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https://www.readbyqxmd.com/read/28635297/medical-students-leading-quality-improvement-a-lean-six-sigma-approach-to-pain-management
#1
David Droullard, Samuel Porter, Anna Zuckerman, Daphne Monie, Judi Brendle, Henry Weil
No abstract text is available yet for this article.
June 1, 2017: American Journal of Medical Quality: the Official Journal of the American College of Medical Quality
https://www.readbyqxmd.com/read/28630601/international-society-of-sports-nutrition-position-stand-diets-and-body-composition
#2
REVIEW
Alan A Aragon, Brad J Schoenfeld, Robert Wildman, Susan Kleiner, Trisha VanDusseldorp, Lem Taylor, Conrad P Earnest, Paul J Arciero, Colin Wilborn, Douglas S Kalman, Jeffrey R Stout, Darryn S Willoughby, Bill Campbell, Shawn M Arent, Laurent Bannock, Abbie E Smith-Ryan, Jose Antonio
Position Statement: The International Society of Sports Nutrition (ISSN) bases the following position stand on a critical analysis of the literature regarding the effects of diet types (macronutrient composition; eating styles) and their influence on body composition. The ISSN has concluded the following. 1) There is a multitude of diet types and eating styles, whereby numerous subtypes fall under each major dietary archetype. 2) All body composition assessment methods have strengths and limitations. 3) Diets primarily focused on fat loss are driven by a sustained caloric deficit...
2017: Journal of the International Society of Sports Nutrition
https://www.readbyqxmd.com/read/28630458/the-value-of-instability-an-investigation-of-intra-subject-variability-in-brain-activity-among-obese-adolescent-girls
#3
L O Bauer, R J Houston
BACKGROUND: The present study investigated the value of intra-subject variability (ISV) as a metric for revealing differences in cognition and brain activation associated with an obese versus lean body mass. METHODS: Ninety-six adolescents with a lean body mass (BMI %-ile=5-85), and 92 adolescents with an obese body mass (BMI %-ile >=95), performed two tasks (Stroop and Go/NoGo) challenging response inhibition skills. The standard deviations and averages of their reaction time and P300 electroencephalographic responses to task stimuli were computed across trials...
June 20, 2017: International Journal of Obesity: Journal of the International Association for the Study of Obesity
https://www.readbyqxmd.com/read/28627053/recovery-of-insulin-sensitivity-and-optimal-body-composition-after-rapid-weight-loss-in-obese-dogs-fed-a-high-protein-medium-carbohydrate-diet
#4
A André, I Leriche, G Chaix, C Thorin, M Burger, P Nguyen
This study investigated the effects of an experimental high-protein medium-carbohydrate diet (protein level, 46% metabolizable energy, ME). First, postprandial plasma glucose and insulin kinetics were determined in steady-state overweight/obese Beagle dogs (28%-41% excess body weight) for an experimental high-protein medium-carbohydrate diet (protein level, 46% ME) and a commercial high-carbohydrate medium-protein diet (protein level, 24%ME) in obese dogs. Secondly, all the dogs were included in a weight loss programme...
June 2017: Journal of Animal Physiology and Animal Nutrition
https://www.readbyqxmd.com/read/28609591/obesity-and-weight-management-at-menopause
#5
Joseph Proietto
BACKGROUND: Many women report gaining weight as they transition through menopause. For most, the weight gain is modest and can be reduced with a conscious effort to limit energy intake and increase energy expenditure. However, many women who are already overweight and obese will gain more weight as they approach menopause. OBJECTIVE: The aims of this paper are to explain the reasons for menopausal weight gain and to detail a method for achieving and sustaining a substantial weight loss...
June 2017: Australian Family Physician
https://www.readbyqxmd.com/read/28602744/prevalence-and-factors-associated-with-neck-pain-a-population-based-study
#6
Caio Vitor Dos Santos Genebra, Nicoly Machado Maciel, Thiago Paulo Frascareli Bento, Sandra Fiorelli Almeida Penteado Simeão, Alberto De Vitta
BACKGROUND: Neck pain is a musculoskeletal condition with high prevalence that may affect the physical, social, and psychological aspects of the individual, contributing to the increase in costs in society and business. OBJECTIVE: To determine the prevalence of neck pain and associated factors in a population-based sample of adults aged 20 and more. METHODS: Cross-sectional study based on a population survey. A total number of 600 individuals were interviewed in their homes, and the following data were collected: (1) participant characteristics (demographic, socioeconomic, and work-related aspects) using a pre-coded questionnaire; (2) physical activity level using the IPAQ; and (3) musculoskeletal symptoms using the Nordic questionnaire...
May 20, 2017: Brazilian Journal of Physical Therapy
https://www.readbyqxmd.com/read/28586671/trends-and-frontiers-for-the-science-and-management-of-the-oceans
#7
EDITORIAL
Peter J Mumby
People have an enduring fascination with the biology of the oceans. When the BBC's 'Blue Planet' series first aired on British television almost a quarter of the nation tuned in. As the diversity of science in this special issue of Current Biology attests, the ocean presents a challenging environment for study while also exhibiting some of the most profound and disruptive symptoms of global change. Marine science has made major advances in the past few decades, which were primarily made possible through important technological innovations...
June 5, 2017: Current Biology: CB
https://www.readbyqxmd.com/read/28575048/effects-of-a-weight-management-program-delivered-by-social-media-on-weight-and-metabolic-syndrome-risk-factors-in-overweight-and-obese-adults-a-randomised-controlled-trial
#8
Monica Jane, Martin Hagger, Jonathan Foster, Suleen Ho, Robert Kane, Sebely Pal
INTRODUCTION: The aim of this project was to evaluate the effectiveness of using social media to augment the delivery of, and provide support for, a weight management program delivered to overweight and obese individuals during a twenty four week intervention. METHODS: Participants randomly divided into either one of two intervention groups or a control group. The two intervention groups were instructed to follow identical weight-management program. One group received the program within a Facebook group, along with a support network with the group, and the other intervention group received the same program in a booklet...
2017: PloS One
https://www.readbyqxmd.com/read/28558814/approach-to-growth-hormone-therapy-in-children-with-chronic-kidney-disease-varies-across-north-america-the-midwest-pediatric-nephrology-consortium-report
#9
Oleh M Akchurin, Amy J Kogon, Juhi Kumar, Christine B Sethna, Hoda T Hammad, Paul J Christos, John D Mahan, Larry A Greenbaum, Robert Woroniecki
BACKGROUND: Growth impairment remains common in children with chronic kidney disease (CKD). Available literature indicates low level of recombinant human growth hormone (rhGH) utilization in short children with CKD. Despite efforts at consensus guidelines, lack of high-level evidence continues to complicate rhGH therapy decision-making and the level of practice variability in rhGH treatment by pediatric nephrologists is unknown. METHODS: Cross-sectional online survey electronically distributed to pediatric nephrologists through the Midwest Pediatric Nephrology Consortium and American Society of Pediatric Nephrology...
May 30, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28554316/beta-hydroxy-beta-methyl-butyrate-hmb-from-experimental-data-to-clinical-evidence-in-sarcopenia
#10
Alfonso J Cruz-Jentoft
β-hydroxy-β-methylbutyrate (HMB) is a metabolite derived from leucine and its ketoacid alpha-ketoisocaproate. Leucine has a role in regulating protein synthesis in muscle cells, and HMB seems to be a key active metabolite in such regulation. HMB has been shown to modulate muscle protein degradation by inhibiting the ubiquitin-proteasome proteolytic pathway, to up-regulate protein synthesis via the mTOR pathway, and to stabilize cell membranes via the rate limiting enzyme to cholesterol synthesis HMG- coenzyme A reductase...
May 28, 2017: Current Protein & Peptide Science
https://www.readbyqxmd.com/read/28552386/tools-and-methods-for-quality-improvement-and-patient-safety-in-perinatal-care
#11
Amy T Nathan, Heather C Kaplan
The quality of health care is now recognized to vary widely in all medical specialties, including perinatal medicine. A national focus on quality improvement (QI) and patient safety is prompting providers to change and improve the care given to patients. All QI and safety efforts require the use of an improvement model to manage the complex process of improving care. This article reviews the most common frameworks in use today, including the Model for Improvement, Six Sigma, and Lean. Specific tools such as affinity, key driver and fishbone diagrams, process maps and statistical process control, as well as checklists are reviewed, with examples from the perinatal literature to illustrate their use in perinatal QI efforts...
May 25, 2017: Seminars in Perinatology
https://www.readbyqxmd.com/read/28538054/achieving-high-reliability-with-people-processes-and-technology
#12
Candice L Saunders, John A Brennan
High reliability as a corporate value in healthcare can be achieved by meeting the "Quadruple Aim" of improving population health, reducing per capita costs, enhancing the patient experience, and improving provider wellness. This drive starts with the board of trustees, CEO, and other senior leaders who ingrain high reliability throughout the organization. At WellStar Health System, the board developed an ambitious goal to become a top-decile health system in safety and quality metrics. To achieve this goal, WellStar has embarked on a journey toward high reliability and has committed to Lean management practices consistent with the Institute for Healthcare Improvement's definition of a high-reliability organization (HRO): one that is committed to the prevention of failure, early identification and mitigation of failure, and redesign of processes based on identifiable failures...
July 2017: Frontiers of Health Services Management
https://www.readbyqxmd.com/read/28532463/exploring-patient-centered-hospitals-a-systematic-review-to-understand-change
#13
Irene Gabutti, Daniele Mascia, Americo Cicchetti
BACKGROUND: The healthcare scenario in developed countries is changing deeply: patients, who are frequently affected by multi-pathological chronic conditions, have risen their expectations. Simultaneously, there exist dramatic financial pressures which require healthcare organizations to provide more and better services with equal (or decreasing) resources. In response to these challenges, hospitals are facing radical transformations by bridging, redesigning and engaging their organization and staff...
May 22, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28528621/using-lean-to-rapidly-and-sustainably-transform-a-behavioral-health-crisis-program-impact-on-throughput-and-safety
#14
Margaret E Balfour, Kathleen Tanner, Paul J Jurica, Dawn Llewellyn, Robert G Williamson, Chris A Carson
BACKGROUND: Lean has been increasingly applied in health care to reduce waste and improve quality, particularly in fast-paced and high-acuity clinical settings such as emergency departments. In addition, Lean's focus on engagement of frontline staff in problem solving can be a catalyst for organizational change. In this study, ConnectionsAZ demonstrates how they applied Lean principles to rapidly and sustainably transform clinical operations in a behavioral health crisis facility. METHODS: A multidisciplinary team of management and frontline staff defined values-based outcome measures, mapped the current and ideal processes, and developed new processes to achieve the ideal...
June 2017: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/28514618/aerobic-or-resistance-exercise-or-both-in-dieting-obese-older-adults
#15
RANDOMIZED CONTROLLED TRIAL
Dennis T Villareal, Lina Aguirre, A Burke Gurney, Debra L Waters, David R Sinacore, Elizabeth Colombo, Reina Armamento-Villareal, Clifford Qualls
BACKGROUND: Obesity causes frailty in older adults; however, weight loss might accelerate age-related loss of muscle and bone mass and resultant sarcopenia and osteopenia. METHODS: In this clinical trial involving 160 obese older adults, we evaluated the effectiveness of several exercise modes in reversing frailty and preventing reduction in muscle and bone mass induced by weight loss. Participants were randomly assigned to a weight-management program plus one of three exercise programs - aerobic training, resistance training, or combined aerobic and resistance training - or to a control group (no weight-management or exercise program)...
May 18, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28501537/effects-of-exercise-on-liver-fat-and-metabolism-in-alcohol-drinkers
#16
David Houghton, Kate Hallsworth, Christian Thoma, Sophie Cassidy, Timothy Hardy, Sarah Heaps, Kieren G Hollingsworth, Roy Taylor, Christopher P Day, Steve Masson, Stuart McPherson, Quentin M Anstee, Michael I Trenell
BACKGROUND & AIMS: Exercise is an important component of obesity associated disorders and has been shown to reduce markers of non-alcoholic fatty liver disease (NAFLD). However, little is known about how these effects are influenced by alcohol intake. We performed a randomized controlled trial to investigate the effects of exercise on hepatic triglyceride content (HTGC) and metabolism in overweight or obese patients who consume alcohol. METHODS: We performed a prospective study of 27 patients (mean age 54±11years, body mass index [BMI], 31±4kg/m2) with >5% HTGC in the United Kingdom, consuming alcohol (mean 221±75 g/week)...
May 10, 2017: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28497213/bone-pain-and-muscle-weakness-in-cancer-patients
#17
REVIEW
Daniel P Milgrom, Neha L Lad, Leonidas G Koniaris, Teresa A Zimmers
PURPOSE OF REVIEW: In this article, we will discuss the current understanding of bone pain and muscle weakness in cancer patients. We will describe the underlying physiology and mechanisms of cancer-induced bone pain (CIBP) and cancer-induced muscle wasting (CIMW), as well as current methods of diagnosis and treatment. We will discuss future therapies and research directions to help patients with these problems. RECENT FINDINGS: There are several pharmacologic therapies that are currently in preclinical and clinical testing that appear to be promising adjuncts to current CIBP and CIMW therapies...
April 2017: Current Osteoporosis Reports
https://www.readbyqxmd.com/read/28494624/an-overview-of-the-performance-improvement-initiatives-by-the-ministry-of-health-in-the-kingdom-of-saudi-arabia
#18
Mazen Hassanain
Saudi Arabia's Ministry of Health (MOH) use corporate performance improvement methodologies to develop and implement performance improvement initiatives designed to continue building on the Ministry's vision of transforming hospital operations and instituting a culture of quality and performance focused on the "patient first" principle. We evaluated the feasibility of setting up a performance improvement unit (PIU) within the MOH to apply the principles of Lean Six Sigma and to change management methodologies...
January 1, 2017: Inquiry: a Journal of Medical Care Organization, Provision and Financing
https://www.readbyqxmd.com/read/28478740/improving-autopsy-report-turnaround-times-by-implementing-lean-management-principles
#19
Susan Cromwell, David A Chiasson, Debra Cassidy, Gino R Somers
The autopsy is an integral part of the service of a large academic pathology department. Timely reporting is central to providing good service and is beneficial for many stakeholders, including the families, the clinical team, the hospital, and the wider community. The current study aimed to improve hospital-consented autopsy reporting times (turnaround time, TAT) by using lean principles modified for a healthcare setting, with an aim of signing out 90% of autopsies in 90 days. An audit of current and historical TATs was performed, and a working group incorporating administrative, technical, and professional staff constructed a value stream map documenting the steps involved in constructing an autopsy report...
January 1, 2017: Pediatric and Developmental Pathology
https://www.readbyqxmd.com/read/28464448/gene-expression-changes-of-thermo-sensitive-transient-receptor-potential-channels-in-obese-mice
#20
Wuping Sun, Chen Lib, Yonghong Zhang, Changyu Jiang, Mingzhu Zhai, Qian Zhou, Lizu Xiao, Qiwen Deng
Adipose tissues play key roles in energy homeostasis. Brown adipocytes and beige adipocytes in white adipose tissue (WAT) sharethe similar characters of thermogenesis, both of them could be potential targets for obesity management. Several thermo-sensitive transient receptor potential channels (thermoTRPs) are shown to be involved in adipocyte biology. However, the expression pattern of thermoTRPs in adipose tissues from obese mice is still unknown. The mRNA expression of thermoTRPs in subcutaneous WAT (sWAT) and interscapular brown adipose tissue (iBAT) from lean and obese mice were measured using Reverse Transcriptase-quantitative PCRs (RT-qPCR)...
May 2, 2017: Cell Biology International
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