Vasovagal syncope and unexplained syncope are the most commonly observed types of syncope in outpatient and hospital settings. Medical interventions usually target at the physiological mechanisms responsible for loss ...Vasovagal syncope and unexplained syncope are the most commonly observed types of syncope in outpatient and hospital settings. Medical interventions usually target at the physiological mechanisms responsible for loss of consciousness in an attempt to limit the frequency of recurrences. However, this type of intervention does not take into account the psychological and functional impact of syncope, nor the importance of psychological variables in triggering and maintaining syncope. In the present pilot study, four participants presenting significant psychological distress and recurrent syncope were treated using a multimodal intervention targeting at both the medical and psychological aspects of the problem. Results showed a significant reduction in the frequency of syncope/presyncope, in the level of emotional distress experienced, as well as improved functional status in three of the four participants. Several recommendations are made to medical practitioners and psychologists, in view of identifying patients likely to benefit from this type of intervention or components thereof.展开更多
BACKGROUND Excessive noise in healthcare environments—commonly described as"unwanted sound"—has been linked to a range of negative impacts on both patients and staff.In clinical settings,elevated noise lev...BACKGROUND Excessive noise in healthcare environments—commonly described as"unwanted sound"—has been linked to a range of negative impacts on both patients and staff.In clinical settings,elevated noise levels have been associated with sleep disruption,heightened cardiovascular stress,and an increased risk of delirium in patients.Among healthcare workers,noise can impair focus and cognitive performance,potentially compromising care quality.AIM To evaluate the effectiveness of educational and behavioural interventions in reducing noise levels within intensive care units(ICUs),recognizing their potential impact on patient outcomes and healthcare effectiveness.METHODS A prospective interventional study in two Singaporean teaching hospitals compared peak and average sound levels between control and intervention groups.An educational and behavioural intervention comprising talks,posters,and self-audits by nurse champions was initiated in two ICUs in one hospital on November 18,2023.Sound measurements were collected at 4 Locations within each ICU before and after intervention.Baseline measurements were taken from October 22,2023 to October 29,2023,and post-intervention measurements from December 21,2023 to December 22,2023.The hospitals served as the primary exposure variable,controlled for ICU type(medical vs surgical)and hour of the day.RESULTS Our analysis generated 48 pairs of peak and average sound level readings for each unit(control n=48 readings;intervention n=48 readings).The effect of the intervention was associated with a significant 4.8 dB decrease in average sound level(P=0.009)and a nonsignificant 4.3 dB decrease in peak sound level(P=0.104),adjusted for hour of day and type of ICU.CONCLUSION Educational and behavioural interventions successfully reduced average sound levels,emphasizing their positive impact on noise control.These findings contribute valuable insights for optimizing noise reduction efforts in critical care settings.Future studies may explore additional systemic and environmental interventions to enhance noise management strategies.展开更多
Introduction: Wise prescription of antibiotics is an ethical duty of physicians in view of rising antimicrobial resistance in the community, it should be balanced between the health requirements of the patients and re...Introduction: Wise prescription of antibiotics is an ethical duty of physicians in view of rising antimicrobial resistance in the community, it should be balanced between the health requirements of the patients and resulting long-term antibiotics resistance. Overuse of antimicrobials is a major cause of emerging resistance to antimicrobials. There are multiple factors in the community that influence the physician’s antibiotic prescriptions. Methods: This is a systematic case-control study on antibiotics prescription for paediatric patients attending Latifa Hospital for Women and Children (LWCH), Dubai Health Authority, to know the effects of behavioral interventions on rates of inappropriate antimicrobials prescription by doctors in the Paediatric Emergency Department. Results: The results of our study showed the effectiveness of behavioral insights by peer comparison in antibiotic use among paediatricians in Latifa Hospital had a statistical significance (P = 0.0038). The rate of the prescription decreased from 41% to 21%, a difference of 20%. Conclusion: The study concluded behavioural intervention is an effective measure in reducing the improper prescription of antibiotics in the hospital setting.展开更多
Background and Objectives:Behavioural strategies can promote adherence to intensive lifestyle treatments for obesity.This study aimed to explore effective behavioural strategies for weight maintenance in Chinese patie...Background and Objectives:Behavioural strategies can promote adherence to intensive lifestyle treatments for obesity.This study aimed to explore effective behavioural strategies for weight maintenance in Chinese patients with overweight or obesity.Methods and Study Design:Retrospective analysis of weight maintenance data was conducted.Patients with overweight or obesity,who had received a 3-month weight loss and behavioural intervention,were asked to complete questionnaires to monitor compliance with behavioural strategies after the weight loss.They continued to follow a daily calorie restriction for 12 months to maintain their weight.The primary outcome was to evaluate the association between a total weight loss(TWL)of more than 5%and compliance with behavioural strategies during the 6-month weight maintenance phase.Results:A total of 131 patients completed the questionnaire.The top three easy-to-perform behaviours were eating vegetables and protein first and carbohydrates later,self-weighing each day and having regular eating times.Of 131 patients,61(46.5%)and 42(32.1%)were followed up for 6 months and 12 months respectively.Reducing high-fat food intake(p=0.002)and eating an average frequency of 5 times a day(p=0.034)were associated with a TWL of more than 5%during 6 months weight maintenance.Reducing high-fat food intake was associated with a TWL of more than 5%during 12 months weight maintenance(p=0.029).Conclusions:Chinese patients with overweight or obesity who experienced a TWL of more than 5%were more likely to reduce high-fat food intake during long-term weight maintenance.展开更多
文摘Vasovagal syncope and unexplained syncope are the most commonly observed types of syncope in outpatient and hospital settings. Medical interventions usually target at the physiological mechanisms responsible for loss of consciousness in an attempt to limit the frequency of recurrences. However, this type of intervention does not take into account the psychological and functional impact of syncope, nor the importance of psychological variables in triggering and maintaining syncope. In the present pilot study, four participants presenting significant psychological distress and recurrent syncope were treated using a multimodal intervention targeting at both the medical and psychological aspects of the problem. Results showed a significant reduction in the frequency of syncope/presyncope, in the level of emotional distress experienced, as well as improved functional status in three of the four participants. Several recommendations are made to medical practitioners and psychologists, in view of identifying patients likely to benefit from this type of intervention or components thereof.
文摘BACKGROUND Excessive noise in healthcare environments—commonly described as"unwanted sound"—has been linked to a range of negative impacts on both patients and staff.In clinical settings,elevated noise levels have been associated with sleep disruption,heightened cardiovascular stress,and an increased risk of delirium in patients.Among healthcare workers,noise can impair focus and cognitive performance,potentially compromising care quality.AIM To evaluate the effectiveness of educational and behavioural interventions in reducing noise levels within intensive care units(ICUs),recognizing their potential impact on patient outcomes and healthcare effectiveness.METHODS A prospective interventional study in two Singaporean teaching hospitals compared peak and average sound levels between control and intervention groups.An educational and behavioural intervention comprising talks,posters,and self-audits by nurse champions was initiated in two ICUs in one hospital on November 18,2023.Sound measurements were collected at 4 Locations within each ICU before and after intervention.Baseline measurements were taken from October 22,2023 to October 29,2023,and post-intervention measurements from December 21,2023 to December 22,2023.The hospitals served as the primary exposure variable,controlled for ICU type(medical vs surgical)and hour of the day.RESULTS Our analysis generated 48 pairs of peak and average sound level readings for each unit(control n=48 readings;intervention n=48 readings).The effect of the intervention was associated with a significant 4.8 dB decrease in average sound level(P=0.009)and a nonsignificant 4.3 dB decrease in peak sound level(P=0.104),adjusted for hour of day and type of ICU.CONCLUSION Educational and behavioural interventions successfully reduced average sound levels,emphasizing their positive impact on noise control.These findings contribute valuable insights for optimizing noise reduction efforts in critical care settings.Future studies may explore additional systemic and environmental interventions to enhance noise management strategies.
文摘Introduction: Wise prescription of antibiotics is an ethical duty of physicians in view of rising antimicrobial resistance in the community, it should be balanced between the health requirements of the patients and resulting long-term antibiotics resistance. Overuse of antimicrobials is a major cause of emerging resistance to antimicrobials. There are multiple factors in the community that influence the physician’s antibiotic prescriptions. Methods: This is a systematic case-control study on antibiotics prescription for paediatric patients attending Latifa Hospital for Women and Children (LWCH), Dubai Health Authority, to know the effects of behavioral interventions on rates of inappropriate antimicrobials prescription by doctors in the Paediatric Emergency Department. Results: The results of our study showed the effectiveness of behavioral insights by peer comparison in antibiotic use among paediatricians in Latifa Hospital had a statistical significance (P = 0.0038). The rate of the prescription decreased from 41% to 21%, a difference of 20%. Conclusion: The study concluded behavioural intervention is an effective measure in reducing the improper prescription of antibiotics in the hospital setting.
基金supported by National High Level Hospital Clinical Research Funding(2022-PUMCH-A-061).
文摘Background and Objectives:Behavioural strategies can promote adherence to intensive lifestyle treatments for obesity.This study aimed to explore effective behavioural strategies for weight maintenance in Chinese patients with overweight or obesity.Methods and Study Design:Retrospective analysis of weight maintenance data was conducted.Patients with overweight or obesity,who had received a 3-month weight loss and behavioural intervention,were asked to complete questionnaires to monitor compliance with behavioural strategies after the weight loss.They continued to follow a daily calorie restriction for 12 months to maintain their weight.The primary outcome was to evaluate the association between a total weight loss(TWL)of more than 5%and compliance with behavioural strategies during the 6-month weight maintenance phase.Results:A total of 131 patients completed the questionnaire.The top three easy-to-perform behaviours were eating vegetables and protein first and carbohydrates later,self-weighing each day and having regular eating times.Of 131 patients,61(46.5%)and 42(32.1%)were followed up for 6 months and 12 months respectively.Reducing high-fat food intake(p=0.002)and eating an average frequency of 5 times a day(p=0.034)were associated with a TWL of more than 5%during 6 months weight maintenance.Reducing high-fat food intake was associated with a TWL of more than 5%during 12 months weight maintenance(p=0.029).Conclusions:Chinese patients with overweight or obesity who experienced a TWL of more than 5%were more likely to reduce high-fat food intake during long-term weight maintenance.
