The science of neurosurgical practice

Public release date: 1-Jan-2013
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Contact: Jo Ann M Eliason
jaeliason@thejns.org
434-982-1209
Journal of Neurosurgery Publishing Group

Charlottesville, VA (January 1, 2013). The January 2013 issue of Neurosurgical Focus is dedicated to the science of neurosurgical practice and is edited by Drs. Anthony L. Asher (Carolina Neurosurgery and Spine Associates & Carolinas Medical Center, Charlotte, NC), Paul C. McCormick (Columbia University College of Physicians and Surgeons, New York, NY), and Douglas Kondziolka (New York University, New York, NY). In this issue, eight papers tackle a new era in neurosurgical practice, in which there is a shift in health-care priorities (and what drives patterns of medical practice) from medical discoveries and technological innovations to relationships between patient safety and outcomes, quality of care, and the economic implications of keeping people healthy. In their Introduction, the editors speak of a parallel shift from an era in which medical knowledge was generated by a small percentage of researcher-physicians to a time in which most physicians will actively participate in the collection of new facts, their interpretation, and the generation of new knowledge. This activity will be made possible by physicians' ability to deposit, access, and compare clinical data in huge long-term prospective databases of medical disorders and treatments.

In the field of neurosurgery, several professional societies have joined together to advance the quality of patient care and to serve the research needs of neurosurgeons and other health-care stakeholders. To this end a national practice data collection, analysis, and reporting platform, the National Neurosurgery Quality and Outcomes Database (N²QOD), has been initiated. This issue of Neurosurgical Focus contains articles describing N²QOD as well as the overall new trend in professional neurosurgerywhat the editors term the "science of neurosurgical practice"from its beginnings to its projected future.

Specific topics in the January issue of Neurosurgical Focus include the following:

Health care reform, as exemplified in the Patient Protection and Affordable Care Act, according to Rachel Groman and Koryn Rubin, "aims to change the US health care system from one that rewards quantity to one that rewards better value through the use of performance measurement." The authors discuss current barriers to this shift toward better care as well as initiatives created by both the federal government and physician societies in ensuring accountability and delivery of high-quality care to patients.

Drs. Peter Angevine and Paul McCormick discuss the science and methods used to measure clinical practice. They also speak of the benefits accrued from physicians' ease of access to the extensive outcomes research contained in clinical registries.

In 1987 the Gamma Knife first became available in North America, at the University of Pittsburgh, ushering in the practice of radiosurgery. Since that time Pitt has documented the techniques of this procedure and outcomes in patients who have undergone Gamma Knife surgery at that institution. Dr. Oren Berkowitz and colleagues review how the Pitt clinical registry evolved and how it has facilitated publication of numerous works on the Pitt experience, advancing knowledge of the techniques and outcomes of radiosurgery.

Dr. Matthew McGirt and colleagues describe an overview of their experience at the Vanderbilt Spine Center (Vanderbilt University Medical Center). Here outcomes data have been collected during routine spine care and recorded in a prospective fashion in a longitudinal registry. These data are used for learning and quality improvement; documentation of safety and effectiveness of care; and research into the comparative effectiveness of different procedures.

In March 2012, the National Neurosurgery Quality and Outcomes Database (N²QOD), sponsored by the American Association of Neurological Surgeons in cooperation with the Congress of Neurological Surgeons, Society of Neurological Surgeons, and American Board of Neurological Surgery, began enrolling patients in its pilot project, an Internet-based database of cases of lumbar spine disorders. When fully functional, the N²QOD will expand its coverage to all facets of neurosurgery and serve as a longitudinal outcomes registry that will provide neurosurgeons with "a quality measurement and feedback system that utilizes meaningful patient-centered data. . . . Providers will have the opportunity to learn which diseases, which patient groups, and which treatments are most effectively treated with surgery and identify areas for improving the quality of neurosurgical and spine care." Articles in this issue by Drs. Anthony Asher, Paul McCormick, and Matthew McGirt with their colleagues describe the development and overall purpose of the N²QOD, the pilot project, and regulatory considerations for prospective registries such as the N²QOD.

Dr. Nathan Selden and coworkers discuss the future of neurosurgical practicebased science as it relates to neurosurgical training and practice as well as to improvements in patient care delivery and compliance with regulatory mandates.

According to Dr. Asher, "Our specialty is now engaged in an unprecedented cooperative effort that aims to create a new integrative culture of neurosurgical practice for the purpose of improving care. Tremendous scientific and economic potential resides untapped within our routine clinical activities. The methods to realize that potential now exist. The promise of those methods can only be realized through concerted effort and organized action."

Asher adds: "If neurosurgeons choose to embrace practice science as an essential feature of modern neurosurgical practice, we will help meet the challenges of creating a sustainable healthcare system, and we will also define the relevance of neurosurgery within the broader realm of medicine and society."

###

All papers are published online January 1, 2013 online in Neurosurgical Focus, Volume 34, Number 1 (http://thejns.org/toc/foc/34/1). Papers in Neurosurgical Focus are free to the public.

Disclosure: Funding information and potential conflicts of interest are listed at the end of each article.

For additional information, please contact:

Jo Ann M. Eliason, Communications Manager
Journal of Neurosurgery Publishing Group
One Morton Drive, Suite 200
Charlottesville, VA 22903
Email: jaeliason@thejns.org
Telephone 434-982-1209
Fax 434-924-2702

Neurosurgical Focus, an online-only, monthly, peer-reviewed journal, covers a different neurosurgery-related topic in depth each month and is available free to all readers at http://www.thejns.org. Enhanced by color images and video clips, each issue constitutes a state-of-the-art "textbook chapter" in the field of neurosurgery. Neurosurgical Focus is one of four monthly journals published by the JNS Publishing Group, the scholarly journal division of the American Association of Neurological Surgeons (http://www.aans.org), an association dedicated to advancing the specialty of neurological surgery in order to promote the highest quality of patient care.

---

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AAAS and EurekAlert! are not responsible for the accuracy of news releases posted to EurekAlert! by contributing institutions or for the use of any information through the EurekAlert! system.

Public release date: 1-Jan-2013
[ | E-mail | Share ]

Contact: Jo Ann M Eliason
jaeliason@thejns.org
434-982-1209
Journal of Neurosurgery Publishing Group

Charlottesville, VA (January 1, 2013). The January 2013 issue of Neurosurgical Focus is dedicated to the science of neurosurgical practice and is edited by Drs. Anthony L. Asher (Carolina Neurosurgery and Spine Associates & Carolinas Medical Center, Charlotte, NC), Paul C. McCormick (Columbia University College of Physicians and Surgeons, New York, NY), and Douglas Kondziolka (New York University, New York, NY). In this issue, eight papers tackle a new era in neurosurgical practice, in which there is a shift in health-care priorities (and what drives patterns of medical practice) from medical discoveries and technological innovations to relationships between patient safety and outcomes, quality of care, and the economic implications of keeping people healthy. In their Introduction, the editors speak of a parallel shift from an era in which medical knowledge was generated by a small percentage of researcher-physicians to a time in which most physicians will actively participate in the collection of new facts, their interpretation, and the generation of new knowledge. This activity will be made possible by physicians' ability to deposit, access, and compare clinical data in huge long-term prospective databases of medical disorders and treatments.

In the field of neurosurgery, several professional societies have joined together to advance the quality of patient care and to serve the research needs of neurosurgeons and other health-care stakeholders. To this end a national practice data collection, analysis, and reporting platform, the National Neurosurgery Quality and Outcomes Database (N²QOD), has been initiated. This issue of Neurosurgical Focus contains articles describing N²QOD as well as the overall new trend in professional neurosurgerywhat the editors term the "science of neurosurgical practice"from its beginnings to its projected future.

Specific topics in the January issue of Neurosurgical Focus include the following:

Health care reform, as exemplified in the Patient Protection and Affordable Care Act, according to Rachel Groman and Koryn Rubin, "aims to change the US health care system from one that rewards quantity to one that rewards better value through the use of performance measurement." The authors discuss current barriers to this shift toward better care as well as initiatives created by both the federal government and physician societies in ensuring accountability and delivery of high-quality care to patients.

Drs. Peter Angevine and Paul McCormick discuss the science and methods used to measure clinical practice. They also speak of the benefits accrued from physicians' ease of access to the extensive outcomes research contained in clinical registries.

In 1987 the Gamma Knife first became available in North America, at the University of Pittsburgh, ushering in the practice of radiosurgery. Since that time Pitt has documented the techniques of this procedure and outcomes in patients who have undergone Gamma Knife surgery at that institution. Dr. Oren Berkowitz and colleagues review how the Pitt clinical registry evolved and how it has facilitated publication of numerous works on the Pitt experience, advancing knowledge of the techniques and outcomes of radiosurgery.

Dr. Matthew McGirt and colleagues describe an overview of their experience at the Vanderbilt Spine Center (Vanderbilt University Medical Center). Here outcomes data have been collected during routine spine care and recorded in a prospective fashion in a longitudinal registry. These data are used for learning and quality improvement; documentation of safety and effectiveness of care; and research into the comparative effectiveness of different procedures.

In March 2012, the National Neurosurgery Quality and Outcomes Database (N²QOD), sponsored by the American Association of Neurological Surgeons in cooperation with the Congress of Neurological Surgeons, Society of Neurological Surgeons, and American Board of Neurological Surgery, began enrolling patients in its pilot project, an Internet-based database of cases of lumbar spine disorders. When fully functional, the N²QOD will expand its coverage to all facets of neurosurgery and serve as a longitudinal outcomes registry that will provide neurosurgeons with "a quality measurement and feedback system that utilizes meaningful patient-centered data. . . . Providers will have the opportunity to learn which diseases, which patient groups, and which treatments are most effectively treated with surgery and identify areas for improving the quality of neurosurgical and spine care." Articles in this issue by Drs. Anthony Asher, Paul McCormick, and Matthew McGirt with their colleagues describe the development and overall purpose of the N²QOD, the pilot project, and regulatory considerations for prospective registries such as the N²QOD.

Dr. Nathan Selden and coworkers discuss the future of neurosurgical practicebased science as it relates to neurosurgical training and practice as well as to improvements in patient care delivery and compliance with regulatory mandates.

According to Dr. Asher, "Our specialty is now engaged in an unprecedented cooperative effort that aims to create a new integrative culture of neurosurgical practice for the purpose of improving care. Tremendous scientific and economic potential resides untapped within our routine clinical activities. The methods to realize that potential now exist. The promise of those methods can only be realized through concerted effort and organized action."

Asher adds: "If neurosurgeons choose to embrace practice science as an essential feature of modern neurosurgical practice, we will help meet the challenges of creating a sustainable healthcare system, and we will also define the relevance of neurosurgery within the broader realm of medicine and society."

###

All papers are published online January 1, 2013 online in Neurosurgical Focus, Volume 34, Number 1 (http://thejns.org/toc/foc/34/1). Papers in Neurosurgical Focus are free to the public.

Disclosure: Funding information and potential conflicts of interest are listed at the end of each article.

For additional information, please contact:

Jo Ann M. Eliason, Communications Manager
Journal of Neurosurgery Publishing Group
One Morton Drive, Suite 200
Charlottesville, VA 22903
Email: jaeliason@thejns.org
Telephone 434-982-1209
Fax 434-924-2702

Neurosurgical Focus, an online-only, monthly, peer-reviewed journal, covers a different neurosurgery-related topic in depth each month and is available free to all readers at http://www.thejns.org. Enhanced by color images and video clips, each issue constitutes a state-of-the-art "textbook chapter" in the field of neurosurgery. Neurosurgical Focus is one of four monthly journals published by the JNS Publishing Group, the scholarly journal division of the American Association of Neurological Surgeons (http://www.aans.org), an association dedicated to advancing the specialty of neurological surgery in order to promote the highest quality of patient care.

---

[ | E-mail | Share ]

?

AAAS and EurekAlert! are not responsible for the accuracy of news releases posted to EurekAlert! by contributing institutions or for the use of any information through the EurekAlert! system.

Source: http://www.eurekalert.org/pub_releases/2013-01/jonp-tso122012.php

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Window Shopping And Product Reviews: Toys Article Category ...

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From May 11 to June 15, Any Fit Mama will hold Stroller Physical fitness Classes each Thursday at 10:00 a very.m. Participants will meet at *play and additionally then travel by way of nearby areas using the neighborhood to make sure you exercise. Involving classes are a great way to bring fit while filing your baby possibly child along. Interested mamas also can preregister for the only thing six classes only at *play for $60 or drop doing on just a brand new few at the best cost of $15 per class.

Source: http://wondersofpakistan.com/window-shopping-and-product-reviews-toys-article-category/

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Source: http://subtraction-desperadoes.blogspot.com/2012/12/window-shopping-and-product-reviews.html

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Source: http://cilekambo.posterous.com/window-shopping-and-product-reviews-toys-arti

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Zoe P. Strassfield: Touching the Sky

I like to joke that every time I say something authoritatively, especially online, circumstances will conspire that will make my statement look somehow silly in retrospect. Like the time I explained to my friend that diving to the bottom of the Marianas Trench was totally possible, even though it had been done only once, in the 1950s... and then a few weeks later James Cameron became the first to do it in 52 years. Or that time I wrote an essay about the Civil War comparing it to a horror story and then some guy wrote Abraham Lincoln: Vampire Hunter and made heaps of money. "We haven't detected any signals from alien civilizations so far." I say, "Of course, with my luck, now that I've said that, we'll get a message tomorrow."

That's what happened back in November of 2008, when one of my online friends innocently enough asked her friends who they would want to be if they could be anyone in the world for one day. Whoever we chose, we would have all of their skills for that day, but wake up as ourselves the next day with only memories.

"Either an astronaut in orbit or an acrobat for Cirque du Soleil." I answered. Being able instantly become someone who already had the years of training necessary for either endeavor and get straight to doing incredible stuff sounded like a good way to spend a day making some awesome memories.

And, true to form, a few months later, in June of 2009, circumstances conspired to make that statement look silly -- because somebody managed to do both! Guy Laliberte, a Canadian former acrobat and fire-eater who had founded Cirque du Soleil in the 1980s, was announced as the next space tourist to visit the International Space Station aboard a Russian Soyuz spacecraft. As a space fan, I watched his mission's launch and docking with the station -- and laughed to see Mr. Laliberte emerge through the Soyuz hatch wearing a rubber clown nose! (A few of my friends made noises about that being "undignified", at which I rolled my eyes.) I watched his live "Poetic Social Mission" broadcast a few days later, featuring performers around the world interpreting the theme of clean water and its importance to life, although because of homework, I regrettably had to stop watching before the end.

After his safe return to Earth later that month, I didn't think much about Laliberte for a while, although I felt proud that I recognized his name when I saw it in an article about Cirque du Soleil in Southwest Airlines Spirit magazine. (This is the case with me and a lot of people connected to space but active in other fields, like Elon Musk and Richard Garriott.) But earlier this month, my Mom mailed me an invitation she'd gotten to a gallery show of photographs he'd taken on the station. "I thought we could go to this together when you come home for break," the sticky note she attached read. My mom appreciates my interest in space travel, and she's picked up a lot from listening to me, but art is definitely her area of expertise, so the exhibit sounded like a good intersection of our interests.

That proved to be the case. I'd seen a lot of photographs taken from the space station before, but never blown up and hanging on the clean white walls of an art gallery. The format encouraged me to look at each photo twice -- first as a documentary piece and then as a work of art. (Like how I'd heard Bradford Washburn's aerial mountain photographs described a few months earlier.) One of the first photos in the gallery, showing clouds over the Gulf of Mexico, was a perfect example of that. My first thought was that the photo perfectly illustrated how cloud tops are flattened out by the temperature difference when they bump up against the tropopause, the boundary between the troposphere and stratosphere. But my second thought was that the lower clouds looked like they'd escaped from an old Dutch masters' seascape.

That was appropriate, given how those paintings of ships setting sail from Holland for exotic ports had been the Renaissance equivalent of the paintings of rocket launches I'd seen at the Air and Space Museum the summer before in the NASA Art exhibit. But, of course, those artists had never had a view like this--they'd never seen the clouds from ABOVE, casting shadows on the world below. That was a view only possible in our current age of flight.

Like the live presentation, Laliberte's photographs focused on the theme of water, showing either bodies of water or dry areas without water. Zoomed in so far that no identifying geography was visible, some of these views appeared abstract--swirls of different-hued blue formed by currents and depth changes in the Caspian Sea and sharp pink outcroppings of rock in the Sahara sticking out of the sand. Some of the photographs were on watercolor paper, which slightly reduced the detail level when seen close-up, making them appear more like paintings.

Having spent the past semester taking a class in Archeological Remote Sensing, my eyes instinctively picked out roads and farm fields, (and areas of greater and lesser growth within the fields) and even the round shapes in fields created by circular sprinklers. But I also found myself pointing at a photo of a peninsula in Turkey and telling my mother "It looks like a leafy sea dragon!", and commenting on the contrasting colors in other photographs.

This artistic-scientific duality was perfectly captured in the 89-minute documentary film about Laliberte's training and flight that played in the gallery, Touch the Sky. In addition to following the mission itself, the film also featured interviews with several of the astronauts and cosmonauts he trained alongside and covered an incredible amount of ground, from the question of the station being safe for tourists to the effects of the Columbia accident on the astronaut corps and their families to the memories of the Apollo program that unite the current generation of space travelers, professional and private alike. Like I said about Space Dive (another documentary about a jeans-wearing, tattooed, nontechnical individual training for a space/near-space mission), watching films about space events I followed as they happened is always enjoyable because it gives me the chance to relive them with more clarity. Thus, it was nice to "meet" and "fly with" Jeffery Williams, Nicole Stott, and Gennady Padalka again. A special treat was being able to see Scott Kelly, recently announced as a crewmember for an upcoming yearlong mission aboard the station, and Chris Hadfield, the current station commander, in interviews filmed long before those present developments. (Another treat was the appearance of noted musician and space enthusiast Bono, who participated in the live broadcast event.)

The film captured Laliberte's initial sense of displacement at being an individual with a nontechnical background in such a highly technical environment, but also how he found common ground with the other astronauts and cosmonauts training in Russia. While Laliberte was an artist who happened to be a space traveler, several of his colleagues were space travelers who happened to be artists--pioneer spacewalker Alexei Leonov described not only his cosmonaut experience, but also his artistic process as a painter and his paintings, and Commander Hadfield played a song he had written about the Soyuz rocket. This symmetry made the idea of a strict artistic-scientific division look rather silly, putting the lie to the "cold, logical machine" and "eccentric, foolish clown" stereotypes that one might have expected the protagonists to fall into.

I wondered if I could get a copy of Touch the Sky to show at the next SEDS meeting after we returned from break, maybe to play at an event open to the whole student body. I thought it definitely captured so much of what I'd been talking about with our lack of members from outside of the College of Arts and Sciences and College of Engineering. Back in April, we saw that some business students are just as enthusiastic about space travel as we are, and having aspiring space entrepreneurs in our club would make it all the stronger. And the same is true for every other residential college. How much stronger would our club be with the addition of aspiring space doctors, lawyers, educators, artists? What new perspectives would we gain?

?

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Source: http://www.huffingtonpost.com/zoe-p-strassfield/space-travel_b_2386044.html

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The Military Frequent Flyer - Ten Tips for Frequent Flying in 2013, Part 1

Now?comes the?most?depressing?time of?the?year?- when all?your?EQM?totals?roll?back?to zero!? So toast?a glass?to all?the?miles and?points?you?accumulated?during?2012 and?get?ready?to do the?ritual all?over?again.? To help?you?out, I have?compiled?a list?of?my?top ten tips?for?achieving?the?status?that?you?desire?(or?have?thrust?upon?you?if?you?are forced?to travel?the?miles like?I do).?? These?go?in to some?detail?so I will?list?five?now?and?the?remaining?five?next?week.? Feel?free?to ask?for?more details?as I really?could?write?a page?on?each?one?of?these?subjects.

1.? Plan your?year.? Don?t be one?of?the?many?who?are scrambling?next?December?because?they?just?realized?that?they?need?2,500 miles to make?Unobtainium?Level?on?their?favorite?airline.? Make?a simple spreadsheet?which?lists?all?your?known?or?probable trips
by?month.? If?you?fly?on?multiple?alliances, total them?in separate?columns.?Now?see?where?you?come out?on?your?total for?2013 and decide what?level?of?elite?flyer?is attainable?for?you.?Now?you?can judge?if?you?need?to reroute?a specific?trip?to get?a few
more miles or?need?to fly?a 10,000 mile mileage?run?to reach?your?desired?level.

2.? Use your?redeemable?miles wisely.? Award?tickets?are one?of?the?key?benefits?to being?a FF?and?spending?all?those?hours?on?a plane.? There?are some?that?advocate?using?(burning) your?miles as quickly?as you?earn?them?so they?are not?devalued?by?a future
increase?in award?redemption?requirements?in the?future.? I say?use them, but?keep?in mind?that?you?are giving?up?earning?EQM?when?taking?an?award?flight.? A better?use may?be to pay?for?your?own?ticket, but?use award?miles for?your?spouse, child, or?battle?buddy?when?flying?a trip?together.

3.? Don?t forget the?credit?card?benefits.? A lot?of?people?focus?on?the?initial?bonus?miles that?CC?companies?dangle?out?there?to get?you?to initially?sign?on, but?there?are many?CC?benefits?that?can help?you?in other?ways.? For?example, my?Chase?Mileage?Plus Signature?Card?gives?me 5,000 EQM once I have?spent?$35k in the?year.? As far as I am?concerned, the?best?CC?deal?out?there?is the?BoA Alaska?Airlines?VISA Signature.? For?a $75 annual fee, you?get?a companion?ticket?for?$99 anywhere AS flies.? You?don?t need AS miles?? No problem?- get the?card, fly?AS with?your?spouse/ buddy, and credit?all?the?miles to DL?or?AA.? Friends?of?mine team?up?every?year?to get?cheap?mileage?runs?by?splitting?the?cost?of?flying?back?and?forth?a couple?of?times across?the?country?for?half?price.? Not?hard?to get?15-20k EQM out?of?this.? You?can even?stop?for?a mini-vacation at a couple?of?locations.? Here?is a link to Lucky?s One?Mile?at?a Time Blog?where?he discusses?a long?list?of?credit?card?offers?out?there.

4.? Keep?an?emergency?supply?of?miles.? While?ticket?prices?go?up?the?closer?to the?flying?date, the?miles required?for?an?anytime?award?ticket?remains?constant.? We?have?all?experienced?a time, such?as a death?in the?family, which?we?need?to travel?at?the?last?minute.? BTW, good?luck?with??bereavement fares?, those?are almost?never?a good?deal.? So keeping?50-100k in miles in your?account?may?save?you?a lot?of?money?when?something?last-minute comes up.? This?strategy?also?works?well?if?you?are flying Space-A and?can?t get a hop?back home.

5.? Shoot?for?early?status.? Racking?up?a bunch?of?miles early?in the?year?can get?you?a great?start?on?your?earning?year?and?get?you?some?status?early?to increase?your?earning?amounts?later?in the?year.? For?example, let?s say you?are starting as no
status?at?the?beginning?of?the?year, by?getting?Silver?in Feb. will?get?you?the?25% bonus RDM?in most?programs?for?the?rest?of?your?earnings?that?year?and?next.? Early?status?will?also?increase?your?chances of?a free?upgrade?on?the?rest?of?your?flights?that?year.

So digest?those?tips?for?now?and?I?ll?have?the?rest?next?week.

Source: http://boardingarea.com/blogs/themilitaryfrequentflyer/2012/12/30/ten-tips-for-frequent-flying-in-2013-part-1/

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Police investigate oil spill

Posted at: 12/30/2012 3:52 PM | Updated at: 12/30/2012 4:54 PM
By: The Associated Press

An investigation is underway involving what KOB Eyewitness News 4 first reported as an oil spill Saturday night.

The spill closed 98th St. over Interstate 40 Saturday night.

The Albuquerque Police Department says the state Transportation Department got a tip that the driver of an 18-wheel gas tanker from Sky City was purposely releasing gasoline onto the roadway.

Police say criminal charges are pending.

Source: http://www.kob.com/article/stories/s2880902.shtml?cat=504

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Heads roll on Black Monday as NFL coaches fired

(Reuters) - Heads continued to roll for under-achieving head coaches across the National Football League as the Philadelphia Eagles' Andy Reid, Buffalo Bills' Chan Gailey and Cleveland Browns' Pat Shurmur were all fired on what has become known as Black Monday.

The unemployment ranks are expected swell even further with reports that the Chicago Bears' Lovie Smith is also out of a job.

The 5-11 Browns, who closed out the season on Sunday with a 24-10 loss to the Pittsburgh Steelers, were among the first to begin house cleaning by announcing Shurmur and general manager Tom Heckert had both been relieved of their duties.

The news was quickly followed by the 6-10 Bills confirming they had sacked Gailey and the 4-12 Eagles announcing Reid was being relieved of his duties after 14 years in charge.

Reid's departure had been widely expected but still came as shock to many after a mostly successful tenure in Philadelphia leading the Eagles to six NFC East titles, five NFC championship games and a Super Bowl appearance in 2004.

His 140 victories are a franchise record and rank 22nd on the all-time NFL coaching list.

But a bitterly disappointing 2012 campaign that ended in 42-7 loss to the New York Giants on Sunday signaled to owner Jeffrey Lurie that is was time for a change.

"Andy Reid won the most games of any head coach in Eagles' history and he is someone I respect greatly and will remain friends with for many years to come," said Lurie in a statement. "But, it is time for the Eagles to move in a new direction.

"Andy leaves us with a winning tradition that we can build upon and we are very excited about the future."

JETS KEEP RYAN

Black Monday began with the Jacksonville Jaguars announcing they had fired general manager Gene Smith and was followed by the New York Jets dumping GM Mike Tannenbaum.

The Jets, however, ended the speculation swirling around Rex Ryan by confirming the under-fire head coach would be back next season.

"Rex Ryan will remain the head coach of our football team. I believe that he has the passion, the talent, and the drive to successfully lead our team," said Jets owner Woody Johnson on the team's website.

After a tumultuous 6-10 season, overshadowed by a quarterbacking controversy around the use of incumbent Mark Sanchez and polarizing Tim Tebow, Ryan was widely expected to pay for the Jets under-achieving results with his job.

With Ryan back for next season the speculation will now center on the futures of Sanchez and Tebow in New York.

The Jets sputtering offense ranked 30th among 32 teams, generating an average of just 299 yards per game.

Changes had been expected in Jacksonville after the toothless Jaguars finished the season tied with Kansas City Chiefs for the NFL's worst record (2-14).

"Now it is time for the Jacksonville Jaguars to begin a new chapter," new owner Shahid Khan said in a statement. "We're not looking back.

"I've made it clear from Day One that we pledge nothing less than to deliver the first Super Bowl championship to Jacksonville.

(Reporting by Steve Keating in Toronto, editing by Ed Osmond and Gene Cherry)

Source: http://news.yahoo.com/shurmur-first-coaching-head-roll-black-monday-161619318--nfl.html

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