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 authoritie

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 5years. 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 physicia

No blue-yellow color vision impairment after acute ethanol ingestion

Several studies showed that a chronic ethanol exposure can cause color vision deficiencies. There is no agreement about the axis of color defects due to alcohol misuse since changes in the red-green and the blue-yellow axis are described in literature. The acute influence of alcohol on the blue-yellow color vision isn’t studied as well. The aim of this study was to determine the effect of acute alcohol ingestion on the blue-yellow color vision by using short wavelength automated perimetry (SWAP) and anomaloscopy with Moreland equation. This is the first study evaluating that question by using SWAP and anomaloscopy. 16 healthy subjects without history of alcohol-related and ophthalmological problems were examined by SWAP and anomaloscopy (Moreland equation) before and after alcohol ingestion. Mean sensitivity (MS), mean deviation (MD), loss of variance (LV), reliability factor (RF) and duration of examination were assessed for perimetry and match midpoint (MP), matching range (MR) and duration of examination for anomaloscopy. Blood alcohol concentrations (BAC) were determined by gas chromatography and phosphatidylethanol concentrations (marker of an alcohol misuse) by liquid-chromatography tandem-mass spectrometry in venous blood samples from a cubital vein. Mean blood BAC was 0.86 +/- 0.20 g/kg while performing perimetry and 0.84 +/- 0.20 g/kg while performing anomaloscopy. MS, MD, RF, MP, MR and duration of perimetry examination were not altered significantly after alcohol intake. LV showed a significant increase. The duration of anomaloscope testing was shortened significantly under influence of alcohol. The subjects also revealed a significant narrower matching range after alcohol intake. In the range of 0.8 g/kg BAC, no blue-yellow vision deficiencies could be demonstrated. In further studies, the effect of higher BAC on blue-yellow vision should be investigated by different methods

Amphiphilic anthanthrene trimers that exfoliate graphite and individualize single wall carbon nanotubes

A phosphodiester-linked dialkynyl substituted anthanthrene trimer (1) has been designed and synthesized. Its graphene ribbon like structure is expected to facilitate interactions with nanographene (NG) and single wall carbon nanotubes (SWCNT) to yield novel and stable carbon-based nanomaterials. Interactions with trimer 1 leads to exfoliation of NG and to the individualization of SWCNTs. Phosphate groups, in general, and their negative charges, in particular, render the resulting nanomaterials soluble in ethanol, which is ecologically favourable over DMF required for the processing of pristine NG or SWCNTs. The newly formed nanomaterials were probed by complementary spectroscopic and microscopic techniques. Of particular importance were transient absorption fluorescence excitation measurements, which revealed an efficient energy transfer within the carbon-based nanomaterials

Leveraging driver vehicle and environment interaction: Machine learning using driver monitoring cameras to detect drunk driving

Excessive alcohol consumption causes disability and death. Digital interventions are promising means to promote behavioral change and thus prevent alcohol-related harm, especially in critical moments such as driving. This requires real-time information on a person's blood alcohol concentration (BAC). Here, we develop an in-vehicle machine learning system to predict critical BAC levels. Our system leverages driver monitoring cameras mandated in numerous countries worldwide. We evaluate our system with n=30 participants in an interventional simulator study. Our system reliably detects driving under any alcohol influence (area under the receiver operating characteristic curve [AUROC] 0.88) and driving above the WHO recommended limit of 0.05g/dL BAC (AUROC 0.79). Model inspection reveals reliance on pathophysiological effects associated with alcohol consumption. To our knowledge, we are the first to rigorously evaluate the use of driver monitoring cameras for detecting drunk driving. Our results highlight the potential of driver monitoring cameras and enable next-generation drunk driver interaction preventing alcohol-related harm

Measurement Back-Action in Quantum Point-Contact Charge Sensing

Charge sensing with quantum point-contacts (QPCs) is a technique widely used in semiconductor quantum-dot research. Understanding the physics of this measurement process, as well as finding ways of suppressing unwanted measurement back-action, are therefore both desirable. In this article, we present experimental studies targeting these two goals. Firstly, we measure the effect of a QPC on electron tunneling between two InAs quantum dots, and show that a model based on the QPC’s shot-noise can account for it. Secondly, we discuss the possibility of lowering the measurement current (and thus the back-action) used for charge sensing by correlating the signals of two independent measurement channels. The performance of this method is tested in a typical experimental setup.Swiss National Science Foundatio

Attitude of Swiss general practitioners to mandatory training in assessing fitness to drive of older drivers

AIMS OF THE STUDY: In Switzerland, drivers over the age of 75 must undergo a medical assessment of their fitness to drive every 2 years. This assessment is usually carried out by a general practitioner (GP). Since 2016, physicians require official accreditation (so-called level 1 competence) to perform these examinations. This can be obtained either by self-declaration of competence or by attending an accredited training course. Little is known about the Swiss GPs' views on this regulation. In this study, we investigated the attitude of GPs towards these modalities. METHODS: A questionnaire was mailed to 2372 GPs in a large part of German-speaking Switzerland, 1198 of whom completed and returned the questionnaire. The anonymised data were analysed by descriptive statistics (frequencies, percentages) to summarise participant demographics and agreement with attitudinal statements. RESULTS: The response rate was 50.5%. Sociodemographic data (age, gender, settlement area) of the participating GPs corresponded to those of the Swiss medical statistics. The majority (93.1%) of respondents worked in an outpatient setting, 6.9% in the inpatient sector. Overall, 34.4% of the GPs completed a training course and 47.7% submitted a self-declaration in order to acquire level 1 competence. Older and more experienced physicians had made more use of the self-declaration option. 58.1% of the respondents would like to retain the existing regulations. Of the respondents who had attended a training course, 51.7% considered themselves more competent in the assessment of older drivers after the training, and 76.1% would like to maintain the course duration of 1 day. Of the physicians surveyed, 70.8% were of the opinion that level 1 examinations are a useful screening tool for older drivers who are unfit to drive, and 78.4% agreed that MFTD (medical fitness to drive) examinations of older drivers should be performed by GPs. CONCLUSIONS: In Switzerland, the currently existing regulation for acquiring level 1 competence is widely accepted by GPs. Almost all respondents considered that they have sufficient knowledge to assess MFTD. However, the majority of GPs who had attended the training course indicated they have benefited from it. Periodic assessment of MFTD of older drivers was considered useful and should preferably be performed by GPs. These results show that the periodic assessment of older drivers' MFTD practised in Switzerland is well accepted

[Lethal atraumatic splenic rupture due to infectious mononucleosis]

The authors report on the sudden and unexpected death of a 20-year-old man from atraumatic rupture of the enlarged spleen due to infectious mononucleosis. The case exemplifies the forensic relevance of infectious mononucleosis, atraumatic splenic rupture and post-mortem serological tests

Die hausärztliche Fahreignungsbeurteilung

Die Beurteilung der Fahreignung von 70-jährigen und älteren Senioren1 ist eine wichtige und anspruchsvolle hausärztliche Tätigkeit. Die am 01.07.2016 in Kraft gesetzten revidierten Mindestanforderungen an Motorfahrzeuglenker sowie neue Bestimmungen zur Qualitätssicherung in der Fahreignungsbeurteilung haben daher für den Grundversorger Bedeutung. In diesem Artikel soll auf die für Hausärzte wichtigsten letztjährigen Änderungen eingegangen werden