Reduced residents’ hours a healthy move

first_imgCutting resident physician work hours has not led to lower-quality physicians.Amid rising concerns about medical errors, residents’ hours were capped at 80 per week in 2003 with shift lengths not to exceed 30 consecutive hours. To assess whether shortened residency training resulted in lower-quality physicians upon completion of residency (as measured by health outcomes of patients treated by newly independent physicians), Anupam Jena, assistant professor of health care policy at Harvard Medical School, and colleagues at Stanford School of Medicine studied data from more than 4 million Florida patients between 2000 and 2009.The findings, published today in the October issue of Health Affairs, show that the reforms did not adversely affect the quality of physicians who trained during that period, as measured by their patients’ hospital length of stay or inpatient mortality.“This is perhaps the most hotly debated question in medical education,” Jena said, “with many believing that doctors trained with fewer hours are less well-prepared for independent practice after the completion of residency.”The movement to limit residents’ hours began in New York state in 1989 following a patient death that was attributed, in part, to mistakes made by exhausted medical residents. Proponents of the reform also believed that sleep-deprived residents were not able to learn at full capacity, thus wasting many of the hours they spent in training by working below their full potential.Opponents of the reform feared that physicians trained with fewer hours of work or shorter shifts would lose important experience by seeing fewer types of conditions and missing out on crucial context from observing patient care over a lengthy admission that might last longer than the maximum allowable shift length under the new restrictions.Following the reforms, studies were conducted that showed some reduction in medical errors committed by residents and demonstrated improvements in resident quality of life, but no study had been done to assess how the modification in training might have changed the quality of doctors after they had completed their training and had begun their independent practice.“A major reason why we have no evidence on the long-term effects of duty-hour reductions on the quality of physicians completing residency is that data linking patient outcomes to physician training history has simply been unavailable,” Jena said.The researchers created a unique data set by linking patient information from hospitals with a physician licensure registry that included details about the timing of each doctor’s education. The study compared patients’ in-hospital mortality rates and average length of stay among three categories of physicians: those who completed their residency before 2003, those who experienced partial exposure to duty-hour reforms (completing residency in 2004 or 2005), and those whose entire residency occurred after the duty-hour reforms of 2003.One hurdle to studying outcomes of newly independent physicians who completed residency prior to the 2003 reforms is that hospital care has improved substantially in the past 15 years, meaning that one would expect hospital mortality to have improved over the study period even without changes in residency work hours and training. To address this issue, Jena and his colleagues used “senior physicians” — those with more than 10 years of post-residency experience — as a control group for comparison to newly independent physicians to account for declines in hospital mortality that would be expected to affect new or experienced physicians alike.After adjusting for improved hospital care, the study found that hospital mortality among patients whose physicians completed internal medicine residency in 2003 or earlier (zero exposure to reduced work hours) was 3.3 percent compared with 3.2 percent among patients whose physicians completed residency in 2006 or later (three years’ exposure to reduced work hours).Interestingly, high-risk patients — those with predicted hospital mortality in the top quarter of all hospitalized patients — whose physicians were trained after 2006, actually had better outcomes. Hospital mortality among high-risk patients whose physicians completed residency in 2003 or earlier was 7.7 percent; this percentage is statistically greater than 7.3 percent for high-risk patients whose physicians completed residency in 2006 or later. This finding suggests that reduced work hours may even have improved the quality of training of physicians caring for high-risk hospitalized patients.Jena acknowledged that hospital mortality is a very crude measure of quality and that the study looked only at internists. Because the patients were anonymous, the researchers couldn’t track readmissions, and richer data would be necessary to measure subtler characteristics like diagnostic skills, procedural outcomes, and physician efficiency.“Mortality, however, is the first and most important measure to evaluate, although there are many other things to consider,” Jena said.  “We are just scratching the surface.”last_img read more

Nelson U14 Girls strike gold at 2012 Sam Steele tournament

first_imgNelson opened the tournament scoring a 3-0 decision over host East Kootenay Rovers.Emily Graeme found the back of the net at the 20th minute to give Nelson a 1 – 0 lead that would hold to the break.Nelson continued to attack and was rewarded by second half goals from Lakpa Dietz and Allie Zondervan.Nelson wrapped up the pool title by edging out Canmore Avalanche 4-1.Bronwyn Sutherland opened the scoring, which was followed quickly with a score by Merissa Dawson to put Nelson in front 2 – 0.Canmore countered with a late first half goal to make the score 2 – 1 for Nelson at the half. The marker was the first allowed by the Nelson squad in six games.The Selects came out strong after the break, with Perkins scoring six minutes into the half followed by a second goal from Sutherland two minutes later.In semi-final action on Sunday morning, Nelson continued its defensive superiority over Kootenay competition by shutting out the Creston Blitz 4-0.Perkins, with a pair, Voisard and Dietz scored for the Selects.The Reps now prepare for the B.C. Soccer Provincial B Cup July 5-8 in Kelowna. The hottest team in Nelson Youth Rep Soccer continues to roll over Kootenay opposition.The Nelson Selects rolled to the gold medal at the U14 Girl’s 2012 Sam Steele tournament Sunday in Cranbrook.Nelson won the gold medal by stopping West Kootenay rival Kootenay South 4-0 in the tourney final.“Again (Pat and I) were impressed by the skill and passion of the squad,” said co-coach Paul Burkart.“Running short a few defenders and with several others playing injured, players were asked to play in positions that they normally did not play and did so admirably  — allowing only a single goal in the four games.”The Gold Medal match was a spirited affair with exciting end-to-end action in the first half.Early in the second half, Naomi Perkins broke the deadlock with an absolute bullet to the top corner of the Kootenay South net from a free kick from outside of the penalty area.Bronwyn Sutherland scored five minutes later and Voisard added a single near the end of the game to give Nelson a 3 – 0 lead.last_img read more

Leafs, Rebels pull off blockbuster KIJHL deal

first_img“It was a very difficult decision to give up Dallon but (Castlegar) wanted some leadership back and with Dallon’s experience in the league Castlegar wanted him badly,” Maida explained.“You really have to take a look at making sure a deal is going to work from a hockey point of view both on an off the ice,” Maida added. “To get two quality players like Wellman and Vlanich we had to give up fair value in return.”In Vlanich Nelson gets the Rebels second leading scorer both in the regular season and playoffs.Vlanich, from Trail and also sought out by the Beaver Valley Nitehawks, finished the season with a combined 28 goals in 48 games.Wellman, a native of Calgary, was Castlegar’s third leading scorer during the Rebels KIJHL run to the Cyclone Taylor Cup, finishing with 21 points after coming to the Sunflower City following a late season deal.Who knows if Leonard fits into the Cyclone Taylor season for the Leafs?The Kamloops backstop is pondering his future and may not play his final season, instead focusing on an electrical trade.The deals come less than three weeks before Nelson takes to the ice for training camp beginning August 30 at the NDCC Arena.Maida was still rustling the KIJHL bushes in an effort to bolster the roster even more before the Leafs begin a season that finishes with the Green and White hosting the Cyclone Taylor Cup, April 10-13 at the NDCC Arena.“We’re still negotiating with some teams,” he confessed. The BC Hockey roster deadline is more than six months away but already Leaf head coach Frank Maida has made more deals than Drew Carey on The Price is Right.Maida sent forwards Dallon Stoddart and James Sorrey along with D-man Seth Schmidt to Castlegar in exchange for sniper Jamie Vlanich and forward Travis Wellman.The Kootenay International Hockey League Murdoch Division deal comes on the heels of the Leafs acquiring the rights to netminder James Leonard from the Golden Rockets in exchange for future considerations.“Getting two experienced players (Wellman and Vlanich) who have been to the Cyclone Taylor (tournament) . . . two players I believe who can provide leadership being 20-year-olds, gives us a much deeper roster,” Maida told The Nelson Daily.Maida said the deal came together after he heard the Wellman and Vlanich requested a trade.However, the Nelson GM realized to get quality Nelson had to give up quality in the likes of Sorrey, Schmidt and Stoddart — the latter a Nelson Minor Hockey grad.last_img read more

Dolan, Coley sign letters of intent

first_imgOn Tuesday, two local track athletes took time away from their preparation for this weekend’s league championships to announce where they’ll be taking their talents next year.McKinleyville’s Lizzie Dolan and Christian Coley, both record holders for the Panthers, will continue their athletic careers in SoCal after graduation, with Dolan heading to UC San Diego and Coley going to Cal Poly Pomona.Each was on hand at the McKinleyville High library to sign a letter of intent for their respective …last_img read more

Evolution as “Scientific Literacy” Dropped by NSB; Sets Off Firestorm

first_imgCan you be called scientifically literate if you deny that humans evolved from lower animals?  What if you deny the universe began with an explosion?  American students have typically scored low on those questions, leading to charges that they are scientifically illiterate compared to other countries in Europe and Asia.  But now, the National Science Board (NSB) decided to drop those hot-button questions in the 2010 edition of Science and Engineering Indicators, a biennial compilation of the state of global science, on the grounds that they don’t accurately reflect students’ knowledge of science, but rather their beliefs.  The decision set off angry protests in certain quarters.    Yudhijit Bhattacharjee reported on this issue in the April 9 issue of Science.1  He quoted Joshua Rosenau of the National Center for Science Education (NCSE) calling it “intellectual malpractice” to discuss scientific literacy without mentioning evolution.  “It downplays the controversy,” he said.  Jon Miller, a science literacy researcher at Michigan State, conducted the survey until 2001.  As the one who added the survey question in the first place, he thinks the current board is making a big mistake.  “If a person says that the earth really is at the center of the universe, … how in the world would you call that person scientifically literate?” he asked.  Bhattacharjee said, “those struggling to keep evolution in the classroom say the omission could hurt their efforts.”    But the NSB defended its decision to drop the “value-charged” question on evolution as a misleading indicator:NSB officials counter that their decision to drop the survey questions on evolution and the big bang from the 2010 edition was based on concerns about accuracy.  The questions were “flawed indicators of scientific knowledge because the responses conflated knowledge and beliefs,” says Louis Lanzerotti, an astrophysicist at the New Jersey Institute of Technology in Newark and chair of the board’s Science and Engineering Indicators (SEI) committee.  John Bruer, a philosopher and president of the James McDonnell Foundation in St. Louis, Missouri, and the lead reviewer for the chapter, says he recommended removing the text and related material because the survey questions “seemed to be very blunt instruments, not designed to capture public understanding” of the two topics.Bruer noted that 72% of Americans answered the question about humans evolving from earlier species correctly when the question was prefaced with the phrase, according to the theory of evolution.  This shows that the questions “reflect factors beyond unfamiliarity with basic elements of science.”  The controversy over Indicators thus boils down to the question whether a student needs to believe, rather than simply know, the facts of a theory to be considered scientifically literate.  Critics of the change, however, see the preface as biasing the answers students will give.    Bhattacharjee ended by showing signs that the controversy over inclusion of evolution questions in Indicators will undoubtedly surface again in the next round.  Lanzerotti feels the board should have explained why the questions were dropped, while “Miller believes that removing the entire section was a clumsy attempt to hide a national embarrassment.”1.  Yudhijit Bhattacharjee, “NSF Board Draws Flak for Dropping Evolution From Indicators,” Science, 9 April 2010: Vol. 328. no. 5975, pp. 150-151, DOI: 10.1126/science.328.5975.150. Well, now, it sounds like the NCSE has flip-flopped on whether there is a controversy about evolution.  Their talking points used to say that “there is no controversy over evolution.  Any putative controversy is one concocted by creationists and the Discovery Institute.”  Now, NCSE rep Josh Rosenau got uptight about Indicators because “it downplays the controversy.”  What controversy?  The controversy over whether there is a controversy?  Does he think now we should teach the controversy?    If students have to believe rather than understand a scientific theory, then science has become a religion.  According to the radical Darwinists, a scientist could have a PhD, earn international honors in science, publish hundreds of papers in peer-reviewed journals, and save millions of lives through his or her discoveries, and yet, if a Darwin doubter (roster), could be judged scientifically illiterate.  Do you want radicals like that influencing education policy?  Do you want them requiring recitation of a pledge of allegiance to Darwin?  Do you want them forcing science curricula to say that to understand science, you must believe that “nothing” banged and became everything by an unguided process?  The only “national embarrassment” is the ill-named National Center for Science Education itself.  Let’s call it what it is: the DODO Dogma Dictatorship.(Visited 16 times, 1 visits today)FacebookTwitterPinterestSave分享0last_img read more

This Friday, Do Something Good

first_img14 September 2010Mentor a young person. Visit an old age home. Start your own volunteer project … as part of its “Legacy” campaign, Brand SA has called on South Africans this Friday to “fly the flag” by volunteering some of your time to South Africans who need it.Brand South Africa’s Legacy campaign aims to leverage the momentum of the 2010 Fifa World Cup by providing platforms for South Africans to keep achieving and showcasing their “South Africanness” to the world, while entrenching the principles of pride, patriotism and solid citizenship that have been established over the past year.SA Legacy campaign explainedFor the past three Fridays, and the next two to come, South Africans have been “celebrating all the things that make us who we are”. Each Friday has a different theme, this Friday’s being a call to do something good for each other, for example:Visiting www.forgood.co.za for how to go about volunteering in your community.Finding a young person in your community that you can mentor.Finding out how you can work with your local SAPS to make your surroundings safer.Organising a visit to an old age home or hospice.Creating your own volunteer project.Volunteering for an existing project.Do Good Week – poster“When we stand as one, we can do anything,” Brand South Africa said in a statement. “We can build stadiums. We can host the most successful Fifa World Cup™. So what if we all came together to do something good for each other?”“This Friday, Fly the Flag by volunteering some of your time and resources to South Africans who need it.”SAinfo reporterSA Legacy campaign: programmeWould you like to use this article in your publication or on your website? See: Using SAinfo materiallast_img read more

South Africa ranks 30 for worldwide innovation influence

first_img3 February 2016South Africa has ranked number 30 out of 56 countries in terms of its domestic policies supporting global innovation.The global technology think tank, Information Technology and Innovation Foundation (ITIF) released the data in its report, called Contributors and Detractors: Ranking Countries’ Impact on Global Innovation.“More innovation will be the determining factor in achieving greater progress,” stated the report, released on 20 January. “Countries’ economic and trade policies can either help or hurt global innovation.“In contrast, policies such as export subsidies or forced localisation harm global innovation. If nations increased their supportive policies and reduced their harmful policies, the rate of innovation worldwide would significantly accelerate.”How does South Africa compare?South Africa and Kenya were the only African countries to have been featured. Kenya ranked at 51.South Africa’s BRICS partners ranked as follows: Brazil came in at 41, Russia 42, India 54 and China 44.The top spots were taken by Finland, Sweden, the UK, Singapore, Netherlands, and Denmark, respectively.The authors of the report looked at various aspects that supported innovation locally, but which had a global effect, such as supportive tax systems, investing in the work force, and research and development.“Robust innovation is essential for economic growth and progress,” said co-author Stephen Ezell, ITIF’s vice-president for global innovation.“As countries increasingly vie for leadership in the innovation economy, they can implement policies that try to benefit only themselves but harm the production of innovation in the rest of the world. Or they can implement ‘win-win’ policies that bolster their own innovation capacity while also generating positive spill-overs for the entire global economy. For innovation to flourish around the world, we need a system that is doing much more of the latter.”According to technology news site IT Web, South Africa’s National Development Plan is the blueprint for “the national system of innovation to function in a coherent and co-ordinated manner, with broad objectives aligned with national priorities.“It seeks to improve the governance of the innovation system, especially by ensuring the alignment of science and technology innovations activities across government and by co-ordinating public funding.”To read the full report, click here.Source: IT Web and SouthAfrica.info reporterlast_img read more

South Africa condemns Garissa massacre

first_img7 April 2015The South African government has condemned “in the strongest possible terms” the “barbaric and cowardly” terrorist attack at Garissa University College in Kenya last week, in which 148 people were killed.Somali militant group Al Shabab, a multi-ethnic group based in Somalia with links to Al- Qaeda, claimed responsibility for Thursday’s attack. The gunmen took more than 700 people hostage, before killing 148 people and injuring 79 or more.It is Kenya’s deadliest attack since the 1998 US embassy bombings in Nairobi, where more than 200 people died. Garissa is in the north-east of the country.President Jacob Zuma expressed his shock and dismay at the attack. He extended condolences to the families of the victims.“Terrorism in any form and from whichever quarter cannot be condoned. South Africa stands firmly with the international community in condemning all terrorism and stands in solidarity with Kenya,” he said.Zuma reiterated South Africa’s support for Kenya and the international community’s efforts aimed at peacekeeping, stability, democracy and nation-building in Somalia.Source: The Presidencylast_img read more

Body of elderly man found floating in swimming pool

first_imgKolkata: Tension cropped up at Hedua after the body of an elderly person was found floating in the swimming pool early on Thursday morning.The deceased has been identified as Karuna Mondal (60) of Goabagan Street near Hedua. According to sources, on Thursday morning, around 5:30 am, several morning walkers saw a man floating in the water of Hedua swimming pool. Primarily none of the morning walkers did not bothered as they thought someone might be swimming or practicing to float. Also Read – Bengal family worships Muslim girl as Goddess Durga in Kumari PujaBut, after a few minutes, some of them suspected something was wrong as he was not moving. Immediately some local residents went in to the water and brought the person ashore. He was rushed to R G Kar Medical College and Hospital where attending doctor declared him brought dead. After the body was fished out of the pool, some local morning walkers identified the persons as Mondal. According to the morning walkers, Mondal used to come there for fishing. It is suspected that he had come there and tried fetching something from pool and he lost balance over his body and fell in the water. It is also suspected that the elderly man couldn’t swim and there was nobody nearby when Mondal came there. Thus, he failed to save himself. An unnatural death case has been registered at Burtolla police station in this regard.last_img read more

US Ford to shut three factories stop making passenger cars in Russia

first_imgMoscow: US carmaker Ford will close three of the four factories of its Russian joint venture after deciding to stop making passenger cars in a country where car sales have slumped in recent years, the company said Wednesday. Ford said in a statement that it has signed a preliminary agreement with its local partner Sollers on “a significant restructuring of its… joint venture in Russia, focusing exclusively on growing its commercial vehicle business moving forward.” Also Read – Thermal coal import may surpass 200 MT this fiscalThe joint venture “will discontinue its passenger vehicle portfolio in Russia to help deliver a more competitive and sustainably profitable business going forward,” Ford said. Ford, based in the US state of Michigan, said that by the end of June this year it will close its vehicle assembly plants in the northwestern city of Saint Petersburg and the city of Naberezhnye Chelny in Tatarstan, central Russia. It will also close an engine plant in Yelabuga in Tatarstan that opened in 2015. Sollers will have a 51 per cent stake in the restructured joint venture. Also Read – Food grain output seen at 140.57 mt in current fiscal on monsoon boostCurrently the factories produce seven models including the Ford Transit van. Ford said that the “Russian passenger vehicle market has been under significant pressure in recent years, with recovery slower than expected and a shift to lower priced passenger vehicle segments.” The carmaker said that this led to “underutilisation” of factories and “inadequate returns on invested capital,” although sales of the Ford Transit continue to grow, with a 15 per cent share of the market segment. Following a period of growth and massive investment by global carmakers, Russia’s car market collapsed between 2013 and 2016, whiplashed by international sanctions over the Ukraine conflict and a crash in global oil prices. New car sales, a key indicator of consumer confidence, fell by more than half during that period. However sales of new cars in Russia rose in 2018 for a second year running, but slowed in February this year. ptilast_img read more