תוצאת חיפוש

Physiological Aspects of Women in Combat

D. Libster, Y. Heled, Y. Shapiro, Y. Epstein

IDF Institute of Military Physiology and Heller Institute for Medical Research, Sheba Medical Center, Tel Hashomer

Since military service is physically demanding, soldiers must maintain high levels of physical fitness for optimal performance of their duties. Women are at a physiological disadvantage when competing against men: they have a smaller muscle mass, more body fat, lower red blood cell counts, lower hemoglobin levels and smaller cardiac outputs. Women are slower and weaker than men and more prone to exercise-induced skeletal injuries. Fewer women than men meet the standards of physically demanding jobs. Therefore integrating women into physically demanding military-oriented jobs requires redesigning or modifying the tasks (different pace, mechanical aids, teamwork). While physical training can increase the physical capacity of women, training cannot completely eliminate gender differences. Thus the data presented do not imply that women cannot be integrated into combat units, but highlight gender-related differences which might have an effect on the ability of women to compete equally with men at the same task.

Primary Care Physicians in Israel Compared with European Countries

P. Shvartzman, R. Gross, H. Tabenkin, D. Yuval, M. Grinshtein, B. Wienka

Dept. of Family Medicine, Ben-Gurion University of the Negev, Beer Sheba;

Brookdale Institute, Jerusalem; and Nivel Institute, Maastricht, the Netherlands

This study compares Israeli primary care physicians with those of European countries. In Israel a larger proportion of those in primary care are women. The Israeli physicians see many patients a day, but almost never make home visits. They also report for work the fewest hours a day, but spend 21 hours a month in continuous medical education. (more than Europeans?) The Israeli primary care physician scores high in screening for breast cancer and blood cholesterol level, but very low in the fields of minor surgery and alcohol and smoking prevention, contraception, nutrition counseling and normal pregnancy follow-up. Residency training and education may be inadequate, and more emphasis has to be put on the health system and recognizing environmental influences.

Patient Satisfaction with Care in Acute-Care Hospitals

Ayelet Berg, Dan Yuval

JDC-Brookdale Institute of Gerontology and Human Development, Jerusalem

Patient satisfaction with the hospitalization process is an important element in the measurement of quality of care. Information from a survey of patients' experiences could therefore help hospitals improve their service, and provide decision-makers with relevant information. We present the findings of a study of some 4,500 patients, aged 18+, released from hospitals in the fall of 1993 and of 1995 from the wards of 9 acute care hospitals, psychiatric and geriatric wards excluded. Self-administered questionnaires were sent and returned by mail, with an overall response rate of 82%.

Despite the many changes in Israel's health system in general and its hospital system in particular, and the social and demographic changes between those 2 periods, patient satisfaction remained constant. Of those discharged from medical or surgical wards, 70% were satisfied to a "great" or "very great" extent with their hospital experience. There was improvement in most areas of hospitalization in the course of the 2 years. The greatest improvement was with regard to admission, nursing staff, hotel services, in patient satisfaction food and supplies. On the other hand there was deterioration in visiting conditions and hours. Satisfaction with physicians, nurses and hotel services had the strongest links with general satisfaction.

Prevalence of Pigmentary Dispersion Syndrome in Israel

D. Gaton, A. Barak, S. Segev, Y. Yassur, G. Treister

Ophthalmology Dept., Beilinson Medical Center, Petah Tikva and Ophthalmology Dept. and Institute for Medical Screening and Assessment, Sheba Medical Center, Tel Hashomer

Pigmentary dispersion syndrome is a precursor of pigmentary glaucoma whose prevalence in the urban population of USA was found to be 2.45%. We evaluated its prevalence during ocular screening examinations among normal Israelis. We screened for excessive pigmentation on the corneal endothelium with the slit-lamp and determined in each patient best corrected visual acuity, intra-ocular pressure (after mydriasis), condition of the anterior segment, cup-disk ratio, posterior segment abnormalities and questioned about history of any ocular disease and family history of glaucoma. 374 patients (mean age 49±11) were examined on 10 consecutive days. In 5.9% excessive corneal endothelial pigmentation was found. Intra-ocular pressure (after mydriasis) averaged 15.52±1.93 mm Hg as compared to 14.73±2.04 among the rest of our study population, (p=0.01). The prevalence of suspected pigmentary dispersion syndrome among young adults in Israelis is high.

Between "Transparent Room" and "Sealed Room:" Professional Confidentiality and Therapeutic Judgement

Yuval Melamed, Ami Levy, Henry Szor

Abarbanel Mental Health Center, Bat Yam and Shalvata Mental Health Center, Hod HaSharon

Patients and therapists are concerned with the complexities of protecting medical confidentiality. The traditional perception of protection of patient confidentiality is that the individual's interest in protecting his confidentiality may conflict with the public's need for information, especially in cases involving possible danger. In fulfilling his dual role of representing both the patient and the public, the therapist acts according to existing laws and regulations. We describe 3 cases in which refraining from providing the Army with information in accordance with the law was recognized in retrospect as having caused the patient suffering, and even danger. It is recommended that the therapist's judgement be considered in addition to other legal criteria for determining whether or not to protect patient confidentiality.

Prognostic Factors And Surgical Results In Traumatic Cataract

Yuval Gelfand, Joseph Pikkel, Benjamin Miller

Ophthalmology Dept., Rambam Medical Center and Bruce Rappoport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa

The visual outcome in 23 men and 2 women with traumatic cataracts was analyzed retrospectively. Their average age was 33 and they ranged from 10 to 69 years. Surgical results were either very good or very poor. Associated retinal injuries significantly decreased final visual acuity (p = 0.001). Those with initial visual acuity restricted to finger counting had better visual results than those with initial visual acuity restricted to light perception (p = 0.01) and hand motions (p = 0.02). Usually the lens was removed via the pars plana; the most common mode of optical correction was contact lenses.

Motor Vehicle Accidents And Eye Injuries

J. Pikkel, Y. Gelfand, E. Mezer, B. Miller

Dept. of Ophthalmology, Rambam Medical Center and Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa

The medical records of 24,632 patients treated in our surgical emergency service over a 3-year period were reviewed to determine the frequency and characteristics of ocular trauma caused by motor vehicle accidents (MVA). MVA-related injuries accounted for 13.9% of all visits to the service and involved 1106 of the patients (33%), of whom 77% were young males. At least 1 pathological finding was found in 858 (77.6%) and 169 (15.2%) were admitted. 16 patients sustained very severe ocular injuries which resulted in poor vision.