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Continuous quality improvement

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https://www.readbyqxmd.com/read/29244035/interprofessional-collaboration-and-peer-mentors-for-bowel-education-in-spinal-cord-injury-a-case-consultation
#1
Ralph D Cabigon, Elizabeth Wojciechowski, Lisa Rosen, David Miller, Cristina Mix, David Chen
BACKGROUND: Evidence shows that having a bowel management program prevents rehospitalization postacute rehabilitation discharge for persons with a spinal cord injury (SCI). Peer mentors have been used to assist patients in managing their care. PURPOSE: The aim of the study was to illustrate how interprofessional collaboration led to utilizing resources of the inpatient rehabilitation facility's peer mentor program and incorporating peer mentors into bowel education for persons with SCI...
December 13, 2017: Rehabilitation Nursing: the Official Journal of the Association of Rehabilitation Nurses
https://www.readbyqxmd.com/read/29243849/therapeutic-patient-education-in-children-with-moderate-to-severe-atopic-dermatitis-a-multicenter-randomized-controlled-trial-in-china
#2
Yuan Liang, Jing Tian, Chun Ping Shen, Feng Xu, Hua Wang, Ping Li, Yan Ping Guo, Feng Lei Wei, Lin Ma
BACKGROUND: Therapeutic patient education is a continuous, systematic, patient-centered learning process to help patients and their families acquire and maintain the skills they need to manage their lives with a chronic disease. It has been proven effective in increasing treatment adherence and improving quality of life for patients with atopic dermatitis (AD) in Western countries. We introduce the first multicenter, randomized controlled clinical trial of therapeutic patient education in Chinese children with AD...
December 15, 2017: Pediatric Dermatology
https://www.readbyqxmd.com/read/29242393/a-risk-index-and-data-display-for-process-performance-in-the-pharmaceutical-industry
#3
Bert Gunter, Daniel Coleman, Aaron Goerke, Theodoro Koulis, Jens Lamerz, Yiming Peng
We propose a new index and graphical display for quantifying and visualizing process performance in the pharmaceutical industry. These tools can provide management a comprehensive, high level overview of the process performance of a global manufacturing network suitable for risk ranking, by which is meant: identifying those processes at greatest risk of failing to meet specifications, and prioritizing resources to drive continuous process improvement. Our index, like others currently in use, compares the observed variation of CQAs -- Critical Quality Attributes -- to their specifications...
December 14, 2017: PDA Journal of Pharmaceutical Science and Technology
https://www.readbyqxmd.com/read/29241602/the-incidence-of-abortion-and-unintended-pregnancy-in-india-2015
#4
Susheela Singh, Chander Shekhar, Rajib Acharya, Ann M Moore, Melissa Stillman, Manas R Pradhan, Jennifer J Frost, Harihar Sahoo, Manoj Alagarajan, Rubina Hussain, Aparna Sundaram, Michael Vlassoff, Shveta Kalyanwala, Alyssa Browne
BACKGROUND: Reliable information on the incidence of induced abortion in India is lacking. Official statistics and national surveys provide incomplete coverage. Since the early 2000s, medication abortion has become increasingly available, improving the way women obtain abortions. The aim of this study was to estimate the national incidence of abortion and unintended pregnancy for 2015. METHODS: National abortion incidence was estimated through three separate components: abortions (medication and surgical) in facilities (including private sector, public sector, and non-governmental organisations [NGOs]); medication abortions outside facilities; and abortions outside of facilities and with methods other than medication abortion...
January 2018: Lancet Global Health
https://www.readbyqxmd.com/read/29240874/wheat-genetic-resources-in-the-post-genomics-era-promise-and-challenges
#5
Awais Rasheed, Abdul Mujeeb-Kazi, Francis Chuks Ogbonnaya, Zhonghu He, Sanjaya Rajaram
Background: Wheat genetic resources have been used for genetic improvement since 1876, when Stephen Wilson (Transactions and Proceedings of the Botanical Society of Edinburgh 12: 286) consciously made the first wide hybrid involving wheat and rye in Scotland. Wide crossing continued with sporadic attempts in the first half of 19th century and became a sophisticated scientific discipline during the last few decades with considerable impact in farmers' fields. However, a large diversity of untapped genetic resources could contribute in meeting future wheat production challenges...
December 12, 2017: Annals of Botany
https://www.readbyqxmd.com/read/29240180/experimental-study-of-the-mode-instability-onset-threshold-in-high-power-fa-lpf-lasers
#6
Marie-Alicia Malleville, Romain Dauliat, Aurélien Benoît, Baptiste Leconte, Dia Darwich, Rémi du Jeu, Raphaël Jamier, Kay Schuster, Philippe Roy
We report here on an experimental investigation of the temporal behavior of transverse mode instabilities into "fully aperiodic large-pitch fibers" (FA-LPFs) operated in high-power continuous-wave laser configuration. To ensure an effective transverse single-mode emission into FA-LPFs, a perfect index matching between the active core and the background cladding materials (Δn=0) is required. The original design of such fibers enables an effective transverse single-mode emission by strengthening the higher-order mode delocalization out of the gain region, even for high heat load levels, consequently leading to the improvement of the beam spatial quality...
December 15, 2017: Optics Letters
https://www.readbyqxmd.com/read/29240127/optimal-design-for-the-support-structure-of-a-cavity-mirror-in-a-chemical-oxygen-iodine-laser-resonator
#7
Ding Cui, Zhaoxiang Deng, Yuqiang Xian, Xiaoyang Hu, Lin Zhang
The dynamic characteristics of the cavity mirror support structure strongly influence the quality of the output beam. However, the contradiction between excellent dynamic performance and light weight make the design process challenging. To cope with the problems encountered in the original design of a chemical oxygen iodine laser system, this paper presents a two-dimensional adjustable support structure based on spherical constraints with large specific stiffness in the initial design phase. Subsequently, a two-level optimization strategy containing a macro design and a detailed design is adopted to optimize the initial structure...
December 10, 2017: Applied Optics
https://www.readbyqxmd.com/read/29236650/perspective-on-publishing-quality-improvement-efforts
#8
Michael Kanter, Patrick T Courneya
Quality improvement (QI) activities are critical to achieve the Triple Aim and to the Institute of Medicine's six "Aims for Quality Improvement": Safe, Effective, Patient-Centered, Timely, Efficient, and Equitable. These QI activities are essential to create a learning health care system. Academic publishing is critical to foster continuous QI and sharing, and yet it tends to favor more traditional research articles. Publishing QI activities has great value, encourages greater rigor, and helps facilitate greater willingness to share improvement opportunities...
2017: Permanente Journal
https://www.readbyqxmd.com/read/29235986/managing-diabetes-in-people-with-dementia-a-realist-review
#9
Frances Bunn, Claire Goodman, Peter Reece Jones, Bridget Russell, Daksha Trivedi, Alan Sinclair, Antony Bayer, Greta Rait, Jo Rycroft-Malone, Chris Burton
BACKGROUND: Dementia and diabetes mellitus are common long-term conditions that coexist in a large number of older people. People living with dementia and diabetes may be at increased risk of complications such as hypoglycaemic episodes because they are less able to manage their diabetes. OBJECTIVES: To identify the key features or mechanisms of programmes that aim to improve the management of diabetes in people with dementia and to identify areas needing further research...
December 2017: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/29235785/the-evolution-of-private-plans-in-medicare
#10
Yash M Patel, Stuart Guterman
Issue: Since the 1980s, private plans have played an increasingly important role in the Medicare program. While initially created with the goals of reducing costs, improving choice, and enhancing quality, risk-based plans--now known as Medicare Advantage plans--have undergone significant policy changes since their inception; these changes have not always aligned with the original policy objectives. Goal: To examine major policy changes to Medicare risk plans and the effects of these policies on plan participation, enrollment, average premiums and cost-sharing, total costs to Medicare, and quality of care...
December 1, 2017: Issue Brief of the Commonwealth Fund
https://www.readbyqxmd.com/read/29235549/treatment-for-unresectable-or-metastatic-oesophageal-cancer-current-evidence-and-trends
#11
REVIEW
Peter S N van Rossum, Nadia Haj Mohammad, Frank P Vleggaar, Richard van Hillegersberg
Approximately half of the patients diagnosed with oesophageal cancer present with unresectable or metastatic disease. Treatment for these patients aims to control dysphagia and other cancer-related symptoms, improve quality of life and prolong survival. In the past 25 years, modestly improved outcomes have been achieved in the treatment of patients with inoperable non-metastatic cancer who are medically not fit for surgery or have unresectable, locally advanced disease. Concurrent chemoradiotherapy offers the best outcomes in these patients...
December 13, 2017: Nature Reviews. Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/29235217/heterologous-protein-expression-in-pichia-pastoris-latest-research-progress-and-applications
#12
REVIEW
Veeresh Juturu, Jin Chuan Wu
Pichia pastoris is a well-known platform strain for heterologous protein expression. Over the past five years, different strategies to improve the efficiency of recombinant protein expression by this yeast strain have been developed; these include a patent-free protein expression kit, construction of the P. pastoris CBS7435Ku70 platform strain with its high efficiency in site-specific recombination of plasmid DNA into the genomic DNA, the design of synthetic promoters and their variants by combining different core promoters with multiple putative transcription factors, the generation of mutant GAP promoter variants with various promoter strengths, codon optimization, engineering the α-factor signal sequence by replacing the native glutamic acid at the Kex2 cleavage site with the other 19 natural amino acids and the addition of mammalian signal sequence to the yeast signal sequence, and the co-expression of single chaperones, multiple chaperones or helper proteins that aid in recombinant protein folding...
December 13, 2017: Chembiochem: a European Journal of Chemical Biology
https://www.readbyqxmd.com/read/29234927/toward-a-unified-integration-approach-uniting-diverse-primary-care-strategies-under-the-primary-care-behavioral-health-pcbh-model
#13
Brian E Sandoval, Jennifer Bell, Parinda Khatri, Patricia J Robinson
Primary care continues to be at the center of health care transformation. The Primary Care Behavioral Health (PCBH) model of service delivery includes patient-centered care delivery strategies that can improve clinical outcomes, cost, and patient and primary care provider satisfaction with services. This article reviews the link between the PCBH model of service delivery and health care services quality improvement, and provides guidance for initiating PCBH model clinical pathways for patients facing depression, chronic pain, alcohol misuse, obesity, insomnia, and social barriers to health...
December 12, 2017: Journal of Clinical Psychology in Medical Settings
https://www.readbyqxmd.com/read/29234553/gait-deficits-under-dual-task-conditions-in-the-concussed-adolescent-and-young-athlete-population-a-systematic-review
#14
Larisa Grants, Bailey Powell, Cody Gessel, Faith Hiser, Amy Hassen
Background: There are no current sport concussion assessments that capture the effects of dual-task conditions on gait. Multiple studies have evaluated changes, but none have comprehensively examined literature related to the adolescent and young adult population.Purpose: The purpose of this systematic review is to synthesize documented changes in gait under dual-task conditions in adolescents and young adults after sustaining a concussion.Study Design: Systematic Review. Methods: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) was consulted to guide this systematic review...
December 2017: International Journal of Sports Physical Therapy
https://www.readbyqxmd.com/read/29234458/robust-genetic-transformation-of-sorghum-sorghum-bicolor-l-using-differentiating-embryogenic-callus-induced-from-immature-embryos
#15
Srinivas Belide, Thomas Vanhercke, James Robertson Petrie, Surinder Pal Singh
Background: Sorghum (Sorghum bicolor L.) is one of the world's most important cereal crops grown for multiple applications and has been identified as a potential biofuel crop. Despite several decades of study, sorghum has been widely considered as a recalcitrant major crop for transformation due to accumulation of phenolic compounds, lack of model genotypes, low regeneration frequency and loss of regeneration potential through sub-cultures. Among different explants used for genetic transformation of sorghum, immature embryos are ideal over other explants...
2017: Plant Methods
https://www.readbyqxmd.com/read/29234341/assuring-potato-tuber-quality-during-storage-a-future-perspective
#16
REVIEW
M C Alamar, Roberta Tosetti, Sandra Landahl, Antonio Bermejo, Leon A Terry
Potatoes represent an important staple food crop across the planet. Yet, to maintain tuber quality and extend availability, there is a necessity to store tubers for long periods often using industrial-scale facilities. In this context, preserving potato quality is pivotal for the seed, fresh and processing sectors. The industry has always innovated and invested in improved post-harvest storage. However, the pace of technological change has and will continue to increase. For instance, more stringent legislation and changing consumer attitudes have driven renewed interest in creating alternative or complementary post-harvest treatments to traditional chemically reliant sprout suppression and disease control...
2017: Frontiers in Plant Science
https://www.readbyqxmd.com/read/29234148/quality-improvement-to-reduce-chronic-lung-disease-rates-in-very-low-birth-weight-infants-high-compliance-with-a-respiratory-care-bundle-in-a-small-nicu
#17
Zuzanna Kubicka, Eyad Zahr, Tamara Rousseau, Henry A Feldman, John Fiascone
OBJECTIVE: Reduce chronic lung disease by 10% among very-low birth weight infants by implementing a consistent respiratory care bundle. STUDY DESIGN: Prospective quality improvement study of infants below 32 weeks gestation in a small neonatal intensive care unit. A respiratory care bundle to eliminate inter-provider variability and minimize use of mechanical ventilation was implemented. This included: defining delivery room management with use of continuous positive airway pressure/nasal intermittent positive pressure ventilation, uniform intubation/extubation criteria, and standardizing ventilation/post-extubation support...
December 12, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/29233632/rationale-and-design-of-the-worldwide-prospective-multicenter-registry-on-radiation-dose-estimates-of-cardiac-ct-angiography-in-daily-practice-in-2017-protection-vi
#18
Thomas J Stocker, Simon Deseive, Marcus Chen, Jonathon Leipsic, Martin Hadamitzky, Ronen Rubinshtein, Erik L Grove, Xiang-Ming Fang, John Lesser, Pál Maurovich-Horvat, Hugo Marques, Daniele Andreini, Ramzi Tabbalat, Joon-Won Kang, Joachim Eckert, Patricia Dickson, Signe H Forsdahl, Jess Lambrechtsen, Roberto C Cury, Jörg Hausleiter
BACKGROUND: Cardiac computed tomography angiography (cardiac CTA) is an increasingly used versatile imaging method to evaluate coronary and cardiac morphology. Owing to improvements in technology, image quality has continuously improved over the last 10-20 years. At the same time, numerous non-randomized and randomized studies have been performed to reduce the associated radiation exposure. Currently, it is unclear if the advances in technology and knowledge about radiation reduction translated into reduced levels of cardiac CTA radiation dose in daily clinical practice as well as a wide utilization of dose-saving strategies...
December 5, 2017: Journal of Cardiovascular Computed Tomography
https://www.readbyqxmd.com/read/29233111/effectiveness-of-two-community-based-strategies-on-disease-knowledge-and-health-behaviour-regarding-malaria-diarrhoea-and-pneumonia-in-ghana
#19
Blanca Escribano-Ferrer, Margaret Gyapong, Jane Bruce, Solomon A Narh Bana, Clement T Narh, Naa-Korkor Allotey, Roland Glover, Charity Azantilow, Constance Bart-Plange, Isabella Sagoe-Moses, Jayne Webster
BACKGROUND: Ghana has developed two community-based strategies that aim to increase access to quality treatment for malaria, diarrhoea and suspected pneumonia, and to improve household and family practices: integrated Community Case Management (iCCM) and Community-based Health Planning and Services (CHPS). The objective of the study was to assess the effectiveness of iCCM and CHPS on disease knowledge and health behaviour regarding malaria, diarrhoea and pneumonia. METHODS: A household survey was conducted two and eight years after implementation of iCCM in the Volta and Northern Regions of Ghana respectively, and more than ten years of CHPS implementation in both regions...
December 12, 2017: BMC Public Health
https://www.readbyqxmd.com/read/29233072/improving-the-development-monitoring-and-reporting-of-stroke-rehabilitation-research-consensus-based-core-recommendations-from-the-stroke-recovery-and-rehabilitation-roundtable
#20
Marion F Walker, Tammy C Hoffmann, Marian C Brady, Catherine M Dean, Janice J Eng, Amanda J Farrin, Cynthia Felix, Anne Forster, Peter Langhorne, Elizabeth A Lynch, Kathryn A Radford, Katharina S Sunnerhagen, Caroline L Watkins
Recent reviews have demonstrated that the quality of stroke rehabilitation research has continued to improve over the last four decades but despite this progress, there are still many barriers in moving the field forward. Rigorous development, monitoring and complete reporting of interventions in stroke trials are essential in providing rehabilitation evidence that is robust, meaningful and implementable. An international partnership of stroke rehabilitation experts committed to develop consensus-based core recommendations with a remit of addressing the issues identified as limiting stroke rehabilitation research in the areas of developing, monitoring and reporting stroke rehabilitation interventions...
October 2017: Neurorehabilitation and Neural Repair
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