Objectives To learn the echocardiography skills of intensivists after receiving a basic critical care echocardiography training course, and investigate factors that may influence their performance. Methods We completed a web-based questionnaire that assessed the skills in ultrasound scanning techniques of intensivists who took a training course on basic critical care echocardiography held in 2019 and 2020. Mann-Whitney test was used to analyze the factors which might affect their performance on image acquisition, recognizing clinical syndrome, and measuring the diameter of inferior vena cava, left ventricular ejection fraction and left ventricular outflow tract velocity-time integral.Results We enrolled 554 physicians from 412 intensive care units across China. Among them, 185 (33.4%) reported that they had 10%-30% chance of being misled by critical care echocardiography when making therapeutic decision, and 34 (6.1%) reported that the chance was greater than 30%. Intensivists who performed echocardiography under the guidance of a mentor and finished ultrasound scanning more than 10 times per week reported significant higher scores in image acquisition, clinical syndrome recognition, and quantitative measurement of inferior vena cava diameter, left ventricular ejection fraction and left ventricular outflow tract velocity-time integral than those without mentor and performing echocardiography 10 times or less per week respectively (all P < 0.05).Conclusion The skills in diagnostic medical echocardiography of Chinese intensivists after a basic echocardiographic training course remain low, and further quality assurance training program is clearly warranted.
Humans ; Clinical Competence ; East Asian People ; Echocardiography/standards* ; Stroke Volume ; Ventricular Function, Left ; Self-Assessment ; Physicians/standards* ; Internal Medicine/standards*

Atrial Fibrillation/diagnosis* ; Humans ; Quality of Life ; Self Report ; Symptom Assessment

Background: The skill of active listening is important in the diagnosis and management of patients by physicians. Objective: The aim of the study was to determine the self-assessed active listening skills and attitude among resident physicians in a tertiary hospital in Iloilo City. Methods: This is a cross sectional study which recruited all sixty-two resident physicians of the different residency training programs of Iloilo Mission Hospital. The participants answered a self-administered questionnaire in January 2020. Data entry and data analysis were done using Microsoft Excel and SPSS. Descriptive statistics were used to summarize the level of active listening skills and attitude of the respondents. ANOVA, T-test, and Pearson chi square at alpha level 0.05 were used to determine the association between the variables. Results: Majority (87%) of resident physicians had medium level of active listening skills and attitude based on their Active Listening Attitude Scale (ALAS) score. The remaining 13% had high ALAS score. There was no socio-economic variable that was found to be associated with ALAS score. Conclusions The resident physicians of Iloilo Mission Hospital have a medium to high level of active listening skills and attitude. The respondents believe that having good active listening skills will help them deal with their patients and honing such skills should be encouraged during residency training.
Self-Assessment ; Attitude ; Tertiary Care Centers ; Physicians

Background: Self-evaluation can augment the facilitation of acquiring knowledge, skills and attitude through a reflective method. Self-assessment video (SAV) can be a very useful reflective method tool that is student-centered and self-directed.

Objective: This study aimed to identify if SAV is an effective supplementary learning tool in improving cardiovascular examination knowledge, skills and attitude of second year medical students.

Methodology: A quasi-experimental two-group design with pre- and post-test was used. The study population by convenience sampling involved second year medical students of the University of Santo Tomas Faculty of Medicine and Surgery. A structured direct observation checklist on cardiovascular precordial examination was used, done on two occasions in a week interval period. The said examinations were recorded in a video and evaluated and scored by two independent facilitators on these two occasions. The experimental group had the opportunity to review their videos immediately after the two examinations and accomplished self-assessment form. One-Way Repeated Measures Multivariate Analysis of Variance (One-Way RM-MANOVA), a parametric multivariate test for between- and within group comparison of multiple dependent variables was used.

Results: It showed that there was a significant improvement in all parameters measured after the intervention (SAV in the experimental group compared to the control group).

Conclusion: The study showed that SAV is an effective supplementary learning tool in cardiovascular examination attitude, knowledge, and skills, and can be a very useful teaching and learning self-evaluation tool.

PURPOSE: The main purpose of this study was to compare the relationships between physical activity (measured using an accelerometer vs. self-reported) and cardiovascular disease risk factors. Differences in accelerometry physical activity between 10-minute bouts and total bouts were also compared.METHODS: Data originated from the Korea National Health and Nutrition Examination Survey. Logistic regression was used to predict cardiovascular disease risk from physical activity levels.RESULTS: Self-reported physical activity could not significantly predict the odds of having cardiovascular risk. However, the insufficiently active group classified according to the total-bout physical activity had significantly greater odds of having hypertension or prehypertension (odds ratio [OR], 1.35; 95% confidence interval [95% CI], 1.00–1.82), diabetes mellitus (OR, 1.77; 95% CI, 1.01–3.19), and dyslipidemia (OR, 1.65; 95% CI, 1.17–2.36) than the highly active group. Regarding the 10-minute bout physical activity, the inactive group had significantly greater odds of having only hypertension or prehypertension (OR, 1.67; 95% CI, 1.02–2.76) than the highly active group.CONCLUSION: Total-bout physical activity measured using an accelerometer could significantly predict the cardiovascular disease risk compared to 10-minute bout physical activity. However, self-reported physical activity could not significantly predict the cardiovascular disease risk.
Accelerometry ; Cardiovascular Diseases ; Diabetes Mellitus ; Dyslipidemias ; Hypertension ; Korea ; Logistic Models ; Motor Activity ; Nutrition Surveys ; Prehypertension ; Risk Assessment ; Risk Factors ; Self Report

BACKGROUND: The living arrangement has been suggested as an important factor affecting health. Recent studies have also suggested that there was a risk among elderly persons who were not alone. This study examined whether the detailed living arrangement was associated with a future decline in functional capacity in the elderly, by gender, in a Japanese suburban city. METHODS: A 3-year longitudinal questionnaire survey (baseline: 2011; follow-up: 2014) for aged 65 years or older was conducted in Kurihara city, Japan. Of the respondents in the baseline survey, we analyzed those who scored 13 points (a perfect score which indicates the highest functional capacity; n = 2627) on the Tokyo Metropolitan Institute of Gerontology Index of Competence at the baseline. The exposure was living arrangement at baseline, divided into five categories: "with spouse only," "living alone," "with child and his/her spouse," "with child without his/her spouse," and "with other family/person." The outcome was the decline in functional capacity at the follow-up survey (score decreased to 10 points or less from 13 points). RESULTS: Of the 2627 analyzed population, 1199 (45.6%) were men. The incidence of the decline was 5.8% in men and 5.9% in women. Multivariable logistic regression analyses adjusted for age, educational attainment, and health behavior and condition revealed that in women, the odds ratio of the decline was higher in living with child and his/her spouse (2.41, 95% confidence interval; 1.10-5.28) referring to living with spouse only. When adjusting activities inside and outside the home such as housework additionally, the association was attenuated to marginal significance (2.25, 0.98-5.18). No statistical significance was observed in men. CONCLUSIONS These results suggested that living with child and spouse of a child was associated with the future decline in women's functional capacity.
Activities of Daily Living ; Aged ; Aged, 80 and over ; Female ; Geriatric Assessment ; Humans ; Independent Living ; statistics & numerical data ; Japan ; Longitudinal Studies ; Male ; Self Report

PURPOSE: This study was designed to allow a student at School of Medicine, Kyungpook National University (KNUSOM) to self-assess how well they had achieved competency and to analyze the differences and trends of the scores by year. Furthermore, students are asked to evaluate the need for curriculum improvement by competency, the tendency of the score is analyzed by year, and the results are reflected in the improvement of the curriculum. METHODS: We conducted a questionnaire survey for fourth-year students of KNUSOM who took medical education classes from 2015 to 2018. Questionnaire items were evaluated on the basis of their current achievement of 30 subordinate competencies of competency and the degree of necessity with respect to revising the curriculum. One-way analysis of variance was performed for the yearly difference analysis. RESULTS: The students' scores on the graduation competency were 2.03 to 4.06. In the yearly difference analysis, there was no significant difference in the average of 30 total competencies, but 16 of the sub-competencies showed significant year-to-year differences. The scores for the 30 graduation competencies were different for each year, but the competencies showing high scores and low scores were found to be similar each year. CONCLUSION: We found that the achievement level of the students was approximately 60% to 70%. We were able to confirm the contents of the education that the students continuously demand. The curriculum trend graphs for each year showed that the students' scores improved when the curriculum was being revised. We found that it is necessary to accept the students' self-evaluation reliable as the students indicated that the contents of the curriculum should be added to the areas where the contents were lacking in the present curriculum.
Curriculum ; Diagnostic Self Evaluation ; Education ; Education, Medical ; Gyeongsangbuk-do ; Humans ; Self-Assessment

OBJECTIVES: To compare and assess the performance of 6 osteoporosis risk assessment tools for screening osteoporosis in Malaysian postmenopausal women. METHODS: Six osteoporosis risk assessments tools (the Simple Calculated Osteoporosis Risk Estimation [SCORE], the Osteoporosis Risk Assessment Instrument, the Age Bulk One or Never Estrogen, the body weight, the Malaysian Osteoporosis Screening Tool, and the Osteoporosis Self-Assessment Tool for Asians) were used to screen postmenopausal women who had not been previously diagnosed with osteoporosis/osteopenia. These women also underwent a dual-energy X-ray absorptiometry (DXA) scan to confirm the absence or presence of osteoporosis. RESULTS: A total of 164/224 participants were recruited (response rate, 73.2%), of which only 150/164 (91.5%) completed their DXA scan. Sixteen participants (10.7%) were found to have osteoporosis, whilst 65/150 (43.3%) were found to have osteopenia. Using precision-recall curves, the recall of the tools ranged from 0.50 to 1.00, whilst precision ranged from 0.04 to 0.14. The area under the curve (AUC) ranged from 0.027 to 0.161. The SCORE had the best balance between recall (1.00), precision (0.04–0.12), and AUC (0.072–0.161). CONCLUSIONS: We found that the SCORE had the best balance between recall, precision, and AUC among the 6 screening tools that were compared among Malaysian postmenopausal women.
Absorptiometry, Photon ; Area Under Curve ; Body Weight ; Bone Diseases, Metabolic ; Estrogens ; Female ; Humans ; Malaysia ; Mass Screening ; Osteoporosis ; Risk Assessment ; Self-Assessment

BACKGROUND: A self-assessment questionnaire, the GERD-Questionnaire (GERD-Q) was used to determine the prevalence of GERD in adolescents, describe the related factors, and determine the impact on quality of life (QoL). METHODS: The incidence of GERD was evaluated using the GERD-Q in adolescents aged 12–18 years. The Pediatric Gastroesophageal Reflux Disease Symptom Questionnaire and Quality of Life Questionnaire (PGSQ-A) for adolescents were additionally administered. Some factors considered related to GERD were also evaluated. RESULTS: The 520 adolescents were included. The prevalence of suspected GERD, according to a GERD-Q cutoff score of ≥7 was 32.9%, and those drinking soda were 1.7 times more likely to have GERD (95% confidence interval, 1.3–2.2; p<0.001). However, soda consumption was not a risk factor for development of GERD symptoms. Applying a cutoff score of ≥8, only 10.9% of the participants had a positive GERD score, but the association with soda consumption persisted. The median PGSQ-A score in subjects suspected of GERD was 8 (range 0–37) on weekends and 1 (range 0–17) during weekdays (p<0.001) compared to those not suspected of GERD, with a median of 2 (range 0–27) during weekends and 0 (range 0–10) during weekdays. Heartburn, regurgitation, and extraesophageal symptoms correlated significantly with QoL (p<0.001). CONCLUSION: The prevalence of suspected GERD in adolescents was 32.9% or 10.9%, depending on the cutoff score used. There was a statistically significant difference in PGSQ-A scores between the subjects suspected or not of GERD, indicating an impaired QoL.
Adolescent ; Drinking ; Gastroesophageal Reflux ; Heartburn ; Humans ; Incidence ; Prevalence ; Quality of Life ; Risk Factors ; Self-Assessment

BACKGROUND: Chronic nonspecific symptoms attributed to indoor nonindustrial work environments are common and may cause disability, but the medical nature of this disability is unclear. The aim was to medically characterize the disability manifested by chronic, recurrent symptoms and restrictions to work participation attributed to low-level indoor pollutants at workplace and whether the condition shares features with idiopathic environmental intolerance. METHODS: We investigated 12 patients with indoor air–related work disability. The examinations included somatic, psychological, and psychiatric evaluations as well as investigations of the autonomic nervous system, cortisol measurements, lung function, and allergy tests. We evaluated well-being, health, disability, insomnia, pain, anxiety, depression, and burnout via questionnaires. RESULTS: The mean symptom history was 10.5 years; for disabling symptoms, 2.7 years. Eleven patients reported reactions triggered mainly by indoor molds, one by fragrances only. Ten reported sensitivity to odorous chemicals, and three, electric devices. Nearly all had co-occurrent somatic and psychiatric diagnoses and signs of pain, insomnia, burnout, and/or elevated sympathetic responses. Avoiding certain environments had led to restrictions in several life areas. On self-assessment scales, disability showed higher severity and anxiety showed lower severity than in physician assessments. CONCLUSION: No medical cause was found to explain the disability. Findings support that the condition is a form of idiopathic environmental intolerance and belongs to functional somatic syndromes. Instead of endless avoidance, rehabilitation approaches of functional somatic syndromes are applicable.
Anxiety ; Autonomic Nervous System ; Depression ; Disability Evaluation ; Fungi ; Humans ; Hydrocortisone ; Hypersensitivity ; Lung ; Multiple Chemical Sensitivity ; Odors ; Rehabilitation ; Self-Assessment ; Sleep Initiation and Maintenance Disorders ; Weights and Measures