International consensus conference recommendations on ultrasound education for undergraduate medical students.

OBJECTIVES: The purpose of this study is to provide expert consensus recommendations to establish a global ultrasound curriculum for undergraduate medical students. METHODS: 64 multi-disciplinary ultrasound experts from 16 countries, 50 multi-disciplinary ultrasound consultants, and 21 medical students and residents contributed to these recommendations. A modified Delphi consensus method was used that included a systematic literature search, evaluation of the quality of literature by the GRADE system, and the RAND appropriateness method for panel judgment and consensus decisions. The process included four in-person international discussion sessions and two rounds of online voting. RESULTS: A total of 332 consensus conference statements in four curricular domains were considered: (1) curricular scope (4 statements), (2) curricular rationale (10 statements), (3) curricular characteristics (14 statements), and (4) curricular content (304 statements). Of these 332 statements, 145 were recommended, 126 were strongly recommended, and 61 were not recommended. Important aspects of an undergraduate ultrasound curriculum identified include curricular integration across the basic and clinical sciences and a competency and entrustable professional activity-based model. The curriculum should form the foundation of a life-long continuum of ultrasound education that prepares students for advanced training and patient care. In addition, the curriculum should complement and support the medical school curriculum as a whole with enhanced understanding of anatomy, physiology, pathophysiological processes and clinical practice without displacing other important undergraduate learning. The content of the curriculum should be appropriate for the medical student level of training, evidence and expert opinion based, and include ongoing collaborative research and development to ensure optimum educational value and patient care. CONCLUSIONS: The international consensus conference has provided the first comprehensive document of recommendations for a basic ultrasound curriculum. The document reflects the opinion of a diverse and representative group of international expert ultrasound practitioners, educators, and learners. These recommendations can standardize undergraduate medical student ultrasound education while serving as a basis for additional research in medical education and the application of ultrasound in clinical practice.

Martial arts training attenuates arterial stiffness in middle aged adults.

PURPOSE: Arterial stiffness increases with age and is related to an increased risk of coronary artery disease. Poor trunk flexibility has been shown to be associated with arterial stiffness in middle-aged subjects. The purpose of our research study was to measure arterial stiffness and flexibility in healthy middle-aged martial artists compared to age and gender matched healthy sedentary controls. METHODS: Ten martial artists (54.0 ± 2.0 years), who practice Soo Bahk Do (SBD), a Korean martial art, and ten sedentary subjects (54.7 ± 1.8 years) for a total of twenty subjects took part in this cross-sectional study. Arterial stiffness was assessed in all subjects using pulse wave velocity (PWV), a recognized index of arterial stiffness. Flexibility of the trunk and hamstring were also measured. The independent variables were the martial artists and matched sedentary controls. The dependent variables were PWV and flexibility. RESULTS: There were significant differences, between the SBD practitioners and sedentary controls, in PWV (P = 0.004), in trunk flexibility (P= 0.002), and in hamstring length (P= 0.003). CONCLUSION: The middle-aged martial artists were more flexible in their trunk and hamstrings and had less arterial stiffness compared to the healthy sedentary controls. The flexibility component of martial art training or flexibility exercises in general may be considered as a possible intervention to reduce the effects of aging on arterial stiffness.

Survey on use of and attitudes toward influenza vaccination among emergency department staff in a New York metropolitan hospital.

OBJECTIVE: Recognizing that the potential transmission of influenza virus would be concentrated at a hospital's primary point of entry, we determined rates of staff compliance with the influenza vaccination recommendations of the Advisory Committee on Immunization Practices (ACIP) in the Emergency Department (ED). We describe the basic knowledge concerning influenza transmission and factors influencing vaccination decisions among ED staff. DESIGN: Cross-sectional study. SETTING AND PARTICIPANTS: A large urban teaching hospital. Participants included ED staff, visiting professionals from other departments, and emergency medical service personnel transferring patients to the hospital. RESULTS: Of 230 surveys that were distributed, 200 were completed. One hundred one respondents (51%) were female. The overall influenza vaccination rate was 50%. Having had influenza previously was the most instrumental factor in whether or not a respondent chose vaccination (P<.001). Use of the Employees Health Services Free Vaccine Program (FVP) was a very important factor influencing whether ED staff sought influenza vaccination (P<.0001). Prior knowledge of the ACIP recommendations proved to be not statistically important (P=.03). A significant factor for respondents declining vaccination was the concern that illness could be caused by the vaccine (P<.0001). Variables such as sex of the respondents (P=.6714) and type of job (P=.3628) were not associated with vaccination. CONCLUSION: Despite ACIP recommendations, 50% of respondents did not receive an influenza vaccination. Misconceptions regarding influenza vaccine efficacy, concerns about adverse effects, and fear of contracting illness were significantly associated with noncompliance with vaccination. Variables that were important contributors to compliance with vaccination were prior influenza illness and services rendered by the FVP.