Some articles....
Jul. 3rd, 2009 12:49 pm![[personal profile]](https://www.dreamwidth.org/img/silk/identity/user.png){kind=small}
conuly
A cop arrests a suspect 15 minutes after graduating from the academy. That's pretty awesome
Stop! Police! Very, Very New Police!
By AL BAKER
He has yet to deliver a baby or rescue a cat while on duty.
But on Thursday, just 15 minutes or so after walking out of his Police Academy graduation ceremony at Madison Square Garden, Officer Dariel Firpo had already made an arrest of a robbery suspect.
The arrest occurred about 1:15 p.m. as Officer Firpo and 249 fellow graduates were heading home.
He was going to the subway with friends and family, when he heard a commotion across the street. Officer Firpo, who had his gun and handcuffs with him, saw civilians trying to restrain a man.
Witnesses said that the man had grabbed a wallet from a 79-year-old man in a Wendy’s restaurant, pushing him to the ground and injuring his wrist. Officer Firpo jumped into action, and signaled to a nearby police officer directing traffic.
The two officers arrested the man, whom the police later identified as Jeffrey Grant, 47, of 400 East 30th Street in Manhattan.
Mr. Grant, who has 48 previous arrests, was charged with robbery, the police said.
The victim was taken to St. Luke’s Hospital, where he was treated for a broken right wrist.
As for Officer Firpo, 23, who has been a cadet for the past three years, he has already caught the attention of his boss.
“Officer Firpo made us all proud,” said Police Commissioner Raymond W. Kelly. “He’s off to a great start.”
Will he choose a path toward a detective’s gold shield? Maybe a job in Brooklyn North Homicide? Pursue work in the counterterrorism bureau? Or do specialized policing in the Bomb Squad?
None of the above. “I’m really trying to stick in the community,” said Officer Firpo, who graduated from Lehman College in January with a degree in political science. So his chosen path? “Community affairs.”
Later, Paul J. Browne, the police spokesman, who was at the graduation ceremony, reflected on the day. The class of 250 new officers was smaller than those in the recent past. But the officer’s actions lent a historic air to the day.
“It may be the fastest police action upon graduation in department history,” Mr. Browne said. “Certainly in memory.”
An editorial on how democracy wasn't the only option in 1776. Interesting.
Life, Liberty and Benign Monarchy?
By KATHLEEN DuVAL
Chapel Hill, N.C.
FROM the perspective of 2009, democracy in the United States is a great success. This makes it is easy to imagine that the march to democracy was the only path — that there is a clear line from the Declaration of Independence to the presidency of Barack Obama, and that democracy is the only fair society. But republican government was a risky choice at the time of the Revolution, and democracy was almost out of the question. There were more proven alternatives for running a society fairly. A look at two other contenders for control of the continent in 1776 — American Indians and Spaniards — reveals that democracy’s supremacy in promoting human rights was far from inevitable.
There were Indians fighting on both sides of the Revolution and others who tried to stay neutral. But whatever their choice, Indians did not fight for an American republic or a British constitutional monarchy but for their own goals, especially sovereignty. While American Indians were politically diverse, by the Revolution their most common governance structure consisted of multiple chiefs with limited power, advised by councils of elders. Chiefs led by persuasion rather than force. As a Mohawk man of the day explained, “We have no forcing rules or laws amongst us.”
For the British, a signed document was what sealed a treaty; but for the Indians they dealt with, a treaty had no validity without public acclaim. At a treaty negotiation, hundreds of people would gather for weeks, discussing and debating in formal sessions and over elaborate meals. Although not always reached, consensus was the ideal.
Historians and anthropologists have hypothesized that this extreme insistence on shared power was a reaction to the fall of earlier, hierarchical Mississippian chiefdoms, which had ruled much of North America from about 700 to 1600 A.D. Mississippian chiefs could be brutal. Weapons and art depicting violence are abundant at Mississippian archaeological sites. Some chiefs were buried with not only piles of luxury goods but also people, killed to accompany their leader in death.
Later American Indians may have inherited a distrust of centralized authority from their oppressed ancestors. Did Indians build democracies? No. Did they provide liberty and justice for their people? Often, yes. Indians built consensus-style government over time, in response to the hard lessons of history.
Indians were the most populous but not the only rivals to British-American occupation of North America in the 1770s. King Charles III of Spain saw the American Revolution as an ideal opportunity to extend his empire north. Although most people forget Spanish involvement in the war, Spain won battles against the British at Baton Rouge, La., Mobile, Ala., and Pensacola, Fla. At the end of the Revolution, European maps showed Spain in possession of most of what is today the continental United States: the entire Gulf Coast and everything west of the Mississippi River.
Immigrants from the new United States were offered free land in the west if they swore an oath to the king and converted to Catholicism. Knowing what we know now about imminent United States dominance, this might look like a bad deal. But thousands of Americans took the king up on his offer as land became scarce in the east. Royalist, imperial, theocratic, bureaucratic Spanish governance was not out of the question.
Surprisingly, the Spanish empire provided some freedoms that the United States would later take away when it expanded westward. Women in the Spanish Empire were not subject to coverture, the legal doctrine under which their legal identities were subsumed under men’s, first by their fathers and then by their husbands. In the post-Revolutionary United States, married women could not own property, participate in local politics, serve on juries, write wills, sign contracts or exercise custody rights over their children. Under the Spanish system, in contrast, women kept their names, property and legal identities. They were not equal to men of their rank, certainly, but they had legal rights unavailable in Anglo-American society.
Slaves in the Spanish colonies of Louisiana and the Floridas also had some rights and opportunities that they would lose under the United States. Slaves who felt mistreated by a master (beyond the “normal” allowed violence) had the right to appeal to the local military commander — and they sometimes won. Slaves could gain freedom through wartime service; thus hundreds served as soldiers, messengers, spies and laborers for the war effort. After the American Revolution, appeals became easier to win, and more than 1,000 slaves in Spanish territory freed themselves either by buying themselves or being paid for by a family member or friend. The life of a slave in Spanish Louisiana and Florida was not easy, but it was far less dehumanizing than the plantation system of the American South.
America’s founders did not want to become Indians or Spaniards. Many of them admired Indian freedoms but believed the natives had no real government. Not knowing of the Mississippian past, Thomas Jefferson wrote in his “Notes on the State of Virginia” that Indians had “never submitted themselves to any laws, any coercive power, any shadow of government.” While he judged that “too much law, as among the civilized Europeans” was worse than “no law, as among the savage Americans,” he believed representative government was best of all.
And the founders believed the Spanish were even more despotic than the hated British. Jefferson believed that the monarchy and priesthood left Spanish subjects “immersed in the darkest ignorance, and brutalized by bigotry and superstition.” He ignored the many black slaves and impoverished white settlers who voted with their feet, moving to Spanish territory for freedom and land.
Councils of elders and monarchies are not better than democracies, and usually are worse. But North American history makes clear that the details of a political system often make more difference in people’s lives than the form does. Our past should give us pride but also humility and caution as we proceed in the world.
An editorial on requiring doctors to study geriactrics before they do their internships
The Patients Doctors Don’t Know
By ROSANNE M. LEIPZIG
AS they do every July, hospitals across America are welcoming new interns, fresh from medical school graduation. Given how much these trainees have yet to learn, common wisdom holds that it’s not a good time of year to get sick. This may be particularly true for older patients, because American medical schools require no training in geriatric medicine.
Often even experienced doctors are unaware that 80-year-olds are not the same as 50-year-olds. Pneumonia in a 50-year-old causes fever, cough and difficulty breathing; an 80-year-old with the same illness may have none of these symptoms, but just seem “not herself” — confused and unsteady, unable to get out of bed.
She may end up in a hospital, where a doctor prescribes a dose of antibiotic that would be right for a woman in her 50s, but is twice as much as an 80-year-old patient should get, and so she develops kidney failure, and grows weaker and more confused. In her confusion, she pulls the tube from her arm and the catheter from her bladder.
Instead of re-evaluating whether the tubes are needed, her doctor then asks the nurses to tie her arms to the bed so she won’t hurt herself. This only increases her agitation and keeps her bed-bound, causing her to lose muscle and bone mass. Eventually, she recovers from the pneumonia and her mind is clearer, so she’s considered ready for discharge — but she is no longer the woman she was before her illness. She’s more frail, and needs help with walking, bathing and daily chores.
This shouldn’t happen. All medical students are required to have clinical experiences in pediatrics and obstetrics, even though after they graduate most will never treat a child or deliver a baby. Yet there is no requirement for any clinical training in geriatrics, even though patients 65 and older account for 32 percent of the average doctor’s workload in surgical care and 43 percent in medical specialty care, and they make up 48 percent of all inpatient hospital days. Medicare, the national health insurance for people 65 and older, contributes more than $8 billion a year to support residency training, yet it does not require that part of that training focus on the unique health care needs of older adults.
Medicare beneficiaries receive care from doctors who may not have been taught that heart attacks in octogenarians usually present without chest pain, or that confusion can be due to bladder infections, heart attacks or Benadryl. They do not routinely check for memory problems, or know which community resources can help these patients manage their conditions. They’re uncomfortable discussing goals of care, and recommend screening tests and treatments to patients who are not going to live long enough to reap the benefits.
I was part of a group of doctors and medical educators who recently published in the journal Academic Medicine a set of minimum abilities that every medical student should demonstrate before graduating and caring for elderly patients. Nicknamed the “don’t kill Granny” list, it includes being able to prescribe medicines, assess patients’ ability to care for themselves, recognize atypical presentations of common diseases, prevent falls, recognize the hazards of hospitalization and decide on treatments based on elderly patients’ prognosis and their personal preferences.
The 2008 Institute of Medicine report “Retooling for an Aging America” resolved that all licensed health care professionals should be required to demonstrate such competence in the care of older adults. But this resolution lacks teeth. Medical resident training programs that receive Medicare money should be required to demonstrate that their trainees are competent in geriatric care. Medicare should finance medical training in nursing homes. And state licensing and medical specialty boards should require demonstration of geriatric competence for licensing and certification.
Basic geriatric knowledge is preventive medicine. Nurses, social workers, pharmacists and other health care professionals should have it, too, in order to improve care for older people. But until doctors get this basic training, we can’t even begin to give 80-year-olds the care they need.
An article on how some states are cutting summer school due to budget cuts
Facing Deficits, Some States Cut Summer School
By SAM DILLON
COCOA, Fla. — A year ago, the Brevard County Schools ran a robust summer program here, with dozens of schools bustling with teachers and some 14,000 children practicing multiplication, reading Harry Potter and studying Spanish verbs, all at no cost to parents.
But this year Florida’s budget crisis has gutted summer school. Brevard classrooms are shuttered, and students like 11-year-old Uvenka Jean-Baptiste, whose mother works in a nursing home, are spending their summer days at home, surfing television channels or loitering at a mall.
Nearly every school system in Florida has eviscerated or eliminated summer school this year, and officials are reporting sweeping cuts in states from North Carolina and Delaware to California and Washington. The cuts have come as states across the country are struggling to approve budgets, and California’s governor, Arnold Schwarzenegger, declared a fiscal state of emergency on Wednesday.
“We’re seeing a disturbing trend of districts making huge cuts to summer school; they’re just devastating these programs,” said Ron Fairchild, executive director of the National Center for Summer Learning at Johns Hopkins University. “It’s having a disproportionate impact on low-income families.”
The federal stimulus law is channeling $100 billion to public education, and Education Secretary Arne Duncan has repeatedly urged states and districts to spend part of the money to keep schools open this summer.
But thousands of districts have ignored Mr. Duncan’s urgings. In Florida and California, for example, government revenues have fallen so precipitously that, even after receiving federal stimulus dollars, local officials have been forced to make deep cuts to school budgets. Officials in many other states, considering summer school a frill, despite research showing it can narrow the achievement gap between poor and affluent children, have spent their stimulus money elsewhere.
An Education Department spokeswoman, Sandra Abrevaya, said the agency did not yet know how many of the nation’s 15,000 school districts had cut summer school this year.
Large districts still offering robust summer programs include Boston, Buffalo, Chicago, Detroit, Minneapolis and Seattle, according to the Council of the Great City Schools, which represents large districts.
New York City has made modest cuts to its summer program, which last year served 120,000 children, said William Havemann, a spokesman for the city’s Department of Education. This year, classes will be offered in 369 schools, down from 562 in 2008, Mr. Havemann said, and the city expects fewer children to enroll, too, although all children who need extra work for promotion to their next grade are eligible.
Some systems have spent federal stimulus money to invigorate summer school. These include Montgomery County, Md., and Cincinnati, where officials have used $1.5 million of the city’s stimulus dollars to offer full-day summer school at its 13 lowest-performing elementary schools, nearly doubling enrollment to 1,700 students.
Mornings are devoted to math and reading, and afternoons to camp-like activities including environmental science and gardening, ballroom dancing and yoga, said Janet Walsh, a Cincinnati schools spokeswoman. Twelve other Cincinnati schools are offering half-day summer programs, Ms. Walsh said.
But thousands of districts have made cuts. In Los Angeles, where school officials are still working to remove hundreds of millions of dollars from a $5.5 billion annual budget, they cut $34 million last month by canceling summer school for all elementary and middle school children except the disabled. That left 150,000 students without summer classes, and parents scrambling for child care.
Hundreds of other California districts, including San Diego, Long Beach and Sacramento, have also trimmed or eliminated summer school. An online survey in late April by the California State PTA found that about 40 percent of responding school districts had reduced summer programs and about 20 percent had eliminated them entirely.
The North Carolina School Boards Association did a similar survey of the state’s 115 districts. Three-quarters of those that responded said they would eliminate summer school or reduce its scope, said Leanne Winner, a director at the association. “Things have gotten worse since we did the survey,” Ms. Winner said.
Wayne Blanton, executive director of the Florida School Boards Association, said, “Nearly all districts in Florida have cut summer school down, and about half have eliminated it altogether.”
In Rutherford County, Tenn., school authorities cited not only money troubles but also swine flu in explaining why they cut elementary summer school after the district lost some state financing.
All the cuts nationwide have put into jeopardy an institution that has turned summertimes past into nostalgic memories for millions of Americans.
“I remember as a child growing up, summer school was enriching and fun,” said Tamara Sortman of Sacramento, where cuts have left her three children with no summer school option. “I took guitar one summer, creative writing another. I remember an arts class where we did tie-dying. I had a single working mom, and summer school kept me out of trouble.”
Kenneth Gold, an education professor at the College of Staten Island who wrote a history of summer learning, said that in the 19th century, many American schools offered their regular classes in summer and winter, with recesses scheduled for spring and fall to allow planting and harvesting. By 1910, however, that cycle had been largely displaced by the September-to-June, 180-day calendar common today, in which summer school is an optional addendum.
Since the 1970s, however, the value of rigorous summer school has gained increasing recognition because of research by a Johns Hopkins professor, Karl Alexander, and other sociologists showing that the academic achievement gap widens during summer vacations.
Low-income students who hold summer jobs or are idle, the research has demonstrated, forget more math and reading skills over the summer than their affluent classmates, who often receive intellectual stimulation in the summer from canoe trips, language camps or ballet lessons.
Richard DiPatri, schools superintendent here in Brevard County, leaned on those findings in recent years as he made free summer school classes available to all students, both for remedial work and for languages and other electives.
“We built it up, but last year here in Florida, our funding just went over the cliff,” Mr. DiPatri said.
Adrimel Marlasca, 12, who just finished sixth grade, said that in previous years, she had enjoyed summer classes at Discovery Elementary in Palm Bay, Fla.. But this summer, she is marooned at home.
The other day, Adrimel was up at midmorning, ate some cereal, then watched a show on the Disney channel. She played with her pet cockatiel and her dog, Princess, ate lunch and watched some more television. Later, she went shopping with her mother, picked up her room and read a mystery book for 45 minutes.
After dinner, her mother used flashcards to drill her in multiplication for a few minutes.
“I like the math because it’s challenging, but sometimes it’s like, ‘Oh my gosh, I can’t answer this,’ and you get nerve-racked,” Adrimel said.
“We’re working with her at home, but its not the same,” said her father, Jose Marlasca. “She ends up watching TV. The best scenario would be to have her at school.”
Stop! Police! Very, Very New Police!
By AL BAKER
He has yet to deliver a baby or rescue a cat while on duty.
But on Thursday, just 15 minutes or so after walking out of his Police Academy graduation ceremony at Madison Square Garden, Officer Dariel Firpo had already made an arrest of a robbery suspect.
The arrest occurred about 1:15 p.m. as Officer Firpo and 249 fellow graduates were heading home.
He was going to the subway with friends and family, when he heard a commotion across the street. Officer Firpo, who had his gun and handcuffs with him, saw civilians trying to restrain a man.
Witnesses said that the man had grabbed a wallet from a 79-year-old man in a Wendy’s restaurant, pushing him to the ground and injuring his wrist. Officer Firpo jumped into action, and signaled to a nearby police officer directing traffic.
The two officers arrested the man, whom the police later identified as Jeffrey Grant, 47, of 400 East 30th Street in Manhattan.
Mr. Grant, who has 48 previous arrests, was charged with robbery, the police said.
The victim was taken to St. Luke’s Hospital, where he was treated for a broken right wrist.
As for Officer Firpo, 23, who has been a cadet for the past three years, he has already caught the attention of his boss.
“Officer Firpo made us all proud,” said Police Commissioner Raymond W. Kelly. “He’s off to a great start.”
Will he choose a path toward a detective’s gold shield? Maybe a job in Brooklyn North Homicide? Pursue work in the counterterrorism bureau? Or do specialized policing in the Bomb Squad?
None of the above. “I’m really trying to stick in the community,” said Officer Firpo, who graduated from Lehman College in January with a degree in political science. So his chosen path? “Community affairs.”
Later, Paul J. Browne, the police spokesman, who was at the graduation ceremony, reflected on the day. The class of 250 new officers was smaller than those in the recent past. But the officer’s actions lent a historic air to the day.
“It may be the fastest police action upon graduation in department history,” Mr. Browne said. “Certainly in memory.”
An editorial on how democracy wasn't the only option in 1776. Interesting.
Life, Liberty and Benign Monarchy?
By KATHLEEN DuVAL
Chapel Hill, N.C.
FROM the perspective of 2009, democracy in the United States is a great success. This makes it is easy to imagine that the march to democracy was the only path — that there is a clear line from the Declaration of Independence to the presidency of Barack Obama, and that democracy is the only fair society. But republican government was a risky choice at the time of the Revolution, and democracy was almost out of the question. There were more proven alternatives for running a society fairly. A look at two other contenders for control of the continent in 1776 — American Indians and Spaniards — reveals that democracy’s supremacy in promoting human rights was far from inevitable.
There were Indians fighting on both sides of the Revolution and others who tried to stay neutral. But whatever their choice, Indians did not fight for an American republic or a British constitutional monarchy but for their own goals, especially sovereignty. While American Indians were politically diverse, by the Revolution their most common governance structure consisted of multiple chiefs with limited power, advised by councils of elders. Chiefs led by persuasion rather than force. As a Mohawk man of the day explained, “We have no forcing rules or laws amongst us.”
For the British, a signed document was what sealed a treaty; but for the Indians they dealt with, a treaty had no validity without public acclaim. At a treaty negotiation, hundreds of people would gather for weeks, discussing and debating in formal sessions and over elaborate meals. Although not always reached, consensus was the ideal.
Historians and anthropologists have hypothesized that this extreme insistence on shared power was a reaction to the fall of earlier, hierarchical Mississippian chiefdoms, which had ruled much of North America from about 700 to 1600 A.D. Mississippian chiefs could be brutal. Weapons and art depicting violence are abundant at Mississippian archaeological sites. Some chiefs were buried with not only piles of luxury goods but also people, killed to accompany their leader in death.
Later American Indians may have inherited a distrust of centralized authority from their oppressed ancestors. Did Indians build democracies? No. Did they provide liberty and justice for their people? Often, yes. Indians built consensus-style government over time, in response to the hard lessons of history.
Indians were the most populous but not the only rivals to British-American occupation of North America in the 1770s. King Charles III of Spain saw the American Revolution as an ideal opportunity to extend his empire north. Although most people forget Spanish involvement in the war, Spain won battles against the British at Baton Rouge, La., Mobile, Ala., and Pensacola, Fla. At the end of the Revolution, European maps showed Spain in possession of most of what is today the continental United States: the entire Gulf Coast and everything west of the Mississippi River.
Immigrants from the new United States were offered free land in the west if they swore an oath to the king and converted to Catholicism. Knowing what we know now about imminent United States dominance, this might look like a bad deal. But thousands of Americans took the king up on his offer as land became scarce in the east. Royalist, imperial, theocratic, bureaucratic Spanish governance was not out of the question.
Surprisingly, the Spanish empire provided some freedoms that the United States would later take away when it expanded westward. Women in the Spanish Empire were not subject to coverture, the legal doctrine under which their legal identities were subsumed under men’s, first by their fathers and then by their husbands. In the post-Revolutionary United States, married women could not own property, participate in local politics, serve on juries, write wills, sign contracts or exercise custody rights over their children. Under the Spanish system, in contrast, women kept their names, property and legal identities. They were not equal to men of their rank, certainly, but they had legal rights unavailable in Anglo-American society.
Slaves in the Spanish colonies of Louisiana and the Floridas also had some rights and opportunities that they would lose under the United States. Slaves who felt mistreated by a master (beyond the “normal” allowed violence) had the right to appeal to the local military commander — and they sometimes won. Slaves could gain freedom through wartime service; thus hundreds served as soldiers, messengers, spies and laborers for the war effort. After the American Revolution, appeals became easier to win, and more than 1,000 slaves in Spanish territory freed themselves either by buying themselves or being paid for by a family member or friend. The life of a slave in Spanish Louisiana and Florida was not easy, but it was far less dehumanizing than the plantation system of the American South.
America’s founders did not want to become Indians or Spaniards. Many of them admired Indian freedoms but believed the natives had no real government. Not knowing of the Mississippian past, Thomas Jefferson wrote in his “Notes on the State of Virginia” that Indians had “never submitted themselves to any laws, any coercive power, any shadow of government.” While he judged that “too much law, as among the civilized Europeans” was worse than “no law, as among the savage Americans,” he believed representative government was best of all.
And the founders believed the Spanish were even more despotic than the hated British. Jefferson believed that the monarchy and priesthood left Spanish subjects “immersed in the darkest ignorance, and brutalized by bigotry and superstition.” He ignored the many black slaves and impoverished white settlers who voted with their feet, moving to Spanish territory for freedom and land.
Councils of elders and monarchies are not better than democracies, and usually are worse. But North American history makes clear that the details of a political system often make more difference in people’s lives than the form does. Our past should give us pride but also humility and caution as we proceed in the world.
An editorial on requiring doctors to study geriactrics before they do their internships
The Patients Doctors Don’t Know
By ROSANNE M. LEIPZIG
AS they do every July, hospitals across America are welcoming new interns, fresh from medical school graduation. Given how much these trainees have yet to learn, common wisdom holds that it’s not a good time of year to get sick. This may be particularly true for older patients, because American medical schools require no training in geriatric medicine.
Often even experienced doctors are unaware that 80-year-olds are not the same as 50-year-olds. Pneumonia in a 50-year-old causes fever, cough and difficulty breathing; an 80-year-old with the same illness may have none of these symptoms, but just seem “not herself” — confused and unsteady, unable to get out of bed.
She may end up in a hospital, where a doctor prescribes a dose of antibiotic that would be right for a woman in her 50s, but is twice as much as an 80-year-old patient should get, and so she develops kidney failure, and grows weaker and more confused. In her confusion, she pulls the tube from her arm and the catheter from her bladder.
Instead of re-evaluating whether the tubes are needed, her doctor then asks the nurses to tie her arms to the bed so she won’t hurt herself. This only increases her agitation and keeps her bed-bound, causing her to lose muscle and bone mass. Eventually, she recovers from the pneumonia and her mind is clearer, so she’s considered ready for discharge — but she is no longer the woman she was before her illness. She’s more frail, and needs help with walking, bathing and daily chores.
This shouldn’t happen. All medical students are required to have clinical experiences in pediatrics and obstetrics, even though after they graduate most will never treat a child or deliver a baby. Yet there is no requirement for any clinical training in geriatrics, even though patients 65 and older account for 32 percent of the average doctor’s workload in surgical care and 43 percent in medical specialty care, and they make up 48 percent of all inpatient hospital days. Medicare, the national health insurance for people 65 and older, contributes more than $8 billion a year to support residency training, yet it does not require that part of that training focus on the unique health care needs of older adults.
Medicare beneficiaries receive care from doctors who may not have been taught that heart attacks in octogenarians usually present without chest pain, or that confusion can be due to bladder infections, heart attacks or Benadryl. They do not routinely check for memory problems, or know which community resources can help these patients manage their conditions. They’re uncomfortable discussing goals of care, and recommend screening tests and treatments to patients who are not going to live long enough to reap the benefits.
I was part of a group of doctors and medical educators who recently published in the journal Academic Medicine a set of minimum abilities that every medical student should demonstrate before graduating and caring for elderly patients. Nicknamed the “don’t kill Granny” list, it includes being able to prescribe medicines, assess patients’ ability to care for themselves, recognize atypical presentations of common diseases, prevent falls, recognize the hazards of hospitalization and decide on treatments based on elderly patients’ prognosis and their personal preferences.
The 2008 Institute of Medicine report “Retooling for an Aging America” resolved that all licensed health care professionals should be required to demonstrate such competence in the care of older adults. But this resolution lacks teeth. Medical resident training programs that receive Medicare money should be required to demonstrate that their trainees are competent in geriatric care. Medicare should finance medical training in nursing homes. And state licensing and medical specialty boards should require demonstration of geriatric competence for licensing and certification.
Basic geriatric knowledge is preventive medicine. Nurses, social workers, pharmacists and other health care professionals should have it, too, in order to improve care for older people. But until doctors get this basic training, we can’t even begin to give 80-year-olds the care they need.
An article on how some states are cutting summer school due to budget cuts
Facing Deficits, Some States Cut Summer School
By SAM DILLON
COCOA, Fla. — A year ago, the Brevard County Schools ran a robust summer program here, with dozens of schools bustling with teachers and some 14,000 children practicing multiplication, reading Harry Potter and studying Spanish verbs, all at no cost to parents.
But this year Florida’s budget crisis has gutted summer school. Brevard classrooms are shuttered, and students like 11-year-old Uvenka Jean-Baptiste, whose mother works in a nursing home, are spending their summer days at home, surfing television channels or loitering at a mall.
Nearly every school system in Florida has eviscerated or eliminated summer school this year, and officials are reporting sweeping cuts in states from North Carolina and Delaware to California and Washington. The cuts have come as states across the country are struggling to approve budgets, and California’s governor, Arnold Schwarzenegger, declared a fiscal state of emergency on Wednesday.
“We’re seeing a disturbing trend of districts making huge cuts to summer school; they’re just devastating these programs,” said Ron Fairchild, executive director of the National Center for Summer Learning at Johns Hopkins University. “It’s having a disproportionate impact on low-income families.”
The federal stimulus law is channeling $100 billion to public education, and Education Secretary Arne Duncan has repeatedly urged states and districts to spend part of the money to keep schools open this summer.
But thousands of districts have ignored Mr. Duncan’s urgings. In Florida and California, for example, government revenues have fallen so precipitously that, even after receiving federal stimulus dollars, local officials have been forced to make deep cuts to school budgets. Officials in many other states, considering summer school a frill, despite research showing it can narrow the achievement gap between poor and affluent children, have spent their stimulus money elsewhere.
An Education Department spokeswoman, Sandra Abrevaya, said the agency did not yet know how many of the nation’s 15,000 school districts had cut summer school this year.
Large districts still offering robust summer programs include Boston, Buffalo, Chicago, Detroit, Minneapolis and Seattle, according to the Council of the Great City Schools, which represents large districts.
New York City has made modest cuts to its summer program, which last year served 120,000 children, said William Havemann, a spokesman for the city’s Department of Education. This year, classes will be offered in 369 schools, down from 562 in 2008, Mr. Havemann said, and the city expects fewer children to enroll, too, although all children who need extra work for promotion to their next grade are eligible.
Some systems have spent federal stimulus money to invigorate summer school. These include Montgomery County, Md., and Cincinnati, where officials have used $1.5 million of the city’s stimulus dollars to offer full-day summer school at its 13 lowest-performing elementary schools, nearly doubling enrollment to 1,700 students.
Mornings are devoted to math and reading, and afternoons to camp-like activities including environmental science and gardening, ballroom dancing and yoga, said Janet Walsh, a Cincinnati schools spokeswoman. Twelve other Cincinnati schools are offering half-day summer programs, Ms. Walsh said.
But thousands of districts have made cuts. In Los Angeles, where school officials are still working to remove hundreds of millions of dollars from a $5.5 billion annual budget, they cut $34 million last month by canceling summer school for all elementary and middle school children except the disabled. That left 150,000 students without summer classes, and parents scrambling for child care.
Hundreds of other California districts, including San Diego, Long Beach and Sacramento, have also trimmed or eliminated summer school. An online survey in late April by the California State PTA found that about 40 percent of responding school districts had reduced summer programs and about 20 percent had eliminated them entirely.
The North Carolina School Boards Association did a similar survey of the state’s 115 districts. Three-quarters of those that responded said they would eliminate summer school or reduce its scope, said Leanne Winner, a director at the association. “Things have gotten worse since we did the survey,” Ms. Winner said.
Wayne Blanton, executive director of the Florida School Boards Association, said, “Nearly all districts in Florida have cut summer school down, and about half have eliminated it altogether.”
In Rutherford County, Tenn., school authorities cited not only money troubles but also swine flu in explaining why they cut elementary summer school after the district lost some state financing.
All the cuts nationwide have put into jeopardy an institution that has turned summertimes past into nostalgic memories for millions of Americans.
“I remember as a child growing up, summer school was enriching and fun,” said Tamara Sortman of Sacramento, where cuts have left her three children with no summer school option. “I took guitar one summer, creative writing another. I remember an arts class where we did tie-dying. I had a single working mom, and summer school kept me out of trouble.”
Kenneth Gold, an education professor at the College of Staten Island who wrote a history of summer learning, said that in the 19th century, many American schools offered their regular classes in summer and winter, with recesses scheduled for spring and fall to allow planting and harvesting. By 1910, however, that cycle had been largely displaced by the September-to-June, 180-day calendar common today, in which summer school is an optional addendum.
Since the 1970s, however, the value of rigorous summer school has gained increasing recognition because of research by a Johns Hopkins professor, Karl Alexander, and other sociologists showing that the academic achievement gap widens during summer vacations.
Low-income students who hold summer jobs or are idle, the research has demonstrated, forget more math and reading skills over the summer than their affluent classmates, who often receive intellectual stimulation in the summer from canoe trips, language camps or ballet lessons.
Richard DiPatri, schools superintendent here in Brevard County, leaned on those findings in recent years as he made free summer school classes available to all students, both for remedial work and for languages and other electives.
“We built it up, but last year here in Florida, our funding just went over the cliff,” Mr. DiPatri said.
Adrimel Marlasca, 12, who just finished sixth grade, said that in previous years, she had enjoyed summer classes at Discovery Elementary in Palm Bay, Fla.. But this summer, she is marooned at home.
The other day, Adrimel was up at midmorning, ate some cereal, then watched a show on the Disney channel. She played with her pet cockatiel and her dog, Princess, ate lunch and watched some more television. Later, she went shopping with her mother, picked up her room and read a mystery book for 45 minutes.
After dinner, her mother used flashcards to drill her in multiplication for a few minutes.
“I like the math because it’s challenging, but sometimes it’s like, ‘Oh my gosh, I can’t answer this,’ and you get nerve-racked,” Adrimel said.
“We’re working with her at home, but its not the same,” said her father, Jose Marlasca. “She ends up watching TV. The best scenario would be to have her at school.”
