How to Rescue American Football.

Blows to the head damage the brain. American football is a contact/collision sport that produces many injuries, including to the brain. Football has many supporters who cite important redeeming characteristics of the activity. Public attention to the hazards of children and adults playing football has heightend recently due to many new scientific discoveries, not least of which is the frequency with which players are seriously harmed and do not recover. It is now incumbent on all interested parties to invent and implement far better safety practices, equipment, rules, and processes or the sport must cease to exist in its current form. This paper presents several safety proposals for consideration and study.

The brain-to-brain loop concept for laboratory testing 40 years after its introduction.

Forty years ago, Lundberg introduced the concept of the brain-to-brain loop for laboratory testing. In this concept, in the brain of the physician caring for the patient, the first step involves the selection of laboratory tests and the final step is the transmission of the test result to the ordering physician. There are many intermediary steps, some of which are preanalytic, ie, before performance of the test; some are analytic and relate to the actual performance of the test; and others are postanalytic and involve transmission of test results into the medical record. The introduction of this concept led to a system to identify and classify errors associated with laboratory test performance. Errors have since been considered as preanalytic, analytic, and postanalytic. During the past 4 decades, changes in medical practice have significantly altered the brain-to-brain loop for laboratory testing. This review describes the changes and their implications for analysis of errors associated with laboratory testing.

Low rates of reporting commercial bias by physicians following online continuing medical education activities.

BACKGROUND: Concerns have been raised about bias in commercially supported continuing medical education (CME) activities, although the data are sparse about whether such bias exists, or if so, its extent. METHODS: Postactivity CME evaluation surveys were analyzed to quantitate reporting rates of bias, overall and by funding source. RESULTS: 5Of 1,621,647 physicians who participated in online CME activities, 1,064,642 (65.7%) completed the evaluation surveys and 5.9% reported no opinion. The affirmative rates of physician perception of bias were 0.63% overall, a weighted average of 0.84% for activities developed with and 0.48% for those developed without commercial support, a difference of 0.36% (P <.001, 95% confidence interval, 0.33-0.39). Among the subgroup who strongly disagreed that there is no bias, the difference between commercial (0.17%) and noncommercial (0.11%) funding was 0.06% (P <.001, 95% confidence interval, 0.05-0.08, P <.05), smaller than the overall difference. CONCLUSIONS: These data demonstrate that about 93% of physician participants affirmatively claim to perceive no commercial bias following online CME activities, over 99% if no opinion is included, overall and regardless of funding source.