How Knowledge-only Reinforcement Can Impact Time-related Changes in Basic Life Support (BLS) Skills of Medical Students on Clinical Clerkship

PURPOSE: Some report that basic life support (BLS) skills decay rapidly, mostly by three months after initial training. Retraining at specific intervals or with more effective methods is necessary to delay this decay. This study was undertaken to determine the effects of the time interval from initial training and to evaluate the impacts of a knowledge-only reinforcement on BLS skills in medical students and interns. METHODS: We tested the single-rescuer BLS performance of 92 medical students and interns with Resusci(R) Anne SkillReporter(TM) and BLS performance criteria. All trainees had been instructed by senior residents in 1~24 months before the test and were assigned into four groups by interval from initial training [group A: 1~3 months (n=21), group B: 4~7 (n=26), group C: 8~15 (n=20), group D: 16~24 (n=25)]. Groups C and D had 1-hour knowledge-only lectures. RESULTS: The performance criteria score of group B was lower than that of group A (p=0.005), but that of group C was higher than that of group B (p=0.025). The percent correct of ventilation (PCV) and compression (PCC) decreased surprisingly during the first three months after initial training. There was no difference in the PCC among the four groups. However, the PCV in group C was lower than that in group A (p=0.047). The PCV and the interval from initial training had a negative correlation (R=-0.273, p=0.009). CONCLUSION: Overall BLS performance of medical students and interns on clinical clerkship, without reinforcement, decreases more significantly after three months compared to the first three months from initial training. The accuracy of the skills decreases rapidly from the time of initial training. A knowledge-only reinforcement could temporally improve overall BLS performance. However, the accuracy of the ventilation skill decays regardless of reinforcement.

Effects of Humoral Factors Released from Ischemic-preconditioned Hearts on Survival of Pancreatic Cells Exposed to Hypoxia: An In vitro Study Using Neonatal Pigs

PURPOSE: Brief myocardial ischemia evokes a cardioprotective response, referred to as "Ischemic Preconditioning", that limits injury caused by a subsequent prolonged ischemic insult. The myocardial ischemic preconditioning effect can be induced by ischemia of "distant" cardiac and noncardiac tissue, implicating the involvement of an as-yet unidentified humoral trigger. The purpose of this study was to prove the protective effect of a preconditioning ischemic trigger (PIT) obtained from coronary effluent to isolated pancreatic cells under hypoxic condition in neonatal pigs. METHODS: Isolated hearts were preconditioned 5 times with 5-min ischemia following 10-min reperfusion. Coronary effluent was collected during reperfusion, filtered by using a Sep-Pak C-18 catridge, and lyophilized after dissolving it with acetonitrile. Isolated pancreatic cells were divided into a PIT-treatment group and a control group, and each group was further divided into time-dependent and dose-dependent groups. Time-dependent groups were incubated under a hypoxic condition for durations of 1, 2, 3, and 4 hrs, and dose-dependent groups were treated with 3 different doses of PIT that had undergone hypoxic incubation for 4 hrs. Viability of the pancreatic cells after the hypoxic incubation period was evaluated by using a confocal microscope. RESULTS: In the control group, the average viability of pancreatic cells after 4 hrs of hypoxia was 60.48 +/- 1.24%, and in the PIT-treated group, the value was 71.88 +/- 1.33%, the difference in the viability between the PIT-treated group and the control group after 4 hrs of hypoxia was statistically significant. In the dose-dependent groups, the viability of pancreatic cells was significantly larger in the groups treated with original PIT and 1/10 PIT than in the control group. CONCLUSION: These data suggest that in the In-vitro pig model, PIT obtained from heart evoked ischemic tolerance to isolated pancreatic cells.

The Study of Body Fat Percent Measured by Bioelectric Impedance Analyzer in a Rural Adult Population / 예방의학회지

Obesity usually is defined as the presence of and abnormally amount of adipose tissue. In many epidemiologic study, obesity as a health risk factor has been estimated by Body Mass Index(BMI) in general. This study was conducted to review of body fat percent measured by Bioelectric impedance analyzer as a estimator of obesity in a rural adult population. The study subjects were 421 men and 664 women who reside in the area on the Juam lake. They were sampled by multistage cluster sampling. Their mean age was 59 years old. Body fat percent increased with age, but BMI decreased with age in this study. Body fat percent was more larger at female and elder on the same BMI. The correlation coefficient between with body fat percent and body mass index was low (r=0.4737). Body fat percent was explained by not only BMI but also sex and age (r(2)=0.63). The result suggested that it is inadequate for BMI only to estimate obesity about elderly person who reside in the rural community. The relation of body fat percent and body mass index of this study agreed with the preceding knowledges and studies in general.

The Degree and Related Factors of the Depression and Burnout among Private Practice Physicians / 예방의학회지

In order to investigate the prevalence and the factors related to the depression and burnout among private practice physicians, a SDS(self-rating depression scale) and MBl(Maslach burnout inventory) -based questionnaire study was performed on 344 private practice physicians in Kwangju and chonnam area. The results were summarized as follows. 1. Mean SDS score was 38.3 in total subjects and the prevalence rate of depression was 48.8%. As for the frequency order of the items of the SDS, decreased libido, diurnal variation and hopelessness were relatively high, and suicidal rumination, constipation and agitation were noted low. 2. Noticeable factors related with depression were smoking, coffee use, sleeping time and satisfaction with income. 3. As a result a factor analysis with the MBl data, five factors named as emotional exhaustion, depersonalization, personal accomplishment, involvement and self-interest were extracted. Statistical analysis of the data demonstrated that 48.8% of the physician sample reported high scores on emotional exhaustion, and 45.3% scored high on depersonalization. Personal accomplishment scores remained high with 45.3% reporting high personal accomplishment. 4. Variables related to the burnout were age, sleeping time, family size religion, medical speciality. duration of practice setting, visiting patient number, closing day per month and job satisfaction. 5. In the relationship with depression, burnout was closely related to depression. Above results showed that the high percentage of private practice physicians experiencing depression and burnout suggests the need for further research to establish trends, to identify causal factors, and to develop avenues to reduce stress.