Located in the periphery, Ashkelon’s Barzilai Medical Center has special problems – including having to cope not only with sick patients but also those wounded in war and terror attacks. But it received good news recently, when the Israel Medical Association’s recognition committee gave it approval to provide comprehensive training in medical administration.
This field is a “super specialty” that can be chosen by any doctor who has earned in a specialty in one of the basic medical professions. Today, having earned a medical specialty following several years of additional training after earning one’s MD degree is a requirement for applying to be a hospital director-general or deputy director-general.
In the new Barzilai program, doctors will be exposed to theoretical and practical studies on how to run a hospital or community health facilities and will have to pass two levels of examinations, as is the case for all medical specialties.
For many years, the appointment of senior hospital administrators has been haphazard, the result of chance among senior doctors who have not necessarily been trained in medical administration.
The program for a specialty in medical administration at Barzilai will be headed by assistant hospital director Dr. Yaniv Sherer, and those who participate will work closely with hospital director-general Dr. Chezy Levy, who was previously a senior Health Ministry administrator.OLDER BIKE RIDERS AT RISK
The incidence of bicycle accidents has increased significantly in the US in recent years, with many serious injuries occurring among riders older than 45, according to a new study recently published in JAMA, the journal of the American Medical Association.
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University of California at San Francisco researchers used a national injury surveillance database to study trends in bicycle injuries between 1998 to 2013. They found that the rate of hospital admissions associated with bicycle injuries more than doubled during that time frame, especially with head and torso injuries.
Altogether, the proportion of injuries occurring to riders above age 45 rose 81 percent, from 23% to 42%, the authors say, and the proportion of hospital admissions to older riders increased 66%, from 39% to 65%.
“These injuries were not only bad enough to bring riders to the emergency room, but the patients had to be admitted for further care,” says UCSF Prof. Benjamin Breyer, chief of urology at San Francisco General Hospital and Trauma Center. “If you take typical 25 year olds and 60 year olds, if they have a similar crash, it’s more likely the older person will have more severe injuries.”
Urban cycling has become increasingly popular in recent years for both recreation and work, and this trend has occurred as the US shifts to an older demographic.
In the new study, the researchers found that the percentage of injured cyclists with head injuries rose from 10% to 16%.
Approximately two-thirds of the total injuries occurred among men, and there was “no significant change in sex ratio over time.” The authors say that their findings highlight the need for safer riding practices and better infrastructure to prevent cycling-related injuries.
“Bicycle riding provides a fantastic way to get exercise and it has a low impact on joints,” says Breyer. But on a national level, we need expanded support for improving the general infrastructure for cycling, especially bike lanes. And all cyclists should be aware of the risks and take appropriate precautions, such as using appropriate safety gear, including helmets, and they should follow the rules of the road.”SMOKING + EARLY MENOPAUSE = BAD NEWS
Women now have another reason to quit smoking, following the results of a recent Swedish study published in Menopause, the journal of the North American Menopause Society (NAM S). The research involving 25,474 women is the first to quantify the combined effects of smoking and age at menopause on overall mortality in terms of survival time by investigating the role of smoking as a possible effect modifier.
A harmful association between younger age at menopause and overall mortality has already been documented. In this study, which followed a large population of Swedish women over 16 years, the difference in median age at death between women with menopause at 40 years and women with menopause at 60 years was 1.3 years.
Cigarette smoking, which decreases age at menopause, has been identified as the only lifestyle factor modifying this connection.
Compared with current smokers, former smokers and never smokers had an older median age at death of 2.5 years.
When the analysis was restricted to current smokers, the difference in age at death between women with menopause at age 40 years and women with menopause at 60 years increased from 1.3 to 2.6 years.
The authors of the study concluded that not only does the age at menopause and smoking relate in predicting mortality, but also that smoking exaggerates the effects of estrogen deficiency on women with menopause at a younger age.
“This study provides credible evidence that women can proactively work to delay menopause through various lifestyle choices such as stopping smoking,” comments NAM S medical director Prof. Wulf Utian, “The ultimate benefit to them is that they may well extend their life expectancy.”
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