Daily music listening to reduce work-related stress: a randomized controlled pilot trial.

BACKGROUND: Literature shows that music can reduce stress conditions. This pilot study investigated the effects of music listening on work-related stress and well-being in healthcare professionals. METHOD: A total of 45 subjects were randomly assigned to three treatment groups: No Music, Individualized Music and Melomics-Health Listening. Music groups experienced a daily 30-min-playlist listening for 3 weeks at home. The Maugeri Stress Index-Revised (MASI-R) and the Psychological General Well-Being Index (PGWBI) were administered at baseline, after 3 weeks and after 7 weeks (follow-up). Longitudinal data were analyzed by means of a nested ANOVA model, testing the main effects of time and treatment and the interaction between them. RESULTS: MASI-R scores showed a positive trend in music groups and a worsening in the control group. Only the interaction time/treatment emerged as supporting a trend toward statistical significance (P = 0.07). PGWBI showed a stability in music groups and a clear decline in controls, without significant effects. CONCLUSIONS: Results from the study support the need for a larger clinical trial: it is suggested that daily music listening could be implemented to reduce work-related stress and that the effects may be related, not only to individual musical preferences and familiarity, but also to specific music structures and parameters.

Addendum to 'Efficacy of music therapy treatment based on cycles of sessions: a randomised controlled trial' (Raglio et al., 2010).

OBJECTIVES: The aim of this paper is to provide further detail about the results of a randomised controlled study published in this journal (Raglio et al., 2010, 14, 900-904), in which we assessed the efficacy of music therapy (MT) on the behavioural disturbances in people with moderate-severe dementia. METHODS: Sixty patients were randomly assigned to the experimental (MT and standard care) and control group (standard care only). The experimental group received three cycles of 12 MT sessions each, three times a week. Each cycle of treatment was followed by one month of washout period, while the standard care activities continued over time. RESULTS: The impact of the treatment (12 MT sessions) was reliable on NPI global scores, as the interaction Time by Group was significant (F(1,49) = 4.09, p = 0.049). After the end of the treatment the NPI global scores of the experimental and control groups tended to become similar, as both groups worsened (Time effect: F(1,48) = 4.67, p = 0.014) and the difference between them disappeared (F < 1). Interaction Time by Group was not significant. CONCLUSIONS: The study confirms that active MT determines a positive response and can amplify and strengthen the efficacy of therapeutic interventions towards people with dementia.

[Heparin-induced thrombocytopenia syndrome and thrombosis in patients undergoing periodic haemodialysis]. / La sindrome di trombocitopenia e trombosi indotte dall eparina (HIT) in emodialisi.

Heparin-induced thrombocytopenia (HIT) is the most important immunological drug reaction that patients face today. Being unfractionated heparin the standard anticoagulation used in haemodialysis, acute or chronic uremic patients starting haemodialysis are at risk of developing HIT. Through the accurate description of two patients, one with chronic and the other with acute uraemia, who developed this complication at the start of haemodialysis, we compare the distinct clinical problems of haemodialysis-related HIT with the general clinical features of HIT. We report the occurrence of repeated clotting of both dialysers and catheters, as well as thrombosis of the central veins where the catheters are placed and of the fistulas. We also report an accurate review of the literature on haemodialysis-related HIT. We have observed that HIT seems to be particularly rare in haemodialysis patients. Since newly treated haemodialysis patients are at risk of developing HIT, and most of the studies were made on long-term chronic haemodialysis patients, we assume that the syndrome is poorly documented. Our own experience on 37 haemodialysis patients who developed HIT is reported by focusing on both the clinical presentation of HIT as well as the long-term follow up of the patients. We present some considerations on the treatment options of acute HIT in uremic patients as well as on the problem of heparin re-exposure subsequent to the HIT episode, a very prominent problem in chronic haemodialysis patient.

What hospitals won't do for a merger. Deals involving Catholic facilities often mean a loss of reproductive services.

As Catholic and non-Catholic hospitals pursue mergers or partnerships with one another, the facilities are discovering a major culture clash, prompting a new set of operating rules. At the heart of it all are prohibitions the Catholic Church slaps on certain reproductive services, such as tubal ligations, abortions and some fertility programs. Sometimes the hurdles prove insurmountable.

AHA 100th anniversary. Good Samaritan business.

In recognition of the American Hospital Association's centennial, we examine the AHA's long history, how it has evolved with the constantly changing healthcare industry and where the next century will take the nation's largest trade group. Our special section features interviews with AHA President Richard Davidson and two of his predecessors. We also look at the hospital's changing role in the community and the AHA's lobbying legacy. In addition, we've included highlights of the association's upcoming centennial membership meeting.

The quiet restructuring. Blaming feds, hospitals shed workers, facilities in droves.

A major downsizing is under way in the hospital industry. Hospitals are laying off thousands of workers and closing down a variety of services. Facilities cite the usual suspects for taking such drastic action: managed care, reimbursement changes in federal healthcare programs, plummeting inpatient loads and consolidation. This is the first in a two-part series on financial turmoil in the industry.

The forum is with them. AHA sees new unit as a way out of declining revenues.

By gobbling up the San Francisco-based Healthcare Forum, the American Hospital Association is increasing its stake in the healthcare publishing and management education business. When the new for-profit company--called the Health InfoSource--is created Sept. 1, Kathryn Johnson will be at the helm as its founding president and CEO.

Provider disunity on labor. Kaiser, CHW adopt strikingly different strategies with unions.

In the past, when it came to labor relations in the healthcare industry, adversarial encounters were the norm. But times are changing, at least at some healthcare organizations, notably Kaiser Permanente, which late last month signed a national labor contract with some two dozen unions. Elsewhere, however, confrontation is often still the order of the day, especially between nurse unions and Catholic Healthcare West.

Rolling out the red carpet.

Legions of lawyers, consultants and accountants are pulling in the big bucks helping providers stay on the right side of government regulations. Compliance is the trendiest buzzword in healthcare today, and it's creating some lucrative business opportunities. Compliance officers, like Roy Snell (left) of University of Wisconsin Medical Foundation, ride herd to make sure healthcare companies stay within the lines.

The expanding reach of risk management.

Although risk management is an industry that came into vogue 20 years ago because of a malpractice crisis, it has evolved beyond the singular concern of professional liability. That's evidenced by the entries for the seventh annual Excellence in Healthcare Risk Management Award competition. Each of this year's winners put a nontraditional twist on risk management.

A year of more and less. Number of hospital deals drops, but more facilities change hands. 1998 hospital mergers, acquisitions, joint ventures, long-term leases and other partnerships.

1998 wasn't quite as busy a year for hospital dealmakers as 1997, but those who went shopping bought in volume. Although the number of deals decreased by almost 9%, 687 hospitals changed hands last year, according to our fifth annual tally of merger and acquisition activity.

Natural selection. Weaker hospitals find today's climate is a jungle.

Most hospital executives would probably agree that it's a jungle out there. In today's competitive market, it's survival of the fittest. Some observers say the healthcare industry's version of Darwinism might not be such a bad thing. The demise of weaker hospitals thins overcapacity and helps control costs. But others say it has gone too far, becoming an unhealthy evolution that's not just winnowing the weak but also bringing down the strong.

The old guard stands down. Generation of CEOs that fostered systems is retiring.

It's a changing of the guard. In the past 18 months, some of the nation's best-known and longest-serving healthcare chief executives have relinquished the day-to-day management of their organizations. And more CEOs have announced their intention to leave this year or next. This is a generation that came of age with the Medicare program and has witnessed the rise of large systems and for-profit healthcare.

Making it a federal case. Suit alleges widespread fraud by Columbia, Quorum.

A federal whistleblower lawsuit unsealed last week alleges widespread Medicare fraud at two of the nation's largest for-profit hospital companies, Columbia/HCA Healthcare Corp. and Quorum Health Group--both relatives of Hospital Corporation of America. The case shows how hospitals' legal troubles have spread since the advent of Medicare's prospective payment system in 1984.

G-men. Federal resources are stacking up to tackle healthcare fraud.

Government fraud fighters are becoming as great a threat to providers as Treasury Agent Eliot Ness once was to mobster Al Capone. Federal agencies are packing heat with the False Claims Act in their fight against healthcare fraud and abuse. Last year the government collected more than $1 billion in fines and settlements. And observers say, for providers, the worst is yet to come.

Lobbies work hard during Congress' recess. Healthcare interest groups promote their positions while lawmakers share the 'big picture'.

Healthcare lobbyists have been working hard during Congress' summer recess. Groups representing hospitals, health plans and senior citizens have blitzed their elected officials through postcards, faxes, advertisements and personal visits, seeking their help on a laundry list of healthcare issues. One of the prominent targets is the vilified Balanced Budget Act of 1997.

Multi-unit Providers Survey. For-profits report decline in acute-care hospitals ... newcomers to top 10.

For-profit hospital systems cleaned house last year. After years of adding hospitals, investor-owned operators shed facilities in 1998, recording the first decline in the number of acute-care hospitals they've owned or managed since 1991, according to our 23rd annual Multi-unit Providers Survey.

A range of results. Healthcare groups had mixed financial picture in 1998.

When it comes to financial performance, some not-for-profit healthcare organizations certainly can say that they're not in the profit business. Their margins are well into negative numbers. But others, including some hospital groups, post margins that would make investor-owned companies jealous. Modern Healthcare takes a look at the financial data contained in not-for-profits' latest filings with the Internal Revenue Service.

Jury convicts two in Columbia fraud case.

Nearly three years after the federal government began a criminal investigation of Columbia/HCA Healthcare Corp. and its executives, a federal jury in Tampa, Fla., found Columbia financial executives Jay Jarrell and Robert Whiteside guilty of defrauding government health programs. A third executive, Michael Neeb, was acquitted in the case, and the jury couldn't reach a verdict on a fourth, Carl Lynn Dick.