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RSNA 2009 Quality Counts

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RSNA 2009 Quality Counts

November 29, 2009 - December 4, 2009 | McCormick Place - Chicago, IL

Founded in 1915, the Radiological Society of North America is a professional membership society committed to excellence in patient care through education and research. More than 40,000 medical imaging professionals are members of RSNA, including radiologists, radiation oncologists, medical physicists and allied scientists.

RSNA hosts the world's largest annual radiology meeting, publishes two highly respected peer-reviewed journals, offers opportunities to earn CME, and provides research and education grants to young investigators.

Annual Conference Homepage

Protests held over closing of UPMC branch

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Dozens of people are protesting the decision to close a suburban Pittsburgh hospital.


The protesters held signs and distributed fliers Nov. 27 outside the University of Pittsburgh Medical Center's headquarters downtown. UPMC plans to close a hospital in nearby Braddock on Jan. 31. UPMC reports the hospital lost $27 million in the past six years, and projects a $10 million annual loss if it remains open.


Opponents say UPMC is closing a vital community resource. The hospital is the borough's largest employer, with about 650 workers. UPMC spokesman Paul Wood says the health system invested $60 million in the Braddock facility but "was unable to create the success story it had hoped for."
modernhealthcare.com

30 ways to outsmart the flu By Francesca Castagnoli

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As anxieties about H1N1 mounths, there are easy steps to keep your family safe from the flu this season.
As anxieties about H1N1 mounths, there are easy steps to keep your family safe from the flu this season.

(Parenting.com) -- In the new "super flu" era, who among us hasn't thought of bundling up our kiddos in hats, gloves, and surgical masks this winter? Better yet, how about plastic bubbles? (Remember that true story?)

Pediatricians' offices have been fielding calls and visits from worried moms since news of the novel flu strain -- originally called "swine flu" but now known officially as the H1N1 virus -- broke last spring and a global pandemic was declared. Yikes! How concerned should you really be?

"You should take H1N1 seriously because the flu is a serious thing, but it's not necessarily any worse than other flu strains," says Dr. David Goldberg, chief of pediatric infectious diseases at St. Joseph's Children's Hospital in Paterson, New Jersey. What you should watch for in your family: the usual flu symptoms of fever, cough, sore throat, congestion, body aches, headache, chills, and fatigue. In addition, a significant number of H1N1 sufferers have experienced vomiting and diarrhea.

The good news is that the Centers for Disease Control and Prevention has been reporting from the onset of the outbreak that most H1N1 victims have experienced only mild symptoms, and at press time that continues to be the case.

But there's still a lot that's unknown, and that's the main reason people are freaking out. Scientists can't predict how the H1N1 virus will behave or what its potential for harm is. What they are sure of: the same illness-prevention strategies that you already know are the key to beating back the flu and other pesky winter bugs. Follow our easy stay-well prescription and watch your family thermometer collect dust in the medicine cabinet. Your most uneventful cold-and-flu season ever awaits!

CNN iReport: How are you battling H1N1 and seasonal flu?

Wake-up call

The immune system functions better with a healthy diet, notes Atlanta, Georgia, pediatrician Dr. Jennifer Shu, the coauthor of Food Fights, so kick off your family's day with a breakfast rich in protein and colorful fruits and vegetables. Think pepper-packed omelettes, broccoli or spinach quiche, pumpkin or zucchini breads.

Be sure to include some whole-grain carbohydrates to keep them pumped until the lunch bell rings. Start a healthy competition to see who can eat the most colorful foods over a week. Post a chart in your kitchen and have everyone fill in what they had daily. Got a kid who tolerates only one food group? Ask your doctor about giving him a multivitamin to make sure he's getting all the nutrients he needs, recommends Shu.

Parenting.com: 12 parenting rules you can break

Germ warfare

• Wipe down the handle of your shopping cart, the doorknobs of public bathrooms, even your kid's menu (just think how many tots have licked the photo of that ice cream sundae).

• Bring your own books, toys, or a portable video game to play with at the doctor's office. Yes, offices clean their toys, but the odds are huge that a sick kid had his hands on them not long before you arrived.

• Use your own pen at the doctor's office, pharmacy, and checkout counter (adults carry germs, too!).

• Spray down the bathroom with a household disinfectant such as Lysol or Clorox Clean-Up if a family member has been sick. Other germ magnets that could use a spritz: phones, remote controls, microwaves, and refrigerator door handles. You can also spray down toys at the end of the day -- once the disinfectant dries, it's no longer hazardous.

• Try not to hug soiled linens close to you to avoid spreading germs from dirty laundry to your body. Wash your hands afterward.

• Sanitize like crazy if you go to an indoor play space!

Avoid wardrobe malfunctions

From chilly bus stops to stuffy classrooms to hot gym classes: Most kids could use a series of costume changes throughout the day. Temperature fluctuations alone won't make him sick, but overheating can lead to dehydration, leaving him run-down and more vulnerable to a bug lurking in another kid's sneeze or on that shared math book. Layers that can be easily snapped on or zipped off with confidence will keep kids comfortable -- and looking cool.

Dish up vitamin D

Making sure your kid is getting enough vitamin D should be another one of your first lines of defense because it helps activate immune cells. Trouble is, most kids aren't these days because the main source of D is sunlight. Between slathering on sunblock in warm weather and spending a lot of time indoors during the winter, seven out of ten children in the U.S. have low levels of vitamin D, according to a study done by Albert Einstein College of Medicine in New York City.

Good food sources of vitamin D include fortified milk and juices, cheese, eggs, and salmon. Still, it's tough to get the recommended 400 international units (IU) daily. Unless your child is a big milk drinker -- to help you do the math, one cup of milk has about 100 IU of vitamin D -- you should talk to your pediatrician about a supplement; the American Academy of Pediatrics now recommends one up until age 18.

Just for baby

Vitamin D is the one thing breast milk unfortunately doesn't have enough of, so if that's what your baby's drinking exclusively, ask your doctor for a 400-IU supplement. Infants who are consuming at least 32 ounces of formula daily are covered, but once solids are added to their diet, they're likely to need a supplement, too.

Parenting.com: Swine flu and pregnancy: What you need to know

Power up the probiotics

Sign us up! A recent study showed that kids who were given twice-daily probiotic supplements for six months experienced fewer fevers, coughs, and runny noses during the cold and flu season than children who were not. But what the heck are probiotics? Good germs that restore balance to the digestive system, thereby boosting immunity. You can find them in:

foods Stonyfield Farms and Dannon make yogurt and yogurt drinks with probiotics. Stir in a spoonful of honey (after age 1) -- it's also believed to trigger immune function. Whole grains and bananas contain prebiotics, a type of fiber that fosters the natural growth of probiotics.

supplements Ask your pediatrician about a supplement like Florastor Kids or Culturelle for Kids -- both can be mixed into juice or soft foods. Probiotic supplements may also be used to treat diarrhea when it's a side effect of antibiotics.

Parenting.com: How to accident-proof your kids

Wipe 'em clean

Kids put their fingers in everything from their friends' cupcake frosting to their own noses, and they may not always have the time -- or the inclination -- to wash their hands during the busy school day. Pack travel-size, alcohol-based hand sanitizer gel or wipes in your child's lunch box, backpack, and gym bag. And check the labels: Studies show that hand sanitizers should have a concentration of at least 60 percent alcohol or they won't work.

Nose blowing 101

It sounds easy enough, but many younger kids reflexively inhale instead of blowing out. Try these tricks:

solo-nostril blow Place your finger over a nostril. Dangle a tissue over the other and ask him to "push" his boogers out. When he blows correctly, he'll see the tissue flutter and understand that the air (and boogers) are coming out of his nose and making the tissue move.

oink it out Give your child a tissue and tell him to make a piggy face by scrunching his nose, then "oink" while blowing hard enough into the tissue that his tummy sucks in.

Wash, wash, and wash again

When To Do It You know the drill -- have your child wash her hands before meals, after using the bathroom, after coughing, sneezing, or nose picking, after touching animals (and cleaning up their waste), and after she's come in from outside. The trick is not to slack off. Ever.

How Long For at least 15 to 20 seconds, or long enough for your child to sing the alphabet or "Happy Birthday" twice.

What Temp Have your kid wash in water that's warm but not too hot. Heat isn't going to kill the bacteria or viruses anyway. Washing removes them, and if your kiddo is comfortable, she's more likely to do it.

Parenting.com: 14 things not to feel guilty about

How Much Soap Some, but not gobs (skip antibacterial soap -- it may promote resistance). Effective hand washing requires soap and friction, says Shu, so make sure she rubs her hands together vigorously.

Is It Contagious?

Cough As a general rule, if a child has an occasional cough but his energy is up, he's probably not still sick -- tickles and hacks can linger long after a cold has run its course. Dry coughs from allergies and asthma are also not contagious. But if a child has a persistent cough and is acting tired or irritable, he is more likely to be coming down with something.

Cough accompanied by a fever should be considered contagious. A barking cough may be croup or whooping cough, while a loud, loose cough from the chest may indicate bronchitis or pneumonia, all of which may be contagious and should be checked out by a doctor.

Parenting.com: 20 of the greatest mom tips, ever

Fever A child is sickest the day before a fever begins and for the first three days she is unwell (if it lasts that long). Once a child is under 101 degrees for 24 hours (without medication), she is much less contagious.

Flu A child is most contagious the day before she comes down with the flu, and she remains contagious until she is under 101 degrees for 24 hours (without medication). The fever can last from three to seven days.

Runny Nose A runny nose is indicative of a cold, which is most contagious for the first three days. Clear, green, yellow, and even rust-colored boogers are all created equal, and while thick, green ones can mean the cold is settling in, they are no more indicative of contagiousness than the clear kind. If the nose is still running after seven to ten days, it can be a sign of a sinus infection, which needs treatment but is not contagious.

Sore Throat A sore throat with other symptoms, especially fever, is possibly strep or something else contagious, so consult your doctor.

Stomach Bug Kids are most contagious the day before they begin to vomit or develop diarrhea (which is probably why the darn bugs spread at lightning speed) and remain contagious for the first three days (again, if it lasts) or until they have not vomited or had diarrhea for 24 hours.

Symptom Soothers

Hello, inevitable: Despite all your best efforts, your kid got sick. A quick checklist for keeping her comfy:

• Give her a pain reliever if she has a fever of 101 degrees or higher. Call your doctor to confirm the dosage.

• Fill her up with extra fluids Offer water, juice, ice pops, or Pedialyte.

• If she has chills, wrap her up so she feels warm but not bundled.

• Prop up her head to allow her nose to clear if she's stuffed up.

• Help her breathe easier by applying a menthol rub like Vicks VapoRub to her chest (for kids over 2).

• Serve her chicken soup. According to some studies, it can actually loosen congestion.

• Give her a shot of saline nasal spray if she'll tolerate it.

• Add nose-and-throat-soothing moisture to her room by turning on a humidifier or vaporizer.

• Run her a bath Cool water may help bring down a fever. If she's coughing or congested, run a hot shower to steam up the bathroom.

• Air out her room while she's taking her bath or shower so it feels fresh and clean for bedtime.

• Keep your cool -- even in the age of H1N1, your child will get better!

Once more into the breach

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A man in Baghdad looks at a newspaper bearing an image of Barack Obama

A man in Baghdad reads a newspaper bearing an image of Barack Obama. Photograph: Sabah Arar/AFP/Getty Images

There is little doubt that, if UN staff and ambassadors could vote, Barack Obama would have won by an even bigger landslide than he achieved. From his speeches they expect him to negotiate where possible, to build consensual international alliances. They may not get all that they want.
(Winning back hearts and minds, 6 November 2008)

After Obama's election I wrote here: "It may not be the second coming, but to use the eschatological phraseology of the Palins of this world, it is certainly the end of the reign of the Antichrist." I also recalled what I'd said during the campaign: "The world looked upon these elections as an IQ test for the American public. The electorate has aced the test. It has put centuries of racism behind it and elected a president who shows signs of knowing where the rest of the world is."

Frankly, while still far from euphoric, I feel vindicated. The coalition of not-so-covert racists, teabaggers, birthers and defenders of Medicare against the state should be a reminder to the purist Obama-detractors of the left just who could instead be staffing the US government now.

OK, Rush Limbaugh's "magic Negro" did not wave a wand and change everything immediately. But in many ways it is remarkable how much Obama has achieved in the face of financial crisis. And no one who saw how much money and support he got from Wall Street can be honestly be surprised at the shape of his response.

The current plans for healthcare reform leaves a lot to be desired, above all a public option. But it is happening, at least. One hopes that Obama is biding his time to come in and leash the Blue Dogs of Capitol Hill to get it through. But even then he has breached the wall of opposition, and another term and "once more into that breach" should bring in reform – if only because of the fiscal costs of not doing it.

Guantánamo is not closed, but it is closing, and with it the lawless domestic and international doctrines of the Bush-era justice department. US troops have been pulled from Iraqi cities, and we can be reasonably sure that if the Iraqi government asked them to leave the country, they would go. Yes there is talk of a build up in Afghanistan, but that is, after all, what Obama promised, even if he certainly should take a more active role in revising the tactics and strategy there. He has scrapped the son-of-Star Wars missile defence programme in Europe that was expensive, ineffective and needlessly provocative to the Russians.

The UN dues are paid up, and Obama has adopted a multilateral outlook. On the Middle East, he has quietly confronted Binyamin Netanyahu, held firm on Israel meeting its own promises on settlements and, relatively un-noticed, told Israel that it should do as Richard Goldstone says and hold an impartial inquiry into Gaza.

When he backslides, by all means let people shove. But let them remember how far up the slope he's pushed us in less than a year.

To read the rest of the Cif America series looking back on Obama's election victory, click here

The politics of quagmire

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Barack Obama talks about healthcare at the White House

Barack Obama talks about healthcare at the White House. Photograph: Mark Wilson/Getty

Obama's message of bipartisan unity may have propelled him to the White House, but it also gave Pennsylvanians permission to deviate from the Democratic party line in the polling booth
(Obama's short coattails, 9 November 2008)

To me, last year's election was not a triumph of the Democratic "brand". Instead, Pennsylvanians voters' ticket-splitting was a victory of personality and policy over party. The mood of Americans over the past year have only underscored that impression.

Take the "missing" Barack Obama supporters. Having coasted to victory in part because of his widespread grassroots support, Obama was supposed to be able to unleash those supporters on issues at will. But his supporters are largely absent from the healthcare debate. Was his support superficial?

Hardly. The missing supporters happen to coincide with dropping approval ratings for congressional healthcare reform and growing pessimism about the country's political compass. For the first time under Obama, a majority of Americans think the country is "headed down the wrong track".

But it's not a conservative backlash to his policies. The underlying poll numbers show that Republicans are disliked more now than a year ago. At the same time, support for healthcare reform's government-run public health insurance option steadily grows, indicating that the darkening mood is coming from the left and centre, and in response to the too conservative approach to reform Congress and the president are taking.

Blame the US Senate. Due to a quirky procedural rule that requires 60 of 100 Senate votes to end debate on any bill or presidential appointment, power to pass laws resides in a small group of corporate-friendly, conservative Democrats. Obama's approach has been muted and focuses on consensus-building and compromise, a strategy suited to passing legislation through the Senate, but which has also resulted in a limping Frankenstein-monster healthcare bill loaded with taxpayer subsidies for private industry and containing a stripped-down and nearly impotent version of the public option. Hardly the stuff of "hope" and "change", or the "fierce urgency of now".

The danger here isn't that Obama supporters will vote in droves for Republicans in the upcoming midterm elections. It's that they will stay home, disillusioned with the government's politics-as-usual, under-the-table game of footsie with corporate America. Obama can change that, but only by matching the boldness of his rhetoric with real reforms.

A good start would be to pressure the Senate into fixing its procedural logjam.

To read the rest of the Cif America series looking back on Obama's 2008 election victory, click here