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Lean health care

L Maïmoun, F Paris, O Coste, C Sultan
Participation in recreational physical activity is widely acknowledged to provide significant health benefits. Conversely, intense training imposes several constraints, such as intermittent or chronic metabolic and psychogenic training stressors and maintenance of very low body fat to maximize performance. Adolescent and adult athletic women are therefore at risk of overtraining and/or poor dietary intake, which may have several consequences for endocrine function particularly on hypothalamic-pituitary-gonadal axis...
October 14, 2016: Gynécologie, Obstétrique & Fertilité
Renée J Roberts, Ashley E Wilson, Zenaide Quezado
Six Sigma and Lean methodologies are effective quality improvement tools in many health care settings. We applied the DMAIC methodology (define, measure, analyze, improve, control) to address deficiencies in our pediatric anesthesia supply chain. We defined supply chain problems by mapping existing processes and soliciting comments from those involved. We used daily distance walked by anesthesia technicians and number of callouts for missing supplies as measurements that we analyzed before and after implementing improvements (anesthesia cart redesign)...
October 3, 2016: Anesthesia and Analgesia
Eric Stice, Jeff M Gau, Paul Rohde, Heather Shaw
Because no single report has examined risk factors that predict future onset each type of eating disorder and core symptom dimensions that crosscut disorders, we addressed these aims to advance knowledge regarding risk factor specificity. Data from 3 prevention trials that targeted young women with body dissatisfaction (N = 1,272; Mage = 18.5, SD = 4.2) and collected annual diagnostic interview data over 3-year follow-up were combined to identify predictors of subthreshold/threshold anorexia nervosa (AN), bulimia nervosa (BN), binge eating disorder (BED), and purging disorder (PD)...
October 6, 2016: Journal of Abnormal Psychology
Dhruv S Kazi, P Gregg Greenough, Rishi Madhok, Aaron Heerboth, Ahmed Shaikh, Jennifer Leaning, Satchit Balsari
BACKGROUND: Planning for mass gatherings often includes temporary healthcare systems to address the needs of attendees. However, paper-based record keeping has traditionally precluded the timely application of collected clinical data for epidemic surveillance or optimization of healthcare delivery. We evaluated the feasibility of harnessing ubiquitous mobile technologies for conducting disease surveillance and monitoring resource utilization at the Allahabad Kumbh Mela in India, a 55-day festival attended by over 70 million people...
September 21, 2016: Journal of Public Health
Fonda G Robinson, Larry L Cunningham, Sharon P Turner, John Lindroth, Deborah Ray, Talib Khan, Audrey Yates
The term "lean production," also known as "Lean," describes a process of operations management pioneered at the Toyota Motor Company that contributed significantly to the success of the company. Although developed by Toyota, the Lean process has been implemented at many other organizations, including those in health care, and should be considered by dental schools in evaluating their clinical operations. Lean combines engineering principles with operations management and improvement tools to optimize business and operating processes...
October 2016: Journal of Dental Education
Deborah Jean Walker
Nurses, whatever their political leanings, can influence the public conversation on health care.
October 2016: American Journal of Nursing
Maya Lefkowich, John L Oliffe, Laura Hurd Clarke, Madeline Hannan-Leith
The pressure on boys and men to engage in extensive body practices (e.g., closely monitored eating and exercise habits) and achieve ideal male bodies has grown significantly over the past 20 years. Central to the depiction of ideal male bodies and body practices are both the pursuit and achievement of lean and well-defined muscles. The labels "pitches," "purchases," and "performativities" were inductively derived from the literature, and used to describe the multifaceted connections between masculinities, muscularity, and idealized male body practices...
September 19, 2016: American Journal of Men's Health
S E Ramel, L Zhang, S Misra, C G Anderson, E W Demerath
BACKGROUND: Recent literature suggests that neonatal adiposity is predictive of later metabolic health, while neonatal lean mass is predictive of later cognitive function amongst preterm infants. Anthropometric indices that accurately reflect neonatal body composition could improve clinical care and aid future research, but their validity has not been systematically tested in preterm infants. OBJECTIVE: To determine the weight/length indices that best reflect neonatal body composition in preterm infants...
September 16, 2016: Pediatric Obesity
Edith Pituskin, Mark Haykowsky, Margaret McNeely, John Mackey, Neil Chua, Ian Paterson
BACKGROUND: Cancer is the leading cause of premature death in Canada. In the last decade, important gains in cancer survival have been achieved by advances in adjuvant treatment. However, many oncologic treatments also result in cardiovascular "toxicity". Furthermore, cardiac risk factors such as hypertension, dyslipidemia, and diabetes mellitus are known to contribute to the progression of cardiac damage and clinical cardiotoxicity. As such, for many survivors, the risk of death from cardiac disease exceeds that of recurrent cancer...
September 15, 2016: BMC Cancer
Jane Yelland, Donna Weetra, Deanna Stuart-Butler, Janiene Deverix, Cathy Leane, Jackie Ah Kit, Karen Glover, Deirdre Gartland, Jonathan Newbury, Stephanie Brown
OBJECTIVE: To investigate the extent to which Aboriginal women access primary care for themselves and their infant in the year after childbirth. METHOD: Cross sectional population-based survey of women giving birth to Aboriginal babies in South Australia between July 2011 and June 2013. RESULTS: A total of 344 women took part in the study 4-9 months after giving birth. The majority had seen a primary health care practitioner since the birth: 86% had seen a Child and Family Health Service (CaFHS) nurse, 81% a general practitioner (GP), and 61% an Aboriginal health worker (AHW)...
October 2016: Australian and New Zealand Journal of Public Health
Roger Woolf, Amanda Locke, Catherine Potts
PURPOSE: Pharmacist prescribing as part of a collaborative drug therapy agreement (CDTA) within an integrated health system in Washington is described. SUMMARY: Virginia Mason Medical Center (VMMC) in Seattle, Washington, uses a team-based care model with broad-based CDTAs to provide quality patient care. The majority of patients are referred to the pharmacist after a diagnosis has been made and a clinical care plan has been started. The pharmacist manages the patient's care within his or her scope of practice as defined by state laws and further detailed by VMMC internal protocols...
September 15, 2016: American Journal of Health-system Pharmacy: AJHP
Nakul P Valsangkar, Andrew C Eppstein, Rick A Lawson, Amber N Taylor
Importance: There are an increasing number of veterans in the United States, and the current delay and wait times prevent Veterans Affairs institutions from fully meeting the needs of current and former service members. Concrete strategies to improve throughput at these facilities have been sparse. Objective: To identify whether lean processes can be used to improve wait times for surgical procedures in Veterans Affairs hospitals. Design, Setting, and Participants: Databases in the Veterans Integrated Service Network 11 Data Warehouse, Veterans Health Administration Support Service Center, and Veterans Information Systems and Technology Architecture/Dynamic Host Configuration Protocol were queried to assess changes in wait times for elective general surgical procedures and clinical volume before, during, and after implementation of lean processes over 3 fiscal years (FYs) at a tertiary care Veterans Affairs medical center...
September 7, 2016: JAMA Surgery
Christian Jung, Michael Lichtenauer, Daniela Strodthoff, Holger Winkels, Bernhard Wernly, Christina Bürger, Uran Kamchybekov, Esther Lutgens, Hans-Reiner Figulla, Norbert Gerdes
BACKGROUND: Obesity represents a major problem for patients and health care systems in most industrialized countries. A chronic inflammatory state in obese individuals leads to disease conditions associated with activation of cellular immune mechanisms. Here, we sought to investigate the role of Th1-, Th2-, and Th17-related cytokines in overweight adolescents and mice on a high-fat diet. METHODS: Plasma samples were obtained from 79 male adolescents aged 13-17 years...
September 6, 2016: Pediatric Diabetes
Patricia A Gabow
The goal of U.S. health care should be good health for every American. This daunting goal will require closing the health care gap in communities with a particular focus on the most vulnerable populations and the safety net institutions that disproportionately serve these communities. This Commentary describes Denver Health's (DH's) two-pronged approach to achieving this goal: (1) creating an integrated system that focuses on the needs of vulnerable populations, and (2) creating an approach for financial viability, quality of care, and employee engagement...
October 2016: Academic Medicine: Journal of the Association of American Medical Colleges
Logandran Naidoo, Ozayr H Mahomed
BACKGROUND: Prolonged waiting time is a source of patient dissatisfaction with health care and is negatively associated with patient satisfaction. Prolonged waiting times in many district hospitals result in many dissatisfied patients, overworked and frustrated staff, and poor quality of care because of the perceived increased workload. AIM: The aim of the study was to determine the impact of Lean principles techniques, and tools on the operational efficiency in the outpatient department (OPD) of a rural district hospital...
2016: African Journal of Primary Health Care & Family Medicine
Aline Lima Pestana Magalhães, Alacoque Lorenzini Erdmann, Elza Lima da Silva, José Luís Guedes Dos Santos
OBJECTIVES: to demonstrate the scientific knowledge developed on lean thinking in health, highlighting the impact and contributions in health care and nursing. METHOD: an integrative literature review in the PubMed, CINAHL, Scopus, Web of Science, Emerald, LILACS and SciELO electronic library databases, from 2006 to 2014, with syntax keywords for each data base, in which 47 articles were selected for analysis. RESULTS: the categories were developed from the quality triad proposed by Donabedian: structure, process and outcome...
August 8, 2016: Revista Latino-americana de Enfermagem
Papis Wongchaisuwat, Diego Klabjan, Siddhartha Reddy Jonnalagadda
BACKGROUND: Community-based question answering (CQA) sites play an important role in addressing health information needs. However, a significant number of posted questions remain unanswered. Automatically answering the posted questions can provide a useful source of information for Web-based health communities. OBJECTIVE: In this study, we developed an algorithm to automatically answer health-related questions based on past questions and answers (QA). We also aimed to understand information embedded within Web-based health content that are good features in identifying valid answers...
2016: JMIR Medical Informatics
Paul Little, Beth Stuart, Fd Richard Hobbs, Jo Kelly, Emily R Smith, Katherine J Bradbury, Stephanie Hughes, Peter W F Smith, Michael V Moore, Mike E J Lean, Barrie M Margetts, Chris D Byrne, Simon Griffin, Mina Davoudianfar, Julie Hooper, Guiqing Yao, Shihua Zhu, James Raftery, Lucy Yardley
BACKGROUND: The obesity epidemic has major public health consequences. Expert dietetic and behavioural counselling with intensive follow-up is effective, but resource requirements severely restrict widespread implementation in primary care, where most patients are managed. We aimed to estimate the effectiveness and cost-effectiveness of an internet-based behavioural intervention (POWeR+) combined with brief practice nurse support in primary care. METHODS: We did this pragmatic, parallel-group, randomised controlled trial at 56 primary care practices in central and south England...
October 2016: Lancet Diabetes & Endocrinology
Peggy M Cawthon, Li-Yung Lui, Charles E McCulloch, Jane A Cauley, Misti L Paudel, Brent Taylor, John T Schousboe, Kristine E Ensrud
BACKGROUND: Although there are several consensus definitions of sarcopenia, their association with health care utilization has not been studied. METHODS: We included women from the prospective Study of Osteoporotic Fractures with complete assessment of sarcopenia by several definitions at the Study of Osteoporotic Fractures Year 10 (Y10) exam (1997-1998) who also had available data from Medicare Fee- For-Service Claims (N = 566) or Kaiser Encounter data (N = 194)...
July 8, 2016: Journals of Gerontology. Series A, Biological Sciences and Medical Sciences
Tiffany Palmer, Esther Murray
BACKGROUND: The shipping industry has historically leaned towards a biomedical model of health when assessing, treating and caring for seafarers. In recent years there has been more concern for the mental health of seafarers in both the academic literature and the commercial world, however, the psychological and emotional well-being of seafarers still largely falls on the shoulders of the port chaplains. The aim of the study was to explore how port chaplains make sense of providing welfare for seafarers by taking an idiographic, phenomenological approach (IPA)...
2016: International Maritime Health
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