Telling the truth to patients before hip fracture surgery

BACKGROUND

Hip fracture repair surgery carries a certain mortality risk, yet evidence suggests that orthopedic surgeons often refrain from discussing this issue with patients prior to surgery.

AIM

This study aims to examine whether orthopedic surgeons raise the issue of one-year post-surgery mortality before hip fracture repair surgery and to explore factors influencing this decision.

METHOD

The study employs a cross-sectional design, administering validated digital questionnaires to 150 orthopedic surgeons.

RESULTS

A minority of orthopedic surgeons reported always informing patients about the risk of mortality in the year following hip fracture surgery. The main reasons for not discussing this risk were a desire to avoid frightening patients, time constraints, and concerns about undermining patient hope. Orthopedic surgeons reported a medium-high level of perceived self-efficacy, with higher self-efficacy associated with a reduced likelihood of discussing one-year mortality risk. Conversely, older age and holding a specialist status in orthopedic surgery were associated with an increased likelihood of discussing this risk with patients.

CONCLUSIONS

These findings suggest a need for interventions to address communication barriers and ensure consistent provision of essential information to patients undergoing hip fracture surgery. Additionally, they highlight the importance of considering individual factors such as self-efficacy, age, and expertise in designing strategies to improve patient-provider communication in orthopedic care settings.

TRIAL REGISTRATION

The study doesn`t report the results of a health care intervention.

Exploring undergraduate elder abuse education in nursing: a scoping review

One in six adults aged 60 and older experiences abuse annually, revealing a prevalence rate of 15.7%. However, knowledge gaps persist regarding the integration of elder abuse education into nursing curricula. The purpose of this scoping review is to fill the gap in understanding how elder abuse is currently taught to undergraduate nursing students, what methods are employed, and what impact these methods have on students' preparedness. A search across CINAHL, Google Scholar, Medline, and PubMed identified 10 relevant studies (2013-present) in English. These studies, encompassing 3,207 undergraduate nursing students, utilized diverse methodologies, focusing on undergraduate nursing education and elder abuse. Limited understanding of elder abuse among undergraduate nursing students is evident, primarily due to inadequate curriculum integration. Various teaching methods, including simulations and participative approaches, show promise in addressing this gap. This scoping review emphasizes the urgent need for enhanced elder abuse education in undergraduate nursing programs. The identified knowledge gap underscores the importance of active teaching methods, especially through simulation integration. Further research is essential to establish a robust evidence base in this critical area.

Patient perspectives on the role of orthopedic nurse practitioners: a cross-sectional study

BACKGROUND

The inclusion of nurse practitioners (NPs) specializing in orthopedics shows potential for improving the quality of care for orthopedic patients. A critical aspect of assessing the feasibility and acceptance of introducing NPs into orthopedic settings involves understanding patients' perspectives on this role. This study aims to explore the receptiveness of orthopedic patients to treatment by orthopedic Nurse Practitioners (NPs). Additionally, it investigates potential associations between patients' willingness to engage with NPs, their familiarity with the NPs role, perceptions of nursing, and satisfaction with orthopedic nursing care.

METHODS

This cross-sectional study involved patients admitted to an orthopedic department in a central Israeli hospital between January and February 2023. Data was collected using a questionnaire consisting of five sections, validated by content experts. Statistical analyses, performed using SPSS, included descriptive statistics, independent samples t-tests, Pearson correlations, and linear regression.

RESULTS

Orthopedic patient participants demonstrated a moderate willingness to undergo treatment by orthopedic NPs, with over two-thirds expressing strong openness. Patients displayed a high willingness for NPs to engage in various clinical tasks, albeit showing lesser enthusiasm for medication management and preoperative evaluation. Positive attitudes towards nurses and familiarity with the NP's role emerged as significant predictors of patient receptiveness to NPs' treatment.

CONCLUSION

Patient acceptance of orthopedic NPs varies across different aspects of care. While there is overall willingness to receive care from NPs, these nuanced preferences should be considered when implementing NPs in orthopedic settings. Awareness and positive perceptions play crucial roles in shaping patients' willingness to receive care from these NPs.

TRIAL REGISTRATION

The research doesn't report the results of a health care intervention.

Nursing Students' Intention to Work in Hospice Care in the Future: A Cross-sectional Study

Studies reveal that nursing students rank hospice nursing among their least preferred career choices. The purpose of this study was to explore the association between nursing students' intention to work in hospice care in the future and their attitudes toward caring for dying patients, death anxiety, personal and/or professional experience of caring for dying patients, and type of nursing program studied. In this cross-sectional study, 200 nursing students completed an online survey based on the Frommelt Attitude Toward Care of the Dying Scale and the Turkish Death Anxiety Scale. Only 11% of the respondents were found to express interest in working in hospice care in the future. Studying in the accelerated program for nonnursing Bachelor of Arts graduates predicted a higher intention to work in hospice care in the future, than studying in the generic program (β = 0.27, P < .001). Completion of clinical experience in a medical ward predicted lower intention (β = -0.21, P < .01). These findings suggest that nursing students in the accelerated program for nonnursing Bachelor of Arts graduates should be provided with appropriate experience and support to maintain their interest in hospice nursing. Clinical experience in medical wards does not seem to be a good substitute for clinical experience in hospice care.

Characteristics of injuries related to traffic crashes in Israel before and during the COVID-19 pandemic

OBJECTIVES

This study explored differences in patient characteristics, injury characteristics, treatment modalities, and treatment outcomes among patients who presented to the Emergency Department (ED) following traffic crashes during the COVID-19 period (from March 15, 2020 to March 15, 2022) in comparison to the previous corresponding period between 2017 and 2019.

METHODS

The study is a retrospective chart review study. The study included a random sample of 610 patients who presented to the ED of a major hospital located in northern-central Israel following traffic crashes: 305 patients who presented during the COVID-19 period (from March 15, 2020 to March 15, 2022) and 305 patients who presented during the previous corresponding period (from March 15, 2017 to March 15, 2019). Socio-demographic data, data regarding the traffic crashes, and medical data of the patients were collected from their medical records, and the data were compared.

RESULTS

In the context of the COVID-19 period, a notable surge in the percentage of cyclist victims was evident, marking an increase from 7.5% to 19% compared to the corresponding period. Conversely, the incidence of pedestrian victims during the COVID-19 period dropped to 19.7%, in contrast to 30.8% in the corresponding period. Notably, patients involved in pedestrian crashes amid the COVID-19 period exhibited a shorter hospital stay (M = 2.8 days, SD = 3.3) compared to the corresponding period (M = 4.3 days, SD = 7.1) [t = 1.8 (df = 141), p < 0.05]. However, a higher fatality rate was observed among these patients during the COVID-19 period compared to the corresponding period (6.7% vs. 0%) [χ2 = 6.4 (df = 1), p < 0.05].

CONCLUSIONS

The study reveals significant changes in traffic crashes characteristics during the pandemic period, including a notable increase in cyclist victims and a decrease in pedestrian incidents. These shifts may be attributed to factors such as changes in transportation patterns, increased use of bicycles for essential travel. Despite these changes, the proportion of severe crashes remained relatively consistent. These findings underscore the importance of understanding the underlying causes behind these shifts and highlight the ongoing need for public education and awareness initiatives to promote traffic safety, particularly for vulnerable road users, during pandemic periods.

Examining the association between stigmatizing attitudes in nursing students and their desire for a career in mental health nursing: A comparative analysis of generic and accelerated programs in Israel

WHAT IS KNOWN ON THE SUBJECT?: Mental health nursing is generally viewed as the least attractive career choice among nursing students. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: Studying in the generic nursing program influence higher desire for a career in mental health nursing. Nursing students who have prior experience working in mental health and have provided care to psychiatric patients are more inclined to express a desire to pursue a career in this field WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Nursing students enrolled in the generic program, who have previous work experience in mental health or experience caring for a person with a mental illness, and who have a lower level of stigmatizing attitudes, may constitute the future workforce in mental health nursing.

ABSTRACT

INTRODUCTION: Mental health nursing is often perceived as an unattractive career choice among nursing students, and it remains unclear whether the type of nursing program influences this view.

AIM

This cross-sectional study aimed to explore the association between stigmatizing attitudes in nursing students and their desire for a career in mental health nursing, comparing students in generic and accelerated programs.

METHOD

A total of 220 nursing students from generic and accelerated programs in North-Center Israel participated in this cross-sectional study, completing a questionnaire on stigmatizing attitudes and their interest in a mental health nursing career.

RESULTS

Nursing students displayed a generally low desire for mental health nursing, influenced by factors such as enrollment in the generic program, previous mental health work experience and stigmatizing attitudes.

DISCUSSION

Students in the generic program, with lower stigmatizing attitudes and prior mental health experience, exhibited a higher inclination towards mental health nursing.

IMPLICATIONS FOR PRACTICE

Prospective mental health nursing professionals may be identified in the generic program, particularly those with prior mental health experience and lower stigmatizing attitudes. Additional studies are required to confirm and broaden their applicability to other contexts.

When all computers shut down: the clinical impact of a major cyber-attack on a general hospital

Importance

Healthcare organizations operate in a data-rich environment and depend on digital computerized systems; thus, they may be exposed to cyber threats. Indeed, one of the most vulnerable sectors to hacks and malware is healthcare. However, the impact of cyberattacks on healthcare organizations remains under-investigated.

Objective

This study aims to describe a major attack on an entire medical center that resulted in a complete shutdown of all computer systems and to identify the critical actions required to resume regular operations.

Setting

This study was conducted on a public, general, and acute care referral university teaching hospital.

Methods

We report the different recovery measures on various hospital clinical activities and their impact on clinical work.

Results

The system malfunction of hospital computers did not reduce the number of heart catheterizations, births, or outpatient clinic visits. However, a sharp drop in surgical activities, emergency room visits, and total hospital occupancy was observed immediately and during the first postattack week. A gradual increase in all clinical activities was detected starting in the second week after the attack, with a significant increase of 30% associated with the restoration of the electronic medical records (EMR) and laboratory module and a 50% increase associated with the return of the imaging module archiving. One limitation of the present study is that, due to its retrospective design, there were no data regarding the number of elective internal care hospitalizations that were considered crucial.

Conclusions and relevance

The risk of ransomware cyberattacks is growing. Healthcare systems at all levels of the hospital should be aware of this threat and implement protocols should this catastrophic event occur. Careful evaluation of steady computer system recovery weekly enables vital hospital function, even under a major cyberattack. The restoration of EMR, laboratory systems, and imaging archiving modules was found to be the most significant factor that allowed the return to normal clinical hospital work.

Ophthalmologists' Attitudes, Knowledge, and Willingness to Report Child Abuse

The aim of the present study was to explore ophthalmologists' attitudes, knowledge, and willingness to report child abuse. One-hundred-and-seven ophthalmologists employed in various hospitals in Israel completed an online questionnaire. Less than half the ophthalmologists (44.9%) reported that they had treated children whom they identified or suspected as being victims of child abuse, while only 43.9% of these reported child abuse. Despite generally positive attitudes towards reporting of child abuse among the ophthalmologists, their average level of knowledge was low. Ophthalmologists who had received training on child abuse and residents displayed a higher level of knowledge. In addition, female ophthalmologists tended to agree more that ophthalmologists are obligated to screen for and report child abuse. Moreover, female ophthalmologists expressed higher willingness to report child abuse. The present study reveals that underreporting of child abuse, and more precisely the discrepancy between identification and reporting, is present among ophthalmologists. It seems that lack of knowledge regarding identification and reporting of child abuse is the main barrier to reporting, especially among medical specialists. These findings underscore the importance of training programs on child abuse, both during formal education in medical school, and post-qualification, for all ophthalmologists, irrespective of seniority.

Mothers' satisfaction with emergency care when their child has an autism spectrum disorder

PURPOSE

This study aimed to examine factors identified by mothers as affecting their satisfaction with the care provided to their children in the Emergency Department (ED), among mothers of children with autistic spectrum disorder (ASD) in comparison to mothers of children without ASD.

DESIGN AND METHODS

In this correlational quantitative study, 128 Israeli mothers - 59 (46%) mothers of children with ASD and 69 (54%) of children without ASD - completed an online survey based on a Ministry of Health national survey of patient experience.

RESULTS

Mothers of children with ASD expressed lower satisfaction with the care provided. The difference was particularly evident concerning waiting times for examination of the child by nurses and physicians in the ED, whether the nurses were attentive and responsive to the mother's questions and concerns, whether the ED staff demonstrated coordination and cooperation with regard to medical care of the child, and whether work in the ED was conducted in an orderly and organized manner. The presence of communication difficulties in children predicted mothers' satisfaction with care.

CONCLUSIONS

These findings suggest that certain needs of mothers and/or their children with ASD do not receive an appropriate response in the ED.

PRACTICE IMPLICATIONS

It is important to raise the awareness of healthcare providers in EDs regarding the needs of children with ASD and their parents, especially children with communication difficulties. Strategies should be implemented to improve the experience of children with ASD and their parents in the ED.

What motivates young Arab Muslim women to choose nursing as a profession: A cross-sectional study

AIM

This study examines the impact of nurse uniforms, the coronavirus pandemic, and the image of nurses and the nursing profession on the career choice of young Muslim Arab women in nursing, with a focus on policy implications.

BACKGROUND

The global nursing shortage poses significant challenges, including in Israel. Attracting young Muslim Arab women to nursing careers is vital. Understanding how nurse uniforms, the pandemic, and perceptions of nurses and the nursing profession shape their career decisions can inform policy interventions.

METHODS

A cross-sectional study utilized digital questionnaires administered to 200 Muslim Arab women aged 20-30 in Israel. The study adhered to the EQUATOR checklist for cross-sectional studies.

RESULTS

Only 29.2% of participants expressed interest in studying nursing. Findings revealed a positive correlation between the pandemic's impact and intention to pursue nursing. A linear regression analysis shows the impact of the white uniform, the image of nurses, and the image of the profession on the choice of a career in nursing.

DISCUSSION

The study emphasizes the significance of nurse uniforms, the image of nurses, and the image of the nursing profession in shaping young Muslim Arab women's career choices in nursing. Policy interventions should raise awareness about nursing roles, expand responsibilities, and highlight nurses' contributions to society.

CONCLUSION

Strategies to attract young Muslim Arab women to nursing careers should address nurse uniforms, the image of nurses, and the image of the nursing profession.

IMPLICATIONS FOR POLICY

Policy interventions should prioritize diversity, promote positive images of nurses and the nursing profession, and raise awareness of nursing roles and contributions among young Muslim Arab women.

Acupuncture Effect on Analgesic Consumption and Cortisol Levels Following Total Knee Arthroplasty: A Randomized Controlled Trial

Objective

Pain following total knee arthroplasty (TKA) is common. Various modalities of treating orthopedic postoperative pain (POP) exist; however, the optimal management of POP remains unclear. The purpose of this study was to examine acupuncture's effect on postoperative analgesic consumption and cortisol levels in patients undergoing TKA.

Materials and Methods

In this randomized controlled trial, 80 patients scheduled for elective TKA surgery were recruited and randomly assigned to 2 groups: (1) an intervention group, receiving acupuncture treatment on days 1 and 2 in addition to standard POP management (n = 40) and a control group, who received standard POP management only (n = 40).

Results

There was no statistical difference between the groups in analgesic consumption on days 1 and 3 postoperatively. On day 5 postoperatively, lower analgesic consumption was seen in the intervention group, compared to the control group. However, this difference was not statistically significant (1.4 versus 2.3, respectively; P = 0.215). There was no statistical difference between the groups in cortisol levels on day 1 postoperatively. In contrast, on day 2 postoperatively, cortisol level was significantly lower in the intervention group, compared to the control group (296 nmol/L versus 400 nmol/L, respectively; P < 0.05).

Conclusions

The findings suggest that acupuncture may have some effect on patients' analgesic consumption short-term after TKA. Further studies with larger samples are required for establishing these results.This trial was registered at ClinicalTrials.gov (Registration #: NCT03415204).

Injury and Sociodemographic Characteristics of Intimate Partner Violence in Women in Israel: A Single-Center Retrospective Cohort Study

BACKGROUND

Intimate partner violence is a growing public health concern worldwide, and nurses are uniquely positioned to help identify and refer patients for services. Yet, intimate partner violence injury patterns and characteristics often go unrecognized.

OBJECTIVE

The purpose of this study is to explore injury and sociodemographic characteristics associated with intimate partner violence in women presenting to a single emergency department in Israel.

METHODS

This retrospective cohort study analyzed medical records of married women injured by their spouse who presented to a single emergency department in Israel from January 1, 2016, to August 31, 2020.

RESULTS

In total, 145 cases were included, of which 110 (76%) were Arab and 35 (24%) were Jewish, with a mean age of 40. Patients' injury patterns consisted of contusions, hematomas, and lacerations to the head, face, or upper extremities, not requiring hospitalization, and having a history of emergency department visits in the past 5 years.

CONCLUSION

Identifying intimate partner violence characteristics and patterns of injury will help nurses identify, initiate treatment, and report suspected abuse.

Mortality, Survival, and Readmissions During a 12-Month Follow-Up After Hip Fracture: Inpatient Rehabilitation Versus Home Rehabilitation

PURPOSE

This study compared readmissions, survival, and mortality during a 12-month follow-up period of inpatient rehabilitation and home rehabilitation for older persons who had experienced a hip fracture.

METHODS

This work was retrospective cohort research. Between January 1 and December 30, 2019, the medical records of 280 elderly patients who were admitted to a hospital with a hip fracture were analyzed. Of these patients, 74.3% received inpatient rehabilitation, whereas 25.7% received home rehabilitation.

RESULTS

In terms of readmissions and death, there were no appreciable differences between the inpatient rehabilitation and home rehabilitation groups. The patients in the inpatient rehabilitation group were older; more likely to need assistance with activities of daily living; and were taking, on average, more prescription drugs on a daily basis than those in the home rehabilitation group.

CONCLUSIONS AND CLINICAL RELEVANCE

In conclusion, as better outcomes were expected for the home rehabilitation group, which on average included less complicated patients, our findings suggest that the home rehabilitation pathway may not be a good alternative to the inpatient rehabilitation pathway.

The role of parental health beliefs in seeking an eye examination for their child

BACKGROUND

We aimed to explore the role of parental health beliefs in parent seeking of eye examinations for their children, using the Health Belief Model.

METHODS

In this quantitative correlational survey study, 100 parents who presented to Barzilai University Medical Center in July 2021 to perform an eye examination to their child completed a questionnaire.

RESULTS

Only 29.6% of the parents knew that a vision screening is performed in first grade, and 10% of the parents were unsure about where to find local eye care for their kids. Moreover, 19% of the parents indicated that they were concerned that their child would be prescribed glasses unnecessarily, and 10% believed that wearing glasses would weaken their child's eyes. Various parental health beliefs regarding children's eye examinations were found associated with parent seeking of eye examinations for their child. Thus, perceived susceptibility (r = 0.52, p < 0.01), perceived benefits (r = 0.39, p < 0.01), and perceived barriers (r=-0.31, p < 0.01) are associated with parent seeking of eye examinations for their child. Also, parents' level of knowledge was associated with seeking eye examinations for their child (r = 0.20, p < 0.01).

CONCLUSION

Parent perceptions of the child's susceptibility to vision problems and perceived barriers to seeking eye examinations predicted parents seeking of eye examinations for their child. Interventions aimed at increasing timely eye examinations among children should focus on raising parent awareness of vision problems in childhood, dispelling misconceptions, and providing parents with practical information regarding available services.

Israeli Female Physicians' Motives for Choosing Orthopedics as Their Specialty Choice

BACKGROUND

Orthopedics is not a popular field of specialization among female medical students. Therefore, the purpose of the study was to examine factors related to women's choice of orthopedics as their field of specialty, compared to those who chose other fields.

METHODS

In this cross-sectional survey, 149 female medical residents from Israel-33 specializing in orthopedics and 116 in other fields-completed a questionnaire. A comparison was held between the two groups.

RESULTS

Orthopedic residents were more likely to have received clinical training in this field during their medical studies and were more likely to have expressed a desire to specialize in orthopedics before and at the completion of their studies. In addition, orthopedic residents ascribed greater importance to job security when choosing a field of specialty and, in contrast, ascribed no importance at all to lifestyle. No difference was found between the two groups in their level of dissatisfaction as a result of their residency. However, orthopedic residents were more inclined to perceive gender discrimination in the field of orthopedics but, despite this, had a greater intention to recommend a residency in orthopedics. A negative association was found between the level of dissatisfaction as a result of the residency and intention to recommend a residency in orthopedics.

CONCLUSIONS

Differences between the two groups point to potential factors that might have been related to women's choice of orthopedics as their field of specialty. The findings may help form strategies for attracting women to specialize in orthopedics.

Cross-sectional Analysis Study Between SIGMA Knee System and ATTUNE in a Cruciate-Retaining Fixed-Bearing Total Knee Replacement, with no Patellar Resurfacing

Background

The purpose of our study was to compare the knee implant SIGMA to the ATTUNE knee implant in a cruciate-retaining (CR) fixed-bearing (FB) total knee replacement (TKR) surgery, with no patellar resurfacing.

Methods

We examined 40 patients (19 SIGMA; 21 ATTUNE) who underwent a TKR FB CR surgery, without patellar resurfacing, due to osteoarthritis, between August 2013 and July 2017. All surgeries were performed by a single surgeon. We performed a cross-sectional analytical study based on preoperative patient data and data collected in follow-up sessions. All patients were asked to fill a quality-of-life (QOL) questionnaire, SF-36 translated to the Hebrew language. All patients were clinically evaluated using the Knee Society Score (KSS) and the Knee Function Score (KFS).

Results

Patients from the SIGMA cohort reported fewer postoperative physical function limitations in the SF-36 (p = 0.01) and the KFS (p = 0.04). Patients who underwent surgery using the SIGMA implant reported increased vitality when compared to the ATTUNE (p = 0.02). No significant differences were found between the groups in other measures of quality of life, ranges of motion, valgus, and postoperative knee stability. The average follow-up period was significantly longer for the SIGMA (p < 0.00001).

Conclusion

Significant differences were found in postoperative physical function and vitality scores between SIGMA and ATTUNE knee implants. SIGMA cohort presented superior results. Presumably, these findings are due to the differences in follow-up times.

Pediatricians' knowledge, attitude and practice on treating children with red eye disease

BACKGROUND

Pediatricians play an important role in the early detection and prompt treatment of ocular disorders in children, including red eye disease. Our aim was to examine the knowledge level of pediatricians regarding treating children with red eye disease, as well as the factors that affect the knowledge level, and the potential implications of a low level of knowledge.

METHODS

In this correlational quantitative study, 152 expert pediatricians completed a questionnaire that included questions on knowledge, attitudes, and experience in treating red eye disease.

RESULTS

Respondents' mean level of knowledge was moderate. Most of the respondents (89.5%) knew that the most likely diagnosis for a child with red eyes and a discharge is viral conjunctivitis and that pain, blurred vision, and a clouded cornea, are symptoms indicative of a more complex systemic problem. In contrast, 78.3% of the pediatricians claimed that the treatment of choice for viral conjunctivitis is a conservative treatment that includes eye flushing and strict hygiene. However, 14.5% (n = 22) of the pediatricians were found to prescribe antibiotics. A negative association was found between the pediatrician's age and years of experience, and level of knowledge concerning treatment of children with red eye. A strong positive association was found between pediatricians' level of knowledge and their attitudes to performing eye tests. Moreover, a negative association was found between the level of knowledge and the number of cases in which pediatricians prescribed antibiotics for children with red eye.

CONCLUSIONS

The research findings indicate that lack of knowledge was more conspicuous among pediatricians with more experience. Knowledge appears to be critical both for readiness to treat red eye and for proper treatment. It is necessary to provide pediatricians with tools for treating eye disorders in children and to refresh their knowledge on red eye, particularly among pediatricians with more years of experience.

Characteristics of Women Presenting at the Emergency Department Who Choose Not to Disclose Being Subjected to Intimate Partner Violence

Literature suggests that some women refrain from disclosing being subjected to intimate partner violence (IPV) upon their contact with the health care system. Such disclosure becomes critical when the violence compels women to seek urgent medical care. The purpose of the present study was to compare characteristics of women who disclose and women who do not disclose being subjected to domestic violence, when presenting at the Emergency Department (ED). In this chart review study, characteristics of 56 randomly sampled women who disclosed and 50 who did not disclose being subjected to domestic violence, when presenting at the ED in a medical center located in central-northern Israel between 2015 and 2018, were compared. It was found that women who did not disclose were more likely to be pregnant, legally defined as helpless, and dependent on others to some extent. In addition, they were more likely to be hospitalized, which may indicate a more severe injury, and were more likely to have been subjected to psychological abuse or neglect alone. A trauma informed approach should guide specific interventions with a focus on women with these characteristics in the ED, in order to facilitate their disclosure of IPV.

[REGENERATIVE MEDICINE IN ORTHOPEDICS - UPDATES AND COMMON USES]

Regenerative medicine is a medical field that aims to heal, rehabilitate, repair, and facilitate the regeneration of diseased and damaged cells, tissues and organs. Regenerative medicine is based on mobilizing the body's self-healing abilities. The use of regenerative medicine to treat various musculoskeletal conditions is an evolving field within orthopedics and sports medicine called 'ortho-biology' or 'ortho-regenerative medicine'. There are currently well-founded findings regarding the safety of ortho-biological treatments, their manner of action, effect, and potential effectiveness. However, there is need for more controlled studies with strong scientific proof in order to better understand the potential of these treatments and how to best use them.

Combined Effect of Seasonality and Hyponatremia on the Occurrence of Hip Fractures Among Older Adults

Background

It is unclear whether climate may play a role in the association between hyponatremia on admission and increased mortality risk among hip fracture patients following a hip fracture repair surgery. We aimed (1) to explore if there is any combined effect of seasonality and hyponatremia on the occurrence of hip fractures among older adults and (2) to explore the effect of hyponatremia on admission on mortality rate at latest follow-up among hip fracture patients following a hip fracture repair surgery in the context of the subtropical climate of Israel.

Methods

We conducted a retrospective cohort study of older patients who underwent a surgery for hip fracture repair in a major 495-bed hospital located in northern-central Israel in 2017-2020. Patients were divided into two groups: hyponatremic (n = 107) and normonatremic (n = 757) patients. Characteristics of the two groups were compared, as well as their survival probability.

Results

Hyponatremic patients were most frequently hospitalized during winter season. Such seasonal variation was observed only among hyponatremic patients. Moreover, patients who were hospitalized during winter season were more likely to be hyponatremic on admission. Hyponatremia on admission was found as a significant independent predictor of mortality rate at latest follow-up (adjusted hazard ratio = 0.377 [0.26-0.52]), when compared to normonatremia.

Conclusion

There is a combined effect of seasonality and hyponatremia on the occurrence of hip fractures among older adults, with hyponatremic patients being at a higher risk of sustaining a hip fracture during winter season than during other seasons. In addition, the association between hyponatremia on admission and mortality rate at latest follow-up among hip fracture patients has been confirmed.

Women's Intention to Consent to Universal Screening for Intimate Partner Violence (IPV) at Well Baby Clinics

The Israeli Ministry of Health requires medical and nursing staff in both hospitals and community settings, screen all women for Intimate Partner Violence (IPV). This study explored factors associated with the intention of Israeli women to consent to universal IPV screening during their visits to well baby clinics, using the Theory of Planned Behavior (TPB). Two hundred Jewish women of childbearing age completed a questionnaire based on the TPB. Only 52% of the women reported that they had undergone IPV screening conducted by nurses at well baby clinics in the last year. The TPB was found to predict 44% of the variance in women's intention to consent to universal IPV screening, whereas control beliefs, perceived behavioral control, and normative beliefs with regard to universal screening, were found to be the most significant predictors. These findings may help design interventions aimed at raising women's intentions to consent to universal IPV screening.

Awareness, Knowledge, and Screening for Intimate Partner Violence Among Orthopedic Surgeons in Israel

This study examines factors associated with screening of female patients for intimate partner violence (IPV) by orthosurgeons in a sample of 100 Israeli orthosurgeons. Findings reveal positive attitudes toward screening female patients but a significant lack of knowledge. Arab orthosurgeons held slightly more negative attitudes toward screening for IPV and had a more prominent lack of knowledge regarding screening for IPV, compared to their Jewish counterparts. Nationality and feeling uncomfortable asking female patients about IPV predicted screening for IPV. The importance of training orthosurgeons on the assessment and treatment of IPV cannot be overemphasized, especially among Arab orthosurgeons.

Characteristics of those who fall during orthopedic hospitalization - A retrospective case-control study

BACKGROUND

The causes of falls are heterogeneous and represent an interaction between patient and environmental factors. This study aimed to explore the characteristics of patients who fell in an in-patient orthopedic department and explore possible reasons for their falls.

METHODS

A retrospective case-control study of adults in an orthopedic in-patient setting at a major hospital, who sustained a fall. Sociodemographic and medical characteristics of randomly sampled patients who fell (cases, n = 128) and their controls (n = 128) were compared.

RESULTS

Fallers were younger, had less comorbidities, took less medications, and had a shorter length of stay than non-fallers. Moreover, fallers' reasons for hospitalization were not necessarily associated with limited mobility. Fall events occurred most frequently from the patient's bed, in the bathroom and during night shifts.

CONCLUSIONS

Our study portrays atypical fallers; that is, patients who had no obvious risk factors for falls and, thus, were not expected to fall. It appears that reduction in falls among high-risk patients may artificially create a population of atypical fallers. The patients may overestimate their abilities and avoid asking for assistance. Our findings suggest that emphasizing the importance of asking for assistance among both low-risk and high-risk patients as well as male and female patients should be an integral part of patient education in orthopedic departments.