scholarly journals Retention Of Cardiac Auscultation Skill Requires Paired Visual And Audio Information In New Learners

2008 ◽  
Vol 2 (2) ◽  
Author(s):  
Glenn Nordehn ◽  
Spencer Strunic ◽  
Tom Soldner ◽  
Nicholas Karlisch ◽  
Ian Kramer ◽  
...  
Keyword(s):  
Visual Information ◽  
Heart Sound ◽  
Heart Sounds ◽  
Sound Recognition ◽  
Cardiac Auscultation ◽  
Time Period ◽  
Significant Difference ◽  
Post Test ◽  
Short Time ◽  
Audio Information

Introduction: Cardiac auscultation accuracy is poor: 20% to 40%. Audio-only of 500 heart sounds cycles over a short time period significantly improved auscultation scores. Hypothesis: adding visual information to an audio-only format, significantly (p<.05) improves short and long term accuracy. Methods: Pre-test: Twenty-two 1st and 2nd year medical student participants took an audio-only pre-test. Seven students comprising our audio-only training cohort heard audio-only, of 500 heart sound repetitions. 15 students comprising our paired visual with audio cohort heard and simultaneously watched video spectrograms of the heart sounds. Immediately after trainings, both cohorts took audio-only post-tests; the visual with audio cohort also took a visual with audio post-test, a test providing audio with simultaneous video spectrograms. All tests were repeated in six months. Results: All tests given immediately after trainings showed significant improvement with no significant difference between the cohorts. Six months later neither cohorts maintained significant improvement on audio-only post-tests. Six months later the visual with audio cohort maintained significant improvement (p<.05) on the visual with audio post-test. Conclusions: Audio retention of heart sound recognition is not maintained if: trained using audio-only; or, trained using visual with audio. Providing visual with audio in training and testing allows retention of auscultation accuracy. Devices providing visual information during auscultation could prove beneficial.

Effect of short-term use of oral contraceptive pills on intraocular pressure

2020 ◽  
Vol 35 (3) ◽  
Author(s):  
Tayyaba Gul Malik ◽  
Hina Nadeem ◽  
Eiman Ayesha ◽  
Rabail Alam
Keyword(s):  
Oral Contraceptive ◽  
Childbearing Age ◽  
Short Term ◽  
Oral Contraceptive Pills ◽  
Contraceptive Pills ◽  
Time Period ◽  
Significant Difference ◽  
Group A ◽  
Group B ◽  
Short Time

Objective: To study the effect of short-term use of oral contraceptive pills on intra-ocular pressures of women of childbearing age.   Methods: It was a comparative observational study, conducted at Arif memorial teaching hospital and Allied hospital Faisalabad for a period of six months. Hundred female subjects were divided into two groups of 50 each. Group A, included females, who had been taking oral contraceptive pills (OCP) for more than 6 months and less than 36 months. Group B, included 50 age-matched controls, who had never used OCP. Ophthalmic and systemic history was taken. Careful Slit lamp examination was performed and intraocular pressures (IOP) were measured using Goldman Applanation tonometer. Fundus examination was done to rule out any posterior segment disease. After collection of data, we analyzed and compared the intra ocular pressures between the two groups by using ANOVA in SPSS version 21.   Results: Average duration of using OCP was 14.9 months. There was no significant difference of Cup to Disc ratios between the two groups (p= 0.109). However, significant difference was noted between the IOP of OCP group and controls. (p=0.000). Conclusion: OCP significantly increase IOP even when used for short time period.

scholarly journals Effect of Short-term Use of Oral Contraceptive Pills on Intraocular Pressure

2019 ◽  
Vol 35 (3) ◽  
Author(s):  
Tayyaba Gul Malik, Hina Nadeem Eiman Ayesha Rabail Alam
Keyword(s):  
Oral Contraceptive ◽  
Childbearing Age ◽  
Short Term ◽  
Oral Contraceptive Pills ◽  
Contraceptive Pills ◽  
Time Period ◽  
Significant Difference ◽  
Group A ◽  
Group B ◽  
Short Time

Purpose: To study the effect of short-term use of oral contraceptive pills on intra-ocular pressures of women of childbearing age. Study Design: Observational case control study. Place and Duration of Study: The study was conducted at Arif memorial teaching hospital and Allied hospital Faisalabad from October 2017 to March 2018. Material and Methods: There were 100 female subjects, who were divided into two groups of 50 each. Group A, included females, who had been taking oral contraceptive pills (OCP) for more than 6 months and less than 36 months. Group B, included 50 age-matched controls, who had never used OCP. Ophthalmic and systemic history was taken. Careful Slit lamp examination was performed and intraocular pressures (IOP) were measured using Goldman Applanation tonometer. Fundus examination was done to rule out any posterior segment disease. We compared the intra ocular pressures between the two groups by using Student t test. Results: Average age was 29.16 in group A and 27.74 years in group B. Average duration of using OCP was 14.9 months. Mean IOP in right eye was 13.08 � 1.41 mm of Hg and 13.34 � 1.27 mm of Hg in left eye in Group A. While, mean IOP in right eye was 11.72 � 1.35 mm of Hg and in left eye was 11.92 � 1.3 mm of Hg in controls. Significant difference was noted between the IOP of OCP group and controls. (p = 0.000). Conclusion: OCP significantly increases IOP even when used for short time period. Key words: Oral contraceptive pills, Intra-ocular pressure, Glaucoma.

The Utility of Real-Time Remote Cardiac Auscultation Using a Bluetooth-Connected Electronic Stethoscope: Open-Label Randomized Controlled Pilot Trial (Preprint)

2020 ◽  
Author(s):  
Takanobu Hirosawa ◽  
Yukinori Harada ◽  
Kohei Ikenoya ◽  
Shintaro Kakimoto ◽  
Taro Shimizu
Keyword(s):  
Real Time ◽  
Heart Sound ◽  
Intervention Group ◽  
Heart Sounds ◽  
Control Group ◽  
Cardiac Auscultation ◽  
Open Label ◽  
Patient Simulator ◽  
Electronic Stethoscope ◽  
Randomized Controlled

BACKGROUND With the coronavirus disease 2019 pandemic, the need for telemedicine is rapidly growing worldwide. The development and improvement of remote physical examination systems, especially remote auscultation, are required to facilitate telemedicine. A Bluetooth system combined with an electronic stethoscope is a promising option for remote auscultation in clinics and hospitals. In our previous work, we demonstrated that the utility of a Bluetooth-connected real-time remote auscultation system for the lung simulator is comparable to that of classical direct auscultation. However, the utility of such systems remains unknown for cardiac auscultation. OBJECTIVE This study was conducted to evaluate the utility of real-time auscultation using a Bluetooth-connected electronic stethoscope compared to that of classical auscultation using a cardiology patient simulator. METHODS This was an open-label randomized controlled trial, including senior residents and faculty members in the Department of General Internal Medicine of a university hospital. The only exclusion criterion was a refusal to participate. All participants attended a tutorial session, in which they listened to 15 heart sounds on the cardiology patient simulator using a traditional stethoscope and were told the correct classification. Thereafter, participants were randomly assigned to either the real-time remote auscultation group (intervention group) or the classical auscultation group (control group) for test sessions. In the test sessions, participants had to classify a series of ten heart sounds. The intervention group remotely listened to the heart sounds using an electronic stethoscope, a Bluetooth transmitter, and a wireless, noise-canceling, stereo headset. The control group listened to the heart sounds directly using a classic stethoscope. The primary outcome was the test score. The secondary outcomes were the rates of correct answers for each heart sound. The two groups were compared using Fisher’s exact test. RESULTS In total, 20 participants were included; six and 14 were assigned to the intervention and control groups, respectively. There was no difference in age (P=.99), sex (P=.99), or years from graduation (P=.78) between the two groups. The overall test score in the intervention group (50/60, 83.3%) was not different from that in the control group (119/140, 85.0%) (P=.77). There was no heart sound for which the correct answer rate differed between groups. CONCLUSIONS This study demonstrated that the utility of a real-time remote cardiac auscultation system using a Bluetooth-connected electronic stethoscope was comparable to that of direct auscultation using a classic stethoscope. This implies that the real world’s essential heart sounds could be classified by a real-time remote cardiac auscultation system using a Bluetooth-connected electronic stethoscope. CLINICALTRIAL UMIN-CTR UMIN000041601; https://upload.umin.ac.jp/cgi-open-bin/ctr/ctr_view.cgi?recptno=R000047136

scholarly journals Outcomes of Using Heart Sound Simulator in Teaching Cardiac Auscultation

2010 ◽  
Vol 1 (1) ◽  
pp. e46-e50 ◽  
Author(s):  
Ralitsa Akins ◽  
Hoi Ho
Keyword(s):  
Curriculum Reform ◽  
Heart Sound ◽  
Medical Training ◽  
Clinical Skills ◽  
Training Session ◽  
Resident Training ◽  
Training System ◽  
Heart Sounds ◽  
Training Methods ◽  
Significant Difference

Background - Despite continued curriculum reform, the clinical skills competencies of medical graduates at all levels are steadily declining within a training system, where bedside opportunities become a luxury and the laboratory tests prevail over the clinical skills. While high-fidelity expensive simulators are being embraced by high-procedure volume specialties, low-fidelity and relatively inexpensive simulators, such as the heart sounds simulators remain under-utilized in medical training.  Methods - We used a commercially available heart sound synthesizer in 2-hour training sessions with students and residents. Pre-post testing was completed at the beginning of the training session and three weeks after the session; participant responses were recorded by audience interactive response system.  Results - Data analysis was accomplished with statistical software SPSS 17.0 utilizing paired t-test, and showed a statistically significant difference in learners’ knowledge and skills attainment 3 weeks after completion of the simulation training (p<0.0001).  Conclusions - Based on our findings and the review of literature, we recommend that heart sound simulation is introduced at medical student level as the standard for teaching cardiologic auscultation findings and as preparation for auscultation of live patients.  We also suggest that training with digitally simulated heart sounds is similarly beneficial in resident training.

scholarly journals Development of a Finger-Ring-Shaped Hybrid Smart Stethoscope for Automatic S1 and S2 Heart Sound Identification

Sensors ◽  
2021 ◽  
Vol 21 (18) ◽  
pp. 6294
Author(s):  
Soomin Lee ◽  
Qun Wei ◽  
Heejoon Park ◽  
Yuri Na ◽  
Donghwa Jeong ◽  
...  
Keyword(s):  
Heart Sound ◽  
Heart Sounds ◽  
Experimental Results ◽  
Time Interval ◽  
Signal Acquisition ◽  
Cardiac Auscultation ◽  
Sound Analysis ◽  
Physiological Signal ◽  
Ring Shape ◽  
Prototype Device

Cardiac auscultation is one of the most popular diagnosis approaches to determine cardiovascular status based on listening to heart sounds with a stethoscope. However, heart sounds can be masked by visceral sounds such as organ movement and breathing, and a doctor’s level of experience can more seriously affect the accuracy of auscultation results. To improve the accuracy of auscultation, and to allow nonmedical staff to conduct cardiac auscultation anywhere and anytime, a hybrid-type personal smart stethoscope with an automatic heart sound analysis function is presented in this paper. The device was designed with a folding finger-ring shape that can be worn on the finger and placed on the chest to measure photoplethysmogram (PPG) signals and acquire the heart sound simultaneously. The measured heart sounds are detected as phonocardiogram (PCG) signals, and the boundaries of the heart sound variation and the peaks of the PPG signal are detected in preprocessing by an advanced Shannon entropy envelope. According to the relationship between PCG and PPG signals, an automatic heart sound analysis algorithm based on calculating the time interval between the first and second heart sounds (S1, S2) and the peak of the PPG was developed and implemented via the manufactured prototype device. The prototype device underwent accuracy and usability testing with 20 young adults, and the experimental results showed that the proposed smart stethoscope could satisfactorily collect the heart sounds and PPG signals. In addition, within the developed algorithm, the device was as accurate in start-points of heart sound detection as professional physiological signal-acquisition systems. Furthermore, the experimental results demonstrated that the device was able to identify S1 and S2 heart sounds automatically with high accuracy.

Negative Life Events Associated With Deliberate Self-Harm in an African Population in Uganda

Crisis ◽  
2005 ◽  
Vol 26 (1) ◽  
pp. 4-11 ◽  
Author(s):  
E. Kinyanda ◽  
H. Hjelmeland ◽  
S. Musisi
Keyword(s):  
Life Events ◽  
Negative Life Events ◽  
Life Time ◽  
Later Life ◽  
Dose Effect ◽  
Deliberate Self Harm ◽  
Time Period ◽  
Significant Difference ◽  
Self Harm ◽  
Suicide Interventions

Abstract. Negative life events associated with deliberate self-harm (DSH) were investigated in an African context in Uganda. Patients admitted at three general hospitals in Kampala, Uganda were interviewed using a Luganda version (predominant language in the study area) of the European Parasuicide Study Interview Schedule I. The results of the life events and histories module are reported in this paper. The categories of negative life events in childhood that were significantly associated with DSH included those related to parents, significant others, personal events, and the total negative life events load in childhood. For the later-life time period, the negative life events load in the partner category and the total negative life events in this time period were associated with DSH. In the last-year time period, the negative life events load related to personal events and the total number of negative life events in this time period were associated with DSH. A statistically significant difference between the cases and controls for the total number of negative life events reported over the entire lifetime of the respondents was also observed, which suggests a dose effect of negative life events on DSH. Gender differences were also observed among the cases. In conclusion, life events appear to be an important factor in DSH in this cultural environment. The implication of these results for treatment and the future development of suicide interventions in this country are discussed.

Situational Factors Competing for Attention

2010 ◽  
Vol 22 (1) ◽  
pp. 2-13 ◽  
Author(s):  
Weiyu Zhang ◽  
Se-Hoon Jeong ◽  
Martin Fishbein†
Keyword(s):  
Task Performance ◽  
Visual Information ◽  
Situational Factors ◽  
Sexual Content ◽  
Sexually Explicit ◽  
Explicit Content ◽  
Audio Information

This study investigates how multitasking interacts with levels of sexually explicit content to influence an individual’s ability to recognize TV content. A 2 (multitasking vs. nonmultitasking) by 3 (low, medium, and high sexual content) between-subjects experiment was conducted. The analyses revealed that multitasking not only impaired task performance, but also decreased TV recognition. An inverted-U relationship between degree of sexually explicit content and recognition of TV content was found, but only when subjects were multitasking. In addition, multitasking interfered with subjects’ ability to recognize audio information more than their ability to recognize visual information.

World Economy: Prospects and Barriers for Recovery

2012 ◽  
pp. 61-83 ◽  
Author(s):  
M. Ershov
Keyword(s):  
World Economy ◽  
Western World ◽  
Short Time Period ◽  
Market Segments ◽  
Junk Bonds ◽  
The Past ◽  
Time Period ◽  
The Us ◽  
Global Liquidity ◽  
Short Time

According to the latest forecasts, it will take 10 years for the world economy to get back to “decent shape”. Some more critical estimates suggest that the whole western world will have a “colossal mess” within the next 5–10 years. Regulators of some major countries significantly and over a short time‑period changed their forecasts for the worse which means that uncertainty in the outlook for the future persists. Indeed, the intensive anti‑crisis measures have reduced the severity of the past problems, however the problems themselves have not disappeared. Moreover, some of them have become more intense — the eurocrisis, excessive debts, global liquidity glut against the backdrop of its deficit in some of market segments. As was the case prior to the crisis, derivatives and high‑risk operations with “junk” bonds grow; budget problems — “fiscal cliff” in the US — and other problems worsen. All of the above forces the regulators to take unprecedented (in their scope and nature) steps. Will they be able to tackle the problems which emerge?

Implicit and explicit corrective feedback and feedback exposure conditions

2020 ◽  
Vol 4 (1) ◽  
pp. 3-48
Author(s):  
Takehiro Iizuka ◽  
Kimi Nakatsukasa
Keyword(s):  
Explicit Knowledge ◽  
Corrective Feedback ◽  
Significant Difference ◽  
Oral Corrective Feedback ◽  
Post Test ◽  
Picture Description ◽  
Potential Factors ◽  
Implicit And Explicit ◽  
Instructional Settings ◽  
The Impact

This exploratory study examined the impact of implicit and explicit oral corrective feedback (CF) on the development of implicit and explicit knowledge of Japanese locative particles (activity de, movement ni and location ni) for those who directly received CF and those who observed CF in the classroom. Thirty-six college students in a beginning Japanese language course received either recast (implicit), metalinguistic (explicit) or no feedback during an information-gap picture description activity, and completed a timed picture description test (implicit knowledge) and an untimed grammaticality judgement test (explicit knowledge) in a pre-test, immediate post-test and delayed post-test. The results showed that overall there was no significant difference between CF types, and that CF benefited direct and indirect recipients similarly. Potential factors that might influence the effectiveness of CF, such as instructional settings, complexity of target structures and pedagogy styles, are discussed.

Employing Personal Reading Logs through Short Stories to Enhance Students’ L2 Reading Comprehension Achievement

2019 ◽  
Vol 3 (2) ◽  
pp. 1
Author(s):  
Eliyas Sulaiman Mohandas ◽  
Nik Mastura Nik Ismail Azlan ◽  
Salwa Othman ◽  
Muhammad Aizat Azhari
Keyword(s):  
Short Stories ◽  
Reading Comprehension ◽  
P Value ◽  
L2 Reading ◽  
Reading Score ◽  
Paired Samples ◽  
Significant Difference ◽  
Post Test ◽  
The Mean ◽  
L2 Reading Comprehension

This study aims to investigate whether the use of six selected short stories throughout the duration of a 14-week course could enhance students’ reading comprehension achievement at the end of the semester. Out of the six short stories read, three were chosen as in-class assignments known as ‘Personal Reading Logs’ (hereafter, PRLs). One group of semester two Diploma students taking a reading skills course was selected through a convenience sampling method. A pre-test was conducted by having the students answer a past semester reading quiz of which the results would then be compared to their post-test (final reading exam) results. A paired samples t-test revealed no significant difference in the reading scores of the pre-test and the post-test, t (17) = -.265, p > .05. Since the p-value was bigger than 0.05, this indicated that the mean reading score of the post-test (M = 50.556) was not significantly higher than the mean reading score of the pre-test (M = 49.722). Therefore, the null hypothesis which stated that there was no difference in the mean score of the pre-test and post-test was retained. Overall, the result refuted the findings of other studies promoting the effectiveness of using short stories to enhance L2 reading comprehension achievement.

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