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36 participants with the most severe collection of risk factors were 4.6 times more likely than those with none of the risk factors to have had shoulder joint pain. They were also cheers nearly six times more likely to have had a second shoulder condition, rotator cuff tendinopathy. Participants with mid-level heart risk were less likely to have had either health tips articles shoulder condition, at 1.5 to 3-fold. It may seem like physical strain would be at least just as likely to cause shoulder pain but data from the 1,226 skilled laborers who took part in the study suggest otherwise. Ergonomists carefully monitored airbag manufacturers, meat, processors, cabinet makers and skilled laborers. Every forceful twist, push, and pull was factored into a strain index assigned to each worker. But a more straining job did not translate to an uptick in shoulder difficulties. Nor did more time spent doing other physical activities. “What we think we are seeing is that high force can accelerate rotator cuff issues but is not the primary driver,” says Hegmann. “Cardiovascular disease risk factors could be more important than job factors for incurring these types of problems.” http://justrileyhernandez.hawapets.org/2016/08/07/using-your-fingers-or-a-soft-cloth-gently-apply-cleanser-in-small-circles-over-your-face-working-from-your-nose-to-your-hairlineHe says it’s possible that controlling blood pressure and other heart risk factors could alleviate shoulder discomfort, too. ### The research was supported by the National Institute on Occupational Safety and Health and published as “Association as Cardiovascular Disease Risk Factors and Rotator Cuff Tendinopathy”.
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Based on 30-day readmission rates after initial hospitalization for acute myocardial infarction, congestive heart failure or pneumonia, the researchers categorized hospitals into one of four groups based on the penalties they had incurred under the Hospital Readmission Reduction Program: highest performance (0% penalty), average performance (greater than 0% but less than 0.5% penalty), low performance (equal to or greater than 0.5% but less than 0.99% penalty), and lowest performance (equal to or greater than 0.99% penalty). “We analyzed data from more than 15 million Medicare discharges, said co-senior author Francesca Dominici, PhD, Professor of Biostatistics and Senior Associate Dean for Research at Harvard T.H. Chan School of Public Health. We implemented Bayesian hierarchical models to estimate readmission rates for each hospital, accounting for differences in each hospitals patient population. We then used pre-post analysis methods to assess whether there were accelerated reductions in readmission rates within each group after the passage of the reform. It turned out that all groups of hospitals improved to some degree. Notably, we found that it was the hospitals that were the lowest performers before passage of the Affordable Care Act that went on to improve the most after being penalized financially. For every 10,000 patients discharged per year, the worst performing hospitals which were penalized the most avoided 95 readmissions they would have had if theyd continued along their current trajectory before the implementation of the law, added Dominici. Its a testament to the fact that hospitals do respond to financial penalties, in particular when these penalties are also tied to publicly reported performance goals. Paying hospitals not just for what they do, but for how well they do thats still a relatively new way of reimbursing hospitals, and it looks to be effective, Yeh added. This work was funded, in part, by grants from the National Institutes of Health (P01 CA 134294, R01 GM111339, R01 ES024332 and K23 HL 118138-01), as well as support from the Massachusetts General Hospital Cardiology Divisions Hassenfeld Scholars Program.
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