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Children With Sickle Cell Disease Need A Good Night's Sleep
Children with sickle cell disease tend to have interrupted sleep many times during the night leaving them tired and irritable during the day.

Gut Hormone Has 'Remote Control' On Blood Sugar
A gut hormone first described in 1928 plays an unanticipated and important role in the remote control of blood sugar production in the liver, according to a report in the August 6th Cell Metabolism, a Cell Press publication. What"s more, the researchers show that rats fed a high-fat diet for a few days become resistant to the glucose-lowering hormone known as cholecystokinin (CCK).
News of the day
Poor Working Conditions For Docs May Affect Quality Of Care
"Adverse working conditions for primary care doctors, including time pressures and an unfavorable organizational culture, may lead to stress, burnout, and ultimately to lower quality patient care, a new study found," MedPage Today reports. The study, published in the July 7 issue of The Annals of Internal Medicine, found that "53.1% of primary care physicians reported time pressure during physical examinations, while 48.1% reported chaotic working environments. Only 23.7% felt that quality was strongly emphasized in their practices. ... Moreover, 48.8% described their jobs as moderately or highly stressful, while 26.5% reported burnout, and 30.1% said they were at least moderately likely to leave their practices within two years." The authors wrote that the findings "are disturbing at a time when recruitment and retention in primary care are of major concern."
Nutrition

Ambulance Diversion Studied

When a hospital"s emergency department is overcrowded with seriously sick and injured patients, it may "go on diversion," re-routing ambulances to other emergency departments. But the benefits of "diversion" are largely unproven. Often those emergency departments are just as crowded, and the greater distance to that other hospital can worsen the condition of some patients. In 2006, a group of teaching hospitals in Boston agreed to stop going on diversion for two weeks, to see if eliminating diversion would cause any problems. A team of researchers led by Dr. Franklin Friedman at Tufts Medical Center examined what happened during these two weeks, as compared to the two weeks right before the "no diversion" experiment. The researchers found that no significant problems arose. There were no changes in the numbers of patients seen in the emergency departments, or in the amount of time the ambulances crews had to wait at the hospital for emergency department staff to take over patient care - and the amount of time that admitted patients had to wait in the emergency department for a hospital bed actually decreased by about 18 minutes. The state of Massachusetts, noting the findings from this study, has now ended the practice of ambulance diversion state-wide as of 1/1/09, in part due to the results of this study. The presentation, entitled "A Trial To End Ambulance Diversion In Boston," was given by Dr. Franklin Friedman in the Emergency Medical Services / Out-of-Hospital forum at the 2009 SAEM Annual Meeting at the Sheraton New Orleans on May 16 at 9:30 AM. Abstracts are published in Vol. 16, No. 4, Supplement 1, April 2009 of Academic Emergency Medicine, the official journal of the Society for Academic Emergency Medicine. Sean Wagner Wiley-Blackwell


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