December 8th, 2011 by RyanDuBosar in News
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The percentage of hospital outpatient department visits seen only by a physician assistant or advanced practice nurse rose from 10% to 15%, while the percentage of joint physician/nonphysician clinician visits remained at about 3%, health researchers found.
Among other findings in the Centers for Disease Control and Prevention report:
–About three-fourths of the more than 103 million hospital outpatient department visits in 2008-2009 were seen by a physician and 18% were seen by a physician assistant or advanced practice nurse;
–Among visits to a non-physician, 65% were seen by an advanced practice nurse and 35% were seen by a physician assistant;
–The percentage of outpatient department visits attended only by physicians declined from 77% in 2000-2001 to 72% in 2008-2009; and
–The percentage of visits not seen by a physician, physician assistant, or advanced practice nurse remained the same (10%).
Following previous trends, physician assistants or advanced practice nurses are the only provider for visits more often in rural areas, and with younger patients. Read more »
*This blog post was originally published at ACP Hospitalist*
December 7th, 2011 by RyanDuBosar in News, Research
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Don’t assume elderly heart failure patients are assumed to prefer improved quality of life over longevity, study authors noted. The majority of them prefer longevity over quality of life, half expressed a desire for resuscitation if needed, and it was difficult to predict individual preferences.
Researchers looked at patients’ willingness to trade survival time for quality-of-life and the preferences for among 622 heart failure patients aged 60 or older participating in the Trial of Intensified vs. Standard Medical Therapy in Elderly Patients with Congestive Heart Failure.
End-of-life preferences were assessed by using a time trade-off tool and one question concerning CPR preference. To assess time trade-off, patients were asked whether they preferred living 2 years in their current state of health or living 1 year in excellent health. If 1 year in excellent health was chosen, the patients were asked whether they would prefer 2 years in their current state of health or 6 months in perfect health. If 2 years in the current state were chosen, then they were asked whether they would prefer 2 years in their current state of health or 18 months in perfect health. The series continued until the choices were the same. This time point subtracted from 24 months derived the number of months of survival time that the patient would be willing to trade.
End-of-life preferences were assessed at baseline, and at 12 and 18 months. Read more »
*This blog post was originally published at ACP Hospitalist*
December 5th, 2011 by RyanDuBosar in News, Research
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Too much vitamin D can lead to 2.5 times the risk of atrial fibrillation, researchers found.
To determine if there is a correlation between too much vitamin D and increased heart risk, researchers examined blood tests from 132,000 patients in the Intermountain Healthcare Center database. Results were presented at the American Heart Association Scientific Sessions in November, and appeared at the Intermountain website.
Patients did not have any known history of atrial fibrillation, and all had previously received a vitamin D assessment as part of their routine care. Patients were then placed into categories to compare levels of vitamin D: low (less than 20 ng/dL), low/normal (21-40 ng/dL), normal (41-80 ng/dL), high/normal (81-100 ng/dL), and excess (more than 100 ng/dL).
Patients with low, low-normal, normal and high-normal levels of vitamin D had no increased risk of atrial fibrillation. However, atrial fibrillation risk Read more »
*This blog post was originally published at ACP Hospitalist*
December 3rd, 2011 by RyanDuBosar in Research
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A simple optical illusion might encourage better eating habits, researchers found.
The Delboeuf illusion makes equal size circles appear to be different sizes by surrounding them with larger or smaller concentric rings. Applied to eating, smaller plates make the food servings appear larger.
One problem is that the size of commercially available dinnerware has increased from 9.6 inches to 11.8 inches in the past century. Eating only 50 calories a day more as a result equals enough calories to add five pounds of weight annually.
Practical implications of the research include encouraging people to replace larger plates and bowls with smaller ones, choose plates that contrast starkly with food, and even choose tablecloths that match their dinnerware, the researchers noted. Those with eating disorders or elderly people who need to eat more could follow the opposite advice to improve their intake.
Researchers Read more »
*This blog post was originally published at ACP Internist*
November 29th, 2011 by RyanDuBosar in Research
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The idea that the eyes are a window to the soul traces back through history in many forms, but the idea that the eyes might reveal medical secrets didn’t fall far behind the metaphor.
The clues lie on the retina, which reflects the same microvascular changes that might be seen elsewhere in the body from cardiovascular changes and other diseases. The question now is how to associate retinal changes to specific diseases.
To assess potential associations between retinal microvascular changes with disability in performing activities of daily living, researchers conducted a prospective cohort study of 1,487 community-dwelling, disability-free participants in the Cardiovascular Health Study.
The main outcome measure was Read more »
*This blog post was originally published at ACP Internist*
