Behavioral adjustment plays an important role in the treatment and relapse of drug addiction. Nonetheless, few studies have examined behavioral adjustment and its plasticity following error commission in methamphetamine (METH) dependence, which is detrimental to human health. Thus, we investigated the behavioral adjustment performance following error commission in long-term METH addicts and how it varied with the application of repetitive transcranial magnetic stimulation (rTMS) of the left dorsolateral prefrontal cortex (DLPFC). Twenty-nine male long-term METH addicts (for > 3 years) were randomly assigned to high-frequency (10 Hz, n = 15) or sham (n = 14) rTMS of the left DLPFC during a two-choice oddball task. Twenty-six age-matched, healthy male adults participated in the two-choice oddball task pretest to establish normal performance for comparison. The results showed that 10 Hz rTMS over the left DLPFC significantly decreased the post-error slowing effect in response times of METH addicts. In addition, the 10 Hz rTMS intervention remarkably reduced the reaction times during post-error trials but not post-correct trials. While the 10 Hz rTMS group showed a more pronounced post-error slowing effect than the healthy participants during the pretest, the post-error slowing effect in the posttest of this sample was similar to that in the healthy participants. These results suggest that high-frequency rTMS over the left DLPFC is a useful protocol for the improvement of behavioral adjustment after error commission in long-term METH addicts.
Adjustment Disorders ; etiology ; therapy ; Adult ; Amphetamine-Related Disorders ; complications ; therapy ; Case-Control Studies ; Central Nervous System Stimulants ; adverse effects ; Choice Behavior ; physiology ; Functional Laterality ; Humans ; Male ; Methamphetamine ; adverse effects ; Middle Aged ; Prefrontal Cortex ; physiology ; Reaction Time ; physiology ; Transcranial Magnetic Stimulation ; methods ; Young Adult

INTRODUCTION: Medical school fees are rising globally. Student debt and financial background may affect residency choices, but few studies have been conducted in Asia. This study aimed to explore the relationship between financial background, student debt and postgraduate residency choices among medical students in Singapore. METHODS: An anonymised survey of all medical students in Singapore was conducted and had a response rate of 67.9%. RESULTS: 40.5% of our study population would graduate with debt. Medical students with monthly per capita household income < SGD 1,000 were more likely to graduate with debt (unadjusted odds ratio [OR] 2.0, 95% confidence interval [CI] 1.6-2.7; p < 0.001) and feel burdened by the cost of medical education (unadjusted OR 2.8, 95% CI 2.0-3.9; p < 0.001). Students with monthly per capita household income < SGD 1,000 (unadjusted OR 1.818, 95% CI 1.338-2.470, p < 0.001; adjusted OR 1.692, 95% CI 1.202-2.381, p = 0.003) and those with debt (unadjusted OR 1.623, 95% CI 1.261-2.090, p < 0.001; adjusted OR 1.393, 95% CI 1.048-1.851, p = 0.022) were more likely to rank at least one economic factor as 'very significant' in influencing their postgraduate training choices. CONCLUSION It is concerning that despite financial aid schemes, the cost of medical education remains a burden to students from lower-income households in Singapore. Student debt and financial background may distort postgraduate career choices, creating an undue push towards high-paying specialties.
Career Choice ; Choice Behavior ; Education, Medical ; economics ; Humans ; Internship and Residency ; economics ; Odds Ratio ; Schools, Medical ; economics ; Singapore ; Social Class ; Students, Medical ; statistics & numerical data ; Surveys and Questionnaires ; Training Support

This study was a correlation study to analyze the effects of smartphone usage time on food choice perceptions and behavior in middle school students in Seoul areas. The subjects to be surveyed were middle school students attending junior high schools in Mapo-gu, Seoul. A total of 133, 102, and 102 students were in the first second, and third grades, respectively. The usage time of smartphones was the weekday and weekend usage time except for the call function. Food choice perception and its behavior as dietary habits were constructed referring to previous research and food balance wheels data for the correct dietary habits of the Ministry of Health & Welfare and Korean Nutrition Society. The food choice behavior was categorized into non-recommended food and recommended food. The results are summarized as follows. First, the longer the time spent on smartphones, the less favorable the perception of correct food choices. Second, the higher the dependence on smartphones, the less favorable the perception of correct food choices. Third, the correct perception of food choices has been shown to reduce food choices, known as non-recommended foods. In addition, proper perception of food choices has been shown to increase the choice of recommended foods. In conclusion, the usage time and reliance of smartphones of middle school students was found to affect the food choice behavior by lowering the perception of correct food choices. This research is expected to form the basis for the development of programs and educational materials that can be of assistance to adolescents who are experiencing difficulties.
Adolescent ; Choice Behavior ; Eating ; Food Habits ; Humans ; Seoul ; Smartphone ; Statistics as Topic

BACKGROUND: Compared to other specialties, a lower number of medical students contemplate later choosing Family and Community Medicine. At the UP College of Medicine, only a small fraction of graduates pursue residency training in the specialty. A multitude of factors have been shown to have influenced the medical students of specialty considerations.
OBJECTIVE: To determine whether the Family and Community Medicine curriculum and medical school factors influence third to fifth year students of UP College of Medicine to consider Family and Community Medicine as a future specialty.
METHODOLOGY: UP College of Medicine third to fifth year students during Academic Year 2015-2016 rotating in the Department of Family and Community Medicine from January to June 2016 were asked to participate. A descriptive study design was used. Consideration of Family and Community Medicine was compared from pre- to post- rotation and factors associated with inclination towards residency training in the specialty were examined post-rotation through a questionnaire.
RESULTS: Of the medical students who planned to pursue residency training, 8% had Family and Community Medicine in the top three choices for residency training at the start of the rotation, which increased to 15% at the end of the rotation. Family and Community Medicine as a future specialty was "considered a little" by the three year levels at the start and end of the rotation. Many factors were deemed by the medical students to have no effect on considering the specialty. Some factors were considered to have a strong positive influence on choosing Family and Community Medicine, especially for medical clerks. A few factors were perceived to have a negative influence in considering the specialty.
CONCLUSION: Curriculum and medical school factors have an influence on the consideration of Family and Community Medicine as a future specialty.

Human ; Male ; Female ; Adult ; Choice Behavior ; Community Medicine ; Curriculum ; Internship And Residency ; Medicine ; Schools, Medical ; Students, Medical ; Surveys And Questionnaires ; Family Practice

OBJECTIVES: Nowadays, the multicultural families make up significant portion of Korean population and communities. Successful re-settling in a new country can be difficult, particularly when there are disparities in dietary behavior compared to home country. The objective of the study was to investigate the dietary behavior of marriage migrant women according to their nationality in multicultural families. METHODS: The primary research was conducted targeting 94 marriage migrant women who came from China (40.4%), Vietnam (26.6%), and other countries except for Japan (33.0%). We investigated their dietary behavior, such as eating attitude and food choice behavior for Korea acculturation. We also studied dietary behavior among 14 selected subjects who had high level of integration and assimilation acculturation patterns by administering the Focus Group Interview (FGI). RESULTS: The multicultural families had more integration acculturation patterns, which could have been influenced by their nationality. Vietnamese origin has the highest cultural adaptation as marginalization pattern. The common types of Korea acculturation were integration (3.03 +/- 1.08), separation (3.10 +/- 0.59), marginalization (3.10 +/- 0.58), followed by assimilation (2.84 +/- 0.51). There were significant differences in the four types of acculturation by marriage immigrant women's country of origin (p<0.05). According to dietary behavior, 'eliminating hunger' was the most important value in a meal. Chinese marriage migrant women, who had higher level of food intake attitude significantly, also considered 'being healthy' an important value. Regarding food choice behavior, Vietnamese had lowest frequency of homeland food intake. Most of marriage immigrant women were satisfied with the Korean food, and need for education was very high with interest for cooking, good nutrition, and managing their children's dietary life. CONCLUSIONS: Coping with a change in dietary behavior is one of the biggest transitional difficulties, and family members may need support to find their familiar food items and to continue their cultural food choice behavior in the local areas. Further researches with quantitative and qualitative analysis are needed to understand the effect of dietary behavior for acculturation in multicultural families.
Acculturation ; Asian Continental Ancestry Group ; China ; Choice Behavior ; Cooking ; Eating ; Education ; Emigrants and Immigrants ; Ethnic Groups* ; Female ; Focus Groups ; Humans ; Japan ; Korea ; Marriage* ; Meals ; Transients and Migrants* ; Vietnam

PURPOSE: The purpose of this study was to determine the relationship between personality traits, using the Five-Factor Model, and characteristics and motivational factors affecting specialty choice in Korean medical students. METHODS: A questionnaire survey of Year 4 medical students (n=110) in July 2015 was administered. We evaluated the personality traits of Extraversion, Agreeableness, Conscientiousness, Neuroticism, and Openness by using the Korean version of Big Five Inventory. Questions about general characteristics, medical specialties most preferred as a career, motivational factors in determining specialty choice were included. Data between five personality traits and general characteristics and motivational factors affecting specialty choice were analyzed using Student t-test, Mann-Whitney test and analysis of variance. RESULTS: Of the 110 eligible medical students, 105 (95.4% response rate) completed the questionnaire. More Agreeableness students preferred clinical medicine to basic medicine (p=0.010) and more Openness students preferred medical departments to others (p=0.031). Personal interest was the significant motivational factors in more Openness students (p=0.003) and Conscientiousness students (p=0.003). CONCLUSION: Medical students with more Agreeableness were more likely to prefer clinical medicine and those with more Openness preferred medical departments. Personal interest was a significant influential factor determining specialty choice in more Openness and Conscientiousness students. These findings may be helpful to medical educators or career counselors in the specialty choice process.
Adult ; Choice Behavior ; Female ; Humans ; Male ; *Medicine ; *Motivation ; *Personality ; Republic of Korea ; *Specialization ; *Students, Medical ; Surveys and Questionnaires

INTRODUCTIONThe study aimed to assess the level of awareness and knowledge of contraception among women in Singapore, and identify the factors that influence contraception choice.

METHODSWe conducted a cross-sectional survey of 259 female patients, aged 21-49 years, who attended the Obstetrics and Gynaecology Clinic at National University Hospital, Singapore. An original questionnaire on nine contraceptive methods was used. Respondents who had ≥ 2 correct answers for a method (out of four questions) were considered to have good knowledge of the method. Participants were asked to rate factors known to influence contraceptive choice as important or not important.

RESULTSAwareness of the following methods was high: condom (100.0%), oral contraception pill (89.2%), tubal ligation (73.0%) and copper intrauterine device (IUD) (72.2%). The women were least aware of hormonal IUD (24.3%). Women who were parous, had a previous abortion, had completed their family or used contraception previously were more likely to have a higher awareness of contraception. 89.2% of the women had good knowledge of the condom; among those aware of hormonal IUD, only 46.0% had good knowledge of it. Women who had used hormonal IUD and the condom were more likely to have good knowledge of them. Many rated efficacy (90.5%) and a healthcare professional's advice (90.1%) as important in contraceptive choice. Few considered peer influence (21.0%) and cultural practices (16.3%) to be important.

CONCLUSIONWomen in Singapore have poor awareness and knowledge of contraception, especially long-acting reversible methods. More effective ways are needed to educate women about contraceptive methods.

Abortion, Induced ; Adult ; Choice Behavior ; Condoms ; Contraception ; methods ; Contraceptives, Oral ; Cross-Sectional Studies ; Female ; Health Knowledge, Attitudes, Practice ; Humans ; Intrauterine Devices ; Middle Aged ; Parity ; Patient Education as Topic ; Singapore ; Social Class ; Sterilization, Tubal ; Surveys and Questionnaires ; Young Adult

PURPOSE: It aimed to find if written test results improved for advanced cardiac life support (ACLS) taught in flipped classroom/team-based Learning (FC/TBL) vs. lecture-based (LB) control in University of California-Irvine School of Medicine, USA. METHODS: Medical students took 2010 ACLS with FC/TBL (2015), compared to 3 classes in LB (2012-14) format. There were 27.5 hours of instruction for FC/TBL model (TBL 10.5, podcasts 9, small-group simulation 8 hours), and 20 (12 lecture, simulation 8 hours) in LB. TBL covered 13 cardiac cases; LB had none. Seven simulation cases and didactic content were the same by lecture (2012-14) or podcast (2015) as was testing: 50 multiple-choice questions (MCQ), 20 rhythm matchings, and 7 fill-in clinical cases. RESULTS: 354 students took the course (259 [73.1%] in LB in 2012-14, and 95 [26.9%] in FC/TBL in 2015). Two of 3 tests (MCQ and fill-in) improved for FC/TBL. Overall, median scores increased from 93.5% (IQR 90.6, 95.4) to 95.1% (92.8, 96.7, P=0.0001). For the fill-in test: 94.1% for LB (89.6, 97.2) to 96.6% for FC/TBL (92.4, 99.20 P=0.0001). For MC: 88% for LB (84, 92) to 90% for FC/TBL (86, 94, P=0.0002). For the rhythm test: median 100% for both formats. More students failed 1 of 3 tests with LB vs. FC/TBL (24.7% vs. 14.7%), and 2 or 3 components (8.1% vs. 3.2%, P=0.006). Conversely, 82.1% passed all 3 with FC/TBL vs. 67.2% with LB (difference 14.9%, 95% CI 4.8-24.0%). CONCLUSION: A FC/TBL format for ACLS marginally improved written test results.
Advanced Cardiac Life Support* ; California* ; Choice Behavior ; Humans ; Learning* ; Students, Medical* ; United States

One of the first decisions that patients must make; that is, the choice of a primary care doctor (PCD). What factors influence patient decision? Moreover is the patient's first contact observation a contributing factor in the patient's choice of this attending physician, hence this study.
METHODOLOGY: Using a pre-validated standardized survey questionnaire, this study involved purposively selected 400 patients admitted in Visayas Community Medical Center from March 2015 to August 2015. After informed consents were secured from the respondents, a face-to-face survey approach was conducted to ensure that the question included in the survey reflected the reality of patients' perception and their experience of choice. The respondents were interviewed in emergency room/ in the patient's room which may last between 10 and 15 minutes.
RESULTS: The respondents choice of physicians was greatly influenced by family members (50%). They highly rated the physicians' respect to patients (mean = 10.00), with good communication skills (mean = 10.00), friendly clinic staff (mean = 10.00), rapport (mean = 9.98), quality of care (mean = 9.98), and compassion (mean = 9.02). In terms of qualifications, the respondents would prefer doctors who are Board-certified (mean = 8.95) and achievers (mean = 7.50). Lastly, hospital or clinical factors were anchored on organization of clinic (mean = 10.00), ease of access (mean = 10.00), duration of waiting time (mean = 9.07), and practice open after 5pm (mean = 9.01).
CONCLUSION: The common factors identified by respondents in choosing their primary physicians were; respect to patients, good communication skills, friendliness of physicians staff, rapport with the patients, quality of care, and compassion. They focused on the doctors having board certificate, organization of clinic, ease of access, duration of waiting time, and clinical practice beyond 5pm. Lastly, they would prefer doctors who were referred by family members or friends.   

 

Human ; Male ; Female ; Aged 80 And Over ; Aged ; Middle Aged ; Adult ; Young Adult ; Adolescent ; Physicians ; Patients ; Quality Of Life ; Ambulatory Care Facilities ; Choice Behavior ; Emergency Service, Hospital ; Informed Consent ; Patients' Rooms ; Philippines ; Primary Health Care ; Surveys And Questionnaires

The goal of this study was to assess student perceptions of a variety of instructional practices and attitudes toward class attendance. Data were obtained and analyzed by administering a questionnaire to students of the Shifa College of Medicine, Pakistan in 2011 and 2012. The subjects positively assessed most instructional practices, and in particular felt that teaching sessions conducted in small groups were more valuable than formal lectures in large groups. Students did not like having to give presentations, quizzes, panel discussions, and journal club. A positive correlation was found between the perceived importance of attendance and levels of academic motivation. Of the students surveyed, 11.8% were against mandatory attendance, saying that it reduced motivation and that attendance should be optional. In conclusion, the students had a positive perception of a range of instructional practices, and felt especially positively about practices that involve student activity in small groups. Programmatic improvement in instructional practices might increase class attendance.
Choice Behavior ; Humans ; Learning ; Lectures ; Motivation ; Pakistan* ; Students, Medical*