Train hard,sleep well? Perceived training load,sleep quantity and sleep stage distribution in elite level athletes

Objectives

Sleep is essential for recovery and performance in elite athletes. While it is generally assumed that exercise benefits sleep, high training load may jeopardize sleep and hence limit adequate recovery. To examine this, the current study assessed objective sleep quantity and sleep stage distributions in elite athletes and calculated their association with perceived training load.

Prevalence of hepatitis C in U.S. Army aircrew: do flaws in the data exist?

BACKGROUND: Hepatitis C virus (HCV) infection is a rare condition with unknown prevalence in Army aircrew. This is a retrospective serial prevalence study to determine the prevalence of HCV in Army aircrew and discuss whether this reflects the true prevalence rate. METHOD: The Aviation Epidemiology Data Registry (AEDR) at the U.S. Army Aeromedical Center was queried by ICD-9-CM codes for cases of hepatitis from January 1988 to October 1999. These records were further reviewed for documented cases of HCV. Case details were extracted and then the data were evaluated. RESULTS: The prevalence rate in this population is exceedingly low at 0.000087 cases per year averaged over the 12 yr, or 1 case in 11,000 aircrew per year with an average of 24,077 records per year. The total number of cases was 31, with 22 of those involving pilots. Subjects averaged 15.26 yr of military service. CONCLUSION: The prevalence of HCV in aircrew is low and is much lower than in the general and military populations. These prevalence rates may be skewed low due to lack of universal reporting method, no screening, and asymptomatic nature of initial infection. Conversely, the prevalence may be accurate due to high fitness levels, population motivation, and required healthcare visits. Current prevalence rates do not support a need for universal screening, but the cost of case detection in lost training dollars and experience is significant. A definitive study would assess the true prevalence rate and determine if screening in this population is warranted.     

Whither mental health legislation? (Locking up the disturbed and the deviant)

The publication of the Government's two-part White Paper - Reforming The Mental Health Act - provides the opportunity to review and comment upon some of its main proposals against a background of current concerns with issues of public protection in mental health and criminal justice.     

Do military uniform and rank impact on the therapeutic relationship between military mental health clients and clinicians?

OBJECTIVE: to measure the perceptions of military staff of the impact of wearing military uniform on the therapeutic relationship with mental health clients. METHOD: a brief questionnaire was distributed to all military clinicians in Departments of Community Mental Health to measure their attitudes. RESULTS: there was a 67.9% (n=70) response rate regarding the impact of uniform on the therapeutic relationship. 20% of responses were positive, 31% negative, 37% mixed and 12% gave no answer. CONCLUSION: there was no clear pre-existing literature on this issue. Overall, the wearing of uniform appeared to be perceived positively positive. There is a need to assess clients' points of view in future studies.     

Patients' safety, privacy and effectiveness--a conflict of interests in health care information systems?

Information technology (IT) is finding its way into daily clinical work. IT is primarily seen as a tool for providing quality of service, cutting costs and promoting efficiency in every aspect of health care, but improvements for patients' safety are also a driving force. IT-solutions can be found both at an administrative and a clinical level, supporting everything from documentation, distribution and storing of patient data to workflows, monitoring and decision making. However, the increasing use of IT in health care raises questions. What is the impact on patients' rights and privacy? Does the law benefit IT-solutions in health care, or does it raise barriers for optimized use? Which interests does the law safeguard in the health care sector, and in the light of an increasing use of IT, do any of these identified interests collide? In conjunction with a governmental national project (InfoVU) during 2001-2004, the Swedish National Board of Health and Welfare (NBHW) had to address these issues and other legal aspects of IT use in health care. The agency's analysis was published in November 2005. The purpose of this article is to present some of the agency's conclusions on legal issues pertaining to the management and processing of patient data. It will show, from a Swedish legislative point of view, the need for a common information security strategy for health care information management as well as discussing other legislative issues in order to meet both the patients' and the health care provider's interests in an electronic environment.     

‘Lost’: listening to the voices and mental health needs of forced migrants in London

Abstract

Research into the mental health needs of asylum seekers and refugees has revealed that they are likely to experience poorer mental health as well as higher levels of exclusion and vulnerability than native populations. This paper reports on data drawn from semi-structured interviews of 21 refugees and asylum seekers that describe the complexity experienced by those living in exile, and the necessity for a more integrated and holistic approach in the planning and delivery of services to support mental health. Incorporating a perspective from service users will encourage providers to take account of the multitude of practical, social, cultural, economic and legal difficulties that can influence the long-term mental health of this population. The implications highlight a need to shift from a simple biomedical model of the causes and effects of ill-health to a social model, which will require re-organisation not only in healthcare but in welfare, housing, employment and immigration policy.     

Do U.S. medical licensure examination step 1 scores correlate with council on resident education in obstetrics and gynecology in-training examination scores and American board of obstetrics and gynecology written examination performance?

OBJECTIVE: The purpose of this study was to assess the possible association between scores of >200 on U.S. Medical Licensure Examination (USMLE) step 1 and the Council on Resident Education in Obstetrics and Gynecology (CREOG) in-training examinations and the pass rate on the American Board of Obstetrics and Gynecology (ABOG) written examination. METHODS: The USMLE step 1 and postgraduate year 1 to 4 CREOG in-training examination scores for the graduating chief residents in eight accredited obstetrics and gynecology residency programs were obtained. Performance on USMLE step 1 was correlated with ABOG examination performance and CREOG in-training examination scores. The correlations between USMLE step 1 and CREOG in-training examination scores and ABOG examination performance were analyzed by using the Spearman correlation coefficient. RESULTS: USMLE step 1 scores were significantly correlated with CREOG in-training examination scores (p < 0.000). None of the residents who scored >200 on USMLE step 1 and a mean of >200 on the CREOG in-training examinations failed the ABOG written examination. CONCLUSION: Program directors have used USMLE step 1 to identify trainees who are likely to perform well on the CREOG in-training examination. The CREOG in-training examination has been used to identify residents who are likely to pass the ABOG written examination. The results of this study document the strength of these associations.     

Aggression and violence towards health care providers – A problem in Turkey?

Health care providers are increasingly concerned about the escalating incidence of verbal and physical abuse to healthcare staff. Factors, such as long wait in hospital areas, which lead to client frustration over an inability to obtain needed services promptly, are influencing these situations. Nonetheless, incidents of this nature can cause immense psychological harm as well as physical damage among medical employees. The current study aimed to ascertain from staff members aggressive experiences in the workplace, and the effects on the individual. The results of this study mirrored those of similar surveys in Turkey. Non-reporting was revealed as a major problem. Respondents believed they were treated less seriously than similar incidents involving private citizens. Accordingly, staff criticized hospital managers, the police, and the courts for their attitude about assaults towards hospital employees. They reported feeling vulnerable to abuse and there was a general desire for training in preventing and protection. These include teaching staff breakaway techniques, increasing the number of trained security officers on duty, issuing personal alarms, and encouraging staff to officially report all incidents.     

Mapping the war: gender,health, and the medical profession in France and Germany, 1914–1918

This article compares the gender and health politics of the German and the French medical professions, which incorporated military command structures into their civilian self-conception. Mobilized doctors committed themselves to the new circumstances and opportunities offered by the war. They applied the established military spatial ‘map’ which distinguished between the male-dominated front and the female-dominated home front and turned it into an epidemiological map, identifying danger zones which arose from points of contact between men and women. The analysis singles out two case studies: the rapid spread of venereal disease and psychiatric disorders. These case studies allow for a comparative analysis of the following questions: How did doctors assess the impacts of the war on the individual and the society as a whole? How did they view the war’s impact on conventional gender orders, individual and national health? And how did they see their own role as a part of an independent civilian profession?     

Where do veterans health administration patients obtain heart, liver, and kidney transplants?

We sought to determine whether Veterans Health Administration (VA) enrollees use the VA system or the private sector for solid-organ transplantation and whether VA system use is associated with patients' proximity to a VA transplant center. Using a national VA/Medicare inpatient data set and a comprehensive New York State VA/private-sector inpatient data set for 1998 to 2000, we found that veterans enrolled in the VA system obtained approximately one-half of their liver transplants, but few heart and kidney transplants, in the VA system. Patients were much more likely to use the VA system if they lived in a VA service area that offered relevant transplant services. Our findings suggest that VA transplant centers intended to meet national needs are more likely to serve local residents. Furthermore, our analysis indicates that use of only the VA/Medicare data set may substantially underestimate VA enrollees' reliance on the private sector for health care services.