Tuesday, November 26, 2019

Association of the Work Schedules of Hospitalists With Patient Outcomes of Hospitalization.

Interesting if true. Hypothesis is reasonable. - TFH



Association of the Work Schedules of Hospitalists With Patient Outcomes of Hospitalization.:

Related Articles
Association of the Work Schedules of Hospitalists With Patient Outcomes of Hospitalization.

JAMA Intern Med. 2019 Nov 25;:

Authors: Goodwin JS, Li S, Kuo YF

Abstract

Importance: The working schedules of hospitalists vary widely. Discontinuous schedules, such as 24 hours on and 48 hours off, result in several hospitalists providing care during a patient's hospital stay. Poor continuity of care during hospitalization may be associated with poor patient outcomes.

Objective: To determine whether admitted patients receiving care from hospitalists with more discontinuous schedules experience worse outcomes.

Design, Setting, and Participants: This retrospective cohort study used conditional models to assess Medicare claims data for 114 777 medical admissions of patients with a 3-day to 6-day length of stay from January 1, 2014, through November 30, 2016, who received all general medical care from hospitalists in 229 hospitals in Texas. Data were analyzed from November 2018 to June 2019.

Exposures: For each admission, the weighted mean of schedule continuity for the treating hospitalists, assessed as the percentage of all their working days in that year that were part of a block of 7 or more consecutive working days, was calculated.

Main Outcomes and Measures: The primary outcome was patient mortality in the 30 days after discharge. Secondary outcomes were readmission rates and Medicare costs in the 30 days after discharge, and discharge destination.

Results: Of the 114 777 patient admissions, the mean (SD) age was 79.9 (8.3) years, and 70 047 (61.0%) were women. For admissions in the lowest quartile for continuity of hospitalist schedules, the hospitalists providing care worked 0% to 30% of their total working days as part of a block of 7 or more consecutive days vs 67% to 100% for hospitalists providing care for patients in the highest quartile for continuity. Patient characteristics were not associated with the continuity of working schedules for the hospitalist(s) providing care. In conditional logistic regression models, admitted patients cared for by hospitalists in the highest quartile of schedule continuity (vs the lowest quartile) had lower 30-day mortality after discharge (adjusted odds ratio [aOR], 0.88; 95% CI, 0.81-0.95), lower readmission rates (aOR, 0.94; 95% CI, 0.90-0.99), higher rates of discharge to the home (aOR, 1.08; 95% CI, 1.03-1.13), and lower 30-day postdischarge costs (-$223; 95% CI, -$441 to -$7). The results were similar across a range of different methods for defining continuity of hospitalist schedules and selecting the cohort.

Conclusions and Relevance: Hospitalist schedules vary widely. Admitted patients receiving care from hospitalists with schedules that promote inpatient continuity of care may experience better outcomes of hospitalization.

PMID: 31764937 [PubMed - as supplied by publisher]

Wednesday, November 20, 2019

Survey: More Americans Eating Less Meat, Opting For Plant-Based Options Instead

As long as sugar intake stays low, this might be a good development. Still, there are a lot of supporters of the keto diet. We'll see how things pan out but it likely with take several years. - TFH



Survey: More Americans Eating Less Meat, Opting For Plant-Based Options Instead:

Woman disgusted by burger
New research shows “flexitarian” diet growing in popularity as more adults prefer to eat meat only on occasion. NEW YORK — Cheeseburgers, steaks, and hot dogs are synonymous with American cuisine, or at least they were at one time. According to a new survey of 2,000 Americans, if these dishes are a common part of your…

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Saturday, November 16, 2019

Flu Shots Help Prevent Early Death In Heart Disease Patients — Yet 1 In 3 Skip Vaccination

I recommend taking with your PCP about the pneumovax, shingles vaccine, and annual flu shot. - TFH



Flu Shots Help Prevent Early Death In Heart Disease Patients — Yet 1 In 3 Skip Vaccination:

flu shot, vaccine, vaccination
DALLAS — Vaccines can be a divisive subject in certain circles, but a recent set of research has found yet another reason why a yearly flu shot is a smart idea. Annual influenza vaccinations can help prevent further illness and premature death among people already suffering from heart disease, according to a study presented at the…

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Can’t Avoid The Seasonal Blues? Joining A Yoga Class Boosts Positivity, Reduces Depression Symptoms

This is a better first step than taking medications. - TFH



Can’t Avoid The Seasonal Blues? Joining A Yoga Class Boosts Positivity, Reduces Depression Symptoms:

Women working out, doing yoga at gym
BOSTON — Millions of Americans battle symptoms of depression, affecting about one in seven adults at some point in their lives. Many often feel especially blue as temperatures grow colder and winter arrives. A new study shows that joining a regular yoga class could have the power to reduce those symptoms in both the short and…

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Friday, November 8, 2019

Biological Clockwork: Daylight Saving Time Has Long-Term Impact On The Brain, Study Warns

Daylight savings time should be abolished. - TFH



Biological Clockwork: Daylight Saving Time Has Long-Term Impact On The Brain, Study Warns:

Closeup of clock
Neurology professor says daylight saving is not worth the harm to our bodies: ‘It’s a misalignment of our biologic clocks for eight months of the year.’ NASHVILLE, Tenn. — Daylight saving time is typically considered nothing more than an annoyance or simple fact of life as we “spring forward” and “fall back” each year. But, are…

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Brain Drain: Screen Time Among Preschoolers Linked To Lower Literacy, Language Scores

Reading to children... from a book... is important for brain development. - TFH



Brain Drain: Screen Time Among Preschoolers Linked To Lower Literacy, Language Scores:

Toddler using ipad
New study shows that young children who frequently use digital devices, resulting in excess screen time, have lower levels of white matter in their brains. CINCINNATI — Young children have never been easy to keep entertained. It’s frequently a challenge for parents to keep their pre-schoolers content, especially on long car rides, visits to in-laws, or…

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Tuesday, November 5, 2019

Pneumocystis jirovecii pneumonia in HIV-uninfected, rituximab treated non-Hodgkin lymphoma patients.

Prophylaxis probably is an excellent idea in this patient group. - TFH



Pneumocystis jirovecii pneumonia in HIV-uninfected, rituximab treated non-Hodgkin lymphoma patients.:

Icon for Nature Publishing Group Icon for PubMed Central Related Articles
Pneumocystis jirovecii pneumonia in HIV-uninfected, rituximab treated non-Hodgkin lymphoma patients.

Sci Rep. 2018 05 29;8(1):8321

Authors: Wei KC, Sy C, Wu SY, Chuang TJ, Huang WC, Lai PC

Abstract

Rituximab is associated with a higher incidence of Pneumocystis jirovecii pneumonia infection. Pneumocystis prophylaxis is advised in many immunocompromised populations treated with rituximab. However, the beneficial effect of pneumocystis prophylaxis in HIV-uninfected, rituximab-treated non-Hodgkin lymphoma (NHL) patients has not been assessed. Thus, we conducted this retrospective study to explore pneumocystis infection in HIV-uninfected NHL patients who received at least three courses of chemotherapy without haematopoietic stem cell transplantation using the Taiwan National Health Insurance Research Database. Patients who had rituximab-based chemotherapy were included in the experimental (rituximab) group, while the rest of the patients who did not receive any rituximab-based chemotherapy throughout the study period formed the control group. The prevalence rate of pneumocystis infection in the rituximab group (N = 7,554) was significantly higher than that in the control group (N = 4,604) (2.95% vs. 1.32%). The onset of pneumocystis infection occurred between 6 and 16 weeks after chemotherapy. Patients who had pneumocystis prophylaxis, whether or not they had a pneumocystis infection later in their treatment course, had significantly better first-year survival rates (73% vs. 38%). Regular pneumocystis prophylaxis should be considered in this group of patients.

PMID: 29844519 [PubMed - indexed for MEDLINE]

Monday, November 4, 2019

Inferiority Complex: 8 In 10 Millennials Believe They Aren’t ‘Good Enough’

The truth is that they are good enough, even better than good enough. Just learn to relax! - TFH



Inferiority Complex: 8 In 10 Millennials Believe They Aren’t ‘Good Enough’:

Stressed, upset millennial sitting at work computer
Survey reveals most young adults feel frequently overwhelmed by the demands of their work and social lives, with many experiencing adverse mental health effects. Nearly six in ten millennials believe many of society’s expectations for them are unrealistic. LONDON — It feels like everyday there is another article published blaming millennials for this or that. A certain…

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Saturday, November 2, 2019

Silence Is Golden: Living In A Noisy Area May Increase Risk Of More Serious Stroke

An increased stroke rate is a potential side-effect of the mass deployment of windmills. Nuclear energy is much safer. - TFH



Silence Is Golden: Living In A Noisy Area May Increase Risk Of More Serious Stroke:

New York City street - Manhattan
BARCELONA, Spain — We’ve all dealt with the occasional noisy party next door or been woken up rudely by a car alarm, but these are just small annoyances with no real health consequences right? Well, according to a new international study conducted in Barcelona, Spain, all that noise may actually cause a more serious stroke at…

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Misunderstood Generation? Millennials Perform More Good Deeds Than Any Older Age Group, Survey Claims

Keep it up! - TFH



Misunderstood Generation? Millennials Perform More Good Deeds Than Any Older Age Group, Survey Claims:

Millennials hash tag
NEW YORK — Millennials are often given a bad rap these days for being lazy, entitled, and careless with their words and actions. The subject of millennials’ influence on modern society has already been discussed ad nauseam, so much so that it feels like many older Americans’ beliefs about everyone born after 1981 has already turned…

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Find the Joy

Lyrics I don’t know why it happened. Where it’s going, a mystery. Somewhere there’s an answer, But the hurt is still inside. And time just k...