scholarly journals Alcoholic Beverage and Traffic Accidents: Impact of the Drunk-Driving Law in Severity and Mortality of Victims

Author(s):  
Lilia de S Nogueira ◽  
Cristiane de A Domingues ◽  
Ane KS Bonfim

ABSTRACT Objectives To analyze the impact of the Drunk-Driving Law on the characteristics and severity of traffic accident victims and to identify risk factors for mortality before and after law enforcement. Materials and methods A retrospective, quantitative study that analyzed victims of traffic accidents attended at a hospital in São Paulo, Brazil, between 2006 and 2010, through the analysis of medical records. The Drunk-Driving Law was considered the time frame of this research, and the victims were distributed in two groups: Before the law (January 2006 to June 2008) and after the law (July 2008 to December 2010). Pearson chi-square, Mann–Whitney, and multiple logistic regression tests were used, with a significance level of 5%. Results The sample consisted of 1,405 victims, the majority being males (78.01%), with a mean age of 37.39 years. In the group comparison (before and after the Drunk-Driving Law), there was a significant difference related to the external cause, admission to the ICU, and discharge conditions. Factors associated with prelaw mortality were age, number of injured body regions, and New Injury Severity Score. The length of hospital stay and the Revised Trauma Score were considered as protective factors for this outcome. After the validity of the law, in addition to the variables described earlier, the head/neck and abdomen regions most severely injured were added as risk factors for mortality. Conclusion The impact of the Drunk-Driving Law set a positive outcome in the survival of the victims. However, when it comes to the statistics and severity of the trauma, it is necessary to sustain the law with reinforcement of the inspection so that more lives are saved. Clinical significance The results of this study provide support to managers on the importance of sustaining the law and the need of implementing new trauma prevention strategies. How to cite this article Bonfim AKS, Nogueira LS, Domingues CA. Alcoholic Beverage and Traffic Accidents: Impact of the Drunk-Driving Law in Severity and Mortality of Victims. Panam J Trauma Crit Care Emerg Surg 2017;6(1):17-24.

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S609-S609
Author(s):  
Molly Hillenbrand ◽  
Senu Apewokin

Abstract Background The incidence of Candida bloodstream infections has risen over the last several decades. Complications of candidemia include endogenous fungal endophthalmitis which can result in devastating outcomes including vision loss. In 2015, the IDSA guidelines were updated to recommend echinocandins as initial therapy for candidemia. Given the poor ocular penetration of echinocandins there has been some concern this change may portend an increased incidence of ocular complications in candidemic patients. We sought to examine whether patients who received empiric echinocandin therapy developed higher rates of ophthalmic complications of candidemia. Methods We identified patients in our healthcare system who had blood cultures positive for Candida species and a completed ophthalmology consult between January 1, 2014 and April 30, 2019. Chi-squared analysis was used to compare antifungal prescribing patterns before and after release of the updated IDSA guidelines. We assessed whether the switch to empiric echinocandin therapy as directed by the guidelines was associated with higher rates of abnormal eye exams. Results 47 patients treated before the guideline change were compared to 57 patients treated after the guideline change. There was no significant difference in age, gender, or comorbid diabetes and hypertension between the groups. Before the guideline change, 24/47 (51%) of patients received eye-penetrating antifungals. This decreased to 21/57 after the updated guideline (37%, p=0.21). The percentage of patients with positive eye exams was nearly equal before and after the updated guidelines, 10/47 (21%) before vs 13/57 (22%) after (p=1). After the guideline change, 7/21 (33%) of the patients treated with penetrating antifungals had positive eye exams vs 6/36 (16%) who received echinocandins (p=0.19). Conclusion Echinocandins are known to have poor ocular penetration yet our data demonstrate no change in the incidence of ophthalmic complications of candidemia after the 2016 guideline endorsed echinocandins as empiric therapy. The prevalence of positive eye exams throughout our study period was 22%, suggesting ongoing utility for these exams. Ongoing investigation is necessary to confirm and further study these findings. Disclosures All Authors: No reported disclosures


Author(s):  
Carlos Mena Canata ◽  
Rebeca Noemí Ruiz Vallejos

The objective of this study is to determine the impact of adenotonsillectomy on the quality of life of postoperative patients.The study is observational, cross-sectional, and retrospective. The files of all postoperative adenotonsillectomy patients in Otorhinolaryngology Service, Hospital de Clínicas, San Lorenzo Paraguay. The Obstructive sleep apnea – 18 questionnaire (OSA 18) was applied, asking patients about symptoms before and after surgery. An effective sample of 143 postoperative patients was obtained. The average age was 6.05 ± 2.08 years, 55.10% (81) were male and 44.89% (66) were female, 65.30% (96) were from urban areas and 34.69% (51) from the rural areas. The t test was performed for means of two paired samples, comparing the results of the Obstructive sleep apnea – 18 questionnaire surveys before and after surgery which presented a significant difference (p <0.05) with a tendency to improve the quality of life after surgery. It has been shown that there is a significant difference, a considerable improvement in the quality of life of patients after adenotonsillectomy.


2016 ◽  
Vol 8 (11) ◽  
pp. 193 ◽  
Author(s):  
Arfianti Novita Anwar

<p>This study aims to analyze the performance of Islamic banks and conventional banks before and after the implementation of Islamic Banking Act 2008. The performance will be measured using CAMEL ratio selected. This research is considered essential in examining the positive contribution of the application of the Act to improve the performance of Islamic banks in Indonesia. By using secondary data, this study compared the performance of Islamic banks with that conventional bank selected as samples during the study period. Data were analyzed using the Wilcoxon Signed Rank Test for inter-temporal and Mann-Whitney test for inter-bank. Inter-temporal Tests conducted on Islamic Banking showed that a significant difference was only seen in the NPF ratio of 2 years before and after implementation of Islamic Banking Act. As for conventional banks showed a more diverse ie for 1 year before and after the application of the Law on Islamic Banking there are significant differences for the ROA and ROE, two years before and after implementation of the Law Islamic banking there are significant differences for the CAR, ROA, ROE and NIM and for the overall test a significant difference to CAR, ROA, ROE, NIM and efficiency. Inter-bank testing showed that prior to the application of Islamic Banking Act there are significant differences between conventional banks and Islamic banks to CAR, ROA and efficiency. Furthermore, after the application of Islamic Banking Act there is a significant difference for the CAR and LDR / FDR.</p>


Nutrients ◽  
2019 ◽  
Vol 11 (7) ◽  
pp. 1545 ◽  
Author(s):  
Lily Ding ◽  
Nazimah Hamid ◽  
Daniel Shepherd ◽  
Kevin Kantono

More people working at offices are choosing to eat meals at their desks, making “desktop dining” an increasingly common phenomenon. Previous studies have reported that environmental distractors, such as television viewing, can influence meal intake and subsequent snack intake. However, the impact of stressful mental tasks on eating behavior has received relatively less attention, focusing only on subsequent meal intake or concurrent snack intake. This study sets out to determine whether eating while working influenced current meal energy intake. This research also examined the relationship between dietary restraint status and energy intake. A crossover experimental design was employed requiring participants (14 males and 29 females) to eat pizza quietly and at rest (control), and while working on a computer (work). Measurements included BMI, energy intake, state anxiety, restrained eating behavior, stress levels (pre- and post-eating), and appetite (before and after both work and control sessions). The findings showed that consuming food while working on a computer significantly increased stress but had no influence on energy intake compared to the control condition. However, post-eating hunger levels were significantly higher in the work condition compared to the control condition. As expected, satiety levels decreased significantly from pre- to post-eating for both work and control conditions. In addition, no significant relationship was observed between restrained eating behavior and energy intake in both work and control conditions. These results suggest that eating while working affected satiety of normal weight participants, as indicated by the significant difference in post-meal satiety levels between work and control conditions.


Author(s):  
Duaa Mohamed Bakhshwin ◽  
Abdulaziz Bakhshwin

Background: On March 11, 2020, the World Health Organization (WHO) announced the Coronavirus outbreak officially as a pandemic. This pandemic has led to new measurements to prevent viral spread. The measures included decreasing the person’s mobility outside homes with subsequent changes in the lifestyles, particularly in physical activity and eating habits. It has been noticed that consumption of some vitamins may help in preventing or reducing the symptoms of viral infection. Those vitamins include vitamin C, D and zinc. There is a common observation that the general public believes that the use of vitamins, especially vitamins C, D and zinc, reduces the chance of acquiring COVID-19. Objectives: The aim of this study was to determine the impact of COVID-19 pandemic on taking vitamins supplements by the Saudi general population in order to explore their believes regarding the protective value of these vitamins against COVID-19 infection. Subjects and Methods: This cross-sectional study was conducted using a self-administrated questionnaire that was designed, uploaded to the Google form and distributed online to the general Saudi population through the social media (Whatsapp, Twitter) as well as through email between August and December 2020. Statistical Packaged of Social Sciences program (SPSS) for Windows (version 17.0., Chicago: SPSS Inc) was used to analyze the data. A significant difference was considered when the p value is < 0.05. Student t-test and Chi-square (χ2) test were used to compare the studied variables as appropriate. Results: A total of 1043 participants were included in this study (64.9% females, 35.1% males). The mean age for them was 35.3±14.78 years. Only 9.3% (97 participants) were diagnosed to have COVID-19. About 28% of the participants were in contact with COVID-19 cases. Among participants diagnosed to have COVID-19 infection, (13% versus 29%) were taking vitamin C and (2% versus 15%) were taking zinc supplements daily during the 6 months before and after the pandemic, respectively, while (20% versus 25%) were taking vitamin D supplements weekly during the 6 months before and after the pandemic, respectively. Among participants who were in contact with COVID-19 cases, (8% versus 20%) and (3% versus 11%) were taking vitamin C and zinc supplements daily during the 6 months before and after the pandemic, respectively, while (14% versus 16%) were taking vitamin D supplements weekly during the 6 months before and after the pandemic Conclusion: The interest of taking multivitamin by Saudi population, such as vitamins C and D, zinc increased during and after the pandemic compared to that before it. There is no scientific evidence based on previous studies confirmed the role of dietary supplementation and multivitamins in preventing COVID-19 infection, therefore, effective education on the rationale use of vitamins during COVID-19 pandemic should be emphasized at local and/or national levels.


2017 ◽  
Vol 14 (3) ◽  
pp. 157-169 ◽  
Author(s):  
Barbara Sveva Magnanelli ◽  
Elisa Raoli ◽  
Riccardo Tiscini

The purpose of this paper is to investigate the state of art of female directors in terms of presence, role and remuneration for Italian corporate boards. The analysis wants to highlight the changes occurred after the introduction of the mandatory female quotas legislation in 2012 and to check how many firms are already complying with the law after 2 years. The picture of the state of art is drawn looking at 163 Italian listed firms for a period of 4 years, from 2011 to 2014. The analysis of the data reveals relevant differences in board composition before and after the law. A significant result concerning the presence of female directors stands in the difference between family and non-family firms: the first are those with higher number of female members in the board. Additionally, an interesting data refers to the amount of remuneration for women, which is significantly lower than the remuneration provided to male directors. Being the first work which charts the situation of board composition and board member remuneration in Italy before and after female quotas introduction, this paper wants to trace some key points for future analysis about the impact of female quotas on various firm’s aspects, such as firm performance, firm earning management and quality, governance characteristics.


2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Hannah Elkadi ◽  
Eleanor Dodd ◽  
Theodore Poulton ◽  
William Bolton ◽  
Joshua Burke ◽  
...  

Abstract Aims Despite being the most common surgical procedure, there is wide variation that exists in the management of simple subcutaneous abscesses with no national guideline describing best practice. During the COVID-19 Pandemic national guidelines promoted the use of regional or local anaesthetic (LA) instead of general anaesthesia (GA) to avoid aerosol generating intubation associated with GA. This study aimed to assess the impact of anaesthetic choice in outcomes following incision and drainage of subcutaneous abscesses. Methods Two cohorts of patients undergoing abscess incision and drainage at St. James’ University Hospital Leeds were retrospectively identified over a 14-week period before and after the introduction of the new COVID-19 anaesthetic guidelines. Wound healing surrogate endpoints were used: i) total number of follow up appointments and ii) attendance to healthcare services after 30 days from I&D. Result 133 patients were included. Significantly more procedures were performed under LA after the intervention (84.1% vs 5.7%; p &lt; 0.0001) with a significant reduction in wound packing (68.3% vs 87.1%. p=0.00473). Follow up data found no significant difference in the average number of follow-up appointments (7.46 vs 5.11; p = 0.0731) and the number of patients who required ongoing treatment after 30 days (n = 14 vs n = 14, p = 0.921). Conclusion Drainage of simple subcutaneous abscess under 5 cm is safe under local anaesthetic with no significant difference in surrogate endpoints of wound healing observed in this patient cohort. Recurrent packing may not be required. Future work should explore patient reported measures such as pain management and the health economics of this intervention.


Author(s):  
Sara Catherine Pearson ◽  
Kristin O’Connor ◽  
Kimberly Keller ◽  
T J Hodge ◽  
Ross Nesbit

Abstract Disclaimer In an effort to expedite the publication of articles related to the COVID-19 pandemic, AJHP is posting these manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time. Purpose Hyperkalemia more commonly affects patients with a glomerular filtration rate of less than 60 mL/min. Using intravenous (IV) insulin to shift potassium intracellularly may cause hypoglycemia, requiring additional treatment or longer hospitalization. Literature on insulin dosing in this context is limited, with one previous study indicating that 5 units of IV insulin might be as effective and result in less hypoglycemia than the standard dose of 10 units of IV insulin. The hyperkalemia treatment pathway at our institution was revised in May 2018 to include a reduced-dose option (5 units of insulin) for patients with end-stage renal disease. This study aimed to compare the prevalence of hypoglycemia between patients who received standard-dose vs reduced-dose IV insulin. Methods This single-center, retrospective, quasi-experimental study evaluated the impact of revision of the hyperkalemia treatment pathway by assessing rates of hypoglycemia during the 6 months before and after implementation of the revised pathway. The primary endpoint was prevalence of hypoglycemia, defined as a blood glucose level of less than or equal to 70 mg/dL. Results There was no statistically significant difference in the occurrence of hypoglycemia when comparing the pre- and postimplementation groups (36 [17.7%] patients vs 34 [18.7%] patients; P = 0.7924). The postimplementation group had a statistically significant lower reduction in potassium levels after treatment than the preimplementation group (mean [interquartile range], –0.9 [–1.3, –0.5] mEq/L vs –0.6 [–1.2, –0.2] mEq/L; P = 0.0095). Baseline potassium levels were similar between the groups. Conclusion Administration of reduced-dose IV insulin for treatment of hyperkalemia was significantly less effective in lowering serum potassium levels and did not decrease prevalence of hypoglycemia. When accounting for potential confounders, the only variable that was associated with hypoglycemia was pretreatment glucose level.


Author(s):  
Brahim Hiba

This paper discusses the insightful and illuminating findings of teaching critical reading within the theoretical framework of critical pedagogy. More specifically, this paper examines the impact of a critical-reading course on students’ reading skills and beliefs about discourse production and interpretation. The course was conducted according to the principles of transformative participatory action research and, thus, a corpus of 50 essays, written by a convenience sample of 25 post-graduate students in the pre-test and post-test phases, was analyzed to examine the effect of the course on students’ reading-habits and their representations of different discourses. Pretest findings showed that most students used to think that discourses are innocent and ideology-free and that reading a text consists in understanding its general idea, extracting its writer’s viewpoint, making sense of its vocabulary, and paraphrasing it. As far as text’s function is concerned, most students used to believe that a text’s basic function is delivering information. In addition, most of them were unaware of the fact that a text has ideological and socio-political functions. Post-test findings revealed that students’ discourse awareness and reading habits have become more critical and developed at two levels: the worldview level and the meta-language level. The t-test statistics suggest that there is a significant difference of p˂.001 between students’ reading scores before and after the intervention. Therefore, the null hypothesis which says that there is no significant difference between studying critical reading from a critical pedagogy perspective and studying it from a functional or conventional perspective is false.


2014 ◽  
Vol 3 (6) ◽  
pp. 92
Author(s):  
Tatjana Goranovic ◽  
Boris Simunjak ◽  
Dinko Tonkovic ◽  
Miran Martinac

Objective: To analyze the impact of the hospital board’s cost saving measure on physicians’ decision to indicate head and neck surgery according to the type of anaesthesia (general versus local). Methods: Design: a retrospective analysis of medical charts on head and neck surgery and anaesthesia covering 2011-2012. Setting: department of otorhinolaryngology and head and neck surgery, university hospital, Croatia. Participants: patients undergoing head and neck surgery. Intervention(s): reduction of departmental financial fund for general anaesthesia for 10%. Main Outcome Measure(s): an overall of number of head and neck surgeries performed in general versus local anaesthesia before and after the implementation of the intervention measure. Results: There were a total of 984 head and neck surgeries in general anaesthesia in 2011 and 861 in 2012. There were a total of 460 head and neck surgeries in local anaesthesia in 2011 and 528 in 2012. The performance of head and neck surgeries in general anaesthesia was significantly reduced in a year after the implementation of the intervention (p = .01) There was no statistical significant difference in the performance of head and neck surgeries in local anaesthesia before and after the intervention. Conclusions: The reduction of departmental fund for general anaesthesia as a cost saving method resulted only in reducing the total performance of surgeries in general anaesthesia without any switch to performing surgeries in local anaesthesia. It seems that the hospital board’s cost saving measure did not have any impact on physicians’ decisions to indicate more surgeries in local anaesthesia. 


Sign in / Sign up

Export Citation Format

Share Document