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LEAN quality improvement

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https://www.readbyqxmd.com/read/29791782/obesity-leads-to-impairments-in-the-morphology-and-organization-of-human-skeletal-muscle-lipid-droplets-and-mitochondrial-networks-which-are-resolved-with-gastric-bypass-surgery-induced-improvements-in-insulin-sensitivity
#1
Marianne D Kristensen, Signe M Petersen, Kjestine E Møller, Michael T Lund, Merethe Hansen, Christina N Hansen, Julie Courraud, Jørn W Helge, Flemming Dela, Clara Prats
AIMS: Skeletal muscle lipid stores and mitochondrial function have been appointed as key players in obesity-induced insulin resistance. However, there are conflicting reports in the literature based on in vitro quantitative measurements. Here we test the hypothesis that it is not the quantity but the quality that matters. METHODS: The present study combines quantitative and qualitative structural measurements of lipid stores and mitochondrial dynamics in skeletal muscle from lean subjects, and subjects with morbid obesity, with and without type 2 diabetes, before and after gastric bypass surgery...
May 23, 2018: Acta Physiologica
https://www.readbyqxmd.com/read/29790443/improvement-of-laboratory-turnaround-time-using-lean-methodology
#2
Shradha Gupta, Sahil Kapil, Monica Sharma
Purpose The purpose of this paper is to discuss the implementation of lean methodology to reduce the turnaround time (TAT) of a clinical laboratory in a super speciality hospital. Delays in report delivery lead to delayed diagnosis increased waiting time and decreased customer satisfaction. The reduction in TAT will lead to increased patient satisfaction, quality of care, employee satisfaction and ultimately the hospital's revenue. Design/methodology/approach The generic causes resulting in increasing TAT of clinical laboratories were identified using lean tools and techniques such as value stream mapping (VSM), Gemba, Pareto Analysis and Root Cause Analysis...
May 14, 2018: International Journal of Health Care Quality Assurance
https://www.readbyqxmd.com/read/29788170/systematic-review-and-meta-analysis-of-the-evidence-for-oral-nutritional-intervention-on-nutritional-and-clinical-outcomes-during-chemo-radio-therapy-current-evidence-and-guidance-for-design-of-future-trials
#3
M A E de van der Schueren, A Laviano, H Blanchard, M Jourdan, J Arends, V E Baracos
Background: Driven by reduced nutritional intakes and metabolic alterations, malnutrition in cancer patients adversely affects quality of life, treatment tolerance and survival. We examined evidence for oral nutritional interventions during chemo(radio)therapy. Design: We carried out a systematic review of randomized controlled trials (RCT) with either dietary counseling (DC), high-energy oral nutritional supplements (ONS) aiming at improving intakes or ONS enriched with protein and n-3 polyunsaturated fatty acids (PUFA) additionally aiming for modulation of cancer-related metabolic alterations...
May 1, 2018: Annals of Oncology: Official Journal of the European Society for Medical Oncology
https://www.readbyqxmd.com/read/29756982/clinical-nutritional-inflammatory-and-oxidative-stress-predictors-in-hemodialysis-mortality-a-review
#4
Andreza De Paula Santos Epifânio, Karla Pereira Balbino, Sonia Machado Rocha Ribeiro, Sylvia C C Franceschini, Helen Hermana Miranda Hermsdorff
The evaluation of clinical-nutrition status is essential to increase life quality and improve clinical outcomes of patients in hemodialysis (HD). In the absence of a gold standard, the goal of this integrative review was to present and discuss the latest scientific literature on the ability of clinical-nutritional indicators and inflammatory and oxidative stress markers to predict morbidity and mortality in HD. In this context, the lean and fat mass indexes have become good predictors of mortality in HD individuals, regardless of BMI...
January 18, 2018: Nutrición Hospitalaria: Organo Oficial de la Sociedad Española de Nutrición Parenteral y Enteral
https://www.readbyqxmd.com/read/29751089/effect-of-obesity-on-patterns-and-mechanisms-of-injury-systematic-review-and-meta-analysis
#5
REVIEW
Tarn Stroud, N M Bagnall, Philip H Pucher
BACKGROUND: Trauma is one of the major causes of morbidity and mortality globally, especially in younger populations. With an increase in obesity globally, it is important to assess the potential differences in injury pattern and management of obese patients presenting with trauma compared to lean patients to try and improve patient care. This study aims to review the available literature comparing injury patterns between obese and non-obese patients. METHODS: A systematic review of articles which assessed the association between obesity and different patterns of trauma and injury were assessed...
May 8, 2018: International Journal of Surgery
https://www.readbyqxmd.com/read/29725220/evaluation-of-the-quality-of-beef-patties-formulated-with-dried-pumpkin-pulp-and-seed
#6
M Serdaroğlu, H S Kavuşan, G İpek, B Öztürk
The objective of this study was to investigate quality attributes of beef patties formulated with dried pumpkin pulp and seed mixture (PM). Four different meatball formulations were prepared where lean was replaced with PM as C (0% PM), P2 (2% PM), P3 (3% PM) and P5 (5% PM). Utilization of PM decreased moisture and increased ash content of the patties. Incorporation of 5% PM (P5) increased the pH value of both uncooked and cooked patties compared to C group. Increasing levels of PM increased water-holding capacity...
February 2018: Korean Journal for Food Science of Animal Resources
https://www.readbyqxmd.com/read/29716978/therapy-of-endocrine-disease-growth-hormone-replacement-therapy-in-adults-thirty-years-of-personal-clinical-experience
#7
Jens Otto L Jorgensen, Anders Juul
The acute metabolic actions of purified human GH was first documented in adult hypopituitary patients more than 50 years ago, and placebo controlled long term GH trials in GH-deficient adults (GHDA) surfaced in 1989 with the availability of biosynthetic human GH. Untreated GHDA is associated with excess morbidity and mortality from cardiovascular disease and the phenotype includes fatigue, reduced aerobic exercise capacity, abdominal obesity, reduced lean body mass, osteopenia, and elevated levels of circulating cardiovascular biomarkers...
May 1, 2018: European Journal of Endocrinology
https://www.readbyqxmd.com/read/29712718/persisting-adverse-body-composition-changes-2-years-after-cessation-of-androgen-deprivation-therapy-for-localised-prostate-cancer
#8
Ada S Cheung, Alistair Tinson, Stefan Milevski, Rudolf Hoermann, Jd Zajac, Mathis Grossmann
OBJECTIVE: Hypogonadism from androgen deprivation therapy (ADT) for prostate cancer causes adverse body composition changes associated with insulin resistance and decreased quality of life (QoL). Our objective was to assess whether adverse body composition changes improve after cessation of ADT. DESIGN: Prospective case-control study in a tertiary referral hospital. Thirty-four men newly commencing ADT (cases, median age 67.6 years [interquartile range 64.6, 72...
April 30, 2018: European Journal of Endocrinology
https://www.readbyqxmd.com/read/29706143/genome-wide-association-studies-for-seven-production-traits-highlight-genomic-regions-useful-to-dissect-dry-cured-ham-quality-and-production-traits-in-duroc-heavy-pigs
#9
F Bertolini, G Schiavo, G Galimberti, S Bovo, M D'Andrea, M Gallo, L Buttazzoni, M F Rothschild, L Fontanesi
Protected designation of origin dry-cured hams are obtained from heavy pigs (slaughtered at about 160 kg of live weight). A specific breeding program designed to improve meat quality for this production has included as key traits the level of intermuscular fat between the leg muscles and ham weight loss during the seasoning period together with a balance between fat and lean cuts. In this study we carried out genome-wide association studies for seven traits used in the genetic merit of Italian Duroc heavy pigs, five related to meat and carcass quality traits (visible intermuscular fat, ham weight loss at first salting, backfat thickness, ham weight and lean cuts), and two related to performance and efficiency traits (average daily gain and feed : gain ratio)...
April 30, 2018: Animal: An International Journal of Animal Bioscience
https://www.readbyqxmd.com/read/29704862/a-nonrestrictive-weight-loss-diet-focused-on-fiber-and-lean-protein-increase
#10
Lijuan Zhang, Sherry Pagoto, Barbara Olendzki, Gioia Persuitte, Linda Churchill, Jessica Oleski, Yunsheng Ma
OBJECTIVE: We examined the feasibility and acceptability of a non-restrictive diet that was focused on increasing dietary fiber and lean protein intake for weight loss. METHODS: Dietary intake was assessed using three randomly selected 24-h dietary recalls. Fifteen obese adults enrolled in a 12-wk study that included six biweekly individual dietary counseling sessions to attain a daily goal of higher fiber (35 g/d) and lean protein (0.8 g/kg/d of individual's ideal body weight) intake...
March 22, 2018: Nutrition
https://www.readbyqxmd.com/read/29697274/effect-of-eicosapentaenoic-acid-on-body-composition-and-inflammation-markers-in-patients-with-head-and-neck-squamous-cell-cancer-from-a-public-hospital-in-mexico
#11
Obed Solís-Martínez, Valentina Plasa-Carvalho, Geraldine Phillips-Sixtos, Yanelly Trujillo-Cabrera, Arturo Hernández-Cuellar, Gloria E Queipo-García, Eduardo Meaney-Mendiolea, Guillermo M Ceballos-Reyes, Vanessa Fuchs-Tarlovsky
INTRODUCTION: Head and neck cancer patients are at high risk of anorexia-cachexia syndrome and literature shows that Eicosapentaenoic acid (EPA) could regulate it. We aim to determine the EPA effect on body composition and pro-inflammatory markers in patients with head neck cancer. MATERIALS AND METHODS: A randomized single-blind placebo-controlled clinical trial was conducted in patients with head and neck squamous cell cancer who received a polymeric diet with 2 g of EPA or a standard polymeric diet for six weeks before antineoplastic treatment...
May 2018: Nutrition and Cancer
https://www.readbyqxmd.com/read/29681169/system-wide-lean-implementation-in-health-care-a-multiple-case-study
#12
Federica Centauri, Pamela Mazzocato, Stefano Villa, Marta Marsilio
Background Lean practices have been widely used by health care organizations to meet efficiency, performance and quality improvement needs. The lean health care literature shows that the effective implementation of lean requires a holistic system-wide approach. However, there is still limited evidence on what drives effective system-wide lean implementation in health care. The existing literature suggests that a deeper understanding of how lean interventions interact with the organizational context is necessary to identify the critical variables to successfully sustain system-wide lean strategies...
January 1, 2018: Health Services Management Research
https://www.readbyqxmd.com/read/29679690/reduced-body-weight-or-increased-muscle-quality-which-is-more-important-for-improving-physical-function-following-exercise-and-weight-loss-in-overweight-and-obese-older-women
#13
Chad R Straight, Alison C Berg, Rachelle A Reed, Mary Ann Johnson, Ellen M Evans
The purpose of this study was to examine the relative contributions of changes in muscle quality and body composition to changes in lower-extremity physical function (LEPF) following a 6-month exercise and weight loss intervention in overweight and obese older women. Thirty-eight overweight and obese (BMI = 30.0 ± 4.4 kg/m2 ) older (age = 69.3 ± 4.1 y) women completed 6 months of multicomponent exercise (cardiorespiratory, resistance, balance and flexibility training) and weight loss (hypocaloric diet that reduced energy intake by ~500 kcal/d)...
April 19, 2018: Experimental Gerontology
https://www.readbyqxmd.com/read/29673837/movements-of-older-adults-during-exergaming-interventions-that-are-associated-with-the-systems-framework-for-postural-control-a-systematic-review
#14
REVIEW
Robin Tahmosybayat, Katherine Baker, Alan Godfrey, Nick Caplan, Gill Barry
One in three older adults fall annually, in part due to impairments in the physiological systems that make up the postural control (PC) system. Exercise, particularly balance training, helps to prevent deterioration and even to improve outcomes in the PC system. Exergaming (exercise-gaming) is interactive computer gaming whereby an individual moves the body in response to onscreen cues in a playful format. Exergaming is an alternative method to standard practice for improving PC outcomes, which has been shown to reduce the risk of falling...
May 2018: Maturitas
https://www.readbyqxmd.com/read/29659862/effects-of-hormonal-growth-promotants-on-beef-quality-a-meta-analysis
#15
I J Lean, H M Golder, N M Lees, P McGilchrist, J E P Santos
Background: Benefits of hormonal growth promotants (HGP) include production efficiency, profit, and reduced environmental effects for beef cattle. Questions remain about effects of HGP on beef quality, particularly on measures of toughness such as Warner-Bratzler shear force (WBSF), tenderness, and other taste-panel attributes of beef. Objective: To assess the effects of HGP on beef quality using the results of randomized controlled trials. Design: Searches of 3 databases...
April 6, 2018: Journal of Animal Science
https://www.readbyqxmd.com/read/29615014/assessing-the-implementation-processes-of-a-large-scale-multi-year-quality-improvement-initiative-survey-of-health-care-providers
#16
Donna Goodridge, Masud Rana, Elizabeth L Harrison, Thomas Rotter, Roy Dobson, Gary Groot, Sonia Udod, Joshua Lloyd
BACKGROUND: Beginning in 2012, Lean was introduced to improve health care quality and promote patient-centredness throughout the province of Saskatchewan, Canada with the aim of producing coordinated, system-wide change. Significant investments have been made in training and implementation, although limited evaluation of the outcomes have been reported. In order to better understand the complex influences that make innovations such as Lean "workable" in practice, Normalization Process Theory guided this study...
April 3, 2018: BMC Health Services Research
https://www.readbyqxmd.com/read/29614993/impact-of-resistance-training-on-body-composition-and-metabolic-syndrome-variables-during-androgen-deprivation-therapy-for-prostate-cancer-a-pilot-randomized-controlled-trial
#17
Jacqueline K Dawson, Tanya B Dorff, E Todd Schroeder, Christianne J Lane, Mitchell E Gross, Christina M Dieli-Conwright
BACKGROUND: Prostate cancer patients on androgen deprivation therapy (ADT) experience adverse effects such as lean mass loss, known as sarcopenia, fat gain, and changes in cardiometabolic factors that increase risk of metabolic syndrome (MetS). Resistance training can increase lean mass, reduce body fat, and improve physical function and quality of life, but no exercise interventions in prostate cancer patients on ADT have concomitantly improved body composition and MetS. This pilot trial investigated 12 weeks of resistance training on body composition and MetS changes in prostate cancer patients on ADT...
April 3, 2018: BMC Cancer
https://www.readbyqxmd.com/read/29580590/decreasing-postanesthesia-care-unit-to-floor-transfer-times-to-facilitate-short-stay-total-joint-replacements
#18
Udai S Sibia, Jennifer Grover, Justin J Turcotte, Michelle L Seanger, Kimberly A England, Jennifer L King, Paul J King
PURPOSE: We describe a process for studying and improving baseline postanesthesia care unit (PACU)-to-floor transfer times after total joint replacements. DESIGN: Quality improvement project using lean methodology. METHODS: Phase I of the investigational process involved collection of baseline data. Phase II involved developing targeted solutions to improve throughput. Phase III involved measured project sustainability. FINDINGS: Phase I investigations revealed that patients spent an additional 62 minutes waiting in the PACU after being designated ready for transfer...
April 2018: Journal of Perianesthesia Nursing: Official Journal of the American Society of PeriAnesthesia Nurses
https://www.readbyqxmd.com/read/29553029/association-between-dietary-fibre-carbohydrate-intake-ratio-and-insulin-resistance-in-japanese-adults-without-type-2-diabetes
#19
Nobuhisa Morimoto, Chikako Kasuga, Airi Tanaka, Keiko Kamachi, Masumi Ai, Kevin Y Urayama, Akira Tanaka
An easily understandable index that measures the quality of carbohydrate may aid people in adopting dietary habits that improve their glucose tolerance. We aimed to evaluate the relationship between a ratio of dietary fibre to carbohydrate intakes (fibre:carbohydrate ratio (F:C-R)) and glucose tolerance cross-sectionally and longitudinally. Subjects were 190 Japanese men and women without type 2 diabetes (mean age 55·4 years) who participated in a 5-month diet and exercise programme. We compared baseline anthropometric, dietary and metabolic profiles between those with higher F:C-R and those with lower ratios...
March 2018: British Journal of Nutrition
https://www.readbyqxmd.com/read/29548356/operating-room-efficiency
#20
David H Rothstein, Mehul V Raval
The operating room is the financial hub of any hospital, and maximizing operating room efficiency has important implications for cost savings, patient satisfaction, and medical team morale. Over the past decade, manufacturing principles and processes such as Lean and Six Sigma have been applied to various aspects of healthcare including the operating room. Although time consuming, process mapping and deep examinations of each step of the patient journey from pre-operative visit to post-operative discharge can have multiplicative benefits that extend from cost savings to maintaining the focus on improving quality and patient safety...
April 2018: Seminars in Pediatric Surgery
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