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

BACKGROUND: Management of atopic dermatitis (AD) involves the regular use of emollients together with topical steroids or calcineurin inhibitors for acute flares. However, the long-term use of oral medications in young children may have certain limitations. Wet wrap dressing (WWD) is an interesting alternative therapy for the short-term control of severe or refractory flares, thus avoiding the use of systemic treatments. OBJECTIVE: This study aimed to compare the efficacy between WWD and topical steroid agents and to control and estimate the utility of WWD in pediatric AD. METHODS: A total of 40 patients with mild-to-severe AD (eczema area and severity index of ≥3) aged <13 years were included in this study. Twenty patients were treated with WWD using two layers of cotton bandages or garments (Tubifast™), and the remaining were applied with topical steroid agents without cotton bandages. Improvement in severity of atopic dermatitis was evaluated using the eczema area and severity index (EASI). Improvement in skin barrier dysfunction was evaluated by measuring the transepidermal water loss (TEWL). We compared the two groups after 1 week of treatment using analysis of covariance and t-test. Furthermore, we surveyed the study groups using a questionnaire to estimate the utility of WWD and its adverse effects as well as to evaluate subjective outcomes of WWD. RESULTS: There were significant reductions in the mean EASI (−6.3, 95% confidence interval [CI]: −7.5 to −5.1, p=0.013) and TEWL (−26.7, 95% CI: −31.2 to −22.3, p=0.002) after 1 week of WWD treatment compared with the mean EASI (−4.0, 95% CI: −5.2 to −2.9) and TEWL (−15.4, 95% CI: −19.8 to −10.9) of the control group. Results of patient self-assessment and scores in the visual analogue scale (VAS) for pruritus were improved in both groups, but the differences were not statistically significant. Usefulness of WWD as an alternative therapy for the conventional therapy was satisfactory. CONCLUSION: This study is meaningful in that it estimates both the subjective and objective efficacy of WWD. In view of these findings, WWD showed superior therapeutic effects than conventional steroid application in the treatment of AD in children, with good compliance of patients and parent-caregivers.
Bandages ; Calcineurin Inhibitors ; Child ; Clothing ; Compliance ; Dermatitis, Atopic ; Eczema ; Emollients ; Humans ; Pruritus ; Self-Assessment ; Skin ; Steroids ; Therapeutic Uses ; Water

PURPOSE: This study evaluates the efficacy of a Self-Care Reinforcement Program (SCRP) based on the Selection Optimization Compensation (SOC) model, in socially vulnerable elderly women with metabolic syndrome. METHODS: This study adopts a pretest-posttest nonequivalent control group design. The participants were 64 socially vulnerable elderly Korean women with metabolic syndrome (experimental group: 31, control group: 33). Participants' body composition analysis, nutrient intake, risk factors of metabolic syndrome, depressive symptoms, and social network were measured. Data were analyzed with an independent t-test; statistical significance levels were set at p<.05. The SCRP, including metabolic syndrome education, nutritional education, exercise, and social network, was performed three times a week for 8 weeks. RESULTS: There were statistically significant differences between the experimental and control groups in terms of systolic blood pressure, diastolic pressure, fasting blood sugar, triglycerides, sodium intake, depressive symptoms, and social networks. CONCLUSION: The SCRP is effective and can be recommended as a community health nursing intervention for socially vulnerable elderly women with metabolic syndrome.
Aged ; Blood Glucose ; Blood Pressure ; Body Composition ; Community Health Nursing ; Compensation and Redress ; Depression ; Depressive Disorder ; Education ; Fasting ; Female ; Humans ; Korea ; Nutrition Assessment ; Risk Factors ; Self Care ; Social Networking ; Sodium ; Triglycerides ; Vulnerable Populations

PURPOSE: The goal was to use electronic health records to identify factors and outcomes associated with falls among patients admitted to hematology units. METHODS: This retrospective case-control study included data from a tertiary university hospital. Analysis was done of records from 117 patients with a history of falls and 201 patients with no history of falls who were admitted to the hematology unit from January 1, 2013 to December 31, 2014. Risk factors were analyzed using hierarchical logistic regression; patient outcomes were analyzed using multiple logistic regression, Cox proportional hazards regression, and multiple linear regression. RESULTS: Clinical factors such as self-care nursing (OR=4.47, CI=1.64~12.11), leukopenia (OR=6.03; CI=2.51~14.50), and hypoalbuminemia (OR=2.79, CI=1.31~5.96); treatment factors such as use of narcotics (OR=2.06, CI=1.01~4.19), antipsychotics (OR=3.05, CI=1.20~7.75), and steroids (OR=4.51, CI=1.92~10.58); and patient factors such as low education (OR=3.16, CI=1.44~6.94) were significant risk factors. Falls were also associated with increased length of hospital stay to 21.58 days (p < .001), and healthcare costs of 17,052,784 Won (p < .001). CONCLUSION: These findings can be a resource for fall prevention education and to help develop fall risk assessment tools for adults admitted to hematology units.
Accidental Falls ; Adult ; Antipsychotic Agents ; Case-Control Studies ; Education ; Electronic Health Records ; Health Care Costs ; Hematology ; Humans ; Hypoalbuminemia ; Length of Stay ; Leukopenia ; Linear Models ; Logistic Models ; Narcotics ; Nursing ; Retrospective Studies ; Risk Assessment ; Risk Factors ; Self Care ; Steroids

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