Qualitative website analysis of information on birth after caesarean section

Date of Acceptance: 10/08/2015 © 2015 Peddie et al.Peer reviewedPublisher PD

Decreasing Check-In to Discharge Time in the PTC

The Physician Treatment Center at Central DuPage Hospital was born out of the Emergency Department. It was conceived as an idea of how to keep patients from being admitted to the hospital through and emergency visit for non-emergency situations. It is a unique hospital department, and it offers a variety of services. The PTC offers medication infusions, blood transfusions, wound care, and avast number of procedures. The project team partnered with Northwestern Medicine’s Performance Improvement Office at Central DuPage Hospital to tackle this project. The project team utilized Six Sigma’s DMAIC methodology to approach this project. DMAIC is broken down into five phases: Define, Measure, Analyze, Improve, and Control. The structured problem-solving approach gives guidance to the project and how to proceed (iSixSigma, 2017).B.S. (Bachelor of Science

Drivers of Pasture Growth in Perennial Ryegrass Pastures in Northern New Zealand Dairy Pastures

The critical importance of pasture production to New Zealand’s economic performance has been widely recognised. However, a number of critical issues have been identified that limit dairy industry growth, including sub-optimal pasture condition and poor pasture persistence. Dairy farm systems in the Waikato and Bay of Plenty provinces in the upper North Island of New Zealand are predominantly pasture-based, with a temperate climate and they represent around 30% of New Zealand’s total number of dairy farms (LIC and DairyNZ, 2012). This project was established to quantify pasture performance and identify factors that drive that performance. We established a network of on-farm trials where case studies of pasture renewal practices and outcomes were developed. Ten farms in each province were monitored for three consecutive years – four paddocks from each province are considered here

Decreasing Check-In to Discharge Time in the PTC

The Physician Treatment Center (PTC) at Central DuPage Hospital, part of Northwestern Medicine, has seen a 21% increase in patients over the past year. This increase caused severe strain on PTC staff and space. Before deciding to purchase more resources, according to best business practices, the project team was assembled to optimize process efficiency. The purpose of this study is to reduce overworking and overcrowding in the PTC through accurate centralized scheduling and the reduction of patient in-room time. These together will lead to a reduction in the check-in to discharge time of the patient. These objectives were accomplished through the use of Six Sigma’s DMAIC Cycle and Lean methodology.B.S. (Bachelor of Science

Agreement and relationship between measures of absolute and relative intensity during walking: a systematic review with meta-regression

IntroductionA metabolic equivalent (MET) is one of the most common methods used to objectively quantify physical activity intensity. Although the MET provides an ‘objective’ measure, it does not account for inter-individual differences in cardiorespiratory fitness. In contrast, ‘relative’ measures of physical activity intensity, such as heart rate reserve (HRR), do account for cardiorespiratory fitness. The purpose of this systematic review with meta-regression was to compare measures of absolute and relative physical activity intensity collected during walking.MethodsA systematic search of four databases (SPORTDiscus, Medline, Academic Search Premier and CINAHL) was completed. Keyword searches were: (i) step* OR walk* OR strid* OR "physical activity"; (ii) absolute OR “absolute intensity” OR mets OR metabolic equivalent OR actigraph* OR acceleromet*; (iii) relative OR “relative intensity” OR "heart rate" OR "heart rate reserve" OR “VO2 reserve” OR VO2* OR “VO2 uptake” OR HRmax* OR metmax. Categories (i) to (iii) were combined using ‘AND;’ with studies related to running excluded. A Bayesian regression was conducted to quantify the relationship between METs and %HRR, with Bayesian logistic regression conducted to examine the classification agreement between methods. A modified Downs and Black scale incorporating 13 questions relative to cross-sectional study design was used to assess quality and risk of bias in all included studies.ResultsA total of 15 papers were included in the systematic review. A comparison of means between absolute (METs) and relative (%HRR, %HRmax, %VO2R, %VO2max, HRindex) values in 8 studies identified agreement in how intensity was classified (light, moderate or vigorous) in 60% of the trials. We received raw data from three authors, incorporating 3 studies and 290 participants. A Bayesian random intercept logistic regression was conducted to examine the agreement between relative and absolute intensity, showing agreement in 43% of all trials. Two studies had identical relative variables (%HRR) totalling 240 participants included in the Bayesian random intercept regression. The best performing model was a log-log regression, which showed that for every 1% increase in METs, %HRR increased by 1.12% (95% CI: 1.10–1.14). Specifically, the model predicts at the lower bound of absolute moderate intensity (3 METs), %HRR was estimated to be 33% (95%CI: 18–57) and at vigorous intensity (6 METs) %HRR was estimated to be 71% (38–100).ConclusionThis study highlights the discrepancies between absolute and relative measures of physical activity intensity during walking with large disagreement observed between methods and large variation in %HRR at a given MET. Consequently, health professionals should be aware of this lack of agreement between absolute and relative measures. Moreover, if we are to move towards a more individualised approach to exercise prescription and monitoring as advocated, relative intensity could be more highly prioritised

Variation in Individual Responses to Time-Restricted Feeding and Resistance Training

Time-restricted feeding (TRF) is a form of intermittent fasting which limits all caloric intake to a certain period of time each day in an attempt to reduce daily energy intake, promote weight loss, and improve health. Resistance training (RT) has been reported to increase muscular strength and improve body composition. Very limited information is available on the combination of TRF and RT. The purpose of this study was to examine the variation in individual body composition, dietary intake, and muscular performance responses to an 8-wk TRF and RT program. Healthy males (n = 20; age = 22 ± 3 y; BMI = 27 ± 6 kg/m2; % fat = 22 ± 6 % wt) were randomized to TRF + RT or RT alone for 8 wks. RT was performed 3 dys/wk and consisted of alternate workouts of upper and lower body using a resistance progression scheme. TRF limited energy intake to a 4-hr period on the 4 dys/wk when RT was not performed. Energy intake was not restricted in either group, and eating times were not specified in the RT alone group. Body composition, muscular performance, and dietary records were assessed at 0, 4, and 8 wks. Inter- and intra-individual variations in outcome measures were estimated by hierarchical linear growth modeling. The amount of variability attributable to characteristics between or within participants was evaluated from variance estimates. For TRF + RT, percent changes ranged from -5.5 to +2.6% for body weight, -22.1 to +9.4% for fat mass, -7.7 to +4.6% for lean body mass, +3.4 to +30.4% for bench press 1-RM, and +10.1 to +67.6% for leg press 1-RM. For RT alone, percent changes ranged from -6.6 to +2.1% for body weight, -14.4 to +12.6% for fat mass, -4.1 to +3.9% for lean body mass, +4.9 to +12.9% for bench press 1-RM, and +14.3 to +37.7% for leg press 1-RM. Percentages of total variability attributed to inter-individual factors ranged from 3.3 to 49.2% for dietary measures, 59.0 to 93.9% for muscular performance, and 97.0 to 99.6% for body composition. Remaining variability was attributed to intra-individual factors. Individual responses to the study interventions varied widely. Differences between individuals were an important source of variability, indicating participant samples should be homogenous and/or quite large to examine changes in body composition or muscular performance using nutrition and exercise interventions

Exploring the effects of tomato extract supplementation on cognitive function during exercise and at rest

It has been reported that tomato (Solanum lycopersicum) fruit extracts may have beneficial effects on cognition. To assess if those effects are reproducible, cognitive function was assessed using a double-blind, randomised control trial design; 17 healthy test participants were given encapsulated tomato fruit (n=8) extract (290 mg) or a placebo control (n=9). Cognition was assessed at rest and, as exercise is known to negatively impact on cognitive function, equivalent tests were also undertaken after controlled physical exertion using the Bath University Rugby Shuttle Test (45 minutes and 90 minutes exercise). After normalisation of raw data to remove performance related error, the tomato fruit extract improved (P [less than] 0.05) normalised detection scores and detection times after 90 minutes exercise. These positive effects were specific to psychomotor function, relating to both ability and speed of response; compared to placebo controls, the supplemented group recorded scores 6.5% (P=0.02) and speeds ~17% (P=0.03) better when compared to the placebo group. A repeated measures linear mixed model (LMM) was undertaken and again significance reported (P [less than] 0.05) for overall effects of treatment (detection speeds and scores) and additionally for the identification speed. A suggestion (P [less than] 0.1) of treatment effects was observed for identification scores. LMM analysis therefore also identifies positive benefits for reaction times and visual attention after supplementation. No effect on one-card-learning (visual learning) scores or speeds was detected; also there is no evidence of any learning effect on the data. Collectively this data shows certain tomato fruit extracts have a trait specific beneficial effect on cognition

Evaluating the Ecological Impact of a Youth Program

Youth are the weakest population within the workforce and long-term unemployment leaves them unable to develop work skills, reaches into their future prospects, and can weaken the economy, education systems, and overall social structure. Through ecological qualitative methodology, the reported research gathered in-depth accounts of experiences of ten urban youth who participated in a federally-funded Summer Youth Employment Program (SYEP). To develop an understanding of aspects of the youth’s lives, individual interviews were conducted and ecomaps were completed with participants. Personal narratives support the premises that documenting the ecosystems of individuals provides insights into daily lives, histories, and lived experiences in a way that provides a window into how services and prevention efforts can be targeted. Results concluded that for these participants, the SYEP made a difference in their lives in terms of helping them make connections to positive role models, learning workplace communication, and providing an entrance into the workforce on varying levels consistent with their barriers. This research can be applied to inform practitioners, teachers, and decision makers with a better understanding of the social, emotional, educational, and workforce realities of adolescents. The research advances the conversation about federally funded youth employment programs creating opportunities for marginalized youth to learn skills for succeeding in the mainstream economy