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Objectives: To assess physicians' responses to written feedback on medication discrepancies found with their elderly ambulatory patients. Design: Cross-sectional survey. Setting: Four clinics of a large university-affiliated, multispecialty group practice associated with a 186,000-member health maintenance organization. Participants: Patients aged 65 and older (n=202) and their family physicians (n=32). Measurements: Medication discrepancies and physicians' responses to written feedback on letters and adhesive labels containing a list of patients' actual medications. Results: A medication discrepancy was identified with 171 of 202 patients (84.7%). They resulted from patients not taking charted medications (52.9%), patients taking medications that were not charted (34.3%), or difference in dosage and/or schedule (12.8%). The medications involved were mostly complementary/alternative (28.3%), respiratory/allergy (15.1%), and analgesics (14.1%). The majority of physicians reported that the letters (93.8%) and accompanying labels (90.6%) were helpful to them. Half of the physicians reported filing the letters in patients' charts, whereas the other half discarded them. The majority (93.8%) also perceived the labels as an additional benefit to their practice and placed them in patients' charts to be used to correct patients' medications. Receptivity to the feedback was unrelated to physician age group, sex, years in practice, or clinic of practice. Conclusion: Although medication discrepancies are common in elderly ambulatory patients, their family physicians appreciate assistance in correcting these discrepancies, although potential problems, such as cultural or organizational resistance to the open disclosure of medication discrepancies in medical records due to associated legal ramifications, may need to be resolved. [ABSTRACT FROM AUTHOR]

The authors determined the incidence of concussion as well as correlates of grade II and grade III concussion among high school varsity football athletes. School team physicians completed an Internet-based incident card on their athletes who sustained a concussion on the field of play over three football seasons. Reported information included demographic data, school size, play position, game quarter of injury, and grade of concussion. A total of 70 concussions were reported on 981 eligible athletes for a cumulative incidence of 2.4 per 100 eligible players. The majority was grade II (52.9%). Most concussions occurred during the second (41.4%) and fourth (28.6%) quarters. The risk of concussion increased with increasing school size. After controlling for grade, weight, play position, and school size, playing during the fourth quarter was the only significant correlate of grade II and grade III concussion. Compared to playing during the first quarter, the risk of grade II and grade III concussion occurring during the fourth quarter was 8.7 (95% confidence interval, 1.2-64.2). Although the authors found a lower incidence of concussion than reported by others, they recommend that football coaches and team physicians be extra vigilant during the fourth quarter. [ABSTRACT FROM AUTHOR]

Despite increasing recognition of injury as a major public health problem worldwide, it has received limited attention and resources. This lack of attention is most notable in low-income countries. As part of efforts to develop coordinated injury control activities in Africa, a round table session was held at the Third International Conference on Injury Prevention and Control in Melbourne, Australia. The aims of the forum were to provide injury control researchers from Africa the opportunity to come together and reflect on issues of injury control in Africa, to deliberate on strategies of getting African governments to show more interest in injury control, and to solicit more assistance from the international donor community. Participants from Ghana, Kenya, South Africa and Zimbabwe presented the magnitude of the injury burden in their respective countries, reflected on current research efforts and highlighted the preventive efforts being undertaken. The forum made many recommendations including several regarding specific actions required of African governments, individual researchers and donor agencies. [ABSTRACT FROM AUTHOR]