Does experience change anything? Attitudes of paramedic students regarding drinking and driving

Purpose

The current study examined attitudes and behavior of first degree emergency medical technician (paramedic) students at Ben-Gurion University of the Negev in Israel toward DUI (driving under the influence).

Methods

Students were asked to complete an anonymous, self-administered, multiple-choice questionnaire and a demographic questionnaire.

Results

We found that 42% of respondents (n = 59) had driven after drinking, and 56% of them had driven after more than one drink in the past year. Furthermore, 70% of the students had been designated drivers in the past year, 31% of whom had drunk-driven. No significant difference was found between past volunteers at MDA* and those who did not volunteer regarding the number of DUI events or the amount of alcohol consumed, but those who did volunteer drank more when engaging in DUI.

Conclusion

Our findings are worrisome and may reveal the strength of social norms for consumption of alcohol on one hand and the lack of suitable education regarding the dangers of alcohol in the health care department on the other hand.

     

Frequency of idiopathic aseptic necrosis in medically treated alcoholics

Summary The occurrence of idiopathic aseptic necrosis of bone in multiple sites has been studied in persons who have had medical treatment for excessive consumption of alcohol. The incidence was 5.3% in 1157 such persons and there were 92 different sites in 62 patients. There were 82 lesions affecting the femoral head, 46 in the left hip and 36 in the right. In 10, it was present in the head of the humerus. Multiple foci were found in 6.1% of patients with the disease. In 2 men and 2 women both femoral heads and both humeral heads were affected. In 2 men the necrosis was present in both humeral heads and the head of the right femur.

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Résumé La survenue de nécrose osseuse aseptique idiopathique de diverses localisations a été étudiée chez des sujets traités pour consommation excessive d'alcool. Chez 1157 de ces sujets la fréquence a été de 5,3%, soit 62 malades présentant 92 lésions. 82 étaient situées au niveau de la tête fémorale, 46 à gauche et 36 à droite. Dix fois la tête humérale était atteinte. 6,1% des patients présentaient plusieurs localisations de la maladie. Chez 2 hommes et 2 femmes les deux têtes fémorales et les deux têtes humérales étaient atteintes. Chez deux hommes la nécrose affectait les deux têtes humérales et celle du fémur droit.

     

LACTATE AS PREDICTOR OF MORTALITY IN POLYTRAUMA

Background:

The lactate is a product of anaerobic metabolism; it can be used as a marker on demand and availability of oxygen. Changes in lactate levels can be effectively used as a marker in resuscitation maneuvers, even in patients with stable vital signs.

Aim:

To verify the lactate clearance as a predictor of mortality in trauma patients, in need of intensive care.

Method:

A total of 851 patients were admitted in ICU, in which 146 were victims of multiple trauma; due to the exclusion criteria, were included 117.

Results:

Patients were 87% male, mean age 32.4 years, motorcycle drivers, Glasgow coma scale between 3-8, affected by cranial trauma, followed by abdominal trauma. Was verified mortality up to 48 h and global mortality, that did not show statistical relationship between lactate clearance and mortality (p=0.928).

Conclusion:

There is no correlation between admission lactate or lactate clearance and mortality in patients treated with multiple trauma.     

Exploring cannabis use and perspectives among psoriatic disease patients

Clinical Rheumatology - To assess the correlation between cannabis use and psoriatic disease severity, health-related quality of life, pain, psychosocial outcomes, and cytokine levels in psoriasis...     

Models for projecting supply and demand for nurses in Israel

Background

Concern is growing over serious shortages in the nursing workforce and imbalance between supply and demand. Projections indicate that the demand for the nursing workforce will increase due to the aging population and an increase of the percentage of elderly people requiring assistance.

Study goals

To examine the expected balance between supply and several demand projections for nurses in Israel in order to contribute to planning the nursing workforce.

Methods

1. Open interviews with key figures in the healthcare and nursing care systems; 2. Examination of supply and demand for nurses; 3. Examination of the balance between supply and demand projections.

Main findings

A considerable gap was found between the supply and demand projections for registered nurses, which will increase over time according to each of the demand projection models up to 2030. All of the models indicate that the projected shortage will be significantly affected by the age at which the nurses retire. Models based on a fixed ratio of nurses or infrastructure (beds, positions) per population show a particularly great gap between demand and supply. However, a more conservative model (based on hospital utilization), that takes the system's infrastructures and limitations, as well as the growing population and changes in its composition into account, without an increase in the direct ratio of the number of nurses, also predict a significant shortage of nurses within 20 years.

Conclusions

The gaps between the demand and supply projections indicate the need to augment the workforce in addition to the steps currently taken to recruit nursing staff and increase the number of training institutions for nurses. The relatively simple supply prediction models, which are based on available sources of information that can be easily revised, will make it possible to monitor and update projections regularly over time. The models developed in this study should help the process of long-term strategic planning for the number of nurses in Israel.

     

Urothelial cancer in patients with Endemic Balkan Nephropathy (EN) after renal transplantation

GOAL: Analysis of the incidence of urothelial cancer and outcome of treatment in patients with Endemic Balkan Nephropathy (EN) after renal transplantation. METHODS: From January 1985 until October 2006, 550 kidney transplantations (389 cadaveric) and 5 combined kidney and pancreas transplantations were performed in University Hospital Center Rijeka. In only 6 (1.1%) of 555 transplant recipients, EN was diagnosed as the original kidney disease, based on medical history, clinical findings, and laboratory results, but without pathohistologic verification. All patients with EN received the first renal transplant from a cadaver. Patients' mean age at transplantation was 50.3 +/-15.9 yrs, five patients (83.3%) were male. The incidence of malignant tumors in all 555 transplant recipients was analyzed, with an emphasis on the incidence of urothelial cancer and outcome of treatment in the group of patients with EN. RESULTS: During posttransplant follow-up period, malignancy was diagnosed in 27 (4.9%) out of 555 transplant recipients. Skin cancer was diagnosed in 7 patients (1.3%), followed by cancer of the urinary tract in 6 patients (1.1%) and breast cancer in 3 patients (0.5%). In 3 of 6 patients with EN, urothelial cancer was diagnosed, resulting in the death in two patients. In the third patient, urothelial cancer showed a high affinity for recurrence, and besides the strong reduction of immunosuppressive therapy, repeated surgical treatment was needed. CONCLUSIONS: Patients with EN show a high incidence of urothelial cancer after renal transplantation. A thorough nephro-urological evaluation is needed before transplantation, and a careful follow-up is required afterward to ensure an early diagnosis of malignancy. Preventive nephroureterectomy is recommended.