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Continuous quality improvement

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https://www.readbyqxmd.com/read/28531775/a-protocol-for-sustained-reduction-of-total-parenteral-nutrition-and-cost-savings-by-improvement-of-nutritional-care-in-hospitals
#1
Rian van Schaik, Kurt Van den Abeele, Glenn Melsens, Peter Schepens, Truus Lanssens, Bernadette Vlaemynck, Maria Devisch, Theo A Niewold
BACKGROUND AND AIMS: Malnutrition and the use of Total Parenteral Nutrition (TPN) contribute considerably to hospital costs. Recently, we reported on the introduction of malnutrition screening and monitoring of TPN use in our hospital, which resulted in a large (40%) reduction in TPN and improved quality of nutritional care in two years (2011/12). Here, we aimed to assure continuation of improved care by developing a detailed malnutrition screening and TPN use protocol involving instruction tools for hospital staff, while monitoring the results in the following two years (2013/14)...
October 2016: Clinical Nutrition ESPEN
https://www.readbyqxmd.com/read/28531328/factors-associated-with-compliance-to-aha-acc-performance-measures-in-a-myocardial-infarction-system-of-care-in-brazil
#2
Maria Letícia L Lana, Andrea Z Beaton, Luisa C C Brant, Isadora C R S Bozzi, Osias de Magalhães, Luiz Ricardo de A Castro, Francisco César T da Silva Júnior, José Luiz P da Silva, Antonio Luiz P Ribeiro, Bruno R Nascimento
Objective: To evaluate compliance with American Heart Association/American College of Cardiology (AHA/ACC) performance measures for adults with acute myocardial infarction (AMI) and to investigate the factors associated with compliance, in an AMI System of Care in Brazil. Design: Observational longitudinal study. Setting: A high-complexity University Hospital, part of the AMI System of Care implemented in Belo Horizonte, Brazil, in 2010. Participants: Of note, 1129 patients with ST-elevation myocardial infarction (STEMI) and non-ST-elevation myocardial infarction (NSTEMI) admitted to a single center over 36 months (between 2011 and 2014)...
May 20, 2017: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/28530341/-measuring-the-effect-of-multi-sensory-stimulation-in-the-snoezelen-room-on-sleep-quality-of-alzheimer-patients-using-actigraph
#3
Doron Todder, Meital Levartovsky, Tzvi Dwolatzky
BACKGROUND: The most common cause of dementia is Alzheimer's disease. The major manifestation of the disease is the cognitive impairment which appears at the onset of the disease. In addition to the cognitive impairment there are behavioral dysfunctions such as apathy, anxiety, depression and sleep disturbances. The treatment for the manifestations of Alzheimer is currently pharmacological and behavioral. One of the newest behavioral treatments for Alzheimer is the multi-sensory treatment using the Snoezelen room...
December 2016: Harefuah
https://www.readbyqxmd.com/read/28530070/-the-coronary-sinus-reducer-a-devicebased-therapy-for-refractory-angina
#4
REVIEW
Maayan Konigstein, Shmuel Banai
Alongside the remarkable progress in therapeutic strategies destined to patients with coronary artery disease (CAD), a growing number of patients who suffer from severe and diffuse CAD not amenable for revascularization, continue to experience severe debilitating angina despite optimal medical therapy. The Coronary Sinus (CS) Reducer has emerged as a novel therapeutic strategy for patients with refractory angina pectoris. The Reducer is a stainless steel, balloon-expandable, hourglass shaped device implanted percutaneously through the right internal jugular vein in the coronary sinus...
November 2016: Harefuah
https://www.readbyqxmd.com/read/28529841/rapid-and-conformal-coating-of-polymer-resins-by-airbrushing-for-continuous-and-high-speed-roll-to-roll-nanopatterning-parametric-quality-controls-and-extended-applications
#5
Jae Hyuk Lee, Minho Na, Jiyeop Kim, Kangeun Yoo, Jaekyu Park, Jeong Dae Kim, Dong Kyo Oh, Seungjo Lee, Hongseok Youn, Moon Kyu Kwak, Jong G Ok
We present a facile and scalable coating method based on controlled airbrushing, which is suitable for conformal resin coating in continuous roll-to-roll (R2R) nanoimprint lithography (NIL) process. By controlling the concentration of UV-curable polymeric resin with mixing the volatile solvent and its airbrushing time, the coated resin film thickness can be readily tuned. After R2R NIL using a flexible nanoscale line pattern (nanograting) mold is conducted upon the airbrushed resin film, a large-area uniform nanograting pattern is fabricated with controlled residual layer thickness (RLT) based on the initial film thickness...
2017: Nano Convergence
https://www.readbyqxmd.com/read/28529546/disease-management-programs-for-patients-with-type-2-diabetes-mellitus-in-germany-a-longitudinal-population-based-descriptive-study
#6
Michael Mehring, Ewan Donnachie, Florian Cornelius Bonke, Christoph Werner, Antonius Schneider
BACKGROUND: The primary aim of the disease management program (DMP) for patients with diabetes mellitus type 2 is to improve the quality of health care and the treatment process. 12 years after its introduction in Germany, there is still no consensus as to whether DMP has been effective in reaching these goals. METHODS: A retrospective longitudinal population-based study between 2004 and 2015 were conducted to evaluate the DMP for type 2 diabetes in Bavaria using routinely collected patient medical records hold from the National Association of Statutory Health Insurance Physicians of Bavaria...
2017: Diabetology & Metabolic Syndrome
https://www.readbyqxmd.com/read/28528091/antiproliferative-activity-of-ontario-grown-onions-against-colorectal-adenocarcinoma-cells
#7
Abdulmonem I Murayyan, Cynthya M Manohar, Gordon Hayward, Suresh Neethirajan
Cancer is the leading cause of mortality in Canada and other industrialized nations; the development of new/improved cancer therapies is desperately needed and continues to be a major focus of cancer research. Flavonoids, which are found in high levels in onions, have been shown to exert antiproliferative and potentially anti-cancer activities. To test their therapeutic potential, we assessed the antiproliferative, cytotoxic, apoptosis-inducing, and anti-migratory activities of five onion varieties grown in Ontario against human adenocarcinoma (Caco-2) cells...
June 2017: Food Research International
https://www.readbyqxmd.com/read/28527678/patient-reported-quality-of-life-after-endovascular-repair-of-thoracoabdominal-aortic-aneurysms
#8
Andrew J Meltzer, Peter H Connolly, Sharif Ellozy, Darren B Schneider
OBJECTIVE: The purpose of this study was to assess patient-reported physical and emotional well-being during follow-up after endovascular repair of TAAA. METHODS: All patients were treated in the context of a physician-sponsored investigational device exemption clinical study for patients at high risk for open TAAA repair. The SF-36 instrument was administered preoperatively, and at 1, 6, and 12 months. Results were analyzed using paired t-tests, with sub-group comparisons to assess impact of adverse events and technical results on quality of life...
May 17, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28527534/austerity-and-the-sector-wide-approach-to-health-the-mozambique-experience
#9
James Pfeiffer, Sarah Gimbel, Baltazar Chilundo, Stephen Gloyd, Rachel Chapman, Kenneth Sherr
Fiscal austerity policies imposed by the IMF have reduced investments in social services, leaving post-independence nations like Mozambique struggling to recover from civil war and high disease burden. By 2000, a sector-wide approach (SWAp) was promoted to maximize aid effectiveness. 'Like-minded' bilateral donors, from Europe and Canada, promoted a unified approach to health sector support focusing on joint planning, common basket funding, and streamlined monitoring and evaluation to improve sector coordination, amplify country ownership, and build sustainable health systems...
May 4, 2017: Social Science & Medicine
https://www.readbyqxmd.com/read/28526493/improving-comfort-around-dying-in-elderly-people-a-cluster-randomised-controlled-trial
#10
Kim Beernaert, Tinne Smets, Joachim Cohen, Rebecca Verhofstede, Massimo Costantini, Kim Eecloo, Nele Van Den Noortgate, Luc Deliens
BACKGROUND: Over 50% of elderly people die in acute hospital settings, where the quality of end-of-life care is often suboptimum. We aimed to assess the effectiveness of the Care Programme for the Last Days of Life (CAREFuL) at improving comfort and quality of care in the dying phase in elderly people. METHODS: We did a cluster randomised controlled trial in acute geriatric wards in ten hospitals in Flemish Region, Belgium, between Oct 1, 2012, and March 31, 2015...
May 16, 2017: Lancet
https://www.readbyqxmd.com/read/28525558/electronic-clinical-quality-measure-reporting-challenges-findings-from-the-medicare-ehr-incentive-program-s-controlling-high-blood-pressure-measure
#11
Dawn M Heisey-Grove, Hilary K Wall, Janet S Wright
Objective: To identify physician and practice characteristics associated with high clinical and technical performance on the electronic clinical quality measure (eCQM) that calculates the proportion of patients with hypertension who have controlled blood pressure. Materials and Methods: The study included 268 602 physicians participating in the Medicare Electronic Health Record Incentive Program between 2011 and 2014. Independent variables included delivery reform participation and physician, practice level, and area characteristics...
May 19, 2017: Journal of the American Medical Informatics Association: JAMIA
https://www.readbyqxmd.com/read/28524457/cyclization-of-motor-cortex-stimulation-for-neuropathic-pain-a-prospective-randomized-blinded-trial
#12
Zurab Ivanishvili, Anujan Poologaindran, Christopher R Honey
OBJECTIVES: Programming guidelines for motor cortex stimulation (MCS) in neuropathic pain requires further investigation. After optimizing voltage as a percentage of motor threshold, we evaluated the effect of cyclizing time of stimulation on pain relief for chronic neuropathic pain. METHODS: Six patients were enrolled into this trial. In a prospective, randomized, double-blinded manner, patients were programmed to receive stimulation 100, 83.3, 66.7, or 50% of the time in 30-min intervals...
May 19, 2017: Neuromodulation: Journal of the International Neuromodulation Society
https://www.readbyqxmd.com/read/28523441/progress-in-the-presence-of-failure-updates-in-chronic-systolic-heart-failure-management
#13
REVIEW
Katie M Murphy, Julie L Rosenthal
The therapeutic heart failure armamentarium has evolved from drugs to transplantation to devices through further understanding of its complex pathophysiology and pathogenesis. Current medications capitalize on our evolving understanding of the sympathetic and renin-angiotensin-aldosterone systems that subsequently promote both beneficial and maladaptive responses that ultimately yield a decrease in cardiac function. Despite these advancements, the prevalence of heart failure continues to rise and carries a significant burden on our patients and health care system...
July 2017: Current Treatment Options in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28522999/fermentation-ph-modulates-the-size-distributions-and-functional-properties-of-gluconobacter-albidus-tmw-2-1191-levan
#14
Tharalinee Ua-Arak, Frank Jakob, Rudi F Vogel
Bacterial levan has gained an increasing interest over the last decades due to its unique characteristics and multiple possible applications. Levan and other exopolysaccharides (EPSs) production are usually optimized to obtain the highest concentration or yield while a possible change of the molecular size and mass during the production process is mostly neglected. In this study, the molar mass and radius of levan samples were monitored during fermentations with the food-grade, levan-producing acetic acid bacterium Gluconobacter (G...
2017: Frontiers in Microbiology
https://www.readbyqxmd.com/read/28521798/use-of-malaria-rdts-in-various-health-contexts-across-sub-saharan-africa-a-systematic-review
#15
Matthew R Boyce, Wendy P O'Meara
BACKGROUND: The World Health Organization recommends parasitological confirmation of malaria prior to treatment. Malaria rapid diagnostic tests (RDTs) represent one diagnostic method that is used in a variety of contexts to overcome limitations of other diagnostic techniques. Malaria RDTs increase the availability and feasibility of accurate diagnosis and may result in improved quality of care. Though RDTs are used in a variety of contexts, no studies have compared how well or effectively RDTs are used across these contexts...
May 18, 2017: BMC Public Health
https://www.readbyqxmd.com/read/28521579/cognitive-behavioural-therapy-for-post-stroke-fatigue-and-sleep-disturbance-a-pilot-randomised-controlled-trial-with-blind-assessment
#16
Sylvia Nguyen, Dana Wong, Adam McKay, Shantha M W Rajaratnam, Gershon Spitz, Gavin Williams, Darren Mansfield, Jennie L Ponsford
The objective of this study was to evaluate the effectiveness of individual cognitive behavioural therapy (CBT) for post-stroke fatigue and sleep disturbance compared to treatment as usual (TAU). In a parallel two-group pilot randomised controlled trial of 15 participants, nine were allocated to eight weekly sessions of adapted CBT and six continued usual care rehabilitation. The primary outcome was the Fatigue Severity Scale (FSS-7) at two and four months from baseline. Secondary outcomes included measures of sleep, mood and quality of life...
May 19, 2017: Neuropsychological Rehabilitation
https://www.readbyqxmd.com/read/28520771/quality-of-maternity-care-and-its-determinants-along-the-continuum-in-kenya-a-structural-equation-modeling-analysis
#17
Patrick Opiyo Owili, Miriam Adoyo Muga, Bomar Rojas Mendez, Bradley Chen
BACKGROUND: Improving access to delivery services does not guarantee access to quality obstetric care and better survival, and therefore, concerns for quality of maternal and newborn care in low- and middle-income countries have been raised. Our study explored characteristics associated with the quality of initial assessment, intrapartum, and immediate postpartum and newborn care, and further assessed the relationships along the continuum of care. METHODS: The 2010 Service Provision Assessment data of Kenya for 627 routine deliveries of women aged 15-49 were used...
2017: PloS One
https://www.readbyqxmd.com/read/28520558/data-driven-event-by-event-respiratory-motion-correction-using-tof-pet-list-mode-centroid-of-distribution
#18
Silin Ren, Xiao Jin, Chung Chan, Yiqiang Jian, Tim Mulnix, Chi Liu, Richard E Carson
Data-driven respiratory gating techniques were developed to correct for respiratory motion in PET studies, without the help of external motion tracking systems. Due to the greatly increased image noise in gated reconstructions, it is desirable to develop a data-driven event-by-event respiratory motion correction method. In this study, using the Centroid-of-distribution (COD) algorithm, we established a data-driven event-by-event respiratory motion correction technique using TOF PET list-mode data, and investigated its performance by comparing with an external system-based correction method...
May 18, 2017: Physics in Medicine and Biology
https://www.readbyqxmd.com/read/28516968/preliminary-experience-with-4k-ultra-high-definition-endoscope-analysis-of-pros-and-cons-in-skull-base-surgery
#19
M Rigante, G La Rocca, L Lauretti, G Q D'Alessandris, A Mangiola, C Anile, A Olivi, G Paludetti
During the last two decades endoscopic skull base surgery observed a continuous technical and technological development 3D endoscopy and ultra High Definition (HD) endoscopy have provided great advances in terms of visualisation and spatial resolution. Ultra-high definition (UHD) 4K systems, recently introduced in the clinical practice, will shape next steps forward especially in skull base surgery field. Patients were operated on through transnasal transsphenoidal endoscopic approaches performed using Olympus NBI 4K UHD endoscope with a 4 mm 0° Ultra Telescope, 300 W xenon lamp (CLV-S400) predisposed for narrow band imaging (NBI) technology connected through a camera head to a high-quality control unit (OTV-S400 - VISERA 4K UHD) (Olympus Corporation, Tokyo, Japan)...
June 2017: Acta Otorhinolaryngologica Italica
https://www.readbyqxmd.com/read/28516349/anthropogenic-activities-and-coastal-environmental-quality-a-regional-quantitative-analysis-in-southeast-china-with-management-implications
#20
Kai Chen, Yan Liu, Dongren Huang, Hongwei Ke, Huorong Chen, Songbin Zhang, Shengyun Yang, Minggang Cai
Regional analysis of environmental issues has always been a hot topic in the field of sustainable development. Because the different levels of economic growth, urbanization, resource endowments, etc. in different regions generate apparently different ecological responses, a better description and comparison across different regions will provide more valuable implications for ecological improvement and policymaking. In this study, seven typical bays in southeast China that are a rapid developing area were selected to quantitatively analyze the relationship between socioeconomic development and coastal environmental quality...
May 17, 2017: Environmental Science and Pollution Research International
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