Past interventions suggest that residents' quality of life may improve with work hour limitations, but interpretation of the outcomes of these studies is hampered by suboptimal study design and the use of nonvalidated instruments. The long-term impact of reducing resident work hours on education remains unknown. Current and future interventions should be evaluated with more rigorous methods and should investigate links between residents' quality of life and quality of patient care.

Evidence on patient safety is insufficient to inform the process of reducing resident work hours.

No abstract

The objective of this 'umbrella' review is to synthesize the evidence and provide clinicians a single report which summarizes the state of knowledge regarding the use of corticosteroids in adults with acute asthma. Systematic reviews in the Cochrane Library and additional clinical trials published in English from 1966 to 2007 in MEDLINE, EMBASE, CINAHL, and Cochrane CENTRAL and references from bibliographies of pertinent articles were reviewed. Results indicate that the evidence base is frequently limited to small, single-center studies. Findings suggest that therapy with systemic corticosteroids accelerates resolution of acute asthma and reduces the risk of relapse. There is no evidence that corticosteroid doses higher than standard doses (prednisone 50-100 mg equivalent) are beneficial. Oral and intravenous corticosteroids, as well as intramuscular and oral corticosteroid regimens appear to be similarly effective. A non-tapered 5-10 day course of corticosteroid therapy appears to be sufficient for most discharged patients. Combinations of oral and inhaled corticosteroids on emergency department/hospital discharge may minimize the risk of relapse.