The findings come from one large UK hospital. But researchers say the results could extend to similar medical centers, too.
The
study, reported in the European Heart Journal, looked at records from
2,571 patients treated for a more serious type of heart attack known as a
ST-segment elevation myocardial infarction, or STEMI. Those account for
about one-fifth of all heart attacks.
The best treatment for
STEMI is emergency angioplasty, where a balloon-tipped catheter is
threaded into the arteries to push aside the blockage causing the heart
attack. Often, a tiny, scaffold-like device called a stent is left
behind to keep the artery open.
One question has been whether
STEMI patients who land in the hospital at night or on weekends might
fare worse than those who arrive during "business hours." That's a
possibility because during off-hours, senior staff would likely be on
call rather than at the hospital.
In this study, though, patients
who had an angioplasty during off-hours were no more likely to die in
the hospital: 4.6 percent of them did, versus 4.3 percent of patients
treated on a weekday between 8 a.m. and 6 p.m.
Their longer-term
outlook was also similar. Over the next year and a half, 11 percent
died, compared with 12 percent of patients treated during weekday hours.
The
study was done in a large hospital that does a lot of cardiac
procedures, said Dr. Mohaned Egred of Freeman Hospital and Newcastle
University, the senior researcher on the work.
He thinks the
results could be similar at other big medical centers with experienced
staff and a "robust efficient activation system" that gets STEMI
patients into treatment quickly.
"What the public can take away
is that if they arrive with a heart attack at a high-volume,
well-staffed center, their treatment outcome will be the same whether
they arrive during normal working hours or out of hours," Egred wrote in
an email to Reuters Health.
Dr. Gregg C. Fonarow, co-chief of
clinical cardiology at the University of California, Los Angeles, agreed
there is good news here for patients.
"Some, but not all, prior
studies have suggested that quality of care, rapidity of treatment, and
clinical outcomes may be less favorable in (heart attack) patients
presenting during off-hours," Fonarow said in an email.
But in a
study of 379 U.S. hospitals, Fonarow and his colleagues found that while
off-hours patients waited a bit longer for angioplasty, their survival
rates were the same as those of patients treated during weekday hours.
"Together
these studies suggest there have been significant gains made by
hospitals in providing high-quality care and excellent clinical outcomes
for patients presenting with STEMI, irrespective of the time of day or
day of the week," Fonarow told Reuters Health.
Still, that doesn't mean all hospitals provide the same care, day or night.
The
hospitals in Fonarow's study were all part of the American Heart
Association's "Get With The Guidelines" program - which was designed to
improve heart attack patients' care. The performance at those hospitals
could be better than at other centers.
And Egred said that more studies, particularly at smaller hospitals, are still needed.
Milder,
"non-STEMI" heart attacks can often be treated with medication, though
many patients end up having an angioplasty. However, Egred said, those
patients would typically not need an emergency procedure on the spot.
A survey recently published at Getschooled.com
cites data that as many as 7 million students - about 15% of the K-12
population - are out of school 18 or more days of the school year. And
many of them don’t think skipping school will impact their future.
That’s
not in line with reality. The study points out that students who skip
more than 10 days of school are significantly (about 20%) less likely to
get a high school diploma. And they’re 25% less likely to enroll in
higher education.
Can parents have an impact here? Absolutely.
In fact, parental encouragement to attend school was the most widely
cited factor in what would make students want to go to class diligently.
But
many of those surveyed said their parents didn’t even know when
students skipped. In fact, 42% said their parents either never knew or
rarely knew when their kids were absent from school; another 24% added
that parents knew “sometimes.” So parental engagement and knowledge of
children’s whereabouts seem key to keeping kids in class.
Students
also said that encouragement from anyone to whom they felt a personal
connection, from teachers to coaches to celebrities, could influence
better attendance. “If we - parents, educators, and even celebrities -
show them we truly care about them, their aspirations and frustrations,
they will be more likely to care about making it to school,” writes
Marie Groark, executive director of the Get Schooled Foundation.
Other
solutions: Those surveyed said they wanted to see a “clear connection”
between their classes and the jobs they’d like down the road. They
also cited a better understanding of consequences, greater support of
teachers, and more friends at school as factors that could make them
attend more often.
With her husband's two jobs -- he's also a
fourth-grade teacher and an adjunct professor -- the master's-educated
couple makes four incomes. But, money is tight for this family of six.
While
Longshore's passion for teaching children helps her overlook her modest
life, she sometimes resents her job. She feels under-appreciated by
parents at times and like her profession isn't respected.
"My
paycheck does not reflect my expertise," she wrote on CNN iReport. "The
minimal esteem shown is not warranted, considering my formal schooling
and experience. ... But I teach, because that is who I am."
Despite
administration frustrations and poor classroom conditions -- and for
Chicago teachers, a weeklong strike -- why do they do it? CNN asked
teachers to share their perspectives about the sacrifices they make, and
the motivations for teaching. These are five of their stories:
Inspired by her teachers
The
Longshore family's best electronics are hand-me-downs from when the
school replaces them with new, grant-funded equipment. The laptop that
Longshore uses in the classroom is also the family computer. They opt
for cheap, older cell phones -- no smartphones for this couple.
The
budget for entertainment is $100 per month. One night at the movies or
an outing for frozen yogurt is as far as it goes, she said.
Her
salary of $55,000 to $60,000 may seem adequate, but Longshore hasn't
seen a pay raise in 7 years, not even a cost of living increases, she
said.
Their life is modest but it keeps them content because the couple can keep teaching.
Besides, she made up her mind in second grade. She was going to become a teacher.
"No
matter where I turned, I kept coming back to the idea of teaching,
inspired by the teachers that touched my life," she said. "There just
had to be more people like them in the profession -- and I was
determined to be one of them."
Ms. Barnett was like a "second
mom" when her parents divorced. Mr. Flurry "was the first teacher who
saw me," she said. Mr. Dale taught her to dream beyond poverty. Mrs.
Cook helped her find her voice to speak up.
"Each of them became a
part of who I am today," she said. "Their influence inspired me towards
my utmost. To have opportunity to invest and pour my life's work into
budding politicians, businessmen and women, civil servants -- I could
think of no greater calling."
There's more time with family
Working
"crazy hours" as an operations manager at a startup company, Ryan
Thompson spent little time with his family and little time relaxing.
"I
had no social life and I was frustrated with that. I felt like I was
chasing money to be happy," said the 31-year-old from Somis, California.
When he was laid off from the startup, Thompson saw it as an opportunity to change careers.
He
now teaches entrepreneurship at Thousand Oaks High School and
appreciates each day. "I never feel like I am punching in and punching
out."
But before he was molding young minds, he had a reality
check -- his future, shrunken paycheck. In the beginning, it took awhile
to "be OK with not making a lot of money," he said.
Teacher turned down high-paying job to stay
While
he was studying to become a teacher, he started a small window-cleaning
and pressure-washing business to get by. It was only meant to be
temporary, but it's now a second source of income. "I do that year-round
still to this day, so that supplements the low pay that teachers get,"
he said.
He also took night classes to push himself higher on the
pay scale -- teachers are paid partially based on their work experience
and education. Last year he was making just shy of $45,000 and after
eight graduate classes, he will be making $53,000, he said.
"I do
sometimes wonder what if I stayed in the corporate world and what that
would look like," he said. "But now that I have three kids, I would have
to say that my job is an awesome family job."
There aren't many dads who get the summer free and can come home at 2:15 p.m., so his children love that, he said.
Helping kids who struggle like she did
Mary
Lynch wanted to add a voice "from an often overlooked demographic of
teachers:" those who are not in unions. She teaches art at a private
school for students who have been kicked out of the public school system
in Fairfax County, Virginia.
"I don't think that people
understand that many nonunion teachers are on even lower pay scales than
union teachers," she wrote. "And we usually don't have the protection
that unions provide, nor do we have pension programs."
The salary
of for a public school teacher in a union with the same years of
experience would be making almost $70,000 a year, according to Fairfax
County Public Schools' salary scale. Lynch, who did not share her
salary, works at a nonprofit private school.
She's now entering
her 19th year of teaching and is living paycheck to paycheck. "My plans
for my retirement future are structured around winning the lottery or,
if that fails, working until I die," she said.
Lynch's students
provide professional challenges, as many of the middle- and
high-schoolers cannot read or perform basic math. "We have to work
ridiculously hard to make up ground lost over years and years of
unsuccessful education," she said.
There's also a threat of "physical violence" from her students, she said, which makes the job "emotionally draining."
Yet, the veteran teacher remains fiercely loyal to these struggling kids.
"I
was drawn to this population when I recognized the ease with which
difficult children fall through the educational cracks, and the social
impact that a lack of educating this population has on society," she
said.
Lynch herself struggled through high school and was
diagnosed with a severe learning disability in her 30s. "I saw my
situation as an opportunity to help other students with similar learning
issues find a way to be successful," she said.
"I teach because I
love what I do, and despite losing kids to the judicial system and
street violence, there is nothing like seeing them succeed."
Giving back to kids who need it
Wearing
a red shirt that reads "love" with a figure in a wheelchair
representing the "o", Allie Griffin has been on the picket lines all
week.
The special education teacher joined the Chicago strike
because there are basic needs at her school that just aren't being met.
She works in a program for children with autism at a South Side
elementary school.
Her students need special supplies, so she's
spent $4,000 to $5,000 of her own money since she began teaching three
years ago, she said. She makes $47,000 a year, which was her starting
salary.
"They need adaptive scissors because they can't use
regular scissors," she said. "Most of my students can't write yet;
they're working on fine motor skills so they can hold a pencil," so she
buys Velcro. Magnets and other objects also help the children with
sorting activities.
"I teach special education in Chicago because
regardless of the working conditions, I am going to find the resources
somewhere to make our classroom function," she wrote on CNN iReport.
Even though she misses being in the classroom, she went on strike to speak up for her students, she said.
"Everybody
is here advocating for the students," she said. "I come from a staff of
teachers that love what we do; we love the kids."
iReport: I teach to see them smile
Griffin
grew up in the wealthy Chicago suburb of Naperville, where a good
education was a given, she said. As a teacher, she wants to give her
students the same "premier" education, regardless of where they're from.
For her, it's about giving back.
"I teach special education in Chicago because I leave my job every day knowing that I gave a lot, but was given more," she said.
Finding self-reliance and their own truth
"The
frustrations I face most as an educator are not the low pay, long hours
or poor benefits," says dance educator Daniel Levi-Sanchez.
"It's
the ignorance of politicians that are out of touch with what is
happening on the ground that draft educational policies that have
nothing to do with preparing our future leaders with the tools to become
self-reliant and creative thinking adults."
He uses a creative
art, like dance, to help teach the children self-expression and
individuality. He hopes to shape them into adults who are confident and
passionate in whatever endeavors they pursue.
"Most of my
teaching derives from the curiosity of my students and what I do as an
educator is invest myself in their journey of finding the truth," he
said.
Because I still believe there's a future
The
Piscataway, New Jersey, resident is still on a journey of his own, as he
is striving to become a full-time educator. He left teaching to finish
his master's degree program in dance education; he's in his third year.
For now he, his wife and two girls are living in graduate housing, he
said.
"Each semester I have to answer the very real question: Can
I afford it anymore?" he said. Yet, he forges ahead because he believes
he can help students feel like they are a valued part of society.
"Children
and adolescents are smarter than we give them credit for. If the
administration and politicians really took the time to listen to these
future leaders, we wouldn't be in the mess that we are in today with our
educational system."
After its greatly anticipated unveiling, and the
endless tapping, stroking, pinching and praising at the event, the
iPhone 5 retired for the night to its private suite.
Jony Ive
stopped by to say he was very pleased with its performance on stage, and
ordered iPhone 5 to get some sleep. Tim Cook plugged iPhone 5 in for a
power refresh with its new Lightning connector and fondly wiped its
screen of the smudges from too much handling during the auspicious
event.
As the room gradually emptied, iPhone 5 thought about
Steve Jobs, and how he was missed. The unveiling just wasn't the same
without him. The drama and prestidigitation he brought to the stage
were absent. Tim is a great guy and really knows how to run the company,
but he can't sell ice to Eskimos. Then again, demand for iPhone 5 is
off the charts.
If the iPhone 5 were to reflect on what had been an extraordinary, and exhausting, day, it might offer the following thoughts:
"They
seemed to like me, but I was disappointed that the crowd wasn't
cheering more enthusiastically. I know there were few surprises -- we
don't keep secrets as well anymore --- but I felt the overall reaction
was a bit muted.
"I'm taller, slimmer, lighter, faster and no
more expensive than my predecessor. What's not to love? I am a far
better iPhone than the 4S, and the level of precision engineering,
quality and fit and finish are unmatched in the industry. Every iPhone
owner and even those on the fence will want me, and if not they are
dumb, or even worse, ignorant.
"I hear the complaints. I admit,
they bother me. I should be wider. I should have an even taller screen
than 4-inches. But those people just don't get it. Unlike my longer and
wider competitors, I can still be operated with one hand, and I am even
lighter and thinner. I weigh only 3.95 ounces. Compare that to the
4.7-ounce Samsung Galaxy SIII or the 6.5-ounce Lumia 920. And, I wasn't
designed by a bunch of copycat cloners, who think bigger is better.
"OK,
I don't have NFC like many competitors, but I don't need it now. Phil
Schiller says that iOS6 Passbook is good enough for me. I do feel bad
that my battery life isn't much improved, but what can I do about it?
Bottom line, every pixel, byte of code, and piece of brushed aluminum in
me is as close to perfection as you can get. As Jony said, 'It took all
of our learning, our best thinking, to realize something so simple, so
clear and yet so truly extraordinary.'
"Yet, at the same time I
don't feel that extraordinary, more evolutionary. Maybe I am an
extraordinary evolution. Tim said, 'Only Apple could create such amazing
software, hardware, and services and put them together into such a
powerful, integrated solution.' I don't want to be a 'powerful,
integrated solution.' I prefer to be 'cool,' as Steve used to say.
"I
appreciate all the legal efforts to eradicate the copycats and protect
my unique features, but some days I do get a bit depressed. While I am
close to perfection, I realize that the competition has gotten a lot
better and we are overreaching with lawsuits. I know I will be the most
popular smartphone by far this holiday season. The company will reap
huge financial rewards and I will go down in history as the best selling
phone of all time. I just worry that my successor, iPhone 6, may not
have it so easy."
A restless, but proud iPhone 5 finally drifts
off to sleep, as Jony requested. Overall, iPhone 5 appears to be
confident, but is also feeling the pressure. Not just Apple, but the
U.S. economy is depending on it to succeed. It could end up adding half a
percentage point to the country's gross domestic product growth.
In the meantime, tens of millions of people are counting down to the Sept. 21 delivery date.
The newspaper, The Independent, plastered its
cover with the headline, “Revealed: inside story of US envoy’s
assassination,” and reported inside: “The killings of the US ambassador
to Libya and three of his staff were likely to have been the result of a
serious and continuing security breach … American officials believe the
attack was planned."
The article continued: "According to senior
diplomatic sources, the U.S. State Department had credible information
48 hours before mobs charged the consulate in Benghazi, and the embassy
in Cairo, that American missions may be targeted, but no warnings were
given for diplomats to go on high alert and ‘lockdown’, under which
movement is severely restricted."
Shawn Turner, spokesman for the
Office of the Director of National Intelligence, emailed: “This is
absolutely wrong. We are not aware of any actionable intelligence
indicating that an attack on the U.S. Mission in Benghazi was planned or
imminent.”
The Drudge Report gave the story banner, red-type,
siren treatment, with a photo of President Barack Obama and Secretary of
State Hillary Clinton: “PAPER: U.S. WARNED OF EMBASSY ATTACK BUT DID
NOTHING.”
Taking a page from the academic paper presented
to the central bankers' conference in Jackson Hole, Wyoming in late
August by Michael Woodford, the U.S. central bank on Thursday said it
would continue to buy financial assets until there is a "substantial"
improvement in the labor market. The Fed also said it would keep
interest rates very low well after the economic recovery strengthens.
At
a press conference in Washington D.C., Fed Chairman Ben Bernanke cited
Woodford's research and called him a friend as he explained the
conditions attached to the Fed's third round of bond buying, known as
quantitative easing, or QE3.
Woodford, a Columbia University
professor and one of the foremost thinkers on how economies can escape
from the threat of deflation, welcomed the Fed's new approach in an
interview with Reuters and predicted it would help stabilize financial
markets no matter what news - good or bad - is on the horizon.
"The
uncertainty about how things might be unfolding next is one of the
biggest obstacles to the economy improving, so how you affect
perceptions is really critical at this point to what they're trying to
do," he told Reuters.
Unlike the Fed's first two rounds of
quantitative easing, in which the Fed brought about by $2.3 trillion
worth of securities over time, Woodford argued that the plan unveiled on
Thursday would not give the impression that the central bank has grown
more pessimistic about the economy.
The central bank's new
strategy assures individuals, businesses and investors that it is
committed to both act, and then to shut down its unconventional policy
actions when the time is right, Woodford said.
"They're making
bad news less destabilizing in one direction, and making really good
news less destabilizing in the other direction," he said.
On the
other hand, the first two rounds of Fed bond purchases as well as the
Fed's series of conditional pledges to keep interest rates low until a
future date - the latest of which is mid-2015 - could be interpreted as
"reason to wait and delay future spending," Woodford said.
The
U.S. economy is forecast to grow at around 2.0 percent this year, a
better rate than is expected in most European countries. But the euro
zone crisis and the so-called "fiscal cliff" of possible U.S. tax rises
and spending cuts due in early 2013 threaten to derail the U.S. economic
recovery.
FRIEND AND FORMER COLLEAGUE
The Fed's third
round of quantitative easing kicks off with $40 billion in purchases of
mortgage-backed securities per month, an aggressive and "open-ended"
plan to boost the sputtering economic recovery and to get Americans back
to work.
Asset purchases will continue "if the outlook for the
labor market does not improve substantially," the Fed said on Thursday,
adding it expects "a highly accommodative stance of monetary policy will
remain appropriate for a considerable time after the economic recovery
strengthens."
At his press conference Bernanke cited Woodford's
recent paper on monetary policy options when interest rates are near
zero. The paper argued the best way to defeat stubborn economic weakness
is to keep monetary policy very stimulative for longer than would be
advisable under typical rate-setting rules which weigh both growth and
inflation.
"I think the thrust of his research is that forward
guidance and communication about future policy is in fact the most
powerful tool that central banks have when interest rates are close to
zero," Bernanke said, calling Woodford, a former colleague, co-author
and friend.
ECHOES OF EVANS
Woodford, for his part, was
quick to credit another respected economist who has pushed to tie Fed
policy even more explicitly to specific economic yardsticks: Chicago Fed
President Charles Evans.
Evans, one of the most dovish of Fed
policymakers, has for a year advocated that the central bank promise to
keep an easy money stance until either the jobless rate falls to 7.0
percent or inflation rises to 3.0 percent. U.S. unemployment is now 8.1
percent and inflation is below the Fed's 2.0 percent target.
"They're
clearly saying both of the things Evans was suggesting, it's just that
they're not saying it with the numbers," Woodford said of the Fed's
policy-setting committee.
"I would certainly read it as a very
close cousin to what Evans was proposing to say, except stating it in
general terms rather than with numbers."
Time will tell whether
the Fed's new brand of easing has a more direct influence on the
economy, or whether it dulls the erratic reactions that financial
markets have had to past asset-purchase plans.
The S&P 500
stock index reached its highest level in nearly five years on Thursday,
while U.S. Treasury bond prices ended the day mostly higher.
"To
the extent this strategy works, history may look back on Woodford's
Jackson Hole advocacy of conditional commitment as a turning point in
the way the Fed attacked the sluggish recovery," wrote JPMorgan
economist Michael Feroli in a research note.
"To the extent this strategy doesn't work, at least Bernanke can argue that he threw everything he had at the problem."
Andrew, third child of Queen Elizabeth II and
Prince Philip, took half an hour to descend from the 87th to the 20th
floor of the brand new Shard skyscraper in London to raise money for the
Outward Bound Trust and the Royal Marines Charitable Trust Fund.
"I'm
not even going to say that was a piece of cake or not," the 52 year-old
prince, who raised more than £290,000 in the stunt, said afterwards. "I
will never do it again."
He then quipped: "I have to say, the most difficult bit was walking up the stairs."
However
Andrew, a former Royal Navy helicopter who served in the Falklands War,
admitted later that "the difficult bit was actually stepping out over
the edge".
"You have a moment to realise what you are doing and where you are going to go," he said.
In preparation for the 785-foot drop, Andrew said he had trained over the summer with the Royal Marines in Arbroath.
That, he said, "gave me the confidence to step out over the edge without too much trepidation".
Prince
Andrew, fourth in line to the throne, officially launched the Shard on
July 5 along with Qatari Prime Minister Hamad bin Jassem al-Thani.
The
310-metre (1,017-foot) tall tower, close to London Bridge on the south
bank of the River Thames, was inaugurated with a sound and light show.
The £450 million ($700 million, 570 million euro) project, designed like a shard of glass, was 95 percent funded by Qatar.
The
Shard's inauguration marked the completion of the exterior of the
building, located on the south bank of the River Thames at London
Bridge, while work on the inside is expected to continue into 2013.
The
skyscraper, whose name was coined by its Italian architect Renzo Piano,
is still significantly shorter than Dubai's 828-metre Burj Khalifa, the
tallest building in the world.
It took over from Capital City Moscow Tower as the highest in Europe.
The
building's futuristic silhouette has angered traditionalists who say it
has dwarfed older landmarks such as St Paul's Cathedral and the Houses
of Parliament.
English Heritage, the body responsible for
protecting historic sites, says the skyscraper mars a view of St Paul's,
while UNESCO has said it compromises the "visual integrity" of the
Tower of London, a World Heritage site.
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