Better Work Environment May Cut Hospital Readmission Rates

THURSDAY, Jan. 3 (HealthDay News) -- Hospitals with a good work environment for nurses have fewer patient readmissions than those with poor working conditions, according to a new study. Researchers analyzed data from more than 200,000 nurses and 412 hospitals in California, New Jersey and Pennsylvania. The investigators found that readmission rates to hospital within 30 days after discharge were 7 percent lower for Medicare patients over age 65 with heart failure, 6 percent lower for heart attack patients and 10 percent lower for patients with pneumonia who were treated in hospitals with good work environments. The study by researchers at the University of Pennsylvania School of Nursing appears in the January issue of the journal Medical Care. "Our results suggest that improving nurses' work environment and reducing nurses' workload are organization-wide reforms that could result in fewer readmissions for Medicare beneficiaries with common medical conditions," lead author Matthew McHugh, a health policy expert, said in a nursing school news release. "This is consistent with the evidence showing significant associations between the nurse work environment, staffing, and other patient outcomes," he added. The researchers noted that preventable hospital readmissions cost Medicare more than $15 billion a year, and Medicare is now penalizing hospitals with high rates of patient readmissions. One way to improve nurses' working conditions is to reduce their workload by hiring more nurses, McHugh said. The increased costs of doing so may be offset through things such as increased productivity, fewer patient readmissions, and reduced expenses related to nurse turnover and retraining. While the study found an association between nurses' working conditions and patient readmissions, it did not prove a cause-and-effect relationship. -- Robert Preidt

You can walk or run away from cataracts

http://www.healthnewsobserver.com/articles/detail/you-can-walk-or-run-away-from-cataracts Improved cardiovascular health has been shown to decrease the risk of developing cataracts. This week, in the journal Medicine & Science in Sports & Exercise, researchers compared vigorous (running) and moderate (walking) exercise to the risk of developing cataracts in a group of 32,610 runners and 14,917 walkers enrolled in the National Runners’ and Walker’s Health studies over a 6 year time period. The authors estimated the baseline energy expenditure as metabolic equivalents (METs) for runners and walkers. Typical METs range from 1 at rest, to 3.6 if walking 3.4 miles per hour, to 7 if jogging, to 23 for a world class runner running at a 4:17 mile pace or 14 miles per hour. During the follow up, 733 runners and 1,074 walkers developed cataracts. Compared to those who expended < 1.8 MET hours/day, the risk of cataracts was 16.4% lower for those who expended 1.8 to 3.6 MET hours per day, 19% lower at 3.6 to 5.4 MET hours per day, 26% lower at 5.4 to 7.2 MET hours per day, 34% lower at 7.2 to 9 MET hours/day, and 42% lower at > 9 MET hours per day.

Cataracts are a clouding of the lens within the eye that decreases vision. This is primarily a disease of aging with half of all Americans having a cataract by age 65. Other risk factors include diabetes, smoking, alcohol use, elevated lipids, obesity, and prolonged exposure to sunlight. Now, it appears that lack of exercise may be a risk factor.

While it is difficult to pull out exactly how much running or walking took place each week by participants in this study, it is clear that both running and walking regularly decrease the risk of developing cataracts. The authors concluded that it didn't matter if you ran or walk. The reduction in the risk of developing cataracts was the same. So, you truly can walk or run away from your cataracts.

Researchers find new molecule to target in pancreatic cancer treatment

Researchers find new molecule to target in pancreatic cancer treatment

Medical Clowns - Dream Doctors Project

Joint BMJ/ Telegraph investigation exposes flaws in regulation of medical devices

http://thedailymedical.com/2009/01/19/physical-findings-of-aortic-regurgitaion.aspx

There are many signs of aortic regurgitation or insufficiency that can be present during physical examination and direct us to the diagnosis. A patient with aortic valve insufficiency will present a diastolic decresendo murmur, best heard at the left sternal border. If the regurgitation is severe enough to cause obstruction of the mitral valve area during diastole then the Austin Flint murmur may be present. This is a diastolic murmur heard over the mitral valve area due to obstruction of the mitral valve orifice. The Corrigan’s pulse or water hammer pulse is the result of the acute decreased in pressure during the late systole and early diastole, can be palpated at the radial and femoral area. De Musset’s (head bobbing) and Duroziez’s  (pistol-shot sound over femoral area) signs are the result of the markedly increased in pressure during early systole follow by a decreased in pressure during late systole and late diastole.

Academic Life in Emergency Medicine: P-video: How to remember the GCS scoring

 Academic Life in Emergency Medicine: P-video: How to remember the GCS scoring: In this inaugural P-video, Dr. Jeremy Faust gives us a quick way to remember how keep the maximum subscores of the Glasgow Coma Scale str...