Clinical consequences of road traffic injuries among the elderly in Japan

<p>Abstract</p> <p>Background</p> <p>Road traffic injuries among the elderly have recently become a public health issue; therefore, we investigated the clinical characteristics of such injuries among the elderly in Japan.</p> <p>Methods</p> <p>A retrospective study was performed using data from a medium-sized hospital emergency department. Data were extracted from medical records for one year, and patients were categorized into groups ages 18-64, 65-74 and 75+. Variables included demographic characteristics, injury circumstances, and nature of injury. Univariate and bivariate descriptive statistical analyses were performed, and multivariate logistic regression was used to evaluate injury severity and hospital admission by age groups.</p> <p>Results</p> <p>A total of 1,656 patients were studied. Patients aged 65+ had more chest wall injury, intracranial injury, lower extremity fracture, and intrathoracic injury than patients aged 18-64.</p> <p>Conclusions</p> <p>Injury circumstances and nature of injuries associated with traffic incidents showed different patterns by age groups, particularly among the elderly.</p

Physicians' knowledge and continuing medical education regarding fitness to drive: a questionnaire-based survey in Southeast Switzerland

Valid information for physicians in Switzerland concerning knowledge and continuing education in traffic medicine is not available. Also, their attitude to the legally prescribed periodic driving fitness examinations is unclear. In order to gain more information about these topics, 635 resident physicians in Southeast Switzerland were sent a questionnaire (response rate 52%). In a self-estimation, 79% of the queried physicians claimed to know the minimal medical requirements for drivers which are important in their specialty. Statistically significant differences existed between the specialties, whereby general practitioners most frequently claimed to know the minimal medical requirements (90%). It appears that the minimal medical requirements for drivers are well known to the queried physicians. Fifty-two percent of the physicians favored an expansion of continuing education in traffic medicine. Such an expansion was desired to a lesser extent by physicians without knowledge of the minimal requirements (p < 0.001). A clear majority of the medical professionals adjudged the legally prescribed periodic driving fitness examinations as being an expedient means to identify unfit drivers. A national standardized form for reporting potentially unfit drivers to the licensing authorities was supported by 68% of the responding physicians. Such a form could simplify and standardize the reports to the licensing authorities

Prevalência de quedas em idosos asilados do município de Rio Grande, RS Prevalence of falls in institutionalized elderly in Rio Grande, Southern Brazil

OBJETIVO: O aumento da expectativa de vida nos países em desenvolvimento tem provocado preocupação com a qualidade de vida e o bem-estar dos idosos, principalmente a ocorrência de quedas. Nesse sentido, o objetivo do estudo foi descrever a prevalência de quedas em idosos que vivem em asilos e fatores associados. MÉTODOS: Estudo de delineamento transversal na cidade de Rio Grande (RS), em 2007. Participaram 180 indivíduos idosos (65 anos ou mais) residentes em asilos para acolhimento. Em entrevista, os idosos responderam a questões de instrumento pré-testado sobre a ocorrência de quedas. Além de análise bivariada (Wald), foi realizada análise por regressão de Poisson com cálculo de razões de prevalência e intervalos de confiança de 95%, ajustada para as variáveis de confusão. RESULTADOS: A prevalência de quedas entre os idosos asilados estudados foi de 38,3%. As quedas foram mais comuns no ambiente do asilo (62,3%), sendo o quarto o ambiente onde ocorreu o maior número de quedas (23%). Na análise ajustada, as quedas se mantiveram associadas com cor da pele branca, com os idosos separados e divorciados, com depressão, e maior quantidade referida de medicamentos para uso contínuo. CONCLUSÕES: O estudo mostra que a prevalência de quedas entre idosos asilados é alta. Embora alguns dos possíveis fatores associados sejam passíveis de prevenção, ainda ocorrem quedas em locais que deveriam ser considerados seguros, como o quarto do idoso.<br>OBJETIVO: El aumento de la expectativa de vida en los países en desarrollo ha provocado preocupación con la calidad de vida y el bienestar de los ancianos, principalmente la ocurrencia de caídas. En ese sentido, el objetivo del estudio fue describir la prevalencia de caídas en ancianos que viven en asilos y factores asociados. MÉTODOS: Se realizó estudio de delineamiento transversal en la ciudad de Rio Grande (Sur de Brasil), en 2007. Participaron 180 individuos ancianos (65 años o mas) residentes en asilos para protección. En entrevista, los ancianos respondieron las preguntas de instrumento pre-evaluado sobre la ocurrencia de caídas. Además de un análisis bivariado (Wald), se realizó un análisis por regresión de Poisson con cálculo de razones de prevalencia e intervalos de confianza de 95% ajustada para las variables de confusión. RESULTADOS: La prevalencia de caídas entre los ancianos asilados estudiados fue de 38,3%. Las caídas fueron más comunes en el ambiente del asilo (62,3%), siendo el cuarto el ambiente donde ocurrió el mayor número de caídas (23,0%). En el análisis ajustado, las caídas se mantuvieron asociadas con el color blanco de la piel, con los ancianos separados y divorciados, con la depresión, y mayor cantidad referida de medicamentos para uso continuo. CONCLUSIONES: El estudio muestra que la prevalencia de caídas entre los ancianos asilados es alta. A pesar de que algunos de los posibles factores asociados sean pasibles de prevención, aún ocurren caídas en lugares que deberían ser considerados seguros, como el cuarto del anciano.<br>OBJECTIVE: The increase of life expectancy in developing countries has been a source of concern about quality of life and well-being of elderly people, especially regarding falls. The objective of the study was to assess the prevalence of falls in institutionalized elderly and to describe factors associated. METHODS: Cross-sectional study carried out in the city of Rio Grande (Southern Brazil). A total of 180 elderly (65 years old or more), living in institutions were included in the study. The elderly were interviewed and a pre-tested instrument with questions on falls was administered. In addition to a bivariate analysis (Wald), Poisson's regression analysis was conducted and prevalence ratios and 95% confidence intervals (95% CI) adjusted for confounders were estimated. RESULTS: The prevalence of falls among institutionalized elderly was 38.3%. Falls were most frequently seen at the home premises (62.3%) and mostly in the bedroom (23%). In the adjusted analysis, falls remained associated to white color skin, separated and divorced elderly, depression, and higher continuous use of medications. CONCLUSIONS: The study showed that the prevalence of falls among institutionalized elderly is high and that they can be disabling to this population. Although some of the associated factors are preventable, accidental falls still occur in settings that should be safe, such as the elderly's bedroom

Discretionary medical reporting of potentially unfit drivers: a questionnaire-based survey in southeast Switzerland

In Switzerland, every physician has the right to report a patient that is potentially unfit to drive to the licensing authority without violating medical confidentiality. Verified information regarding physicians' attitudes concerning this discretionary reporting and the frequency of such reports are not available. In order to answer these questions, 635 resident physicians were sent a questionnaire. The response rate was 52%. On average, the responding physicians--for all specialties--reported 0.31 patients (SD 0.64, 95% CI 0.24-0.38) in the year before the survey and 1.00 patient (SD 1.74, 95% CI 0.81-1.20) in the past 5 years. Seventy-nine percent of the responding physicians indicated knowing the current legal requirements for driving in Switzerland. In applied logistic regression analysis, only two factors correlate significantly with reporting: male sex (odds ratio 5.4) and the specialty "general medicine" (odds ratio 3.4). Ninety-seven percent of the physicians were against abolishing medical discretionary reporting and 29% were in favor of introducing mandatory reporting. The great majority of the questioned physicians supported the discretionary reporting of drivers that are potentially unfit to drive as currently practiced in Switzerland. The importance and the necessity of a regular traffic medicine-related continuing education for medical professionals are shown by the low number of reports per physician