Swiss medical weekly
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Swiss medical weekly · Jan 2010
On the way to light the dark: a retrospective inquiry into the registered cases of domestic violence towards women over a six year period with a semi-quantitative analysis of the corresponding forensic documentation.
Domestic violence victims are increasingly identified at emergency departments (ED). Studies report a prevalence of 6-30%; women are more frequently affected and to a more serious extent than men. Studies have shown that without screening domestic violence victims are often not recognised. The primary aim of the study is to collect data descriptive of domestic violence victims and to show whether medical documentation meets the requirements of forensic medicine. ⋯ The present retrospective assessment of medical reports over a 6-year period shows that domestic violence against female patients was documented in 0.4%. This figure is far below the proportions to be expected from recent data. If these data are to be believed the majority of female victims of domestic violence must have been overlooked at the ED. The implementation of screening for domestic violence seems to be crucial. The types of injury are chiefly the result of superficial, blunt violence, meaning of mild degree from the viewpoint of criminal law. The quality of the forensic documentation is poor and usually insufficient for criminal prosecution. Clinicians require training in the forensic aspects of medical records.
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Swiss medical weekly · Jan 2010
Population based screening - the difficulty of how to do more good than harm and how to achieve it.
Screening people without symptoms of disease is an attractive idea. Screening allows early detection of disease or elevated risk of disease, and has the potential for improved treatment and reduction of mortality. The list of future screening opportunities is set to grow because of the refinement of screening techniques, the increasing frequency of degenerative and chronic diseases, and the steadily growing body of evidence on genetic predispositions for various diseases. ⋯ There are several countries that already use established processes and criteria to assess the appropriateness of screening. We argue that the Swiss healthcare system needs a nationwide screening commission mandated to conduct appropriate evidence-based evaluation of the impact of proposed screening interventions, to issue evidence-based recommendations, and to monitor the performance of screening programmes introduced. Without explicit processes there is a danger that beneficial screening programmes could be neglected and that ineffective, and potentially harmful, screening procedures could be introduced.
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Swiss medical weekly · Jan 2010
Emergency physician intershift handover - can a dINAMO checklist speed it up and improve quality?
Physician intershift handover has been identified as an area of high risk for adverse events, representing a critical step in patient care transition. Due to frequent shift changes and high patient numbers, emergency departments offer an ideal study setting. ⋯ An intervention consisting of a simple checklist of five items (dINAMO) and an immediate feedback on quality not only contributes to a significant shortening of time needed for physician intershift handover in a university hospital emergency department, but simultaneously helps to improve quality of information and therefore patient management.
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With reference to the Year of the Lung, current knowledge of the respiratory effects of current ambient air pollution is reviewed. Acute respiratory effects are well established. Studies such as SAPALDIA and others now shed light on the long-term effects on chronic pathologies and on the health benefit of air quality improvements. The identification of those at highest risk and of local effects of not yet regulated traffic-related pollutants remains a research priority.
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Swiss medical weekly · Jan 2010
Outcomes of elderly hip fracture patients in the Swiss healthcare system: A survey prior to the implementation of DRGs and prior to the implementation ofa Geriatric Fracture Centre.
PROBLEM AND QUESTIONS: The consequences for elderly patients with hip fractures are well known. In Switzerland, the introduction of diagnosis related groups (DRG) will bring additional challenges. New models of care, such as Geriatric Fracture Centres (GFC), may be the key to minimising negative outcomes. This study documents outcomes of hip fracture patients in the Swiss healthcare system, for use as baseline data prior to DRG- and GFC-implementation, and compares them to results reported in the literature, for example by Cooper (1997). ⋯ Our results reflect the clinical reality of the hip fracture population in Switzerland. Results one year after fracture were comparable to study findings in different health care systems. Our findings provide important baseline data prior to the implementation of DRG and GFC.