The study aimsed at surveying and analysing the prevailing risks for medical students due to so-called needlestick injuries, I. e., injuries to the skin by handling sharp objects by which blood of patients can be transmitted to the health professional. After introducing preventive measures in a typical German university hospital, a total of 1 903 students of human medicine in their clinical period from 2009 to 2012 (from a total of 2 024 subjects - a rate of 94.0%) were questioned in detail about potential needlestick or other injuries related to their work. The results show that such injuries happen particularly during the clinical period of the medical studies: While only 20.6% of the students indicated a needlestick injury at the beginning of this period, half of the students (50.9%) had experienced at least one injury at the end of the clinical period. The activities mentioned most frequently were taking of blood samples and injections. Needlestick injuries happened most frequently in surgical units, in internal medicine, and in gynaecology. Accidents happened mostly during secondary employment, medical traineeship, or in the context of practical nursing. In consequence, measures for improvement of the primary prevention should start with training on the one hand: Only briefing seems to be insufficient - intensive exercises in using stick-proof instruments seems to be more promising. On the other hand, the comprehensive introduction of stick-proof instruments has to be supported.
Occupational physicians are very often confronted with questions as to the fitness of the postural and locomotor systems, especially the spinal column. Occupational medical assessment and advice can be required by patients with acute symptoms, at routine check-ups, by persons who have problems doing certain jobs, and for expert medical reports as to the fitness of persons with chronic disorders or after operations. Therefore, for occupational medical purposes a physical examination must aim primarily to investigate functions and not structures or radiologic evidence. The physical examination should be structured systematically and according to regions of the body and, together with a specific (pain) anamnesis should provide a basis for the medical assessment.This paper presents a function-oriented system for physical examination of the locomotor system, named fokus(C) (Funktionsorientierte Koerperliche Untersuchungssystematik, also available on DVD). fokus(C) has been developed with a view to its relevance for occupational medical practice and does not aim primarily to provide a precise diagnosis. Decisive for an occupational medical assessment of disorders of the musculoskeletal system is rather information about functional disorders and any impairment of performance or mobility which they can cause. The division of the physical examination into a rapid screening phase and a subsequent more intensive functional diagnostic phase has proved its practicability in many years of day-to-day use. Here, in contrast to the very extensive measures recommended for orthopaedic and manual diagnosis, for reasons of efficiency and usability of the system in routine occupational medical examinations the examination is structured according to the findings. So it is reduced to that which is most necessary and feasible.
Traffic noise is considered causing annoyance and severe health effects like cardiovascular disease (CVD). The present laboratory study examines the importance of individual factors, namely age, gender and personality traits on short term physiological and affective response to vehicle pass-by noises. Four groups of subjects (20-30 vs. 40-55 year-old male or female, n = 66 in total) were exposed to a series of vehicle pass-by noises. Physiological responses (finger-pulse amplitude [FPA], skin conductance level [SCL]) were registered during the exposure; affective responses and judgements regarding the sounds were assessed by questionnaires. Noise sensitivity and sensation seeking were measured by validated questionnaires. The results show different patterns of response depending on age, gender and personality. The strongest sympathetic stress reaction as measured by SCL was found for the older female group. In regression analysis, the SCL response was predicted by the female gender and low score of sensation seeking only (adjusted R2 = 0.139). The FPA response was strongest among the young men and age was the only significant predictor. For affective responses of pleasantness and activation, regression analysis proved noise sensitivity and sensation seeking to be significant predictors (adjusted R2 = 0.187 respectively 0.154). Age, gender and personality influence physiological and affective reactions to traffic noise, which might affect health conditions. Especially, a potential risk of older women for CVD owing to noise should be investigated further. Individual sensitiveness in terms of noise sensitivity or sensation seeking proves to be important for explaining differences in response to noise.
This study demonstrates objective and reproducible data for suction-generated noise levels and could help to evaluate patients' complaints.
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