Working long days tied to cardiovascular risks | Type 2 diabetes better predicted with one-hour hyperglycemia | Study: Patients with heart failure report continued symptoms after hospital stay

August 21, 2015
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Working long days tied to cardiovascular risks
Two analyses reported in The Lancet reveal that people who work long hours are putting their cardiovascular health at risk. One analysis found those who work at least 55 hours a week have a 13% greater risk of developing heart disease than those who work standard schedules. The other dataset showed those who worked at least 55 hours a week were one-third more likely to experience a stroke, while those who worked 41 to 48 hours had 10% higher risk of stroke. Paul Wright of North Shore University Hospital acknowledged that reducing work hours is often not possible, so he urged people to focus on modifiable risk factors, such as eating well and exercising. HealthDay News (8/20)
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Nursing, Health & Medical Science
Type 2 diabetes better predicted with one-hour hyperglycemia
Individuals who presented with normal glucose tolerance and a high one-hour post-load plasma glucose level had a 16.7% incidence rate for type 2 diabetes, compared with 2.9% for those with normal glucose tolerance and a low one-hour post-load plasma glucose level, 12.5% with impaired fasting glucose and 31.4% with impaired glucose tolerance. The findings in The Journal of Clinical Endocrinology & Metabolism were based on 595 white adults without diabetes who had one parent with the disease. Healio (free registration)/Endocrine Today (8/18)
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Study: Patients with heart failure report continued symptoms after hospital stay
Patients with heart failure who are discharged from the hospital often continue to have both traditional symptoms and symptoms not typically associated with the condition that physicians may not adequately address, researchers reported in JAMA Internal Medicine. The study found less than 25% of patients said they were familiar with palliative care and many mistakenly equated it with hospice care or thought it was only for cancer patients. Medscape (free registration) (8/19)
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Study questions value of treating early form of breast cancer
A study reported in JAMA Oncology found treatment may not change outcomes for women diagnosed with a very early form of breast cancer. Women with ductal carcinoma in situ had a 3.3% chance of dying within 20 years, regardless of which treatment they received. Mortality was higher, however, among younger women and black women. Otis W. Brawley, chief medical officer at the American Cancer Society, said it's clear the condition has been overtreated, but a large clinical trial is needed to compare mastectomy, lumpectomy and no treatment before clinicians and patients should consider not treating the disease. The New York Times (free-article access for SmartBrief readers) (8/20), HealthDay News (8/20)
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Trends & Technologies
Hospital nurses have role in diabetes detection, education
Nurses should stay up-to-date on the signs of diabetes and the potential health impact of the disease to ensure hospital patients are screened if needed, said registered nurse Linda Siminerio, director of the University of Pittsburgh Diabetes Institute and chairwoman of the National Diabetes Education Program. Siminerio said nurses should ask patients if they have been tested for diabetes, and nurses are in a good position to help patients who do not expect to be diagnosed with the disease. (8/19)
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Rural hospitals band together to stay financially viable
(OLI SCARFF/Getty Images)
Rural hospitals are forming alliances that allow them to negotiate better pricing deals for supplies and services and to work together on recruiting, technology and training issues. Hospitals hope the strategy will keep them financially viable and open so patients do not have to travel to get health care. "In medicine, distance lessens the chances of survival," said Pam Noland, director of nursing at Northern Cochise Community Hospital. Stateline (8/17)
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ICD-10 has financial, administrative hurdles for home health agencies
Home health care groups and health software companies are warning that home health agencies may experience administrative and financial trouble if they have failed to prepare for the ICD-10 transition. Tricia Twombly of consultant DecisionHealth said agencies had to have implemented the new codes nine weeks before the scheduled Oct. 1 transition because of their unique reimbursement cycle. Health Data Management (8/20)
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Work-Life Balance
Cone Health wellness plan cuts diabetes, hypertension costs
Cone Health reduced employee health care costs for diabetes by $4 million over six years through its "Link to Wellness" program, which emphasizes disease management. Cone Health also expanded pharmacy benefits and added employee outpatient pharmacies across the system. American City Business Journals/Greensboro/Winston-Salem, N.C. (8/19)
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From the Patient's View
Study finds need for more awareness of VA's Blue Button data access
A study in the Journal of Internet Medical Research found that veterans need more education about how the Department of Veterans Affairs' Blue Button program can enable care coordination while allowing patients access to their health data. Researchers interviewed 34 VA patients and 19 providers from inside and outside the agency. Many patients became aware of the initiative by exploring the My HealtheVet website. Some providers were not aware of the program's name but did have experience with patients using it. FierceHealthIT (8/20)
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Legislative Policy & Regulatory News
Ark. governor seeks changes to Medicaid expansion terms
Republican Gov. Asa Hutchinson of Arkansas said he wants to keep the state's expanded Medicaid program but also wants to require beneficiaries to pay premiums if their incomes are above the federal poverty level and to require that Medicaid-eligible people enroll in an employer-sponsored health plan if one is available and meets Affordable Care Act standards. Hutchinson would also shift enrollees with lower incomes to traditional Medicaid instead of commercial plans. The New York Times (free-article access for SmartBrief readers) (8/19)
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