RESUMEN
Non-enzymatic advanced glycation end product (AGE) cross-linking of collagen molecules has been hypothesised to result in significant changes to the mechanical properties of the connective tissues within the body, potentially resulting in a number of age related diseases. We have investigated the effect of two of these cross-links, glucosepane and DOGDIC, on the tensile and lateral moduli of the collagen molecule through the use of a steered molecular dynamics approach, using previously identified preferential formation sites for intra-molecular cross-links. Our results show that the presence of intra-molecular AGE cross-links increases the tensile and lateral Young's moduli in the low strain domain by between 3.0-8.5% and 2.9-60.3% respectively, with little effect exhibited at higher strains.
Asunto(s)
Colágeno Tipo I/química , Reactivos de Enlaces Cruzados/química , Productos Finales de Glicación Avanzada/química , Arginina/química , Colágeno/química , Tejido Conectivo/fisiología , Dipéptidos , Elasticidad , Humanos , Enlace de Hidrógeno , Imidazoles/química , Lisina/análogos & derivados , Lisina/química , Simulación de Dinámica Molecular , Péptidos/química , Dominios Proteicos , Resistencia a la TracciónRESUMEN
This paper presents a set of quality outlines that can be used in the total quality management improvement process for clinical care. The outlines describe problems, potential causes, quality improvement opportunities, and potential methodologies and solutions to improve 15 clinical areas. The necessary improvement steps will depend on the area evaluated, and enhancements can only occur through the commitment of the medical staff and the taking of action steps. When the improvement of quality is given priority, financial gains for the hospital and decreased malpractice risk for the medical staff will follow.
Asunto(s)
Administración Hospitalaria/normas , Grupo de Atención al Paciente/organización & administración , Garantía de la Calidad de Atención de Salud/organización & administración , Comunicación , Departamentos de Hospitales/normas , Humanos , Relaciones Interprofesionales , Auditoría Administrativa , Solución de Problemas , Evaluación de Procesos, Atención de Salud/normas , Proyectos de InvestigaciónAsunto(s)
Quiebra Bancaria , Administración Financiera de Hospitales/organización & administración , Departamentos de Hospitales/economía , Cuerpo Médico de Hospitales/economía , Control de Costos/métodos , Participación en las Decisiones , Rol del Médico , Técnicas de Planificación , Estados UnidosRESUMEN
Implementing a Quality Improvement Program (QIP) is a high priority matter for most health care organizations. Implementation requires the commitment of top management, measurement tools, statistical tools, problem-solving tools, and training for all levels of employees. This article describes the need for managing costs and quality, quality improvement concepts, examples of problem-solving tools, and the role of the facilitator in the QIP process.
