Humans ; Trust ; Conflict of Interest ; Judgment ; Medicine ; Biomedical Research

Artificial liver is one of the effective methods to treat liver failure. Patients with liver failure are critically ill and have great individualized differences. Therefore, the specific program for the treatment of liver failure with artificial liver should be individualized. The commonly used non-biological artificial liver models include simple plasmapheresis, double filtration plasmapheresis, plasma filtration with dialysis, double plasma molecular adsorption system, molecular absorbent recirculating system, hemodiafiltration, continuous venovenous hemodiafiltration, hybrid, etc. The curative effect should be properly judged from patient's symptoms, laboratory test indicators, survival rate and other aspects after artificial liver therapy.
Hemodiafiltration ; Humans ; Judgment ; Liver Failure/therapy* ; Liver, Artificial ; Plasmapheresis

Critical appraisal is the process of reading published research to make a judgement on its scientific value (validity), and to consider how its results can be applied in family and community practice (applicability). There are four main elements of critical appraisal in EBFP i.e., relevance, validity, results, and applicability. Some family practitioners are not so comfortable with appraisal because of their poor background in research. But we developed the guide questions for critical appraisal simple and provide advice on what and where to look for it in the published evidence.
Community Health Services ; Publications ; Reading ; Judgment

judgment were conducted. During this investigation, two adults who performed lung biopsy were recognized for their relevance between humidifier disinfectants and lung disease. At first, we did not think of the relationship to humidifier disinfectant because chest computed tomography (CT) finding of 2 cases were improved. However, they performed lung biopsy and it showed typical humidifier disinfectant lung injury (HDLI) pathologic findings, they could be recognized as HDLI. We report these cases here.CASE PRESENTATION: We selected 2 cases from the fourth-round investigation at Kangbuk Samsung Hospital. Patient of case 1 used humidifier disinfectants since September 2010. The patient was admitted 6 months later to the intensive care unit (ICU) due to severe dyspnea. Pathology following a lung biopsy revealed typical HDLI finding which was determined to be due to humidifier disinfectant exposure. Patient of case 2 used humidifier disinfectant from 2001 to 2008 for about 3 months each winter. The patient's cough and sputum production symptoms began in December of 2007. The patient was admitted to the respiratory medicine department due to worsening dyspnea. Pathology following a lung biopsy revealed typical HDLI finding. This was determined to have been caused by humidifier disinfectant exposure.CONCLUSIONS: Because the typical radiologic findings associated with HDLI can improve over time, it is necessary to consider the revision of current diagnostic criteria that the presence of radiologic findings is important.]]>
Adult ; Biopsy ; Cough ; Disinfectants ; Dyspnea ; Humans ; Humidifiers ; Intensive Care Units ; Judgment ; Korea ; Lung Diseases ; Lung Injury ; Lung ; Pathology ; Pulmonary Medicine ; Sputum ; Thorax

PURPOSE: This study aimed to compare the effects of simulation integrated with problem based learning (S-PBL) according to the sequences of problem-based learning (PBL) and high fidelity simulation training (HFS) on knowledge, clinical performance, clinical judgment, self-confidence, and satisfaction in fourth-grade nursing students. METHODS: In this randomized crossover design study, four S-PBLs on medical-surgical nursing were applied alternatively to two randomly-assigned groups of 26 senior nursing students for 8 weeks. The collected data were analyzed using an independent t-test. RESULTS: The method of administering PBL prior to HFS led to significantly higher scores on knowledge (t=2.28, p=.025) as compared to the method of administering HFS prior to PBL. However, the latter method led to significantly higher scores on clinical performance (t=−6.49, p < .001) and clinical judgment (t=−4.71, p < .001) as compared to the method of administering PBL prior to HFS. There were no differences in the effect of the two methods on self-confidence (t=1.53, p=.128) and satisfaction (t=1.28, p=.202). CONCLUSION: The integration sequences of S-PBL was associated with different learning outcomes. Therefore, when implementing S-PBL, it is necessary to consider the educational goal to executes an appropriate sequence of integration.
Cross-Over Studies ; Humans ; Judgment ; Learning ; Medical-Surgical Nursing ; Methods ; Nursing Education Research ; Nursing ; Problem-Based Learning ; Simulation Training ; Students, Nursing

BACKGROUND AND OBJECTIVES: Considering important role of vitamin D in many physiological processes including vestibular system in the ear, aim of present study is to evaluate saccule function via cervical vestibular evoked myogenic potential (cVEMP), in patients with vitamin D deficiency. SUBJECTS AND METHODS: After routine audiological tests, cVEMP were recorded in 15 patients with vitamin D deficiency and 16 normal subjects. The short tone burst (95 dB nHL, 500 Hz) was presented to ears. cVEMP was recorded with surface electromyography over the contracted ipsilateral sternocleidomastoid muscle. RESULTS: Mean of p13, n13, interpeak latencies and amplitude ratios were measured in both groups. Statistical analysis did not show differences between two groups. CONCLUSIONS: Maybe serum 25-hydroxyvitamin D concentration was not low enough to have effect on saccule in the patients in present study or saccule have had low susceptibility to effects of vitamin D deficiency. For better judgment about effect of vitamin D deficiency on saccular function planning studies with high sample size is recommended.
Ear ; Electromyography ; Humans ; Judgment ; Physiological Processes ; Saccule and Utricle ; Sample Size ; Vitamin D Deficiency ; Vitamin D ; Vitamins

PURPOSE: This study was conducted to obtain data for the development of an effective fall risk assessment tool for pediatric inpatients through a systematic review and meta-analysis of the diagnostic test accuracy of existing scales. METHODS: A literature search using Medline, Science Direct, CINAHL, EMBASE, and the Cochrane Library was performed between March 1 and 31, 2018. Of 890 identified papers, 10 were selected for review. Nine were used in the meta-analysis. Stata version 14.0 was used to create forest plots of sensitivity and specificity. A summary receiver operating characteristic curve was used to compare all diagnostic test accuracies. RESULTS: Four studies used the Humpty Dumpty Falls Scale. The most common items included the patient's diagnoses, use of sedative medications, and mobility. The pooled sensitivity and specificity of the nine studies were .79 and .36, respectively. CONCLUSION: Considering the low specificity of the pediatric fall risk assessment scales currently available, there is a need to subdivide scoring categories and to minimize items that are evaluated using nurses' subjective judgment alone. Fall risk assessment scales should be incorporated into the electronic medical record system and an automated scoring system should be developed.
Accidental Falls ; Diagnosis ; Diagnostic Tests, Routine* ; Electronic Health Records ; Forests ; Humans ; Inpatients* ; Judgment ; Pediatrics ; Risk Assessment* ; ROC Curve ; Sensitivity and Specificity ; Weights and Measures*

BACKGROUND AND OBJECTIVES: Pediatric vocal health problems are relatively common. However, it is not yet well studied whether uniform diagnosis and treatment is done properly in South Korea. The purpose of this study was to investigate the methods that the Korean speech therapists use to diagnose and treat pediatric voice problem. MATERIALS AND METHOD: An anonymous online questionnaire was administered to 32 speech language therapists registered at the Korean laryngeal speech linguistics society detailing demographics, employment institution, general management of pediatric patients with vocal problem including assessment and treatment procedures. RESULTS: Current practice patterns were analyzed on 32 speech language therapists providing services in South Korea mostly working at tertiary university hospital. One third of pediatric patients were assessed without proceeding to treatment. One fifth of patients were treated without assessment. Perceptual assessment was the main pre-treatment assessment methods used. Treatment was done in the following order : Voice rest, SOVT, yawn-sigh and resonant voice. Post-treatment evaluation was used in the following order : Instrumental assessment, clinical judgment, and recording comparison. CONCLUSION: Speech language therapists practice in South Korea mostly follows the ASHA practice guidelines. However, there are still great amount of cases in which only the evaluation was done without appropriate treatment. Further research is needed to make SPLs more systematic and efficient for evaluating and treating pediatric vocal patients.
Anonyms and Pseudonyms ; Clothing ; Demography ; Diagnosis ; Employment ; Humans ; Judgment ; Korea ; Linguistics ; Methods ; Voice

BACKGROUND: Dementia is a condition in which a person who has been living a normal life suffers from various cognitive impairments in memory, words, and judgment that considerably disrupt daily life. The oral care ability and subjective oral status of elderly individuals with dementia are lower than those of a healthy person. The oral health care of individuals admitted to nursing homes inevitably falls to nursing assistants and nursing care staff. This study aimed to investigate the need for oral health management items of and to provide basic direction for the future of the Dementia National Responsibility System. METHODS: Elders aged 65 years and over were selected from a comprehensive welfare center. A total of 155 questionnaires were analyzed. The questionnaire consisted of 15 items about general status, 9 items about recognition of the Dementia National Responsibility System, 5 items of the subjective recognition of oral health, and 6 items of the correlation between oral health and dementia. RESULTS: Among our subjects, 71.0% answered that they did not know about the Dementia National Responsibility System, 78.7% answered that they think they need the system, and 81.9% think that they should add dental health items to the Dementia National Responsibility System. The response to the need for dementia national responsibility, oral health items in the Dementia National Responsibility System, and oral specialists all showed scores of >4 points. The need for the Dementia National Responsibility System, oral health items, and specialists were found. CONCLUSION: It is necessary to include oral health care items in the Dementia National Responsibility System so that elderly individuals with dementia can receive the needed oral health care.
Accidental Falls ; Aged ; Cognition Disorders ; Dementia ; Dental Care ; Humans ; Judgment ; Memory ; Nursing ; Nursing Care ; Nursing Homes ; Oral Health ; Specialization

BACKGROUND: This study aimed to investigate the effects of critical thinking and good communication skills on the problem-solving abilities of dental hygiene students. METHODS: A total of 508 dental hygiene students were convenience-sampled from 3 universities. RESULTS: The results revealed that critical thinking had the highest intellectual fairness score of 3.60, and systematicity was the lowest at 3.19. The values for communication skills were high in reaction, social adequacy, and concentration, with an average of 3.65. Problem-solving abilities were in the following order: clarification of the problem, seeking solutions, and decision making. According to general characteristics, more extroverted personalities possessed higher levels of critical thinking, communication skills, and problem-solving abilities (p<0.01). Critical thinking scores were high (p=0.016) in students who responded that peer relationship was difficult; however, their communication skills were the lowest (p<0.001). Additionally, problem-solving abilities were highest among students who reported a difficult peer relationship (p=0.001). The higher the satisfaction with dental hygiene academics, the higher the critical thinking, communication skill, and problem-solving ability (p<0.001). Critical thinking showed a high positive correlation with variables in the following order: clarification of the problem, performing the solutions, seeking solutions, decision making, and evaluation and reflection. The communication skills were also related to these variables listed above (p<0.01). With critical thinking, confidence, watchfulness, intellectual passion/curiosity, sound skepticism, objectivity, and systematicity all influenced the problem-solving ability. CONCLUSION: Communication skills were influenced by noise control, putting on the other's shoe, social tensions, and efficiency, which affected the problem-solving ability. Dental clinics require dental hygienists to have critical thinking to make analytical judgments and effective communication skills to solve human relation problems with patients and care-givers. Therefore, these skills should be developed in dental hygiene students to improve their problem-solving abilities.
Decision Making ; Dental Clinics ; Dental Hygienists ; Humans ; Judgment ; Noise ; Oral Hygiene ; Shoes ; Thinking