Corrigendum: A Disease Pathway Framework for Pain Point Identification and Elaboration of Product Requirements Across Patient Care Plan Using Innovation Think Tank Global Infrastructure.

[This corrects the article DOI: 10.3389/fpubh.2022.862384.].

A Disease Pathway Framework for Pain Point Identification and Elaboration of Product Requirements Across Patient Care Plan Using Innovation Think Tank Global Infrastructure.

Healthcare providers as well as medical technologists lay a strong focus on clinical conditions for patient centric care delivery. Currently, the challenges are to (1) obtain a consolidated view of various stakeholders and pain points for the entire disease lifecycle, (2) identify interdependencies between different stages of the disease, and (3) prioritize solutions based on customer needs. A structured approach is required to address clinical needs across disease care plans tailored to different geographies and ethnicities. Innovation Think Tank (ITT) teams across multiple locations formed focus groups to elaborate the pathways of 22 global diseases, selected based on ranking of associated economic burden and threat to life. Ideation sessions were held to identify pain points and find innovative solutions. Additionally, inputs were taken from co-creation sessions at universities worldwide. The optimization and design of infographics and care plan was done based on the key information gathered-facts and figures, stakeholders, pain points and solutions. Finally, validation was obtained from clinical and technology experts globally. A disease pathway framework was created to develop pathways for 22 global diseases. Over 1,500 pain points were collected and about 1,900 ideas were proposed. The approach was applied to optimize its application to 30 product and portfolio definition projects over 2 years at Siemens Healthineers, as well as co-creation programs with universities and hospitals. The disease pathway framework provides a unique foundation for extensive collaboration among multiple stakeholders, through information sharing and delivering high-quality solutions based on the identified problems and customer needs.

Determination of Heart Rate Changes using Simulated Head Up Tilt Test for Syncope Patient Assessment.

Home-based self-training can be beneficial to neurocardiogenic patients, particularly for those who experience a decreased heart rate during the clinical head up tilt test (HUT). Many patients, however, may not be able to attend a clinic and/or attend clinics which lack HUT devices. Individualized heart rate prediction based on a simulated HUT (sHUT) model may address this gap in clinical practice. The proposed sHUT model aims to predict whether home-based self-training is an appropriate beneficial intervention based on the calculated decrease in heart rate from the model. The results obtained with the model are in agreement with previous clinical findings with greater than 80% accuracy in identifying patients who could benefit from home training. The predicted home-based training efficacy of syncope against the control group had a corresponding p-value of p<0.0001. Based on these results, physicians may be able to recommend home training as part of online or telemedicine consultation.Clinical Relevance- The simulated Head Up Tilt model predicts the patient-specific efficacy of tilt-training for patients at home diagnosed with syncope.

Dining On Call: Outcomes of a hospital patient dining model.

Dining On Call (DOC) is a hospital foodservice model allowing patients to order meals any time throughout the day and is delivered within 45 minutes of the order. It is positively correlated with patient satisfaction, improvements in malnutrition, and reducing costs. Pre- and post-DOC data were collected from BC Children's Hospital, BC Women's Hospital, and North York General Hospital (NYGH) using patient satisfaction surveys and tray waste audits to measure outcomes. Patient satisfaction scores increased at all hospitals. BC Children's and Women's hospitals demonstrated reductions in tray waste, food cost/meal/day, and labour cost/meal/day post-DOC. North York General Hospital observed decreases in tray waste; however, food cost/meal/day and labour cost/meal/day increased post-DOC. This research provides convincing evidence into the achievable benefits associated with DOC on mother and paediatric units in hospital settings. DOC may prove to be an effective dining model for hospitals seeking to improve patient outcomes and reduce overall costs.

The impact of program-driven wellness initiatives on burnout and depression among surgical trainees.

BACKGROUND: The prevalence of burnout and depression are high among surgical trainees. This study examined the impact of program-driven initiatives to improve surgical trainee wellness. METHODS: A survey was administered to residents and fellows at all surgical training programs across an urban academic health system. The survey measured burnout, depressive symptoms, and perceptions of program-driven wellness initiatives. RESULTS: The response rate was 44% among 369 residents. Of these, 63.2% screened positively for burnout, and 36.7% for depression. Residents who were burned out were more likely to work >80 h per week, have greater clerical duties, and miss educational activities more frequently. Conversely, having opportunities for wellness activities, dedicated faculty and housestaff wellness champions, and assistance with clerical burden were all associated with lower rates of burnout and depression. CONCLUSION: The presence of wellness support was associated with better outcomes, suggesting the value of initiatives to manage workload and support the well-being of surgical resident physicians.

Effect of a Protected Mealtime Pilot on Energy and Protein Intake in a Canadian Hospital.

Purpose: In Canada, approximately 45% of hospitalized patients are moderately or severely malnourished upon admission. The protected mealtime policy was designed to address malnutrition in institutions. This pilot study aimed to provide preliminary results examining the effect of this policy on patient energy and protein intake. Methods: A 1-group, pre-post observation design was conducted in a Canadian hospital. Pre- and post-observations included the frequency and type of interruptions, type of interrupter, and patient energy and protein intake at each meal. Results: The average number and length of interruptions decreased, and the average length of mealtime assistance provided to patients (n = 12) increased in the post-observation period. Energy and protein consumption showed a slight increase during the post-observation period. Conclusion: A protected mealtime policy may be an effective policy to address malnutrition among hospitalized Canadian adults. Further studies are warranted in Canada to determine the effects and feasibility of this policy implementation.

Diabetes Intervention Accentuating Diet and Enhancing Metabolism (DIADEM-I): a randomised controlled trial to examine the impact of an intensive lifestyle intervention consisting of a low-energy diet and physical activity on body weight and metabolism in early type 2 diabetes mellitus: study protocol for a randomized controlled trial.

BACKGROUND: Type 2 diabetes mellitus (T2DM) and obesity are syndemic and will have a significant impact on affected individuals and healthcare services worldwide. Evidence shows that T2DM remission can be achieved with significant weight loss in those who are younger with early diabetes and requiring fewer medications for glycaemic control. DIADEM-I aims to examine the impact of an intensive lifestyle intervention (ILI) using a low-energy diet (LED) meal replacement approach combined with physical activity in younger individuals with early T2DM. METHODS: The planned study is an ongoing, non-blinded, pragmatic, randomised controlled, parallel-group trial examining the impact of an LED-based ILI on body weight and diabetes remission in younger (18-50 years) T2DM individuals with early diabetes (≤ 3-year duration). The ILI will be compared to usual medical care (UMC). The primary outcome will be weight loss at 12 months. Other key outcomes of interest include diabetes remission, glycaemic control, diabetes complications, cardiovascular health, physical activity, mental health, and quality of life. It is planned for the study to include 138 subjects for assessment of the primary outcome. Safety will be assessed throughout. DISCUSSION: If DIADEM-I demonstrates a clinically significant effect for younger individuals with early T2DM, it will inform clinical guidelines and services of the future for management of T2DM. TRIAL REGISTRATION: ISRCTN: ISRCTN20754766 (date assigned: 7 June 2017); ClinicalTrials.gov, ID: NCT03225339 Registered on 26 June 2017.

Dietary acculturation of Arab immigrants in the Greater Toronto Area.

PURPOSE: We explored the eating habits of Arab immigrants to determine whether they have maintained their traditional diet or have consumed a more Westernized diet since immigrating to Canada. METHODS: Arab immigrants who had been in Canada for at least eight years and were currently living in the Greater Toronto Area were recruited. A sample of 24 Arab immigrants completed a mailed, self-administered questionnaire, and six participated in a focus group. The focus group discussion was transcribed verbatim and results were recorded. Latent content analysis was used to analyze, code, and categorize emerging themes. RESULTS: Arab immigrants consumed a mixture of both Arabic and Western food and perceived their current diet to be healthier than it was before they immigrated to Canada. Factors that influenced their food choices included increased nutrition health awareness, differences in food preferences and preparation methods, and preservation of dietary practices in the new environment. CONCLUSIONS: Our findings will help dietitians who work with Arab immigrants to become more aware of factors that motivate this group's food choices, and to create nutrition programs that are more culturally sensitive.

Role of epicellular molecules in the selection of particles by the blue mussel, Mytilus edulis.

This study provides evidence that the suspension-feeding blue mussel, Mytilus edulis, uses biochemical cues to recognize its food. We identified lectins in mucus from the gills and labial palps, two pallial organs involved in the feeding process. These compounds were able to agglutinate rabbit and horse erythrocytes (RBC) and several species of marine microalgae representing different families. Additionally, the agglutination of RBC and microalgae was inhibited by several carbohydrates (fetuin, lipopolysaccharide (LPS), and mannose-related residues), suggesting that a suite of lectins may be present in mucus from the gills and labial palps. Results from feeding experiments, using microspheres with tailored surfaces, demonstrated that mussels preferentially ingested microspheres coated with the neoglycoproteins glucosamide-BSA and mannopyranosylphenyl-BSA but rejected in pseudofeces microspheres coated with BSA alone. The positive selection for neoglycoprotein-coated microspheres was inhibited when mussels were pre-incubated in seawater containing a solution of the same neoglycoprotein. Two surface properties of the microspheres, charge and wettability, had little effect on the observed selection process. Our results, along with our previous findings for oysters, suggest a new concept for the mechanism of particle selection in bivalves and perhaps other suspension-feeding organisms. Specifically, the selection of particles involves interactions between epiparticulate carbohydrates and lectins in the mucus produced by feeding organs.