MONTREAL — When Gaetan Barrette, health minister under the previous Liberal government, wanted to give nurses more authority, he said he had to personally intervene in the file and threaten Quebec’s college of physicians.“Behind closed doors I said: ‘Either you move or I will legislate’ — and they moved,” Barrette said in a recent interview. As a result of his efforts, nurse practitioners in the province gained the authority last March to initiate treatment for six chronic illnesses and to prescribe more medications than had previously been the case.But patients are still required by law to be seen by a doctor within 30 days of being treated by a nurse practitioner. And unlike their counterparts in Ontario, Quebec’s roughly 500 nurse practitioners — also known as registered nurses — are not allowed to make diagnoses on patients.The province’s new health minister, Danielle McCann, wants to change that. She said this week that doctors are ready to cede more room to nurses. By the end of the year, the minister said, Quebec’s registered nurses could be diagnosing patients.Barrette, however, who is now on the opposition benches, says McCann’s comments are wishful thinking unless she is ready to use the legislative stick and force doctors to change their ways. “She will not get what she wants without legislating,” he said.Quebec’s college of physicians did not return a request for comment, but in the past it has opposed giving nurses the authority to make diagnoses. Barrette, a radiologist who was president of the federation of Quebec’s medical specialists from 2006-14, said there is a culture among Quebec doctors that makes it difficult for them to accept change.“It’s their profession, it’s their fibre — their essence,” he said. Some doctors “who are rational,” Barrette said, accept giving nurse practitioners the authority to make diagnoses — but they are a minority.“A doctor in Canada, on average, sees 30-35 patients a day,” Barrette said. “In Quebec, it’s 14. I did everything to change that, and it is changing. But there is more work to be done.”Barrette says the nursing profession is also partly to blame. “We are facing two organizations who are corporatist,” he said. Each side wants to protect its own territory. Nurses want to have a parallel system alongside doctors, Barrette explained, while most doctors don’t want change.Prof. Yannick Melancon Laitre, nurse director at McGill University’s primary care nurse practitioner program, said Quebec has been debating the authority of registered nurses since 2012. He said he is “always a bit skeptical” about whether nurses and doctors can agree to co-operate.“I’m excited for us to just come to a decision — to stop talking about it and arrive at a result that is similar to our colleagues in Ontario,” he said in an interview. Registered nurses in Ontario have significantly more authority than in Quebec. They can diagnose, order and interpret diagnostic tests, and as of 2017, can even prescribe controlled substances such as opioids if they receive additional training.Laitre says the differences between Quebec and Ontario nurses “seem trivial” but they are not, especially when it comes to insurance claims. The fact nurses in Quebec can’t use the word “diagnosis” means the medical care they offer isn’t covered by private insurance policies. Their work must be overseen by a doctor, which increases bureaucracy in the system, he said.“We’re doubling up on the services instead of working in collaboration with doctors,” Laitre said.Barrette said research has shown how to reduce waiting times and increase access to medical care. Doctors need to take on more patients, he said, and nurses and doctors should work together each with their own, clear authority. Unfortunately, he said, less than 20 per cent of doctors in Quebec work this way, he explained.A 2015 government proposal that was eventually dropped because of a backlash from doctors would have required young doctors to be responsible for a minimum of 1,500 patients. Barrette argues that if clinics were properly organized, one doctor could be responsible for 3,000 patients.“But in order to do that you need nurse technicians, auxiliary nurses, and nurse practitioners,” he said. “You need all three. And it exists. But it needs to happen more.”Giuseppe Valiante , The Canadian Press
DANANG, Vietnam – Prime Minister Justin Trudeau says it shouldn’t have come as a surprise to anyone when Canada declined to sign an agreement-in-principle Friday on an updated Trans-Pacific Partnership trade deal.Trudeau’s decision to keep negotiating for a better deal in the 11-country pact led to the abrupt cancellation of a TPP leaders’ meeting on the sidelines of an APEC summit.His move created international headlines because foreign media reports had predicted TPP partners would reach an agreement when they gathered for the APEC event in Vietnam.But Trudeau says anyone who had paid closer attention would have noticed his signals all week that Canada would not be rushed into a TPP deal unless it was right for Canadians.Speaking to reporters today to close the APEC summit in Danang, Trudeau says the TPP trade ministers still made some progress by agreeing to several changes that moved the talks closer to a agreement.But Trudeau says despite the improvements there’s still more work to do, particularly when it comes to protecting Canada’s auto and cultural sectors.
BEIJING — Chinese President Xi Jinping has promised that the country will “never seek hegemony” even as it approaches the centre of the world stage.Xi gave a speech Tuesday to mark the country’s 40 years of reform and opening up.The address credited former leader Deng Xiaoping’s market reforms with saving the country from the brink of economic collapse following the tumultuous Cultural Revolution.Xi also expressed support for a multilateral trading system, but he did not directly address ongoing trade friction with the United States.China has been battling global scrutiny around its outsize economic influence. Xi assured in his speech that the country will not develop “at the expense of other countries’ interests.”The Associated Press
These messages, aimed at governments, regulators, development partners and the private sector, were formed by the UN Advisors Group on Inclusive Financial Sectors, which was created to promote financial inclusion in poorer countries.“Access to a broad range of financial services is a significant development issue everywhere outside of developed countries,” Richard Weingarten, Executive Director of the UN Capital Development Fund (UNCDF), told reporters at UN Headquarters in New York today.He noted that there are nearly three billion people worldwide who lack access to basic financial services. For example, only 30 million of sub-Saharan Africa’s population of 744 million people have access to such services.“Access to financial services is also very important in terms of achieving the Millennium Development Goals (MDGs),” he said, referring to the set of eight targets for slashing social and economic ills by 2015.Improved access will enable poor people to increase their incomes, he said, adding that empirical evidence shows that those participating in microfinance programmes can improve their welfare more than those who do not. “In India,” Mr. Weingarten said, “half of the clients of a well-respected microfinance institution graduated out of poverty.”The Group, in its messages, reminded governments that although increasing access to financial services is crucial, it alone will not eliminate poverty. It also called on governments to lower interest rates to ensure that prices are transparent and that the market remains open and competitive.Regulators must ensure that laws relating to money laundering do not hinder access to financial transfers critical to the poor, the Group said, while the private sector must remember that providing services to the poor presents a considerable business opportunity.In its messages to development partners, the Group said that the paucity of strong institutions and managers obstructs efforts towards inclusive finance.The Group was established with a two-year term following the 2005 International Year of Microcredit, and its members represent governments, central banks, regulatory agencies, microfinance institutions, private sector financial institutions, civil society, development agencies and academia from all over the world. 30 May 2007A United Nations group has issued a series of key messages targeted at encouraging different audiences to boost access to financial services – from opening bank accounts to taking out loans to buying insurance – to the poor.
Following weeks of wrangling over sensitive issues concerning the jurisdiction of the International Criminal Court (ICC), the United Nations Security Council today unanimously adopted a resolution which effectively prevents any potential ICC prosecution of UN peacekeepers for one year. UN Secretary-General Kofi Annan was “deeply gratified that members of the Security Council have resolved the difficult issue that they faced and have been unanimous in their decision,” his spokesman said in a statement.During the Council’s deliberations on the matter, Mr. Annan’s main concerns were “for the integrity of the United Nations Charter and the Statute of the International Criminal Court, and for the integrity of treaty law,” according to the statement, which added that he “also was concerned about the unity of the Security Council and the preservation of UN peacekeeping operations.”In taking its decision today, the Council invoked Article 16 of the ICC’s Rome Statute, under which “no investigation or prosecution may be commenced or proceeded with… for a period of 12 months after the Security Council, in a resolution adopted under Chapter VII of the Charter of the United Nations, has requested the Court to that effect.” Such requests “may be renewed by the Council under the same conditions.”Today’s resolution, adopted under Chapter VII which allows for enforcement, requested that the ICC, for a 12-month period beginning on 1 July, “not proceed with investigation or prosecution of any case” involving “current or former officials or personnel from a contributing State not a Party to the Rome Statute over acts or omissions relating to a United Nations established or authorized operation.”The resolution also expressed the Council’s intention to renew this request each 1 July for a 12-month period.Following the text’s adoption, the Council moved to extend the mandate of two UN operations: the UN Mission in Bosnia and Herzegovina – along with the UN-authorized multinational stabilization force (SFOR) operating in the country – as well as the UN Mission of Observers in Prevlaka (UNMOP).
OSU junior linebacker Raekwon McMillan (5) tackles Tulsa redshirt senior running back James Flanders (20) from behind during the first quarter against Tulsa on Sept.10. The Buckeyes won 48-3. Credit: Alexa Mavrogianis | Photo EditorLast season, Ohio State football fans saw Josh Perry and Darron Lee develop into NFL-quality linebackers. Major concerns before the start of the new year for the Buckeyes were the ability of new starters — junior Dante Booker and redshirt junior Chris Worley — to fill the holes left by the NFL draftees, and how well junior Raekwon McMillan would lead the unit. So far, Buckeye fans have little to complain about in terms of production from that position. After allowing 208 yards rushing in its first two games last year, OSU has allowed just 130 yards to this point on the ground.In addition to being stout against the run, OSU’s linebacker unit has not allowed opponents to score a touchdown. McMillan has credited much of the success to the play of the guys around him.“Every time I turn my head, somebody’s making a great play here,” McMillan said. “I’m just trying to find my ins and outs, trying to find my plays here and there. The guys around me are making me look good.”McMillan went on to thank the defensive line, as well as all of his teammates, for the high level they have played at so far.Although the man in the middle for the Buckeyes is considered to be the leader of the unit, Worley has been around for a longer period of time than McMillan with OSU. The fourth-year strongside linebacker played in 14 of 15 games for the national championship team in 2014, and recorded his first sack last season.Worley recorded four total tackles against Tulsa, while also defending two passes. His play earned him a champion grade from the OSU coaching staff.On the other side, Booker picked up two tackles against Bowling Green in Week 1, but suffered a sprained right knee and did not play against Tulsa. Redshirt freshman weakside linebacker Jerome Baker filled in against Tulsa, picking up five tackles and a fumble recovery.McMillan said he appreciated how well Baker communicated with the team, and how effective he was in his fill-in role.Linebackers have been solid for OSU so far, but will face their biggest challenge against Oklahoma. Sooners quarterback Baker Mayfield and running backs Joe Mixon and Samaje Perine have been the catalysts to a powerful Oklahoma offense.OSU defensive coordinator and associate head coach Greg Schiano knows how tough the task will be for the team come Saturday.“A lot of these guys have never been in this situation. A few of them have but a lot of them haven’t,” Schiano said. “As a coach, you just try to prepare them the best they can. I believe we have the right people here, but that gap between knowing and doing is the biggest gap there is.”
Share this:Click to share on Twitter (Opens in new window)Click to share on Facebook (Opens in new window)RelatedNo-confidence resolution: CJ to rule on “majority” and “dual citizen” challenges at the end of JanuaryJanuary 15, 2019In “Court”APNU/AFC Govt remains defiant inspite of CJ’s ruling; says ‘status quo remains’February 1, 2019In “latest news”Court of Appeal to hear stay on High Court rulings on WednesdayFebruary 16, 2019In “latest news” Attorney-at-Law Anil Nandlall interacting with media operatives outside of the High Court hearing on TuesdayAgainst the backdrop of Chief Justice (CJ), Roxanne George announcing that the “majority” and “dual citizen” challenges to the no confidence resolution will be ruled on by the end of January, People’s Progressive Party Civic (PPP/C) Attorney Anil Nandlall expressed happiness with the decision.Speaking to media operatives following Tuesday’s High Court hearing of the challenges outside of the courtroom, the former Attorney General noted that his confidence in the Court is at an all-time high since it recognizes the urgency of the matter.Further, Nandlall noted that if the decision of the Court is to be challenged by the aggrieved party/parties, this matter must also be heard before the expiration of the time frame fixed by the constitution for elections to be held.“I’m very happy that the Court recognizes that this matter must be heard and determined in this Court, the Court of Appeal and the Caribbean Court of Justice (CCJ) within that 90 days period and this is the Chief Justice of the country. And once the Chief Justice says that, I am satisfied that we will have a disposal of this matter, in the manner contemplated by the constitution” Nandlall explained.According to Nandlall, the constitution provides for a timeline to be prescribed in order for matters before the Court to be dealt with in a fair manner.Article 106 (6) of the Constitution states: “The Cabinet including the President shall resign if the Government is defeated by the vote of a majority of all the elected members of the National Assembly on a vote of confidence.”Meanwhile, clause 7 goes on to state that “Notwithstanding its defeat, the Government shall remain in office and shall hold an election within three months, or such longer period as the National Assembly shall by resolution supported by not less than two-thirds of the votes of all the elected members of the National Assembly determine, and shall resign after the President takes the oath of office following the election.”As such, the Member of Parliament (MP) expressed his satisfaction with the Court ensuring that the balance of interest is effective.“We have to balance the interest here. You have a right to be heard by a litigant which must be balanced against the constitutional timeline prescribed and the Court must ensure that both of those competing interest are addressed and dealt with in a fair and just manner so at the end of the day the litigant goes away from the Court feeling that he had his case ventilated, he had his right ventilated, he was heard fairly by the Court and at the same time, the constitutional deadline fixed by the constitution for the elections to be held is also met. So at the end of the day you have both expectations served and justice served again” Nandlall posited.Moreover, the former Attorney General said that “Even if they seek to appeal, that the appeal to the Court of Appeal and the CCJ will be completed while constitutional time is running and concluded before the expiration of date for elections.”
Vancouver – The Vancouver Fire Department and the Vancouver Firefighters Union are kicking off their annual winter coat drive today.Between now and Dec. 16, firefighters are collecting coats to distribute to youth and teens, though they said that all sizes of coats are welcomed. They are also asking for donations of unopened hygiene products such as shampoo, soap, toothbrushes and toothpaste.The effort is a partnership with 45th Columbia River Scouts, America’s Self Storage and The Source Climbing Gym.Donations can be made at Vancouver Fire Station 2, 400 E 27th St., American Self Storage, 108 NW 139th St., or The Source Climbing Gym, 1118 Main St.
KUSI Newsroom April 10, 2018 SAN DIEGO (KUSI) – Mayor Kevin Faulconer announced today that all city-owned property along the San Diego River has been cleaned at least once.The city owns roughly one-third of riverfront property, and employees have removed nearly 99 tons of debris from 32 locations since last September, he said.Faulconer said the cleanup will continue, particularly in regard to outreach and coordination with owners of the remaining two-thirds of land along the river.“The San Diego River is one of our most precious natural resources and we must continue to give it the care and attention it deserves,” Faulconer said. “While we’ve cleared all of the city’s property once, we still have a lot more work to do, so we’re encouraging every property owner next to the river to join our cleanup efforts and help preserve the San Diego River for future generations.”City employees have sent letters to 33 private property owners, including several businesses, that collectively own another third of riverfront property. Eight owners have allowed city employees to clean their property.Those who reject city services must clean their property or face fines ranging from $100 to $1,000, according to the mayor’s office.The remaining third of riverfront property is owned by a nonprofit and various government agencies, including the Metropolitan Transit System, Caltrans, San Diego River Park Foundation, California Department of Fish & Wildlife, U.S. Postal Service and County of San Diego.Rob Hutsel, president and CEO of the San Diego River Park Foundation, lauded city efforts to clean riverfront property.“Since this effort began, we have seen a dramatic difference along the river in the city,” Hutsel said. “There is less trash, fewer encampments and a new hope that a lasting improvement is being achieved.”Cleanup efforts are part of the “Clean SD” initiative, which launched May 2017. So far, crews have removed more than 1,000 tons of litter from illegal dumping hot spots in Ocean Beach, City Heights, San Ysidro, Logan Heights, Paradise Hills, Webster, Mission Beach, Point Loma and Pacific Beach. Categories: Local San Diego News Tags: Kevin Faulconer, San Diego River FacebookTwitter Posted: April 10, 2018 Mayor Faulconer announces San Diego River cleanup milestone KUSI Newsroom, Updated: 5:21 PM
WASHINGTON — The government shutdown has slowed or halted federal efforts to protect Americans’ health and safety, from probes into the cause of transportation and workplace accidents to tracking the flu. The latest example: investigating an outbreak of salmonella in chicken that has sickened people in 18 states.The federal Centers for Disease Control and Prevention has recalled some of its furloughed staff to deal with the salmonella outbreak, which has sickened more than 270 people and was announced by the Agriculture Department late Monday. Before Tuesday, the CDC had only a handful of scientists working on outbreak detection, severely hampering its ability to track potentially deadly illnesses.With federal workers on leave, the states have had to pick up much of the slack. In the case of food safety, state labs are investigating foodborne illnesses and communicating with each other — without the help of federal authorities, in many cases — to figure out whether outbreaks have spread.Dr. Christopher Braden, head of the CDC division that investigates foodborne illness, said the agency will be able to better monitor the salmonella outbreak with the recalled federal staff. But the agency is monitoring more than 30 outbreaks, and gaps still exist as the federal bureaucracy limps through a shutdown beginning its second week.“There’s a backlog, and the team is going to have to work diligently and long hours to try and overcome that,” Braden said. “It’s possible we may find something we’ve missed, and when that’s the case it’s harder to start investigations later than earlier.”
After learning that the contamination of drinking water on and around Naval Auxiliary Landing Facility Fentress in Chesapeake, Va., is more widespread than previously reported, Virginia Sens. Mark Warner and Tim Kaine on Friday pressed Navy Secretary Ray Mabus to swiftly address the issue and ensure the immediate needs of the surrounding community are met.The Democratic lawmakers requested a detailed briefing on recent lab results, additional testing planned, and health assessments of service members and neighboring residents.“We appreciate the Navy’s proactive efforts to evaluate facilities for this emergent contaminant, promptly notify the local community and deliver bottled water to areas that may have been impacted,” the senators said.On Thursday, the Navy said it found high levels of perfluorinated compounds in two drinking wells within a half-mile of the facility. The wells were among 52 off-base wells tested for the contaminant found in foam used to fight fires. The foam has been used at the facility for decades, reported the Virginian-Pilot.The level of contaminants in the two wells exceeded an Environmental Protection Agency provisional health advisory. The agency doesn’t regulate perfluorinated compounds, but it considers them an “emerging contaminant” that could threaten health or the environment. The EPA is studying the contaminants to figure out whether regulations for acceptable levels are needed, according to the story.In January, the Navy advised employees at Fentress to use only bottled water.The Associated Press reported last week that DOD plans to conduct tests at 664 sites across the nation where perfluorinated compounds may have contaminated groundwater and possibly spread to drinking water.The Navy so far has found elevated levels of the contaminant at Fentress and Naval Weapons Station Earle, N.J. At the New Jersey site, officials found high levels of the chemicals in the groundwater monitoring wells but not in the drinking water supply. Dan Cohen AUTHOR
Lady Gaga’s ex-fiance Christian Carino might have sparked a new controversy after liking Bradley Cooper’s ex-girlfriend Irina Shayk’s sultry pictures on Instagram! For those who have been living under a rock, Russian supermodel Irina Shayk and Bradley Cooper have called off their four-year-long relationship. It has been less than a week since news of the same has been dropped. However, it looks like the two are already living their individual lives with Cooper being spotted hanging out with Lady Gaga while Shayk took a trip. And now, it seems like Gaga’s ex has been found ‘liking’ Irina’s posts on Instagram.Coincidence? Well, we’ll let you guys decide that. Basically, Irina took to Instagram to share some really gorgeous pictures of herself being surrounded by scenic greenery and a stunning waterfall. As she donned a lovely Intimissimi black bodysuit, we are not the only ones she managed to woo with her panache. Turns out even Lady Gaga’s ex Christian Carino has expressed his ‘like’ for Shayk’s pictures. Right post Irina and Bradley’s breakup, Carino liked Irina’s two pictures. Now we give Carino the benefit of the doubt. Perhaps he just admired the scenic wonderment or maybe he actually does like the scenic picture. Whatever might the case be, he seems to have gotten everyone’s attention. Irina Shayk’s post on Instagram InstagramThe fact that he was engaged to Lady Gaga, who split from him earlier this year and with Bradley and Irina calling it quits, we can’t help but wonder. Despite being together for four years, the couple couldn’t work it out as a source told E! News, “They tried to work things out for a while, but it just became clear that the relationship was over. As much as they tried to rekindle what they once had, they couldn’t find that spark. They both want what’s best for their daughter and so far things are amicable. They’re working out custody details and putting everything in writing so there’s no confusion.” Lady Gaga’s post on Instagram InstagramPeople also reported the breakup and a source told them that news of Bradley’s proximity with his A Star is Born co-star Lady Gaga didn’t help. “The rumours about Bradley and Gaga having a love affair didn’t help especially with his constant travels [promoting the film]. He has a huge and overwhelming connection to Gaga, but whether it becomes a real love story in their lives for all the world to see is premature, and it’s difficult to speculate at this sensitive time.” Another source has told The Sun that, “There’s no way Gaga and Bradley will get together. Not now—they’re really good friends and still speak all the time, but it’s not his style to jump into another relationship straight away. Especially after all the rumours about them during A Star Is Born. He wouldn’t do that.”
But the “special items” funding stream has drawn ire from lawmakers who say it’s grown too large and is duplicative of the per-student allotment. Critics have also argued that the items are distributed unevenly among universities and that state budget writers usually don’t go back and evaluate whether they should be kept in subsequent budgets. “Special items were intended to support research, startup costs and other initiatives, not to remain as never-ending line items in the state budget,” Sen. Jane Nelson, R-Flower Mound, the Senate’s lead budget writer, said last year.“The sky really is going to fall if you pass this bill.”— John Sharp , Texas A&M University System Chancellor, about a 2017 effort to eliminate special itemsLast session, some senators tried to zero out the $1.1 billion in funding meant for “special items” — offering to mitigate the effects of the cut with a $700 million infusion to the per-credit pot. The move agitated university leaders, who protested that “special items” frequently pay for entire programs or medical schools. “The sky really is going to fall if you pass this bill,” Texas A&M University System Chancellor John Sharp said at the time.Some universities argue that money removed from the “special items” stream could not be easily replaced. Even if the items were eliminated and the money were reallocated, it would be diffused into the per-credit stream, critics say. That might mean some important projects designated to receive specific money — like the McDonald Observatory in the University of Texas at Austin budget — might be harmed financially.Formula fundingThe per-credit funding mechanism has critics, too, but is less frequently in lawmakers’ crosshairs. Much of it is calculated using a formula that largely hinges on how many students an institution has and what discipline those students are studying. Data from the Texas Higher Education Coordinating Board shows engineering students cost more to educate than their liberal arts peers — and so the formula gives a greater weight to engineering when calculating how much money universities should be paid.(Schools also receive funding for infrastructure costs through this stream, but using a different formula based on square feet and utility rates.)Detractors argue the formulas aren’t a good proxy for what universities’ costs are and don’t accurately account for part-time or other nontraditional students. Colleges with rapidly swelling student populations also complain of budgetary shortfalls, since the per-student funding is based on past years’ enrollment data. Share Stymied, lawmakers agreed to preserve the current system for the next biennium but directed an interim committee to study it and issue recommendations by April 2018.The committee is made up of five representatives tapped by Republican House Speaker Joe Straus and five senators appointed by Republican Lt. Gov. Dan Patrick – none of whom serve on the upper chamber’s higher education committee. Though the panel has leeway to reshape the system, they’d have to overcome numerous political hurdles — and inertia — to do so. It’s unknown who will take the helm of the House in 2019 — Straus is not running for re-election — and the competing interests of legislators and schools make consensus difficult.“I’m not sure that overhauling higher education finance is something that can be done with two meetings in February and a report due in April,” said state Rep. Donna Howard, D-Austin, one of the committee members. “However, I am hopeful that a focused discussion of how higher education financing methods have impacted institutional behavior will reveal some insights before next session.”Special itemsThere are two main components to the state’s current method of funding higher-education: “special items” earmarked for specific projects and a per-credit allocation disbursed using a formula. The “special items” are funds allocated outside the normal formulas to give schools cash infusions to start up new programs or pay for initiatives not always within their academic mission. But state Rep. Trent Ashby, R-Lufkin, one of the committee’s co-chairs, said they’d caused “some heartburn for members,” and they’re set to be the focus of a separate hearing later this month.In the previous biennium, the 362 special items ranged in cost from a $31,500 research initiative at Sul Ross State University to a $61,397,900 allocation for the University of Texas Rio Grande Valley’s School of Medicine. Some schools receive what amounts to a supplement through the “special items” allocation process that they use to hire more professors and staff. After lawmakers last year failed to overhaul how the state funds its public colleges and universities, a special committee on Wednesday will begin a new attempt to review the complicated higher education finance system in Texas. Complaints have crescendoed about eroding government support for higher education. But at stake in the coming months is not how much money Texas pumps into its colleges and universities. It’s whether the state’s method of disbursing nearly $3 billion per year to those schools through formulas and direct appropriations is due for a comprehensive makeover.“The way we fund higher education in Texas is overdue for a close, detailed look and consideration of substantial changes,” said state Sen. Kelly Hancock, R-North Richland Hills, one of the committee’s co-chairs. The Joint Committee on Higher Education Formula Funding was convened out of a compromise at the end of the 2017 legislative session, following an unsuccessful bid by Senate leadership to overhaul the higher education finance system entirely. The Senate’s efforts panicked college leaders and were rejected by powerful members of the House, who have generally called for modifications to be made in lieu of wholesale changes. Illustration by Todd Wiseman / The Texas TribuneTuition costs are rising in Texas as per-student state funding for higher education shrinks. Ashby said that “in most cases, our formulas are in place for good reason.” But he added he was “hopeful that we can agree on some concepts to promote efficiency and equity at all of our institutions.”Outcomes-based fundingThough it may prove politically impossible, the committee has license to recommend an overhaul of how higher education in the state is financed. Its charge says lawmakers can consider realigning or eliminating “special items” and improving the per-credit allocation.Rather than basing it on the number of students in each discipline, lawmakers could tie a school’s funding to how well their students perform. Hancock said the committee should “absolutely see what lessons can be learned from states that successfully implemented outcomes-based funding at four-year institutions,” and the possibility is slated to be discussed during at least one panel Wednesday.The state’s community and technical colleges already receive their funding through a formula that factors in students’ performance. At Texas State Technical College System — appropriations for which have been tied to graduates’ earnings for the past few years — the switch has “worked in a big way,” said Chancellor Mike Reeser.What happened, Reeser said, is administrators’ “obsession” with maximizing class-time was “replaced with an obsession with making sure kids got jobs and making sure they got the training they needed to get good salaries.” Graduation rates there increased 42 percent over a six-year period, and graduates’ salaries went up 83 percent. “Our mission is to create a skilled workforce, so using student employment outcomes was a very natural thing to do,” Reeser said — but he added that institutions with broader goals, like four-year universities, would need to be evaluated using different metrics.Ashby similarly said the outcomes-oriented model has been “critical to driving completion and promoting skilled degrees” there but that the “mission of a larger flagship university or a four-year regional institution is much different.”As an alternative to replacing the formula based on headcount with one based on students’ performance, some university officials say lawmakers could add a sort of outcomes-based supplement — a bonus for schools where students perform well. “Having some type of performance funding tied to each institution’s mission, in addition to a consistent and stable model for funding would benefit Texas students and our economy,” said UT-Arlington President Vistasp Karbhari.
Police search for missing woman Dad slams ‘disgusting’ hospital window Driver named following fatal collision Get the biggest Daily stories by emailSubscribeSee our privacy noticeThank you for subscribingSee our privacy noticeCould not subscribe, try again laterInvalid EmailPolice have seized a vehicle that was speeding on the A50 in Stoke-on-Trent earlier today (Thursday May 16). The vehicle was stopped after travelling at 73mph in a 50mph section of the dual carriageway – with the driver also not insured to drive the vehicle. A Staffordshire Police spokesman said: “Vehicle travelling A50, Stoke on Trent – 73mph in 50mph limit. “Vehicle also seen undertaking & tailgating. Vehicle stopped & it was soon ascertained that the driver wasn’t covered on the insurance policy.” Read MoreTop stories on StokeonTrentLive Punter found hiding in bushes Follow StokeonTrentLive Download our app – You can download our free app for iPhone and iPad from Apple’s App Store , or get the Android version from Google Play . Follow StokeonTrentLive on Facebook – Like our Facebook page to get the latest news in your feed and join in the lively discussions in the comments. Click here to give it a like! Follow us on Twitter – For breaking news and the latest stories, click here to follow SOTLive on Twitter . Follow us on Instagram – Featuring pictures past and present from across Stoke-on-Trent, North Staffordshire & South Cheshire – and if you tag us in your posts, we could repost your picture on our page! We also put the latest news in our Instagram Stories. Click here to follow StokeonTrentLive on Instagram .
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October 15, 2009 – The average hospital charge of $5,292 could be reduced by 50 percent if patients had only two preoperative visits to primary care physicians or the emergency department and one clinical imaging study, according to a study of 383 patients who underwent surgical treatment for gallstones at the University of North Carolina in 2008, presented at the 2009 Clinical Congress of the American College of Surgeons taking place in Chicago, Ill.Researchers found that patients on average had more than four visits to a primary care physician, emergency department, or surgical clinic and nearly three imaging studies, including ultrasound, computed tomography, or a nuclear medicine scan of the liver, gallbladder, biliary tract, and small intestine, from the time they first showed symptoms of gallbladder disease to the time of the operation. The researchers concluded that delays in obtaining surgical care ofsymptomatic gall-stones resulted in unnecessary visits to the emergencydepartment for pain relief and additional diagnostic imaging. “I don’t want to say that physicians are managing gallbladder disease in the wrong way, but we and other researchers are trying to find a better way, particularly in the current climate of trying to improve the quality and reduce the cost of care. As surgeons, we’re hopeful that patients will be referred to us earlier and go the OR sooner rather than come back for more visits and more imaging studies. It just costs more money, and the patient has to go through more pain and waiting in the emergency department. So once the diagnosis of symptomaticgallstones has been made, we believe patients should see a surgeon who can make the determination of when they need to go to the operating room. We also think that if a patient has an imaging modality study that shows gallstones, they don’t need to have another one,” explained Lindsee E. McPhail, M.D., a fellow in gastrointestinal surgery.Findings from the study carry a message not only for primary care physicians who refer patients to surgeons for treatment of gallstones but also for patients. “When patients have a bout with gallstones, they often go to the emergency room to get medications. When they feel better, they don’t feel the need to see a surgeon or have a follow-up. But then they end up having more pain and come back to the emergency department. So the onus is on patients and physicians as well to get this problem taken care of surgically as soon asthey can,” she said. The researchers reviewed every patient who had been surgically treated for gallstones at the University of North Carolina (Chapel Hill) hospitals,tabulated the number of times patients went to the emergency department or saw their primary care physician as well as the number of imaging studies they had prior to their operation, and added up the total hospital charges before they underwent the procedure. The research team plans to extend the study to the entire state of North Carolina. “This study was limited to UNC, so we did not capture patients who were treated and had imaging studies at other hospitals. We hope to get a much better picture of the management of gallbladder diseaseusing all the data from the state,” Dr. McPhail said. Blockage of the bile ducts by gallstones is the most common reason whypatients are hospitalized for severe abdominal pain. Because gallstones almostnever disappear spontaneously, they are treated most effectively by surgicallyremoving the gallbladder [cholecystectomy]. “I think most people know that ifthey have symptomatic gallstones, the answer is to take out the gallbladdersurgically. We are hoping that the information from this study will show thatthe management of gallbladder disease can be streamlined and that timelysurgical care is essential if we hope to contain costs,” Dr. McPhail said. Anthony G. Charles, M.D., MPH, and George F. Sheldon, M.D., FACS, participated in the study, which was presented as a scientific exhibit at the ACS Clinical Congress.Source: American College of SurgeonsFor more information: www.facs.org FacebookTwitterLinkedInPrint分享 Videos | Cardiac Imaging | July 30, 2019 VIDEOS | EP LAB | JULY 26, 2019 VIDEO: What Electrophysiologists Need From CT Imaging Prior to AF and VT Ablations Mark Ibrahim, M.D., F read more News | Artificial Intelligence | August 05, 2019 Montefiore Nyack Hospital Uses Aidoc AI to Spot Urgent Conditions Faster Montefiore Nyack Hospital, an acute care hospital in Rockland County, N.Y., announced it is utilizing artificial… read more Technology | October 15, 2009 Imaging, Delays in Access to Gallbladder Surgery Rose Costs 50 Percent Video Player is loading.Arthur Agatston explains the history of CT calcium scoring Play VideoPlayMuteCurrent Time 0:00/Duration 9:54Loaded: 1.67%Stream Type LIVESeek to live, currently playing liveLIVERemaining Time -9:54 Playback Rate1xChaptersChaptersDescriptionsdescriptions off, selectedCaptionscaptions settings, opens captions settings dialogcaptions off, selectedAudio Trackdefault, selectedFullscreenThis is a modal window.Beginning of dialog window. 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The CT scanner might not come with protocols that are adequate for each hospital situation, so at Phoenix Children’s Hospital they designed their own protocols, said Dianna Bardo, M.D., director of body MR and co-director of the 3D Innovation Lab at Phoenix Children’s. Video Player is loading.Mark Ibrahim explains what EPs need from CT imagingPlay VideoPlayMuteCurrent Time 0:00/Duration 5:23Loaded: 0.00%Stream Type LIVESeek to live, currently playing liveLIVERemaining Time -5:23 Playback Rate1xChaptersChaptersDescriptionsdescriptions off, selectedCaptionscaptions settings, opens captions settings dialogcaptions off, selectedAudio Trackdefault, selectedFullscreenThis is a modal window.Beginning of dialog window. 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Videos | AAPM | July 29, 2019 VIDEO: Trends in Medical Physics at the AAPM 2019 meeting … read more Videos | Computed Tomography (CT) | July 30, 2019 VIDEO: New Advances in CT Imaging Technology Cynthia McColl… read more Videos | Cardiac Imaging | July 30, 2019 VIDEO: The History of CT Calcium Scoring Arthur Agatston, M.D., clinical pro read more Siemens Go.Top CT scanner at SCCT19Video Player is loading.Play VideoPlayMuteCurrent Time 0:00/Duration 1:05Loaded: 15.14%Stream Type LIVESeek to live, currently playing liveLIVERemaining Time -1:05 Playback Rate1xChaptersChaptersDescriptionsdescriptions off, selectedCaptionscaptions settings, opens captions settings dialogcaptions off, selectedAudio Trackdefault, selectedFullscreenThis is a modal window.Beginning of dialog window. 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This article was originally published on Oct. 17, 2011The final time Chito and Pocho took center stage seemed no less stirring, hard-to-believe and ridiculous than the act’s original premise – a crocodile and a human as best friends.After two decades of performing together, Pocho the “domesticated” crocodile died last Tuesday of natural causes in his manmade swamp at Finca Las Tilapias, in the Caribbean-slope town of Siquirres. The croc’s owner, Gilberto Shedden, better known as “Chito,” said his partner was nearing 60 years old.On Sunday – the day Pocho and Chito normally frolicked in the water for visitors – the village held a grand funeral for the huge reptile.Chito placed the 5-meter, 450-kilo dead crocodile in a wagon and hitched it to a car that drove the duo around the town. Dozens of vehicles joined the motorcade. At least 50 mourners kept pace with the procession, while onlookers sprinted up to the cart to snap photos. By the time the tour ended, back at Finca Las Tilapias, some 300 people had shown up at the ranch.“Our act was something very special,” Chito, 54, said. “Always people who didn’t know Pocho took something extraordinary from it.”Chito found Pocho wounded and near death on the shore of the Parismina River, in Limón province, in 1989. The crocodile had been shot in the left eye, and Chito nursed it back to health. A decade later, an employee at the finca saw Chito swimming with Pocho, and told local media. The unusual pair became stars after their first show in the summer of 2000. The ranch kept a veterinarian and a biologist to check on the crocodile’s health. Pocho fed on 30 kilograms of fish and chicken a week. Siquirres native Gilberto Sheedon, or Chito, became famous for his close friendship with an American crocodile named Pocho. The Tico TimesLarge crowds gathered weekly around the artificial lake to watch Pocho and Chito, with the crocodile performing tricks such as winking, rolling over and allowing Chito to put his head inside the giant’s fang-lined mouth.The memorial at Finca Las Tilapias recognized the croc’s importance to the community. Onlookers watched Chito give a passionate goodbye to Pocho, the reptilian half of an act that became the biggest tourist attraction in the small, muggy pueblo and picked up coverage from around the world.The funeral certainly seemed like the biggest event Siquirres had seen in some time. Chito’s friends quoted Bible passages to the audience about loving animals. They dedicated songs to Pocho, and played videos of past performances and interviews with Chito.“It was beautiful,” Siquirres native Xinia Mejía, 40, said. “At least here, we’ve never seen anything like this.”Visitors from across the country came to observe the ceremony. Miguel Arias, 57, from San Carlos in northern Costa Rica, had never seen Chito and Pocho perform, but became interested after seeing a report on the news. Arias said he was stunned by the outpouring of support for the crocodile and the “beautiful” ceremony.Funeral garb, however, was not required. Chito, dark-skinned, bald-headed and fit, dressed in the leopard-print loincloth and bandana he wore during his shows with Pocho. Many congregants wore T-shirts dedicated to Pocho’s memory. The shirts sold for $4 at Finca Las Tilapias, alongside mugs dedicated to Chito and Pocho and a selection of small wooden crocodiles.Pocho’s carcass will be embalmed and placed on display at a museum at Finca Las Tilapias.Skeptics may say the funeral was just a money-making charade, but Chito’s copious tears did not appear to be of the crocodile variety. He seemed to need the attention and support of the crowd to stay composed. While other guests took the microphone to speak about Pocho, Chito could be seen bawling in the arms of his wife, Olga, or leaning over the crocodile with tears on his cheeks.When Chito moved front and center again, he seemed determined to keep the last show with his “brother” Pocho as momentous as past ones. The most peculiar highlight – one that seemed to condense Chito’s affection for Pocho and also his love for the limelight – came when he sang The Platters’ classic “The Great Pretender.” Chito wailed each lyric of the 1950s hit about denial to the fallen crocodile: “Oh yes I’m the great pretender / Pretending I’m doing well / My need is such I pretend too much / I’m lonely but no one can tell.”As Chito and Pocho’s fame grew, there were those who suspected the croc would one day make “Chito finito” out of Shedden. Lolinda Mighty Hall, who grew up with Chito in Siquirres, remembered how fearful everyone was that the crocodile would turn on his trainer. Hall, 58, said over time they saw a genuine connection develop.Other crocodiles later joined Pocho in Chito’s swamp. The question circulated throughout the afternoon of whether Chito would soon begin training the next Pocho.The speculation reached Chito midway through the ceremony. Replace Pocho? Chito sucked in a deep breath.“Pocho is Pocho, the only one,” Chito said, his voice cracking. “Much of the public and all the people of Siquirres responded to him. There is no more Pocho. He will be the only Pocho there ever was.”This story was made possible thanks to The Tico Times 5 % Club. If only 5 percent our readers donated at least $2 a month, we’d have our operating costs covered and could focus on bringing you more original reporting from around Costa Rica.We work hard to keep our reporting independent and groundbreaking, but we can only do it with your help. Join The Tico Times 5% Club and help make stories like this one possible.Support the Tico Times Facebook Comments Related posts:Tico Times #TBT: The one millionth Tico Throwback Thursday: Roosevelt’s fishing trip to Isla del Coco Throwback Thursday: Bulls from 1981 Throwback Thursday: Making cocktails with Cacique
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