39-0.76), depressive episodes (OR 0.63, 95% CI 0.47-0.86), and inpatient care (OR 0.54, 95% CI 0.33-0.86) relative to periods prior to psychoeducation. There was no association with rates of involuntary sectioning or suicide attempts.The results suggest that psychoeducation for bipolar disorder reduces the risk of mood episodes and inpatient care also when implemented in routine clinical practice.
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