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https://www.readbyqxmd.com/read/28528621/using-lean-to-rapidly-and-sustainably-transform-a-behavioral-health-crisis-program-impact-on-throughput-and-safety
#1
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/28526377/orange-juice-allied-to-a-reduced-calorie-diet-results-in-weight-loss-and-ameliorates-obesity-related-biomarkers-a-randomized-controlled-trial
#2
Carolina Ribeiro, Grace Dourado, Thais Cesar
OBJECTIVE: Assumptions have linked orange juice (OJ) consumption with weight gain and adverse effects on health due to its sugar content; however, epidemiologic studies have not shown increased risk for overweight or obesity with the consumption of 100% OJ. The aim of this study was to verify whether the combination of a reduced-calorie diet (RCD) and 100% OJ contribute to weight loss, promote changes in glucose and lipid metabolism, and improve diet quality in obese individuals. METHODS: A randomized controlled trial with 78 obese patients (age 36 ± 1 y, body mass index [BMI] 33 ± 3 kg/m(2)) were enrolled in two groups: Individuals in the OJ group submitted to an RCD that included OJ (500 mL/d), and individuals in the control group submitted to an RCD without OJ...
June 2017: Nutrition
https://www.readbyqxmd.com/read/28507015/preserving-healthy-muscle-during-weight-loss
#3
REVIEW
Edda Cava, Nai Chien Yeat, Bettina Mittendorfer
Weight loss is the cornerstone of therapy for people with obesity because it can ameliorate or completely resolve the metabolic risk factors for diabetes, coronary artery disease, and obesity-associated cancers. The potential health benefits of diet-induced weight loss are thought to be compromised by the weight-loss-associated loss of lean body mass, which could increase the risk of sarcopenia (low muscle mass and impaired muscle function). The objective of this review is to provide an overview of what is known about weight-loss-induced muscle loss and its implications for overall physical function (e...
May 2017: Advances in Nutrition
https://www.readbyqxmd.com/read/28501790/obesity-aggravates-toxic-effect-of-bpa-on-spermatogenesis
#4
Weiyue Hu, Tianyu Dong, Lingling Wang, Quanquan Guan, Ling Song, Daozhen Chen, Zuomin Zhou, Minjian Chen, Yankai Xia, Xinru Wang
Both bisphenol A (BPA) and obesity affect male reproductive system. However, whether there is an interaction between them remains poorly understood. The aim of the present study was to evaluate the interaction between BPA exposure and obesity on semen quality and elucidate the mechanism in humans and animals. We firstly analyzed the interaction on semen volume, sperm count per ejaculate, sperm concentration and sperm motility in 357 men, and found that urinary BPA concentration was significantly correlated with sperm count per ejaculate in obese men (β=-34...
May 11, 2017: Environment International
https://www.readbyqxmd.com/read/28494624/an-overview-of-the-performance-improvement-initiatives-by-the-ministry-of-health-in-the-kingdom-of-saudi-arabia
#5
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/28494385/l-leucine-dietary-supplementation-modulates-muscle-protein-degradation-and-increases-pro-inflammatory-cytokines-in-tumour-bearing-rats
#6
Bread Cruz, André Oliveira, Maria Cristina Cintra Gomes-Marcondes
Cancer cachexia is characterised by involuntary weight loss associated with systemic inflammation and metabolic changes. Studies aimed at maintaining lean body mass in cachectic tumour-bearing hosts have made important contributions reducing the number of deaths and improving the quality of life. In recent years, leucine has demonstrated effective action in maintaining lean body mass by decreasing muscle protein degradation. Currently, there is a growing need to understand how leucine stimulates protein synthesis and acts protectively in a cachectic organism...
May 8, 2017: Cytokine
https://www.readbyqxmd.com/read/28476730/mountain-rescue-cardiopulmonary-resuscitation-a-comparison-between-manual-and-mechanical-chest-compressions-during-manikin-cardio-resuscitation
#7
Oyvind Thomassen, Sven Christjar Skaiaa, Jorg Assmuss, Øyvind Østerås, Jon Kenneth Heltne, Lars Wik, Guttorm Brattebo
AIM: Chest compression devices are useful during mountain rescue but may cause a delay in transport if not immediately available. The aims of this prospective observational study were to compare manual and mechanical cardiopulmonary resuscitation (CPR) during transport on a sledge connected to a snowmobile with a non-moving setting and to compare CPR quality between manual and two mechanical chest compression devices. METHODS: Sixteen healthcare providers simulated four different combined CPR scenarios on a sledge in a non-moving setting and during transport and two mechanical chest compression devices during transport on the sledge...
May 5, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28472139/gene-expression-profiling-in-pekin-duck-embryonic-breast-muscle
#8
Tie-Shan Xu, Li-Hong Gu, Wei Huang, Wan-Liang Xia, Yun-Sheng Zhang, Ya-Ge Zhang, Guang Rong, Kyle Schachtschneider, Shui-Sheng Hou
Lean-type Pekin duck is a breed gained through long-term selection and great effort has been exerted to understand the mechanisms underlying increased muscle yields. However, the genes involved in Pekin duck embryonic breast muscle development have not been explored to date. In this study, we investigated gene expression profiles in Pekin Duck embryonic breast muscle at hatched day 13 (E13), E19, and E27 using RNA-seq. In total, we produced 519,312,178 raw reads resulting in 497,348,158 high-quality reads after filtering...
2017: PloS One
https://www.readbyqxmd.com/read/28464081/a-multivariate-approach-to-determine-the-factors-affecting-response-level-of-growth-carcass-and-meat-quality-traits-in-finishing-pigs-fed-ractopamine
#9
M A Pompeu, L A Rodrigues, L F L Cavalcanti, D O Fontes, F L B Toral
The effect of ractopamine (RAC) supplementation on growth, carcass, and meat quality traits of finishing pigs was studied using a meta-analytical approach. The database was composed of 57 studies published from 2004 to 2016. The dependent variables extracted for the meta-analysis included final BW, ADG, ADFI, feed:gain ratio, HCW, dressing percentage, carcass length, lean yield, back fat thickness, loin muscle area, loin depth, postmortem pH, meat brightness, redness, and yellowness. The studies were grouped by similarity in 3 clusters (C1, C2, and C3) by hierarchical clustering on principle components...
April 2017: Journal of Animal Science
https://www.readbyqxmd.com/read/28443020/bgp-15-protects-against-oxaliplatin-induced-skeletal-myopathy-and-mitochondrial-reactive-oxygen-species-production-in-mice
#10
James C Sorensen, Aaron C Petersen, Cara A Timpani, Dean G Campelj, Jordan Cook, Adam J Trewin, Vanesa Stojanovska, Mathew Stewart, Alan Hayes, Emma Rybalka
Chemotherapy is a leading intervention against cancer. Albeit highly effective, chemotherapy has a multitude of deleterious side-effects including skeletal muscle wasting and fatigue, which considerably reduces patient quality of life and survivability. As such, a defense against chemotherapy-induced skeletal muscle dysfunction is required. Here we investigate the effects of oxaliplatin (OXA) treatment in mice on the skeletal muscle and mitochondria, and the capacity for the Poly ADP-ribose polymerase (PARP) inhibitor, BGP-15, to ameliorate any pathological side-effects induced by OXA...
2017: Frontiers in Pharmacology
https://www.readbyqxmd.com/read/28439134/pharmacy-dashboard-an-innovative-process-for-pharmacy-workload-and-productivity
#11
Ashley Kinney, Quyen Bui, Jane Hodding, Jennifer Le
Background: Innovative approaches, including LEAN systems and dashboards, to enhance pharmacy production continue to evolve in a cost and safety conscious health care environment. Furthermore, implementing and evaluating the effectiveness of these novel methods continues to be challenging for pharmacies. Objective: To describe a comprehensive, real-time pharmacy dashboard that incorporated LEAN methodologies and evaluate its utilization in an inpatient Central Intravenous Additives Services (CIVAS) pharmacy...
March 2017: Hospital Pharmacy
https://www.readbyqxmd.com/read/28435492/applying-systems-engineering-reduces-radiology-transport-cycle-times-in-the-emergency-department
#12
Benjamin A White, Brian J Yun, Michael H Lev, Ali S Raja
INTRODUCTION: Emergency department (ED) crowding is widespread, and can result in care delays, medical errors, increased costs, and decreased patient satisfaction. Simultaneously, while capacity constraints on EDs are worsening, contributing factors such as patient volume and inpatient bed capacity are often outside the influence of ED administrators. Therefore, systems engineering approaches that improve throughput and reduce waste may hold the most readily available gains. Decreasing radiology turnaround times improves ED patient throughput and decreases patient waiting time...
April 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28410831/feasibility-and-efficacy-of-presurgical-exercise-in-survivors-of-rectal-cancer-scheduled-to-receive-curative-resection
#13
Favil Singh, Robert U Newton, Michael K Baker, Nigel A Spry, Dennis R Taaffe, Daniel A Galvão
BACKGROUND: Localized rectal carcinoma is invasive, with surgical resection the standard treatment. The aim of this study was to determine the feasibility of a supervised presurgical exercise intervention in patients with rectal cancer prior to rectal resection. PATIENTS AND METHODS: Twelve patients volunteered to undertake twice-weekly aerobic and resistance exercise for ∼16 weeks prior to surgery. At baseline, presurgery, and ∼8 weeks postsurgery, muscle strength and physical performance, body composition, quality of life, and fatigue were assessed...
March 21, 2017: Clinical Colorectal Cancer
https://www.readbyqxmd.com/read/28410337/adaptation-of-lean-six-sigma-methodologies-for-the-evaluation-of-veterans-choice-program-at-3-urban-veterans-affairs-medical-centers
#14
Sherry L Ball, Lauren D Stevenson, Amy C Ladebue, Marina S McCreight, Emily C Lawrence, Taryn Oestreich, Anne C Lambert-Kerzner
OBJECTIVE: The Veterans Healthcare Administration (VHA) is adapting to meet the changing needs of our Veterans. VHA leaders are promoting quality improvement strategies including Lean Six Sigma (LSS). This study used LSS tools to evaluate the Veterans Choice Program (VCP), a program that aims to improve access to health care services for eligible Veterans by expanding health care options to non-VHA providers. RESEARCH DESIGN: LSS was utilized to assess the current process and efficiency patterns of the VCP at 3 VHA Medical Centers...
April 13, 2017: Medical Care
https://www.readbyqxmd.com/read/28405899/the-quality-of-clinical-information-in-adverse-drug-reaction-reports-by-patients-and-healthcare-professionals-a-retrospective-comparative-analysis
#15
Leàn Rolfes, Florence van Hunsel, Laura van der Linden, Katja Taxis, Eugène van Puijenbroek
INTRODUCTION: Clinical information is needed to assess the causal relationship between a drug and an adverse drug reaction (ADR) in a reliable way. Little is known about the level of relevant clinical information about the ADRs reported by patients. OBJECTIVE: The aim was to determine to what extent patients report relevant clinical information about an ADR compared with their healthcare professional. METHODS: A retrospective analysis of all ADR reports on the same case, i...
April 12, 2017: Drug Safety: An International Journal of Medical Toxicology and Drug Experience
https://www.readbyqxmd.com/read/28404960/impact-of-metformin-on-c-reactive-protein-levels-in-women-with-polycystic-ovary-syndrome-a-meta-analysis
#16
Yong Chen, Meng Li, Hongli Deng, Sheying Wang, Lihua Chen, Ningsha Li, Dan Xu, Qiguang Wang
The impact of the recommended first-line treatment with metformin on C-reactive protein (CRP) levels in patients with polycystic ovary syndrome (PCOS) is still controversial. We conducted a meta-analysis of studies reporting the impact of metformin on serum CRP levels in women with PCOS. The weighted mean differences (WMDs) and the corresponding 95% confidence intervals (CIs) were used to assesse the effects. GRADE approach was used to assesse the quality of the evidence. A total of 20 studies that included 433 women with PCOS were analyzed...
March 8, 2017: Oncotarget
https://www.readbyqxmd.com/read/28399016/the-effects-of-beef-chicken-or-whey-protein-post-workout-on-body-composition-and-muscle-performance
#17
Matthew H Sharp, Ryan P Lowery, Kevin A Shields, Jason R Lane, Jocelyn L Gray, Jeremy M Partl, Daniel W Hayes, Gabriel J Wilson, Chase A Hollmer, Julie R Minivich, Jacob M Wilson
The purpose of this study was to determine the effects of post-workout consumption of beef protein isolate (Beef), hydrolyzed chicken protein (Chx) or whey protein concentrate (WPC), compared to a control on lean mass and strength during 8 weeks of resistance training. Forty-one males and females were randomized into four groups: WPC (m=5, f=5; Age (yrs)=19 ± 2, Height (cm)=171 ± 10, Mass (kg)= 74.60 ± 14.19), Beef (m=5, f=5; Age (yrs)=22 ± 4, Height (cm)=170 ± 7, Mass (kg)=70.13 ± 8.16), ChxC(m=5, f=6; Age (yrs)=21 ± 2, Height (cm)=169 ± 9, Mass (kg)=74...
April 7, 2017: Journal of Strength and Conditioning Research
https://www.readbyqxmd.com/read/28397330/is-meat-quality-of-forage-fed-steers-comparable-to-the-meat-quality-of-conventional-beef-from-concentrate-fed-bulls
#18
M Blanco, I Casasús, G Ripoll, P Albertí, B Panea, M Joy
BACKGROUND: Replacing concentrates with forages in the diet of finishing cattle to satisfy societal demands and for economic reasons is a target for beef farmers, but this change may affect meat acceptance. In the Mediterranean area, young bulls are usually finished on concentrates (Conventional beef). Alternatively, steers can be finished on grass with supplements (G-supp); however, if carcasses are too lean, meat quality may be negatively affected. To increase fat deposition, grazing steers were finished on a total mixed ration composed of alfalfa hay and corn (TMR)...
April 11, 2017: Journal of the Science of Food and Agriculture
https://www.readbyqxmd.com/read/28387575/nutritional-considerations-for-bouldering
#19
Edward J Smith, Ryan Storey, Mayur K Ranchordas
Bouldering competitions are held up to International level and governed by the International Federation of Sport Climbing. Bouldering has been selected to feature at the 2020 Olympic Games in Tokyo, however, physiological qualities and nutritional requirements to optimise performance remain inadequately defined due to large gaps in the literature. The primary goals of training include optimising the capacity of the anaerobic energy systems and developing sport-specific strength, with emphasis on the isometric function of the forearm flexors responsible for grip...
April 7, 2017: International Journal of Sport Nutrition and Exercise Metabolism
https://www.readbyqxmd.com/read/28385026/scaling-lean-in-primary-care-impacts-on-system-performance
#20
Dorothy Y Hung, Michael I Harrison, Meghan C Martinez, Harold S Luft
OBJECTIVES: We examined a wide range of performance outcomes after Lean methodology-a leading strategy to enhance efficiency and patient value-was implemented and scaled across all primary care clinics in a nonprofit, ambulatory care delivery system. STUDY DESIGN: Using a stepped wedge approach, we assessed changes associated with the phased introduction of Lean-based redesigns across 46 primary care departments in 17 different clinic locations. Longitudinal analysis of operational metrics included: workflow efficiency, physician productivity, operating expenses, clinical quality, and satisfaction among patients, physicians, and staff...
March 2017: American Journal of Managed Care
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