The use of ultrasound is now widespread within the field of Emergency Medicine. The availability of lightweight and relatively cheap ultrasound devices has enabled clinicians to obtain more detailed information about the condition of acutely ill and injured patients than can be done with a clinical exam only. This paper discusses the standardized E-FAST exam for trauma; the technical details of the exam and the reliability of the information gained by each of it's components. Other advanced use of ultrasound for evaluation of trauma patients is introduced. Investing in the equipment and physician training to provide emergency ultrasound evaluation of injured and acutely ill patients in Iceland may be a relatively inexpensive way to improve patient care.
Information about the education, training and future employment prospects of Icelandic surgeons has not been available.
The study included all Icelandic surgeons, in all subspecialties, educated at the Faculty of Medicine at the University of Iceland. Information on specialty training, higher academic degrees and in which country these were obtained was collected. Future employment prospects were analysed by calculating supply and demand until the year 2025. Approximations, such as sustained demand for surgeons per capita, were used.
Out of 237 licensed surgeons, two thirds were living in Iceland and 36 were retired. Majority (69.2%) had been trained in Sweden and orthopaedic (26.9%) and general surgery (23.9%) were the most common subspecialties. The average age of surgeons in Iceland was 52 years and 44 years for surgeons abroad. Females were 8% of surgeons in Iceland while being 17.4% among 36 doctors in surgical training overseas. Over 19% had received a PhD degree. Predictions suggest that supply and demand for surgeons in Iceland will be equal in the year 2025, not taking into account the prospects for the working market outside Iceland.
A third of Icelandic surgeons live outside Iceland. The proportion of female surgeons is low but it is increasing. Our predictions indicate a balanced work market for surgeons in Iceland for the next 15 years. However, there are many uncertainty factors in the calculations and they do not predict the prospects for individual subspecialties.
OBJECTIVE: The purpose of the study was to compare wellbeing, health and work environment before and after intervention among employees of ReykjavÃk city day-care centre. MATERIAL AND METHODS: The study is a prospective interventions study. In the year 2000 employees of 16 day-care centres responded to a questionnaire regarding work environment, health and wellbeing. Work environment evaluation was completed and the centre classified into four groups accordingly. Subsequently, the "equipment was renewed" noise protection improved and the employee received education concerning occupational health. Six months, after interventions, in the year 2002 the same questionnaire was readministered. RESULTS: Response rate in 2002 was 88% (n=267) but 90% in the year 2000. Work environment had improved. More employees had received instruction on good workposture and good work technique than 2 years earlier. Fewer employees used awkward posture than before. Better workspace resulted in reduced number of symptoms, also for the youngest employees. Symptoms were also fewer where unskilled employees were in majority and where the fewest of them had received proper education on work posture. In the year 2002, psychosocial wellbeing was better or equal than two years earlier. This was associated with better education and higher age even despite less workspace. Employees awareness towards noise was greatly improved. CONCLUSION: It is possible to improve work methods and work environment of employees with goal directed intervention, thus laying the ground for wellbeing at work. The interplay between the factors education and age is complex, though. Thus it is important, that all workplaces, adopt the process of "risk assessment", intervention, and then reassessment of the work environment. By doing so the goals of health promotion and good occupational health can be reached.
Prevalence of diabetes is increasing worldwide. Education is regarded as an essential part in diabetes care to enable people with diabetes self-care. Self-care in diabetes can be demanding and it is regarded impossible to separate treatment and education. Clinical guidelines in diabetes care recommend using empowerment approach in diabetes education. The empowerment approach emphasizes that people with diabetes are assisted to make informed decisions. Instruments measuring knowledge, self-care, empowerment, well-being and distress were translated into Icelandic, according to internationally accepted guidelines. The questionnaires were tested in a cross-sectional study and used in an educational intervention study. It was found that the instruments are practical and useful and can be used in clinical practice in Iceland. It is argued that in diabetes care, health care practitioners should make more use of appointed instruments that enable them to focus their care on specific needs of each person. The care should be based on answers from the instruments and goals which people with diabetes choose to work towards. The education should be based on the empowerment approach.
BACKGROUND: Various parties have expressed interest in establishing formal postgraduate medical education programs. The interest of residents and medical students to such programs in Iceland has not been evaluated before. METHODS: A questionnaire was sent to 146 interns and residents and 84 senior medical students. The following variables were analyzed: Gender, attitude towards postgraduate training in Iceland, interest to participate in such training, preferred specialty and which factors might influence their decision. RESULTS: 100 subjects completed the questionnaire (response rate 45%), 61 interns and residents and 39 medical students. Of those completing the questionnaire, most interns and residents (97%) and medical students (87%) agreed or agreed strongly with the concept of postgraduate training in Iceland. The majority of responders wanted to undergo part of their postgraduate training in Iceland if this option would be available. Those who preferred postgraduate training in Iceland did so for the following reasons: The importance of "hands-on" training, availability of consultants, favorable social setting and organized teaching. Those who wanted to do all their postgraduate training abroad rated case variability, "hands-on" training, organized teaching and research opportunities as the main factors influencing their decision. CONCLUSIONS: Interns, residents and medical students are in favor of undergoing part of their postgraduate training in Iceland. Those who chose to train abroad rated case variability and research opportunities higher than those in favor of training in Iceland.
Jón Pétursson (1733-1801) was an apprentice af the first Chief Medical Officer of Iceland. In 1765 Pétursson enrolled in the Medical Faculty at the University of Copenhagen. In 1769 with the Faculties approval he published a monograph on the so called Icelandic Scurvy. In 1770-71 Pétursson served as ship's surgeon in the Royal Danish Navy on an expedition to the Mediterranean. In 1772-1775 he served as an assistant to the Chief Medical Officer and the newly appointed apothecary, who shared premises at Nes, Reykjavík. In 1775 he was appointed surgeon (chirurgeon) to the Northern District. Pétursson wrote two medical book while serving his district, both being prepared now for republication. A. The Lækningabók fyrir almúga (Leechbook for common people) published posthumously 1834, edited by Sveinn Pálsson surgeon. It was undoubtedly inspired by the Swiss physician Tissot and his book Avis au peuple sur sa santé ou traité des maladies plus fréquentes 1761. B. A treatise on rheumatism or dirorder of the joints (Stutt ágrip um iktsýki edur lidaveiki, 1782). In Scand J Rheumatol 1996: 25; 134-7 the authors point out that Péturssons description of what he calls arthritis vaga encompasses these essential features: It is common, chronic, destructive, inflammatory polyarthritis, sometimes with systemic manifestations. It affects peope of all ages and has a female preponderance. They state that only rheumatoid arthritis fulfills these specifications. They conclude that medical history should give Pétursson credit for the first definite description of rheumatoid arthritis.
Unilateral spatial neglect is a disorder commonly encountered after hemisphere stroke, most often in the right hemisphere. Neglect patients fail to attend and respond to stimuli presented on the side of space opposite to the brain lesion. Neglect implies a complex dysfunction in the co-action between perception, motor behavior and the environment where the patients attentive capacities and the environmental space are of special importance. Patients difficulties can be seen in that they do not eat from the left side of the plate or omit words to the left when asked to read. Commonly patients do not have a complete insight into their neglect problems. Neglect in stroke patients has been associated with poor outcome on functional activities. Signs of neglect are not always obvious but can be explored and assessed quickly by bedside neuropsychological testing. Neglect is often more unclear to an observer than, e.g. if a patient suffers from paresis or aphasia. Education for patients, their relatives and others are therefore important.