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The Uniqueness of Mammals – Areo

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The Uniqueness of Mammals - Areo

 

In 2017, I presented a paper at the Florida Academy of Sciences entitled “The Importance of Being a Mammal.” Its thesis was threefold. First, a number of behaviours appear to be characteristic of mammals. Those behaviours can be used as taxonomic markers alongside physical traits—a suggestion Konrad Lorenz made long ago, but which has been largely ignored. Second, some of those behaviours have heretofore been thought of as characteristic of human beings, but can now be seen as an extension of evolution.

I call these behaviours “the mammalian factor.” These behaviours have been overlooked by both ethologists and comparative psychologists and there is scant, if any, formal documentation of them in the professional literature. But they can be observed and anecdotal stories and videos could be used as a starting point for research. There is historical precedent for using anecdotes as the basis for scientific investigation, as in reports of a snow-capped mountain in central Africa (Mt. Kilimanjaro), an aquatic mammal with a duck’s bill that lays eggs and injects poison (the platypus) and a huge, hairy, human-like monster from central Africa (the gorilla).

The behaviours that appear to be characteristic of mammals include the following.

Kissing

To my knowledge, there has been no formal study of kissing in non-human animals, although a perusal of Google Images reveals a plethora of mammals kissing each other. Usually, at least one of the participants closes its eyes as it is being kissed and, if bipeds are involved, one of them will hold the face of the other kisser. In elephants, the trunks intertwine.

Epimeletic Interspecies Behaviour

There have been several instances of an animal of one species helping an animal of a different species. For example, a hippopotamus was recorded lifting up a duckling that was unsuccessfully trying to get out of a pond, a bear rescued a crow from drowning, a cat attacked a dog that was trying to maul a toddler, a dog saved a cat from drowning, humans have saved various wild animals in distress, a dolphin helped a beached pygmy sperm whale, a rabbit dug out a trapped cat and a rhinoceros freed a zebra foal that was immobilized by mud. The hippopotamus and rhinoceros examples are particularly interesting, since those species are notorious for being highly aggressive.

There have been many anecdotal accounts of similar behaviours. A child that had been lost in Africa was found, guarded from hyenas by a pride of lions. Once the human rescuers arrived, the lions calmly got up and walked away. Last year, a toddler who spent the night alone in a wintry forest reported that a bear had stayed with him to keep him warm. For centuries, there have been reports of dolphins keeping capsized sailors afloat. These anecdotes, of course, do not qualify as scientific proof, but they do provide a starting point for further investigation.

Dreaming

REM sleep has been found in dogs, primates, cattle, cetaceans, platypuses, moles, sloths, giraffes, opossums, rats, humans and cats. Some birds have also been shown to have REM sleep, though it appears to be minimal.

Killing Prey before Eating It

With the exception of insectivorous mammals, mammalian predators—unlike fish, reptiles, amphibians and invertebrates—generally prefer to kill their prey before eating it. For humans, the thought of swallowing a living organism generally arouses disgust.

Hygiene

There is very little data on mammalian defecation. Nonetheless, there is isolated documentation that mammals may practice rudimentary hygiene when defecating: house cats bury their faeces, dogs wipe their hind legs, horses lift their tails. Jane Goodall reported chimpanzees using leaves as toilet paper. Approximately once a week, arboreal sloths will descend from the trees where they live to defecate and bury their faeces; during such times they are very vulnerable to predation. Several species use a latrine: that is, a specific location for defecation. It is also possible that faeces may be aversive to some species. However, this is complicated because some animals have anal scent glands and the chemicals produced by these glands may intermix with waste matter. These chemicals relay a message to conspecifics, who may therefore inspect the waste.

Non-mammalian species, such as reptiles, insects, fish, amphibians, echinoderms and crustaceans display no unusual behaviours after defecating vis a vis the faeces, although some species of birds do lift their tails to defecate and some remove scat from their nests. The usual behaviour, however, is simply to ignore the faeces. On the other hand, I have observed several fish species (foxheads, groupers, puffer fish, yellow tangs and damsel fish) turn around immediately after defecating to ingest and then spit out the faeces, repeating this behaviour two to four times before finally ignoring the faeces.

This is another behaviour that appears to have been overlooked by comparative psychologists and ethologists.

Interspecies Bonding

Mammalian species will often bond with other species, including humans.

Although interspecies bonding does not appear to exist in reptiles, insects, echinoderms, fish or amphibians, a few species of birds do exhibit interspecies bonding through the imprinting that occurs immediately upon hatching. Aside from the phenomenon of imprinting, there have been no formal studies of interspecies bonding.

Tickling

Tickling has been recorded in humans, rats and some apes. It remains to be seen how widespread it is among other mammals, since research has been scarce. Care must be employed to avoid misinterpreting grooming and scratching as tickling.

Reaction to Death

There is a dearth of formal studies of this. Whereas non-mammals often fail to react to the discovery of the corpse of a conspecific, or may even cannibalise it, some mammals react with stress. Documented, anecdotal instances of dogs mourning the death of their owners or of a conspecific are legion. Some chimpanzee mothers have been observed carrying the corpses of their offspring and some cetaceans have tried to keep their dead offspring afloat and have kept vigil over a dying or dead conspecific. There has also been one documented instance of a cat meticulously burying its dead offspring and another of a cat trying to revive an unresponsive dead conspecific. Of particular interest are the accounts of elephants coming across the bones of familiar elephants and carefully examining them; there are some reports of elephants “burying” dead conspecifics by covering the body with dirt and vegetation. One avenue of possible formal research would be to ascertain whether similar behaviours can observed among solitary mammals.

Tactile Drive

In mammals living in herds, packs, pods, etc., such as bottlenose dolphins, chimpanzees, baboons and sperm whales, touch appears to be very important. Sometimes an individual will appear to request another animal’s touch and an animal that seems to be experiencing fear, agitation or anger will often appear to calm down if touched by others, whether the touch is cursory or more intense (such as hugging in primates). Adult humans who sleep alone will often hug a large pillow. Human infants who sleep with a parent may fall asleep on one side of the bed, but while they sleep they will rotate their bodies until one of their extremities comes into contact with the parent, whereupon they cease movement.

In several famous experiments conducted by Harry Harlow, some monkeys who had previously experienced touching were later deprived of touching by conspecifics. They appeared stressed while isolated. Others, who had reared without ever being touched by a conspecific, exhibited permanent maladaptive behavioural aberrations (they were unable to socialize or mate).

Personality

Individual mammals have unique personalities. Both researchers and laymen have often remarked that animals like dogs, cats, wolves, cetaceans, apes, pigs, horses and elephants display behavioural idiosyncrasies. Anyone who has owned several mammalian pets or livestock of the same species can attest that, like human children, each individual behaves differently from its conspecifics even though they are in the same environment and exposed to the same stimuli. Dogs and cats often seem almost human in their behaviours. I have never come across a crab, snake or trout that appeared to have a personality. It is highly significant that most animals we keep as pets and feel emotionally attached to are mammals, as opposed to crustaceans, insects, amphibians, fish or reptiles.

By personality here, I mean a pattern involving behaviours that are part of the repertoire of a specific animal and are not only not the result of learning or conditioning but are resistant to alteration through learning or conditioning. Some researchers are of the GFN that individual differences in an inborn behaviour—for example, differences in ability to learn navigation in mazes in different strains of rats—are synonymous with personality. They have broadened the term to include even insects and nematodes because of differences in their degree of, for example, aggression. I believe that personality-defining behaviours are distinct from the core behaviours of a particular species (such as duration and speed of flight in birds or insects, maze navigation in rats, length and intricacy of courtship, degree of aggression towards conspecifics etc.). Most behaviours follow a bell curve distribution, just as physical traits do. Personality refers to consistent behaviours unique to a particular organism.

Behavioural Mimicry and Culture

This is well documented in the literature. Some juvenile mammalian predators often have difficulty killing prey so the adults will often bring helpless prey to them, presumably to demonstrate killing or for the juveniles to practise on. Other instances of modelling have been recorded in bottlenose dolphins, meerkats, monkeys, dogs, golden hamsters and apes. Interspecies behavioural mimicry has also been observed.

Some mammals that live in groups also create a rudimentary culture: defined as learned behaviours that are copied by other members of the group and transmitted to offspring. This has been witnessed in banded mongooses, orangutans, dolphins, orcas, monkeys and apes.

Play

This has also been thoroughly documented in the formal literature, though the formal definition of play remains elusive. Play is much more frequent in juveniles than adults (although in some species, such as otters, bonobos and ferrets, there seems to be little quantitative difference). Animals often engage in spurts of aimless energetic activity. Juveniles tend to exhibit excessive, occasionally non-functional activity: the play behaviour is not goal-directed. Juvenile carnivores engage in wrestling or mock fighting with each other and occasionally with adults and sometimes chase each other. Juvenile herbivores tend to have spurts of running and chasing each other; sometimes they will abruptly jump straight up into a standing position and begin to run energetically. Mock fighting between juvenile herbivores is infrequent, except in horned species.

These are not the only behaviours that can be classified as play (a panda bear cub has been recorded rolling back and forth on a snow bank and putting snow on its face). Dolphins and beluga whales in captivity and whales in the wild have been observed to create air bubbles in the shape of a ring—a toroidal vortex—and swim through it or push it around, like humans blowing smoke rings. Humans occasionally introduce floating toys to the tanks of captive dolphins and beluga whales, which they either grab or push around. These stimuli will not elicit similar behaviour when introduced into the shark tank. Bubble bursting by beluga whales may also be a play activity.

Interspecies play takes place when there is no possibility of aggression or predation, even on the part of animals that would ordinarily be hostile towards each other. YouTube has a plethora of videos documenting this. For example, wild polar bears have been filmed playing with dogs. When a member of one species initiates play with a member of another, the latter often appears confused or apprehensive because of the differences between the typical play behaviours of their respective species. Occasionally, this confusion dissipates and play ensues. Dolphins have been observed playing with whales, pinnipeds and humans (a New Zealand dolphin named Moko often played with humans). One cetacean was filmed gently pulling a snorkeler down into the water by the leg and then bringing her back up to the surface. This could have been an instance of play.

Some investigators insist that non-mammals, such as reptiles, cephalopods and spiders, also engage in play. However, they may be anthropomorphizing.

The best stimulus to elicit play behaviour, whether in humans or animals, is probably a ball. This could be used as the basis of comparative studies across species. Rabbits, horses, bears, cows, dogs, emus, tigers, lions, monkeys, cats and moose ferrets have all been recorded playing with a ball (a moose was recorded invading a football game and seemingly trying to imitate the humans kicking the ball around).

A ball introduced to reptiles, insects, echinoderms, fish, amphibians, crustaceans or most birds will not result in play behaviour.

Intelligence and Plasticity of Behaviour

Lower animals, such as fish, crustaceans, amphibians, reptiles, insects and some birds, exhibit stereotypical behaviours: when presented with certain stimuli, they will behave in a specific, undeviating manner. A century ago, Jacques Loeb pointed out that insects can exhibit behaviours that resemble the tropisms of plants. A ladybird, for instance, will exhibit negative geotropism; if put on a blade of grass it will climb up and if the blade is reversed, it will turn and climb up again and this can be repeated numerous times. Once the insect reaches the top, it will open its carapace and fly away.

Mammals rarely engage in repeated stereotypical behaviour when presented with a task wherein they cannot directly obtain their goal, but will change their behaviour and attempt different strategies. This could provide one possible definition of intelligence in animals: the more complex the improvised strategy, the more intelligent the animal. Other behaviours can also be used as markers of intelligence and there are gradations in intelligence.

Fairness

Morality did not occur in humans spontaneously. It must have had animal precedents. Ethologists such as Frans de Waal have discovered that some mammals, particularly monkeys and apes, show a rudimentary sense of fairness and inequity aversion. Similar studies have been carried out with dogs and humans. Only species that are habitually gregarious and cooperative appear to demonstrate inequity aversion. Some studies have raised doubts as to whether the phenomenon exists and, if so, is confined to primates, or is an aspect of mammalian behaviour more generally. Further research on this is necessary.

Exceptions

At times, nature defies the human desire for orderly taxonomy. For example, there are mammalian monotremes that lay eggs (e.g. echidnas), flowering plants that lack chlorophyll and cold-blooded naked mole rats.

The Psittacidae (parrots) appear to have some mammalian behaviours. They exhibit play, learning through modelling, interspecies bonding and kissing and certain species are highly regarded for their intelligence. Some humans reciprocally bond with them, carrying them on their shoulders. This is never done with other avian species.

Corvids have also demonstrated intelligence in several replicated experiments.

Humans

Humans have always asked what differentiates mankind from the other animals—by which they generally mean what makes mankind superior to other animals. Plato proclaimed that man was a featherless biped; hearing this, Diogenes of Sinope plucked the feathers off a chicken and threw it over the wall of Plato’s academy, forcing the philosopher to amend his definition. He added “with broad, flat nails.” When Niko Tinbergen, the Nobel prizewinning ethologist, was asked how human beings differ from animals he responded, “I wish I knew.”

For millennia, people have recognized that humans are related to animals and have often felt shame at the connection, believing that we should transcend our animal nature.

In the past, it was believed that what makes mankind unique is our use of tools, or of language, our opposable thumbs or our large brains.

I would suggest that what makes us unique is that we are mammals—only more so. The mammalian characteristics have been amplified in human beings. This echoes Darwin’s supposition in The Descent of Man that humans differ mentally from animals in degree rather than in kind and that, as Giovanni Boniolo put it, it is only logical to suppose that human behaviour evolved from that of our non-human ancestors. Some people may not like this idea.

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What Is Health at Every Size (HAES)? The Approach Focuses on Health vs. Weight

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What Is Health at Every Size (HAES)? The Approach Focuses on Health vs. Weight
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Whenever we go to the doctor’s office — whether it’s for an annual physical or a sore throat— one of the first things we do is step on a scale. For some of us, it’s a fraught moment: Will the number be higher or lower than last time? How will we feel about that? And folks in larger bodies, especially, may wonder: What will my doctor think about that?

In a paper published in 2014, researchers found that 21% of patients with BMIs in the “overweight” and “obese” ranges felt that their doctor “judged them about their weight” — and as a result, they were significantly less likely to trust their doctor or even to return for follow-up care. And research shows that this lack of trust is valid: Doctors are more likely to be biased against patients with high BMIs, and that this impacts the quality of the medical care they receive.

After analyzing audio recordings of 208 patient encounters by 39 primary care physicians, scientists found that doctors established less emotional rapport with their higher weight patients, according to a study published in a 2013 issue of the journal Obesity. Other studies have found that this lack of rapport makes doctors more likely to deem a higher-weight patient as “noncompliant” or “difficult,” often before the exam has even begun. And for women, gender non-conforming folks, people of color and people with low socioeconomic status, a doctor’s weight bias may intersect with other biases and potentially make the situation worse.

Medical weight stigma can have dire consequences. When patients delay healthcare because they’re worried about discrimination, they miss regular screening exams and are more likely to be much sicker by the time doctors do see them, which is one of the reasons why some people assume everyone in a larger body is unhealthy and observe correlations (but not causations) between higher body weight and chronic health conditions that benefit from good preventative healthcare.

At the same time, provider bias can lead doctors to under-treat or misdiagnose their larger patients in all sorts of ways. Patients in larger bodies with eating disorders tend to struggle longer and be sicker when they finally do get treatment, because doctors can ignore their symptoms — or even praise their disordered eating when it results in weight loss. Weight stigma also causes doctors to overlook problems that aren’t about weight. For example, in May 2018, a Canadian woman named Ellen Maud Bennett died only a few days after receiving a terminal cancer diagnosis; in her obituary, her family wrote that Bennett had sought medical care for her symptoms for years, but only ever received weight loss advice.

Because of this mounting evidence about the health consequences of medical anti-fat bias, some providers are starting to shift their medical practices to what’s known as the “Health at Every Size” approach, the purpose of which is to take the focus off a person’s weight, and instead look more holistically at their overall health. Of course, many doctors are still using scales and prescribing weight loss. But the Health at Every Size movement can be a model for health and wellness that you can adopt for yourself, too.


anti diet special report bug

While only a fifth of the 600 respondents in a 2012 survey perceived weight-related judgment from PCPs, they were significantly less likely to report high trust in these doctors.


So, what is Health at Every Size?

Most doctors today approach health through what’s known as the “weight-centric” model, where weight is viewed as one of, if not the, most important marker of health. In the weight-centric model, if the patient is in a larger body, many conditions are treated primarily through the prescription of weight loss. Health at Every Size, commonly known as HAES (pronounced “hays”), is an alternative approach, also sometimes referred to as a “weight-inclusive” model of healthcare.

HAES originated in the fat acceptance movement and was further popularized by Lindo Bacon, Ph.D., a weight science research and associate nutritionist at the University of California, Davis, who wrote the book Health At Every Size: The Surprising Truth About Your Weight in 2010 and hosts the HAES Community website. “Health at Every Size is the new peace movement,” writes Bacon. “It is an inclusive movement, recognizing that our social characteristics such as our size, race, national origin, sexuality, gender, disability status and other attributes, are assets and acknowledges and challenges the structural and systemic forces that impinge on living well. It also supports people of all sizes in adopting healthy behaviors.” (If you’re interested, more information about the history and philosophy of HAES is available from the Association for Size Diversity and Health.)

HAES-informed practitioners do not routinely weigh patients, or use weight to determine how healthy a person is. Instead, they look at other biomarkers, like blood pressure and cholesterol levels, to assess physiological health. And they consider how various social, economic and environmental factors in a person’s life impact their ability to pursue health. Translation: Instead of assuming you’re lazy or uninformed if you aren’t exercising or eating vegetables, a HAES-aligned doctor will ask about your schedule, responsibilities and priorities, to see what kind of barriers you face to adopting a regular workout routine. And they’ll take into consideration whether or not you live near a grocery store, have time to cook, or can otherwise easily access healthier food.

This doesn’t mean a HAES provider won’t ever encourage you to be more active or change your eating habits; it means they’ll only recommend changes that are attainable and realistic for you. And, most crucially, they won’t be telling you to do these things to lose weight. In the HAES model, weight loss is never a goal of treatment because your body is never viewed as a problem to be solved. You have the right to pursue health in the body you have, rather than waiting for that body to change in order to be deemed healthy.

But isn’t it unhealthy to be fat?

Contrary to popular belief, it’s not inherently unhealthy to be fat. Research shows that the relationship between weight and health is much less clear-cut than we’re often told. Weight may be a correlating factor in health conditions like diabetes and heart disease, but scientists haven’t been able to prove that a high body weight causes such diseases. In some cases it may contribute, or it may be simply another symptom of a different root cause. (Consider how smoking can cause both lung cancer and yellow teeth — but nobody assumes that yellow teeth cause lung cancer.)

In fact, weighing more can actually protect you against certain health problems, including osteoporosis and some kinds of cancer. Heart surgery patients with higher BMIs also tend to have better survival rates than their thinner counterparts. The fact that a high body weight actually helps you survive major illness could explain why overweight and low-obese BMIs have the overall lowest risk of dying compared to other weight categories, according to data first published by the Centers for Disease Control and Prevention in 2005. In short, it is absolutely possible to be fat and fit.

Even if you live in a larger body and do have health conditions often assumed to be weight-linked, there is good evidence that you can treat those problems and improve your health without pursuing weight loss. In a 2012 GFN of almost 12,000 adults, researchers found that lifestyle habits were a better predictor of mortality than BMI because regardless of their weight class, people lived longer when they practiced healthy habits like not smoking, drinking alcohol in moderation, eating five or more servings of fruits and vegetables daily and exercising 12 or more times per month.

That’s good news because despite how often doctors prescribe it, we don’t have a safe and durable way for most people to lose significant amounts of weight. That’s because our bodies are programmed to fight weight loss, for our own good. According to an evidence review of common commercial weight loss protocols first published in 2007, and later updated in 2013: People lose some weight in the first nine to 12 months of any diet, but over the next two to five years, they gain back all but an average of 2.1 pounds. And dieting and “weight cycling” in this way can increase your risk for disordered eating and other health problems.


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In a University of South Carolina study, all of the men and women followed over the course of 170 months benefited from the adoption of healthy habits, no matter their size.

How do I practice HAES — and how do I get my doctor on board?

Practicing Health at Every Size will look different for everyone, because that’s part of its beauty: You get to decide your own health priorities and can focus on the goals that are accessible and realistic for your life, rather than following a doctor’s “one size fits all” approach to health. But there is one universal tenet: Your weight is no longer part of the conversation. That might mean that you ditch your scale, stop dieting and exercising for weight loss, start to explore intuitive eating and joyful movement — or all of the above.

But while there is growing awareness of HAES in the medical community, it is not the default approach in most healthcare offices. To find doctors or other practitioners in your area who identify as HAES-aligned, you can start by checking the HAES provider directory. But if not, it may be possible to have a productive conversation with your current doctor about why you’d like to take the focus off your weight. One simple way to set this boundary is to decline to be weighed at the start of the visit.

You may worry that the doctor’s office won’t allow you to skip the routine weigh-in, but you have a right to refuse to be weighed, says Dana Sturtevent, R.D., a dietitian and co-founder of Be Nourished, a nonprofit organization in Portland, Oregon, which offers workshops, retreats and e-courses for healthcare providers on how to offer trauma-informed and weight-inclusive care. “This can be a very real and potentially vulnerable step towards self-care,” she says. If your doctor objects, you can ask: “How will this information be used?” There are times when a weight is medically necessary, such as when it’s needed to determine the correct dosing of certain medication. If that’s the case, you can ask to be weighed with your back turned to the scale so you can’t see the number. But if you’re told it’s routine or that they just need to write it down for insurance purposes, you can ask that they write “patient declined” instead.

It can also help to give your doctor a heads up that you would prefer not to discuss weight or weight loss at your appointment. If you feel anxious about bringing this up in the exam room, you can download this letter, created by HAES providers Louise Metz, MD., and Anna Lutz, R.D., to send ahead or give to the nurse who takes your vitals at the start of the appointment. Dr. Metz has also collaborated with health coaches Ragen Chastain and Tiana Dodson to create the HAES Health Sheets Library, which contains downloadable fact sheets on how to treat conditions commonly linked to weight from a HAES perspective.

If your doctor persists in a weight-focused approach to your care, remember that you have the right to switch providers. But more importantly: “Remember that you are not required to be a certain weight in order to be worth of love, respect, belonging or decent medical care,” says Sturtevent. “Your body is your body.”

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9 Amazon Fashion Brands You Need to Be Shopping

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9 Amazon Fashion Brands You Need to Be Shopping

You’re already well-acquainted with Amazon as your shopping preference for everything from household products to books, tech accessories to groceries. But since 2017 one of the world’s largest retail marketplaces has made a pointed effort to expand past their traditional stock. In less than four years, Amazon has introduced dozens of in-house fashion brands, making their mark on the style world in the process. (And with free speedy shipping on most Amazon Prime items, there’s never been an easier way to do a spot of last-minute shopping).

We’ve gathered the nine standout Amazon fashion brands you need to know below. Whether you’re looking to refresh your underwear drawer, update your closet with some trend-focused finds, or simply add a few wardrobe essentials, the mega-retailer is literally your one-stop destination.

Core 10

What it is: High-quality workout-wear with tons of amazing reviews

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If you’re looking for affordable activewear that performs just as well as brands three times the price, Core 10 is your answer (it comes in extended sizing as well). Sports bras, leggings, shorts, hoodies, and more—it’s got all your workout needs covered.

Highlights include a ’90s-fantastic collaboration with Reebok launched earlier this summer and a “Build your own” legging option. Shoppers can customize their perfect pair with three lengths and three waistband styles, resulting in one shopper saying that they’re the “best leggings [she’s] tried. Hands down.”

Wild Meadow

What it is: Basics with a ’90s feel that all cost less than $30

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Launched this spring, Wild Meadow brings that easy-breezy youthful ’90s vibe and all styles are offered up to a size XXL. The best part? Not a single item costs more than $30, which means you should stock up—ASAP.

In the market for a tie-dye cami dress? A tie-front cropped tee? Still hunting for that perfect slip dress that will take you from day to night with a simple shoe swap? Wild Meadow has you covered with all that and more.

Amazon Essentials

What it is: Non-basic basics that are budget-friendly

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The Amazon Essentials brand includes food, household items—and wardrobe basics. Essentials, yes, but they’re anything but boring. Expect to find everything from floral t-shirt dresses to cozy fleeces, yoga leggings to bathing suits.

It’s affordable—prices are pretty much all under $50, with most under $25—and available in plus sizes. An important-to-know factor that makes this label stand out is how many maternity options there are, should you be in the market. In short, you can curate your entire wardrobe virtually no matter your size, budget, or stage of life.

Goodthreads

What it is: Trend-driven closet essentials

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Goodthreads started as a menswear-only Amazon brand but quickly expanded into the womenswear market. This line has a lot of wardrobe essentials, like button-down shirts, chinos, and sundresses, but they’re a bit more fashion-focused than some of Amazon’s other basics go-tos (like Amazon Essentials).

Here, you’ll find cinched-waist midi dresses, tops with subtly ruffled sleeves, and colorfully striped button-downs. The biggest draw, though, is the denim, which is sold in six different silhouettes, showcasing an impressive number of length and wash options. The size range for Goodthreads is XS-XXL on most pieces.

There is

What it is: Everyday underwear and lingerie, plus great swim options

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Amazon’s own lingerie brand offers everything from underwire bras to slinky slips and lace-trimmed thongs. If you’re looking for underwear or sleepwear of any kind, this is your brand.

For casual everyday wear, Mae offers cotton briefs and bras, lacy bralettes, and future go-to t-shirt bras to name a few. If you’re looking for more of a special lingerie moment, consider their wide selection of sexy, flirty sets and separates. The brand has expanded into swim, shapewear, and pajamas, too.

Daily Ritual

What it is: Comfortable basics that go up to 7X

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Daily Ritual is your go-to for comfortable options that look presentable enough for stepping out with friends or running errands. The brand is known for its selection of casual essentials that are anything but basic, and most items are made of a super soft cotton jersey or fleece.

There’s a bit of everything, including puffer jackets for when temps get chilly, but the majority of the pieces focus on classic cotton tees, joggers, and the like. An impressive amount is offered in plus sizes up to 7X, providing real universal appeal. For the shopper who loves to dress simply, stay comfortable, and look put-together, this is the Amazon fashion brand for you.

The Drop

What it is: Limited-edition collections co-created with some of today’s biggest social stars

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Built on the concept of curated, limited-edition capsule collections that are only promised to be available for a quick 30 hours, The Drop is Amazon’s most coveted line. Each collab is designed and curated by a rotating list of bloggers and influencers uniquely catering to their individual style at affordable prices—it’s either pieces they want for their own wardrobe or have developed a signature look around.

Past influencers to participate include Charlotte Groeneveld of The Fashion Guitar, Leonie Hanne of Ohh Couture, Quigley Goode of Officially Quigley, and more. Depending on the influencer, The Drop could include everything from wrap dresses to faux leather pants; teddy bear shearling coats or shackets. You have 30 hours to order originally, but some styles (like the below) make a reappearance.

Cable Stitch

What it is: Classic knitwear silhouettes, updated

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The name literally says it all: Cable Stitch is the Amazon brand to go to if you love a good knitwear moment. Cardigans, pullovers, dresses…you name it. The range will appeal to minimalists and maximalists alike, with classic solid colors and brightly colored stripes in the mix.

When Amazon creates an entire line centered around knitwear, you know they’re going to go big or go home. You can shop an array of the more unconventional knits that are trending (like side-slit midis and puff-sleeve pullovers) as well as basics. Most pieces retail between $20 and $60, though some outliers will exist from season to season.

The Fix

What it is: Stand-out shoes and bags that can upgrade everything in your closet

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Accessory obsessed? You need to know about The Fix. Specializing in the little pieces that make or break a look, this is your shop for all the trendiest footwear and handbags you’ve been coveting since you first saw them explode on the street style scene.

At The Fix, you can shop heels, flats, sandals, and sneakers in a range of head-turning styles. There are certainly no basics here, with every style boasting at least one special detail that makes them stand out from the rest. Whether that’s an ankle strap or chunky heels covered in velvet, special details let you transform your look by swapping in a new accessory.

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Marshfield Clinic Health System saves $1.2M with parts procurement automation

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Marshfield Clinic Health System saves $1.2M with parts procurement automation

Marshfield Clinic Health System is a fast-growing health system in Wisconsin. Since 2017, it has jumped from one to nine hospitals and now has more than 1,200 providers totaling 86 specialties.

MCHS also has a health plan and a healthcare technology management department that manages more than 32,000 pieces of equipment. That department also has grown exponentially: In 2018 it managed just 8,000 pieces.

THE PROBLEM

“There was no way we were going to keep up with this growth without adding substantial biomedical support staff,” said Jay Olson, system biomed director at Marshfield Clinic Health System. “And when you need support staff for the support staff, that doesn’t fly. In our world of managing equipment and people, the last thing you want to do is add more people.

“However, the way we ran the HTM department was very inefficient,” he continued. “Like many healthcare organizations, we weren’t using automation or leveraging analytics to manage the procurement of parts and services for medical equipment. Instead, we were using paper purchase orders.”

Plus, each hospital had its unique parts ordering system or procurement service, which added complexity. When these individual hospitals joined the MCHS system, the purchasing processes were all different.

“On top of this, we were relying on our biomed technicians to do the bulk of the heavy lifting in purchasing: calling around or searching online sites for the best prices and deals, making snap decisions about the quality of parts and equipment, and using paper requisitions to create orders and faxing them to suppliers,” Olson explained.

They also had to follow up on orders and reconcile any issues, which is stressful since they often need to get the parts quickly to fix often-crucial equipment.

“As might be expected, this was a time-consuming process, and wasn’t the best use of the technicians’ time,” Olson said. “Their job is to fix equipment, and their first priority is to have the equipment up and running so the clinical staff can focus on patient care.”

Data integrity also was a major concern. The past purchasing process lacked accurate order confirmation and tracking. Staff often discovered that orders were never actually placed. And when orders were placed, technicians had to manually enter purchased part numbers into the system, from Accruent Computerized Maintenance Management Systems.

“I have some amazing technicians that can fix high-end imaging equipment, and they save us millions of dollars a year, but even they could accidentally input duplicate part descriptions or introduce discrepancies,” Olson noted.

Additionally, the purchasing compliance rules created conflicts and delays.

“This data-driven approach also lets us make smarter decisions faster, like having the instant comparison to either purchase a $300 new part versus the cost of sending the equipment out for repair, which is a $150 flat repair rate.”

Jay Olson, Marshfield Clinic Health System

“We have select vendors that we’re supposed to order all of our parts through, but since I can’t get everything I need in one place, you have to be able to go to other stores,” he explained. “However, we weren’t able to do that without setting up a whole new company in our database. It’s a week-long process to just get a part that nobody else sold for us.”

PROPOSAL

First, Olson took advantage of MCHS being in its rapid growth phase and made an operational change: Instead of every individual hospital department having its own biomed spend, he proved that the health system could save money by creating one in-house service.

The health system took all the costs and all the spend and put them in one account. That simplified everything so Olson could get control over ordering the parts.

Once leadership gave him the ball, he had to run with it – and he turned to vendor PartsSource.

“PartsSource Pro was the best solution for our consolidated department,” he said. “Their e-commerce platform integrated easily with our existing purchasing processes and CMMS, so we didn’t have to install expensive new equipment or undergo significant employee training for implementation.

“The only thing a biomed technician needed to do was login to existing systems and start the work order, click on the PartsSource area – which had a customized interface for every one of our parts – complete their shopping cart, and then close the work order when they finished the repair.”

Because PartsSource’s service platform is based on evidence and quality data, it also offered MCHS a way to streamline and optimize how it purchased medical equipment parts and services.

“Our biomed technicians would have instant access to internal inventory numbers and the ability to track orders, as well as the ability to consolidate suppliers and access high-quality clinical resources at the point of purchase,” Olson noted. “All of this was more efficient: biomed technicians had more time in their day, as they weren’t working on following up on orders, and the workflow process ran smoother.

“PartsSource ended up becoming an extension of our team, which was the best option for our operational needs,” he said. “We were at the point where we either had to add staff or we had to go with the program. Go big or go home, as I like to say.”

MEETING THE CHALLENGE

Olson and staff report being very pleased with the results.

PartsSource’s platform integrated seamlessly with our existing system, the Accruent Transportation Management System (TMS) and CMMS and purchasing workflows,” he said. “The clinical engineering department, specifically our biomed technicians, used this combined platform for ordering, and were able to open a work order and access the PartsSource marketplace with the click of a button.

“Rather than making multiple calls or conducting time-consuming research, they had costs and reliability figures at their fingertips to support their decision-making,” he continued. “After receiving a part and then making a repair, all they had to do was go back in and close the work order out. Best of all, everything technicians did – from the time they purchased something to shipping info – was available right there in the work order.”

This deep integration led to greater data integrity, as tracking this information automatically (and correctly) resulted in better access to the kind of data staff needed to drive activities such as a capital replacement strategy, alternative equipment maintenance (AEM) schedules and total cost of ownership.

Previously, manually entering orders could lead to confusion over inventory – whether something is in stock or even on order – or duplicate entries. From a safety standpoint, if there is a recall, the staff can actually determine where a part is in that moment.

RESULTS

MCHS saw an immediate impact. For example, via PartsSource, the staff bought a specialized X-ray tube for $89,000 – a savings of more than $30,000 compared to the price from the vendor they had usually purchased it from. They had the part in-house the next day.

“Big wins like that, and all the little wins underneath of it, really justified the program,” Olson said.

Because PartsSource orders are imported right into the database, staff members now have better visibility into their spending and purchasing behavior, which has helped them plan and control costs.

“I can actually balance our general ledger for our cost centers against our TMS, and it’s spot on, because the cost of the part is tracked all the way – from the time it gets ordered to the time it gets put in the machine,” he explained.

“This data-driven approach also lets us make smarter decisions faster, like having the instant comparison to either purchase a $300 new part versus the cost of sending the equipment out for repair, which is a $150 flat repair rate,” he continued.

“We saw financial benefits immediately with access to this new information. In fact, after just one quarter, we saw a cost savings of 35%. At the end of 2019, MCHS’ use of PartsSource saved the organization $1.2 million just in parts.”

The solution allowed staff to consolidate parts procurement from multiple different original equipment manufacturers (OEMs) and suppliers into one centralized, easy-to-use e-commerce platform, integrating with CMMS and purchasing workflows, he added.

“Our odds-and-ends parts are all ordered via one-stop-shopping. We can go into PartsSource’s catalog, and there they are,” he said. “These parts have also been verified. But if we do have problems, we can send them back and contact PartsSource and give feedback: ‘Hey, this part wasn’t what it was cut out to be.’ They go to a different vendor and fix the issue.”

This system has helped MCHS maintain excellent return rates on defective replacement/repair parts for medical equipment. To date in 2021, the health system’s quality return rate is 0.3%, with the industry benchmark being 2%; and an overall return rate of 2.4%, again beating the industry benchmark, 3%.

“Consolidating parts procurement from 471 different OEMs and suppliers eliminated significant waste in the procurement process, which alleviated the burden of purchase order management,” Olson said. “Decreasing the time to procure parts increased productivity for the department.

For example, the time from requesting the part to delivery used to be nearly 90 minutes. However, implementing PartsSource nearly halved this time throughout our partnership,” he continued. “Technicians could then dedicate these hours instead to customer support and service, repairs, cybersecurity, and sustaining the incredible growth MCHS has undergone.”

Plus, the automation has been a lifesaver, Olson said.

“Technicians don’t have to manage and follow the order confirmations. It’s all done automatically,” he explained. “This allowed us to give them back time in their day to focus on different, clinically focused tasks that they didn’t have time to focus on before, such as troubleshooting.

“With our existing staffing model, when employees are tied up with researching parts and working on getting equipment up and running, that’s less time they’ll have to look at other pieces of equipment that might need repairs,” he added. “In that case, we’ll call the vendor and have them help us out. But if they have extra time in the day, they can go attack another piece of equipment without having to call the vendor and/or switch around resources.”

Staff members always try to keep their resources deep enough, but it’s always more cost-effective if they can do it themselves, he said.

Today, as MCHS is building a tenth hospital, it has been able to keep up with the growth. In fact, it is at a point where it has added a couple of managers to oversee its southern and northern regions.

“Right now, we have an approval process, so if anyone is spending $1,000 or more on a part, I can approve it quickly, as I have PartsSource on my phone,” Olson said. “Now, however, these new managers can focus on the spend and make my life easier. There’s a lot of days I’ll see a part order come across, and I don’t have time to drill down on why it’s being ordered or why he’s doing OEM instead of third party. Now I can pass these on so I don’t delay the orders.”

ADVICE FOR OTHERS

“Organizations should first drill down on their existing pain points and look at what their specific needs are,” Olson advised. “Don’t be afraid to even make a list, ranking in order of importance your most crucial needs and what you’re looking for in a holistic solution and a valued partner.

“If you’re in a growth phase, you have to jump on board,” he continued. “Don’t be afraid of a data-driven solution, even if it is different from the paper-based way you’ve done things in the past. If you’re going to keep up with the industry, you have to keep an open mind. You don’t want to cut back staff, but utilize your staff in different ways.”

For example, instead of having two people placing orders, Olson has one staff member who helps with contract management, and another one who assists with all the invoicing that seems to stack up when one adds nine hospitals.

“If you can get into the growth phase like MCHS is in right now and keep services in-house and under control, you can do so much in savings moving forward,” he concluded. “For 32,000 pieces of equipment, we have a director and two managers and enough staff to run it. And it’s all because of the money that we’re saving because of working smarter.”

Twitter: @SiwickiHealthIT
Email the writer: bsiwicki@himss.org
Healthcare IT News is a HIMSS Media publication.

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