Pooling doctors’ diagnoses could improve accuracy

first_img Read Full Story It’s estimated that about 12 million people in the U.S. are misdiagnosed in outpatient care every year.And that’s a very conservative estimate, according to Harvard T.H. Chan School of Public Health’s Michael Barnett.Now, a new study led by Barnett, assistant professor of health policy and management, suggests that pooling the diagnoses of multiple physicians into ranked lists, facilitated by online tools, could help improve diagnostic accuracy. In resource-rich settings, the use of smartphones and the internet could potentially enable group diagnoses in near real-time, say the authors. But even in low-resource settings where paper and pencil are the norm, diagnostic accuracy could potentially be improved by using collective intelligence.The study was published in JAMA Network Open.For centuries the prevailing model of diagnosis has been for an individual physician to assess a patient and arrive at a diagnosis. One exception is in hospitals, where teams routinely meet to discuss cases. Although collaborative, team-based diagnosis is considered superior to individual diagnoses, there hasn’t been much evidence to prove that that is true.To test whether combining multiple individuals’ diagnoses, or a “collective intelligence” approach, could improve diagnostic accuracy, Barnett, senior author David Bates, professor in the Department of Health Policy and Management, and colleagues analyzed data from the Human Diagnosis Project (Human Dx), a large online database through which physicians and medical trainees solve user-submitted cases. Participants in the Human Dx community are able to create cases from their own clinical practice with information such as a patient’s medical history, physical exam, and diagnostic test results. Respondents submit a ranked list of possible diagnoses for a case and learn from the Human Dx platform how their answers compared to the final diagnosis.The new study — the largest to date of “collective intelligence” in medicine — included more than 2,000 physicians and trainees solving more than 1,500 clinical cases. The researchers compared the accuracy of individual physicians or trainees solving cases to the accuracy of pooling together multiple physicians’ diagnoses and picking the highest-ranked collective diagnoses.The study found that combining multiple diagnoses into a ranked list outperformed individual accuracy even in groups as small as two (62.5 percent versus 75.1 percent accuracy), with accuracy increasing up to groups of nine (85.6 percent accuracy) across a broad range of medical cases and common symptoms such as chest pain or fever. “The magnitude of the increased accuracy with even small teams was surprising,” said Barnett.The study found that groups even outperformed specialists in solving cases that were matched to the specialist’s are of expertise.The findings suggest that virtual team-based diagnosis could be an important new tool to tackle the difficult challenge of misdiagnosis, Barnett said. In the U.S. and similar settings, the ability to gather collective intelligence about diagnoses, either online or through another technology, could be a big help in the busy medical world because it could provide superior results with little coordination. “It could also be a cheap way to improve diagnostic accuracy even in low-resource settings, where diagnostic expertise can be hard to come by,” he said.last_img read more

American Hero Opens Off-Broadway

first_img At a toasted subs franchise in the local mall, three up and coming “sandwich artists”—a teenager, a single mom and a downsized refugee from corporate banking—are perfecting the mustard to cheese ratio according to the company manual. But when their shot at the American dream is interrupted by a series of strange events, they become unlikely allies in a post-recession world. Star Files The New York premiere of Bess Wohl’s American Hero opens on May 22 as part of Second Stage’s twelfth annual Uptown Series. Under the direction of Leigh Silverman, the play stars Ari Graynor, Jerry O’Connell, Daoud Heidami and Erin Wilhelmi. Ari Graynor American Hero, which recently announced a one-week extension, will run through June 15 at the McGinn/Cazale Theatre. Jerry O’Connell View Commentslast_img read more

The Lion King Reaches 7000 Performances on Broadway

first_img The Lion King The Julie Taymor-helmed production premiered in Minneapolis on July 13, 1997. Four months later, on November 13, the show celebrated its opening night on Broadway at the New Amsterdam Theatre. It went on to win six 1998 Tony Awards, including Best Musical and Best Direction. On June 13, 2006, the production moved to its current home, the Minskoff Theatre. The show has played 21 countries and has been translated into eight different languages. Related Shows The current cast of The Lion King features Aaron Nelson as Simba, Chantel Riley as Nala, Alton Fitzgerald White as Mufasa, Gareth Saxe as Scar, Nteliseng Nkhela as Rafiki, Jeffrey Kuhn as Zazu, Ben Jeffrey as Pumbaa and Fred Berman as Timon. Additional cast members include James Brown-Orleans, Bonita J. Hamilton, Enrique Segura, Cole Bullock, Caleb McLaughlin, Teshi Thomas and Kaci Walfall. View Commentscenter_img Based on the popular Disney film, The Lion King is the story of Simba, a young lion prince who idolizes his kingly father, Mufasa, while youthfully shirking the responsibility his position in life requires. When an unthinkable tragedy, orchestrated by Simba’s wicked uncle, Scar, takes his father’s life, Simba flees the Pride Lands. He starts anew, but eventually, the weight of responsibility comes to find the adult prince. The score by Elton John and Tim Rice features the songs “The Circle of Life” and the Oscar-winning “Can You Feel The Love Tonight.” From the day they arrived on this planet (well, on Broadway), they’ve captivated audiences with their jaw-dropping puppetry, inventive costumes and soaring melodies. Now, nearly 17 years later, The Lion King is celebrating yet another landmark: 7000 performances on the Great White Way. The Tony-winning Disney tuner hits the new milestone on September 3. Only three other shows have made it that far on Broadway: The Phantom of the Opera, Cats and Chicago. from $75.00last_img read more

Radon Testing

first_imgThe University of Georgia Radon Education Program recommends testing your home for radon in recognition of National Radon Action Month in January.Testing is easy and affordable. Radon test kits can be purchased from some UGA Cooperative Extension offices for $10 or online for $13. For more information, or to order a test kit, go to www.ugaradon.org.Radon, a naturally-occurring, odorless gas, is the leading cause of lung cancer among non-smokers and the second leading cause of lung cancer in America, claiming 21,000 lives annually.The U.S. Environmental Protection Agency estimates one out of every 15 homes in the country has high radon levels. According to the EPA, the northern third of Georgia has a moderate to high radon potential, but radon also may be found in other parts of the state.Radon occurs naturally when uranium breaks down to radium, which then breaks down to form radon. Radon is released into the soil and can easily enter homes through the foundation and well water.The UGA Radon Education Program, sponsored by the UGA Cooperative Extension and the UGA College of Family and Consumer Sciences, educates communities throughout the state to increase radon awareness and promote testing. The Georgia Radon Symposium will be held on Wednesday, Jan. 27 at the UGA Gwinnett Campus from 9 a.m. – 3 p.m. The cost of the symposium is $20, which includes lunch. Register online at www.ugaradon.org. Officials from the UGA Radon Education Program, EPA, Department of Community Affairs, Centers for Disease Control and Prevention and Georgia State University will discuss topics such as radon testing and mitigation.Write to [email protected] for information.last_img read more

$1 million from NSF to connect UVM and Vermont State Colleges

first_imgIncreasingly, scientific research depends upon huge pools of data ‘ like gene sequences or weather models ‘ shared between scientists at numerous institutions. And this sharing depends upon fast fiber-optic networks and other so-called cyber-infrastructure ‘ far faster than a conventional internet hook-up.In Vermont, that information pipeline has been not been as big as necessary or entirely missing in places.But that’s changing.The Vermont Experimental Program to Stimulate Competitive Research (VT EPSCoR) at the University of Vermont has received a $1 million grant from the National Science Foundation for the next two years to connect the Vermont State Colleges (VSC) and the University of Vermont with high-speed fiber optic cables and other information-sharing technologies.The new service between UVM and the VSC data hub will allow all twenty-nine VSC locations to participate more fully in collaborative research with UVM scientists and educators ‘ including all 12 Community College of Vermont (CCV) centers; both campuses and two nursing education centers of Vermont Technical College (VTC); and the Castleton State College, Johnson State College, and Lyndon State College campuses.The current connection is 300 megabytes per second. The new system will be 10 gigabytes per second ‘ thirty-three times faster.”Our proposal was designed as part of a larger effort to improve teaching and research initiatives across Vermont in so-called STEM fields ‘ science, technology, engineering, and mathematics,” said Judith Van Houten, professor of biology and state director of VT EPSCoR, “U.S. and state leaders increasingly see improvement in these areas as a key to future economic success and job development.”The new in-state system will also be connected to a larger “Fiber Ring” that links UVM to a hub through Albany, N.Y., and Hanover, N.H. This fiber ring system allows researchers around the region to share information at 60 gigabytes per second. This link helps connect Vermont with “Internet2,” an expanding advanced networking consortium involving hundreds of U.S. research universities and corporations. Vermont businesses will also be able to access the fiber ring.The new funding comes through an arm of the National Science Foundation’s Research Infrastructure Improvement Program that seeks to make better cyber connections on campuses and between colleges.”This increased cyber-capacity will better connect researchers and partner institutions within the Vermont State Colleges — especially the new engagement with the Community College of Vermont,” said Timothy Donovan, chancellor of the Vermont State College system, “new courses and opportunities for students seeking careers in science and technology will be offered as a result.”The new award will also provide funding to connect a network of K-12 schools, libraries, museums, art galleries and hospitals in Vermont, through an initiative of Internet2, making many new resources available to Vermont community institutions”We aim to improve collaboration among diverse participants and campuses and communities in Vermont and throughout the region,” said Kelvin Chu, associate professor of physics at UVM and VT EPSCoR associate project director. “Videoconferencing capability, visualization and new curriculum options across the state and region are also part of this project.”Additional plans for the grant include:â ¢ A new bioinformatics course, organized at Johnson State College, to be offered across the whole Vermont State College system in spring 2012 and taught by faculty at UVM and across the Northeast.â ¢At Lyndon State College, the award will enable faculty studying weather forecasting within Vermont to improve their ability to analyze and collaborate with fellow researchers around the region.â ¢ Policy studies at UVM will involve students from several state colleges in their survey work.The award complements recent funding to support the Northeast Cyberinfrastructure Consortium (NECC) initiative that enabled a high-speed connection between UVM and the Internet2 network.UVM. 9.27.2011last_img read more

Center for Hemispheric Defense Studies is Renamed for William J. Perry

first_imgBy Dialogo April 15, 2013 WASHINGTON — As U.S. secretary of defense in the Clinton administration, William J. Perry often envisioned a place where scholars and officials from throughout the Western Hemisphere could study how the military functions in a democratic society. Perry’s idea would become the Center for Hemispheric Defense Studies at Washington’s National Defense University. Yet once he left his post in 1997, Perry often wondered if the center would survive him. That doubt turned out to be one of the few misjudgments in Perry’s long military career, one in which he was key in the development of the Pentagon’s Stealth aircraft and Global Positioning System technology. On April 2, the CHDS was named in his honor during a ceremony at Fort McNair, where the project is located. Speaking to an audience that included his family, foreign generals and embassy dignitaries and former Georgia Sen. Sam Nunn, the 85-year-old Perry reminded his audience that a civilian-run military shouldn’t be taken for granted. “That might be obvious and simple to all of you,” said Perry, speaking in the Abraham Lincoln Hall auditorium. “But believe me, it isn’t so simple in other countries.” Perry helped foster regional military cooperation Ideological resistance to the idea of wide-ranging cooperation among defense departments throughout the Americas was evident early in Perry’s tenure in the Clinton administration. The 19th U.S. secretary of defense recalled how he wanted to visit Mexico City to engage his counterpart, Gen. Enrique Cervantes Aguirre, and was told it was not a good idea due to lingering resentments against the United States dating back to the mid-19th century. “I wanted to push the reset button on relations with Mexico,” said Perry, who nonetheless pursued a relationship with Aguirre and in October 1995 became the first U.S. defense secretary in modern times to visit Mexico. The emerging friendship helped thaw relations between the militaries of the two neighboring countries and led to the first Defense Ministerial of the Americas in Williamsburg, Virginia, in August 1995. From these meetings, the Center for Hemispheric Defense Studies — now the William J. Perry Center for Hemispheric Defense Studies — was born in 1997. “This is very important for the exchange of ideas and understanding one another,” said Lt. Col. Ricardo Melendez, a military attaché to the Mexican Embassy who attended the ceremony. “It’s good to know how the United States has achieved” balance between military officials and the civilian agencies which direct them. The glaring exception to hemispheric cooperation is Cuba. In the autumn of 1962, Perry — then director of a private defense laboratory in California — was summoned to Washington by the Kennedy administration to help assess the threat of Soviet missile bases in Cuba. Words of praise from Paul Kern, Ashton Carter Also present at the CHDS ceremony was a man who accompanied Perry on some of the most historic events of the 1990s, including the 1995 Dayton Accords which effectively ended Bosnia’s civil war. That man is retired Army Gen. Paul J. Kern, Perry’s senior military assistant during his tenure as defense secretary. “Without Secretary Perry’s influence, we would never have gone into the Balkans,” said Kern, 67, former commanding general of the U.S. Army Material Command. “He re-energized NATO to act as things were getting worse [in the former Yugoslavia] instead of better.” It was also a moment when a Russian brigade joined an American division in Bosnia, marking bilateral military cooperation for the first time since the end of World War II. “Bill helped negotiate peace in the Balkans and welcomed Russia into the KFOR” international peacekeeping force in Kosovo, said Dr. Ashton B. Carter, 58, a protégé of Perry’s who introduced him at the re-naming ceremony. “Vision and integrity equals Bill Perry,” said Carter, currently the nation’s deputy secretary of defense under Chuck Hagel. “His achievements were highlighted in the Ukraine in the summer of 1996 when the last nuclear weapons left that country.” center_img But it was progress on this side of the world that the pomp — accompanied with song by the United States Marine Brass Quintet — was all about. Inscribed on the Perry Center’s seal are the Latin words mens et fides mutual which mean “understanding and mutual trust. Renaming ceremony helps Perry’s legacy endure The center was inaugurated Sept. 17, 1997, about eight months after Perry left the Pentagon. Its aim is to foster partnerships with other nations while advancing defense and promoting civilian-military relationships in democratic societies. And it does this through a variety of academic projects, research and outreach programs. Other activities include post-graduate seminars in national security planning workshops. The center began accepting its first students in early 1998. Kenneth A. LaPlante, acting director of the Perry Center, said it took an act of Congress and just over five years to get the center renamed for Perry. LaPlante noted that during Perry’s tenure as defense secretary, three other centers with similar goals were established around the world: the Marshall European Center for Security Studies in Germany; the Asia Pacific center in Hawaii and the Africa Center for Strategic Studies, also on the NDU campus at Fort McNair. All of these things, Perry said, show “just how much the world has changed, just how much our security has changed … how much the Department of Defense has changed and just how much [the job of secretary of defense] has changed. Those changes, as well as stories about the man who helped bring them about, are being documented by Perry’s daughter Robin, who now assists her father with writing his memoirs. “When we were growing up back in Palo Alto, we thought of him as just a father who loved his family,” she said. “But when Dad went to the Pentagon for the first time in 1977, we all knew how accomplished he’d become.” Let’s follow the example of William Perry’s vision. His capacity for equilibrium, for mutual understanding between soldiers and civilians, which lead us towards development with peace, justice and safety. It is a good tribute for those of us that follow him.last_img read more

Talk of the towns: Sussex

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PBU plans talks to ease forced pension switching within work sector

first_imgJan Rasmussen, director of business development, told IPE: “The first phase of this process is to discuss how we can address the challenge that different pension funds offer different conditions for these workers.”In Denmark, ‘pædagog’ or education practitioner, is the professional name for specifically trained staff in nurseries, kindergartens, after-school clubs and day and residential institutions.Other pension funds covering education practitioners are those run by, for example, PKA, PenSam and Lærernes Pension, the pension fund for teachers, Rasmussen said.In the last five years, PBU estimates that nearly one-third of its working members transferred to another pension fund based on their new workplace, or transferred into PBU. It said changing fund and scheme could be confusing and costly for members.Asked whether the talks could end up with a decision to merge pension funds in some way, Rasmussen said: “One cannot exclude the possibility these talks will end up in the decision to have one set-up for all education practitioners, but, presently, we don’t have specific plans, and that would eventually be years from now.” PBU’s 108,000 members were covered by a homogeneous market-rate product, he said, while other pension funds that had members with the same qualification provided a with-profits (gennemsnitsrente) pension product.Rasmussen said this type of process to reduce the differences between labour-market pension scheme types was a common challenge within the Danish pension sector.“But this is especially the case in our sector, where there is high mobility between different pension funds,” he said.Ultimately, Rasmussen said, PBU’s aim in the task it is undertaking is to make conditions better for its members.Neither PKA nor Lærernes Pension were immediately able to comment on the matter. Denmark’s DKK55bn (€7.4bn) pension fund for education practitioners, PBU, is aiming to start talks with other pension funds and stakeholders that it says could lead to all people in the profession having the same pension, rather than the diverse provision that exists now.As things stand, education practitioners in Denmark may be part of collective agreements where their pension is provided by PBU (Pædagogernes Pensionskasse), or belong to agreements using another pension fund for their pension.This means individuals may find themselves having to switch pension provider when they change jobs within the same profession.PBU said it had now started a process aimed at solving this problem.last_img read more

NN IP: Green bonds an ‘economic alternative’ to traditional bonds

first_imgIt noted that the duration of the green bond index had significantly increased since the start of 2017, when France issued its first green bond of €7bn with a duration of 22 years.The longer duration increased the susceptibility of the green bonds for interest rate changes. As interest rates had dropped further in 2019, the green bond index performed better than the aggregate index, NN IP explained.The asset manager further found that green corporate bonds returned 6.4% in 2019, against 6.2% for traditional credit, and had outperformed in 2016, 2018 and 2019.The manager said that annual volatility of green bonds was higher in each of the past four years, whereas the volatility of corporate bonds had decreased every year.It added that the difference in volatility between the green and the non-green index was decreasing as a consequence of growth and an increased diversification of the green credit market.It said that the duration of both indices is now almost equal.Bram Bos, lead portfolio manager green bonds at NN IP, said the consistent outperformance of green bonds relative to tradional ones, confirmed that green bond issuers are less exposed to climate and environmental, social and governance (ESG) risks and are more transparent.Green bonds are usually issued by innovative and future-oriented companies that take climate change into account.Bos said NN IP’s analysis showed the indices for green bonds had become a real alternative for tradional bond indices.He highlighted that NN IP only invested in “dark green” bonds with a measurable performance aimed at solving large sustainability problems, and therefore excluded 15% of the worldwide issued green paper deemed insufficiently green. Dutch asset manager NN Investment Partners (NN IP) has argued that green bonds – corporate bonds in particular – have become an economic alternative for traditional bonds, thanks to their returns and volatility.It said that a comparison between the Bloomberg Barclays MSCI Euro Green Bond Index and the Bloomberg Barclays MSCI Euro Aggregate Index over the past four years, had shown that green bonds had returned 7.4% last year, whereas traditional bonds had generated 6%.It added that the asset class had outperformed by 70 bps on average during three of the past four years.According to NN IP, the annual volatility of the green bond index had been higher for the last three years, which means that higher returns were largely thanks to higher risk.last_img read more

Discover Dominica Authority News Update for the week ending Friday November 25th, 2011

first_imgLocalNews Discover Dominica Authority News Update for the week ending Friday November 25th, 2011 by: – November 25, 2011 Share **Kalinago Territory launch Home Stay Programme and Promotional Materials**In an effort to improve the marketability of the Carib Territory, a major component of Dominica’s tourism product, Discover Dominica Authority (DDA) in collaboration with the Kalinago community have upgraded and expanded the website, produced a brochure to include all the sites and attractions of the Territory and finalized the Home Stay Programme Guideline. In celebration of these first time activities, the Discover Dominica Authority in collaboration with the Kalinago Barana Aute of the Ministry of Tourism and Legal Affairs will launch the promotional material and the home stay programme on Friday, November 25, 2011 from 2:30pm at the Kalinago Barana Aute, Salybia. To mark the occasion, the Kalinago Chief, the Kalinago Council, Parliamentary Representative for the constituency, the Local Government Department, Kalinago home stay providers and other Kalinago stakeholders will be present at the event. Media houses are expected at the launch. The brochure and website will be showcased and the Karina Cultural Group will celebrate the event with a performance. ** Increased inquiries about Dominica from France Nationals**Interface Tourism, Dominica’s representatives in France, received an influx of inquiries from persons planning to travel to Dominica, further to the publication of an article in Le Figaro magazine on the destination in September 2011. Discover Dominica Authority partnered with French tour operator Iles du Monde to host journalists from Le Figaro magazine in February. Le Figaro magazine features articles on lifestyle and leisure among other topics and has a circulation of over 300, 000. The media value of the article is in excess of 2 million euros and it is read by over 1 million persons in France. **I am Dominica. Are You? Scrapbook competition for preschoolers in the North**The Leo Club of Dominica in collaboration with Discover Dominica Authority will involve preschoolers in the I am Dominica. Are You? Campaign through a scrapbook competition this November. Preschoolers in the north of the island will participate in the scrapbook competition as they portray through pictures, photos and drawings what they love about Dominica, and how they can help to develop and promote Dominica. Scrapbooks will be judged for neatness, applicability to the I am Dominica. Are You? concept and creativity. The Pennville Preschool, Thibaud Preschool, Paix Bouche Preschool, Sunflower Preschool and Gospel Life Christian Academy will take part in the competition. The judging of the scrapbooks will take place on November 25, 2011 by Community Leaders of the north and representatives of the Leo Club of Dominica and Discover Dominica Authority. **The UK market continues to be very productive in delivering great PR for the island**.The DDA hosted journalist Judy Bastyra from May 28 – June 5, earlier this year. Judy who writes for the UK market is a lover of the destination and its natural wonders. She travelled along with a photographer who was able to capture the true beauty of the island and its cuisine. Judy’s latest article appeared in the December issue of the Food & Travel magazine entitled ‘Isle of Youth’ which has an abundance of lovely images of great local produce and picturesque views of the island. Judy was able to visit many of the local spots where organic farms, cassava bread, bakeries and eateries where secret recipes could be found. Fine dining restaurants were also discovered throughout the island to get a true feel of the tastes and flavors of Dominica. Much support was received from the private sector – Calibishie Lodges, Silks Hotel, Riverstone Bar & Grill, Picard Cottages, Beau Rive, Rosalie Bay, Zandoli Inn, Kalinago Barana Aute, Jungle Bay Resort, Mrs. Fae Martin, Roots Organic Farm, Roy’s Organic Farm, Cocoa Cottages and more. A quote from the article reads, “The Caribbean island of Dominica is very different from its neighbors….it has waterfalls, lush rainforest and produce so good it’s practically an elixir for long life. ” The DDA hosted UK journalist David Hoppit from March 24 – April 1 this year which produced several articles on the destination with the latest being featured last weekend in The Sunday Telegraph. The three-page feature on the island was entitled ‘A Boy’s Own Island’ where David brought his grandsons along on his adventure to get a true family experience on the island. The Sunday Telegraph is a weekly newspaper and online publication with a circulation of 471,894. The feature is a beautiful written piece with the journalist concluding that “the only hard thing about our visit to the natural history island was leaving it behind”. Many of the service providers gave tremendous support to this trip – Beau Rive, Dr. Lennox Honychurch, Waitukubuli National Trail, Papillote Wilderness Retreat, Castle Comfort Lodge & Dive Centre, Irie Safari, Jungle Bay Resort, Zandoli Inn, Rainforest Aerial Tram, Calibishie Cove, Calibishie Lodges and Kalinago Barana Aute and we would like to thank them and encourage them to assist the authority in creating further awareness of the destination. http://www.telegraph.co.uk/travel/activityandadventure/8899219/Dominica-the-Caribbean-a-Boys-Own-island.html Press ReleaseDiscover Dominica Authority Sharing is caring! 230 Views   no discussionscenter_img Share Share Tweetlast_img read more