Name: setup and execution of the blindfolded code training exercise
Uploaded: 2019-03-29T14:45:00
Description: Watch this Scientific Journal Video about Setup and Execution Of the Blindfolded Code Training Exercise at JoVE.com

作者没有任何承认。

这里所述的所有方法都不受综合机构审查委员会的审查。
1. 准备工作
<ol><li>
在开始被蒙住眼睛的代码训练练习之前, 准备模拟实验室。
	<ol>
<li>准备代码复苏所需的所有用品, 包括静脉注射 (IV) 启动套件、静脉注射液、代码车、带垫子的除颤器、包阀面罩、非复吸面罩、鼻插管、脉搏血氧仪和插管用品 (包括喉镜、气管插管、支架、注射器、潮末二氧化碳监测仪?...

<ol>
	<li>Brindley, P. G., Hudson, D., Lord, J. A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+blindfolded+learner+&#8211;+a+simple+intervention+to+improve+crisis+resource+management+skills.">The blindfolded learner &#8211; a simple intervention to improve crisis resource management skills.</a> Journal of Critical Care. 23 (2), 253-254 (2008).</li><li>Accreditation Council for Graduate Medical Education. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=.">.</a> ACGME Program Requirements for Graduate Medical Education in Pulmonary Disease and Critical Care Medicine (Internal Medicine). , (2017).</li><li>Accreditation Council for Graduate Medical Education and American Board of Emergency Medicine. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=.">.</a> The Emergency Medicine Milestone Project. , (2015).</li><li>Murphy, M., Curtis, K., McCloughen, A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=What+is+the+impact+of+multidisciplinary+team+simulation+training+on+team+performance+and+efficiency+of+patient+care?+An+integrative+review.">What is the impact of multidisciplinary team simulation training on team performance and efficiency of patient care? An integrative review.</a> Australasian Emergency Nursing Journal. 19 (1), 44-53 (2016).</li><li>Ahmed, R., Hughes, K., Hughes, P. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+blindfolded+code+training+exercise.">The blindfolded code training exercise.</a> The Clinical Teacher. 15 (2), 120-125 (2018).</li><li>Ryoo, E. N., Ha, E. H. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+Importance+of+Debriefing+in+Simulation-Based+Learning:+Comparison+Between+Debriefing+and+No+Debriefing.">The Importance of Debriefing in Simulation-Based Learning: Comparison Between Debriefing and No Debriefing.</a> Computers, Informatics, Nursing. 33 (12), 538-545 (2015).</li><li>Shinnick, M. A., Woo, M., Horwich, T. B., Steadman, R. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Debriefing:+The+Most+Important+Component+in+Simulation?.">Debriefing: The Most Important Component in Simulation?.</a> Clinical Simulation in Nursing. 7 (3), e105-e111 (2011).</li><li>Bergs, E. A., Rutten, F. L., Tadros, T., Krijnen, P., Schipper, I. B. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Communication+during+trauma+resuscitation:+do+we+know+what+is+happening?.">Communication during trauma resuscitation: do we know what is happening?.</a> Injury. 36 (8), 905-911 (2005).</li><li>Carter, E. A., Waterhouse, L. J., Kovler, M. L., Fritzeen, J., Burd, R. S. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Adherence+to+ATLS+primary+and+secondary+surveys+during+pediatric+trauma+resuscitation.">Adherence to ATLS primary and secondary surveys during pediatric trauma resuscitation.</a> Resuscitation. 84 (1), 66-71 (2013).</li><li>Spanjersberg, W. R., Bergs, E. A., Mushkudiani, N., Klimek, M., Schipper, I. B. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Protocol+compliance+and+time+management+in+blunt+trauma+resuscitation.">Protocol compliance and time management in blunt trauma resuscitation.</a> Emergency Medicine Journal. 26 (1), 23-27 (2009).</li><li>Fitzgerald, M., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Using+video+audit+to+improve+trauma+resuscitation&#8212;time+for+a+new+approach.">Using video audit to improve trauma resuscitation&#8212;time for a new approach.</a> Canadian Journal of Surgery. 49 (3), 208-211 (2006).</li><li>Hughes, P. G., Ahmed, R. A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+Blindfolded+Trauma+Team+Resuscitation:+a+strategy+for+improved+leadership+and+communication.">The Blindfolded Trauma Team Resuscitation: a strategy for improved leadership and communication.</a> BMJ Simulation &amp; Technology Enhanced Learning. , (2017).</li></ol>

被蒙住眼睛的代码练习包括几个关键步骤。首先, 这项工作需要初步的教师示范, 以减少学习者对蒙住眼睛进行复苏的恐吓和焦虑。它还可以为学习者提供一个成功表现为眼睛复苏的例子。面对远离复苏团队的代码团队领导, 确保领导无法可视化场景, 并迫使他们下达响亮、清晰的命令 (图 1)。此外, 开始高级居民担任代码团队领导, 因为这项工作要求领导保持一个概念框架, 在...

开发了蒙住眼睛的代码培训活动, 以改善闭环通信、利用概念框架组织复苏管理以及批判性思维能力。以前的学者报告说, 在模拟复苏过程中蒙住医生的眼睛, 加强了沟通、角色清晰和团队合作.住院医生, 特别是重症监护室的住院医生, 经常被置于高敏锐度的环境中。为了适当管理这些高风险病例, 住院医生需要在高风险环境中接受领导战略和沟通方面的培训 2、3.仿真是危机资源管理原理和沟通技能教学中普遍使用的有效方法4。
目前, 在高敏锐度情况下, 改进住院医师沟通和领导策略的创新技术知识有限。尽管在模拟实验室中观察到正确的管理和领导力, 但无效通信仍可能继续。以前的一项研究强调, 与典型的代码训练相比, 被蒙住眼睛的代码训练练习更具挑战性, 并迫使学习者使用批判性思维能力和闭环通信。学习者觉得这项运动巩固了领导技能, 并要求他们在没有视觉暗示的情况下保持精神组织5。
在准备被蒙住眼睛的代码训练练习时, 教职员工提供了一个演示, 解释如何执行这种先进的方法, 以减少学习者对练习的恐吓。一旦示威结束, 队长就被蒙住了眼睛。组长必须使用闭环沟通, 并向复苏小组发出明确的命令, 要求重复所有命令。如果没有团队领导的明确指示, 团队就无法独立启动任何程序或管理。团队成员只能执行团队领导的订单, 这些订单是按名称明确指向他们的。如果团队负责人没有确定执行操作的特定人员, 则不会执行该操作。例如, 如果团队领导在未将其定向到特定团队成员的情况下声明 "启动压缩", 则订单不会完成。所有队员都一动不动。如果领导向团队成员下达了命令, 但不要求他们重复该命令作为确认, 则可以执行该命令, 但在订单完成时不会向团队负责人提供口头反馈。这应该会促使组长要求随后的订单重复返回, 因为领导没有视觉刺激来确认订单完成。
如果团队领导要求团队成员重复命令, 团队成员必须使用闭环通信回复团队领导。这将在收到订单并完成订单时向组长发出警报。例如, 如果队长琼斯博士要求约翰 "静脉注射1毫克肾上腺素", 约翰会回答 "我会得到1毫克的肾上腺素。琼斯博士, 1 毫克肾上腺素已被静脉注射 "。组长可以询问有关班长的问题。然而, 团队成员只能用外行人的术语来描述心脏节律的出现 (表 1)。例如, 心室心动过速将被描述为一个广泛的复杂的规则节律在显示器上显示的速率。在描述心脏监测仪时, 团队成员不能使用医学术语, 如室性心动过速或无脉冲电活动。最后, 如果代码小组组长指示团队成员进行体检, 教师将口头澄清所有体检结果。
通过消除视觉刺激, 被蒙住眼睛的代码训练练习迫使组长保持心理组织, 并使用闭环通信, 以有效地管理复苏。描述被蒙住眼睛的代码训练练习的目的是为如何执行这种创新的教学技术以强制闭环通信提供指导。

<table border="0" cellpadding="0" cellspacing="0" style="width:666px;" width="667">
	<tbody>
		<tr height="21">
			<td height="21" style="height:21px;width:222px;">Bag valve mask</td>
			<td style="width:74px;"></td>
			<td style="width:123px;"></td>
			<td style="width:249px;"></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:222px;">Blindfold</td>
			<td style="width:74px;"></td>
			<td style="width:123px;"></td>
			<td style="width:249px;"></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:222px;">Blood pressure cuff</td>
			<td style="width:74px;"></td>
			<td style="width:123px;"></td>
			<td style="width:249px;"></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:222px;">Cardiac monitor</td>
			<td style="width:74px;"></td>
			<td style="width:123px;"></td>
			<td style="width:249px;"></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:222px;">Chair</td>
			<td style="width:74px;"></td>
			<td style="width:123px;"></td>
			<td style="width:249px;"></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:222px;">Code Cart</td>
			<td style="width:74px;"></td>
			<td style="width:123px;"></td>
			<td style="width:249px;">ACLS medications</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:222px;">Defibrillator with pads</td>
			<td style="width:74px;"></td>
			<td style="width:123px;"></td>
			<td style="width:249px;"></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:222px;">Emergency department bed</td>
			<td style="width:74px;"></td>
			<td style="width:123px;"></td>
			<td style="width:249px;"></td>
		</tr>
		<tr height="42">
			<td height="42" style="height:42px;width:222px;">End-tidal carbon dioxde monitor</td>
			<td style="width:74px;"></td>
			<td style="width:123px;"></td>
			<td style="width:249px;"></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:222px;">Human-patient simulator</td>
			<td style="width:74px;"></td>
			<td style="width:123px;"></td>
			<td style="width:249px;"></td>
		</tr>
		<tr height="62">
			<td height="62" style="height:63px;width:222px;">Intubation Kit&#160;</td>
			<td style="width:74px;"></td>
			<td style="width:123px;"></td>
			<td style="width:249px;">endotracheal tube, laryngoscope, stylet, 10 mL syringe, endotracheal tube holder</td>
		</tr>
		<tr height="42">
			<td height="42" style="height:42px;width:222px;">IV fluids</td>
			<td style="width:74px;"></td>
			<td style="width:123px;"></td>
			<td style="width:249px;">1 L normal saline or lactated ringer&#39;s</td>
		</tr>
		<tr height="42">
			<td height="42" style="height:42px;width:222px;">IV start kit</td>
			<td style="width:74px;"></td>
			<td style="width:123px;"></td>
			<td style="width:249px;">tourniquet, tape, tegaderm, IV catheter</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:222px;">Nasal cannula</td>
			<td style="width:74px;"></td>
			<td style="width:123px;"></td>
			<td style="width:249px;"></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:222px;">Non-rebreather mask</td>
			<td style="width:74px;"></td>
			<td style="width:123px;"></td>
			<td style="width:249px;"></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:222px;">Pulse oximeter</td>
			<td style="width:74px;"></td>
			<td style="width:123px;"></td>
			<td style="width:249px;"></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:222px;">Step stool</td>
			<td style="width:74px;"></td>
			<td style="width:123px;"></td>
			<td style="width:249px;"></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:222px;">Stethoscope</td>
			<td style="width:74px;"></td>
			<td style="width:123px;"></td>
			<td style="width:249px;"></td>
		</tr>
	</tbody>
</table>

setup and execution of the blindfolded code training exercise

误传是医学上可预防的患者伤害的最常见原因。目前, 在高敏锐度情况下, 改进住院医师沟通和领导策略的创新技术知识有限。被蒙住眼睛的代码训练练习消除了团队领导的视觉刺激, 迫使组长有效地利用闭环通信。蒙住团队领导的简单的操作创造了一个学习环境, 领导者必须利用一个概念框架和批判性思维策略来组织团队和管理复苏。这种教学技术的优点是它不需要任何特殊的仿真设备, 使其成为一种低成本的方法。被蒙住眼睛的代码培训活动可用于任何危重病人的管理, 其主要目标是在急性复苏中注重发展沟通技能。描述被蒙住眼睛的代码训练练习的目的是为如何实施这种创新的教学技术以强制有效的闭环通信提供指导。

正如 Ahmed 等人所指出的, 所有居民 (100%, 27/27) 都坚决同意, 在被蒙住眼睛的代码训练活动中获得的知识可以转移到临床环境5。此外, 大多数居民强烈认为, 蒙住眼睛的代码训练练习更具挑战性 (81.5, 22), 使他们能够运用批判性思维能力 (81.5, 22/27), 并改进了使用闭环通信 (88.9%, 24/27)典型的代码训练练习 (表 2)。
从 Ahmed 等人的驻地调查中确定的定性主...

Watch this Scientific Journal Video about Setup and Execution Of the Blindfolded Code Training Exercise at JoVE.com

Setup and Execution Of the Blindfolded Code Training Exercise

被蒙住眼睛的代码训练练习, 在代码复苏模拟中蒙住了团队领导的眼睛, 是一种先进的教学技术, 可以提高闭环沟通、组织技能和批判性思维。

盲民代码训练练习的设置和执行

Miscommunication is the most common cause of preventable patient harm in medicine. Currently, there is limited knowledge of innovative techniques to ...

沟通错误是所有药物中可预防的患者伤害的主导原因。蒙住眼睛的代码训练技术旨在改善闭环通信，改善高危情况下的批判性思维。这种教学技术的主要优点是，它教驻地医生有效的沟通和领导策略在高敏锐的情况下，而无需任何特殊设备。在开始蒙眼的代码训练练习之前，收集所有必要的用品和材料，将人类患者模拟器放在急诊室的病床上。打开模拟器并连接到无线网络。提供一个座位，离床脚五英尺远，并为代码组组长蒙上眼睛。然后让团队领导面对远离团队。为教职员工打印代码复苏模拟场景，并上传每个患者场景所需的放射图像和心电图。在开始练习之前，请与学员一起复习规则，让团队领导蒙上眼睛。让复苏小组成员口头向蒙着眼睛的代码组组长介绍自己在床上与病人的关系。。我是帕特里克，我是博士生，我在病人的右边的床。我是埃德加，我是急诊科居民，我会在床头。我是帕特，我是你的护士，我在病人的床的左边，可以给药。我是凯特，我是你的高级居民，我在床的左边。当所有团队成员都自我介绍时，请向代码组组长阅读案例场景的茎，并根据案例方案大纲更改患者生命和心脏节律。然后运行案例场景 8 到 10 分钟。大家好，我叫劳伦。我会成为你的队长请以闭环方式重复所有订单。大家都明白吗？是的，好吧，埃德加，我们的病人长什么样？所以是中年人他反应迟钝，没有呼吸困难。好的，我在显示器上看到了什么节奏？您会看到 Y 复杂、不规则的节奏，没有明显的 P、QRS 或 T 波。听起来像是V-fib帕特，你感觉到脉搏了吗？我没有， 好的， 凯特， 请开始胸部压缩。开始胸部压缩。好的，帕特里克，请给我们的除颤器充电200焦耳。打开除颤器并充电至 200 焦耳。好的，埃德加，请开始用每30次压缩两次呼吸的速度装袋我们的病人。好吧，我每30次压缩就开始为病人吸两口。除颤器收费为200焦耳。好的，凯特，请暂停胸部压缩。停止胸部压缩。请来一个震撼，帕特里克冲击已交付。好的，凯特，继续胸部压缩恢复胸部压缩。好吧，埃德加，下次脉搏检查时，我要请你给病人插看。好的，我会在下次脉搏检查时准备给病人插管的用品。好的，帕特，你能抽出一毫克肾上腺素吗？画出一毫克肾上腺素。准备好时请交付。好的，一毫克肾上腺素画好了给病人一毫克肾上腺素。好。埃德加，自从我们上次脉搏检查以来，已经过去多少时间了？上次脉搏检查已经90秒了埃德加，两分钟后，你能告诉我吗？两分钟后我会让你知道的。在案例场景结束时，向代码团队汇报约 10 分钟，重点介绍闭环通信的利用、领导者在领导复苏方面的有效性，以及与高级心脏生命支持或高级创伤生命支持算法相关的管理决策。然后选择另一个代码团队领导，并在汇报结束时重复此过程。在这项具有代表性的研究中，100%的居民同意或强烈同意在蒙眼代码训练练习中获得的知识可以转移到临床环境中。大多数居民强烈同意，蒙眼的代码训练练习更具挑战性，允许他们应用批判性思维技能，并改进了闭环通信的使用，与典型的代码训练练习相比。居民们也觉得，在没有视觉暗示的情况下保持精神组织是这项工作最具挑战性的部分。在开始模拟之前，与学员一起查看规则，让所有团队成员向蒙着眼睛的代码团队领导介绍自己，这一点很重要。这种创新的教学技术可以应用于任何危重病人的管理，重点是在高风险环境中制定更有效的沟通策略。本研究的未来方向包括利用经过验证的评估工具，在将蒙上眼睛的团队领导者与高视力情况下的非盲区团队领导者进行比较时，评估团队合作、沟通和领导力。

setup-and-execution-of-the-blindfolded-code-training-exercise

Research

Education

JoVE Core

JoVE Journal

Nursing

Medicine

Unit 1

Communication

SCIENTISTS IN ACTION

Determining The Electromyographic Fatigue Threshold Following a Single Visit Exercise Test

Theoretically, the electromyographic (EMG) fatigue threshold is the exercise intensity an individual can maintain indefinitely without the need to recruit more motor units which is associated with an increase in the EMG amplitude. Although different protocols have been used to estimate the EMG fatigue threshold they require multiple visits which are impractical for a clinical setting. Here, we present a protocol for estimating the EMG fatigue threshold for cycle ergometry which requires a single visit. This protocol is simple, convenient, and completed within 15-20 min, therefore, has the potential to be translated into a tool that clinicians can use in exercise prescription.

This protocol describes the electromyographic fatigue threshold which demarcates between nonfatiguing and fatiguing exercise workloads. This information could be used to develop a more individualized training program.

确定肌电疲劳阈值以下单次访问运动试验

Theoretically, the electromyographic (EMG) fatigue threshold is the exercise intensity an individual can maintain indefinitely without the need to recruit ...

科研

医学

Ultrasound Assessment of Endothelial Function: A Technical Guideline of the Flow-mediated Dilation Test

Cardiovascular disease is the primary cause of mortality and a major cause of disability worldwide. The dysfunction of the vascular endothelium is a pathological condition characterized mainly by a disruption in the balance between vasodilator and vasoconstrictor substances and is proposed to play an important role in the development of atherosclerotic cardiovascular disease. Therefore, a precise evaluation of endothelial function in humans represents an important tool that could help better understand the etiology of multiple cardio-centric pathologies.
Over the past twenty-five years, many methodological approaches have been developed to provide an assessment of endothelial function in humans. Introduced in 1989, the FMD test incorporates a forearm occlusion and subsequent reactive hyperemia that promotes nitric oxide production and vasodilation of the brachial artery. The FMD test is now the most widely utilized, non-invasive, ultrasonic assessment of endothelial function in humans and has been associated with future cardiovascular events.
Although the FMD test could have clinical utility, it is a physiological assessment that has inherited several confounding factors that need to be considered. This article describes a standardized protocol for determining FMD including the recommended methodology to help minimize the physiological and technical issues and improve the precision and reproducibility of the assessment.

The flow mediated dilation (FMD) test is the most commonly utilized, non-invasive, ultrasound assessment of endothelial function in humans. Although the FMD test has been related with the prediction of future cardiovascular disease and events, it is a physiological assessment with many inherent confounding factors that need to be considered.

血管内皮功能的超声评估：血流介导的舒张试验的技术指导原则

Cardiovascular disease is the primary cause of mortality and a major cause of disability worldwide. The dysfunction of the vascular endothelium is a ...

Induction and Assessment of Exertional Skeletal Muscle Damage in Humans

Contraction-induced muscle damage via voluntary eccentric (lengthening) contractions offers an excellent model for studying muscle adaptation and recovery in humans. Herein we discuss the design of an eccentric exercise protocol to induce damage in the quadriceps muscles, marked by changes in strength, soreness, and plasma creatine kinase levels. This method is simple, ethical, and widely applicable since it is performed in human participants and eliminates the interspecies translation of the results. Subjects perform 300 maximal eccentric contractions of the knee extensor muscles at a speed of 120&#176;/sec on an isokinetic dynamometer. The extent of the damage is measurable using relatively non-invasive isokinetic and isometric measures of strength loss, soreness, and plasma creatine kinase levels over several days following the exercise. Therefore, its application can be directed to specific populations in an attempt to identify mechanisms for muscle adaptation and regeneration.

This article describes a safe and reliable method to induce and quantify exertional skeletal muscle damage in human subjects.

诱导和人类劳力骨骼肌损伤评估

Contraction-induced muscle damage via voluntary eccentric (lengthening) contractions offers an excellent model for studying muscle adaptation and recovery ...

'Boden Food Plate': Novel Interactive Web-based Method for the Assessment of Dietary Intake

Different methods can be used in research to assess dietary intake, many of which are still paper-based. Written estimated food diaries are often utilized in clinical trials, despite being a burden for both study participants and researchers. This method requires participant literacy, it is time consuming, labor intensive, and can easily lead to under-reporting. With advancements in technology, there is a growing interest in electronic diaries that automate the dietary assessment process. These are focused on improving accuracy, reducing both time and cost and providing users with a visual and more enjoyable experience. The methodology presented here aimed to validate the &#39;Boden Food Plate&#39;, a novel web-based platform for self-recording of food and drink items, compared to a traditional estimated food diary. The application was also rated on a satisfaction scale by study participants using a paper-based questionnaire. Sixty-seven participants completed the dietary measures on both the three-day electronic and paper food diaries. For the analysis, only dietary data completed at both study time points (baseline and week six) was utilized. Despite small mean differences between dietary data collection methods, Bland Altman analysis showed fairly wide 95% limits of agreement between the electronic platform and the written estimated food diary and there were few cases which did not fall within the 95% confidence intervals. Overall, participants found the electronic food diary to be more fun than the paper method and as easy to use as hard copy diaries. The new platform has potential as a self-recording tool for the collection of dietary data, particularly when utilized in clinical trial settings. However, further validation studies are needed to improve the validity of this novel electronic dietary data collection tool.

&#039;Boden Food Plate&#039;: Novel Interactive Web-based Method for the Assessment of Dietary Intake

The &#39;Boden Food Plate&#39; is an electronic food diary designed to be an interactive and fun method to collect dietary intake using visual depictions. The purpose of this study was to validate the web-based application against a traditional three-day estimated food diary method.

"食品板块": 一种新的基于交互式 Web 的膳食摄入量评估方法

Different methods can be used in research to assess dietary intake, many of which are still paper-based. Written estimated food diaries are often utilized ...

Conducting Maximal and Submaximal Endurance Exercise Testing to Measure Physiological and Biological Responses to Acute Exercise in Humans

Regular physical activity has a positive effect on human health, but the mechanisms controlling these effects remain unclear. The physiologic and biologic responses to acute exercise are predominantly influenced by the duration and intensity of the exercise regimen. As exercise is increasingly thought of as a therapeutic treatment and/or diagnostic tool, it is important that standardizable methodologies be utilized to understand the variability and to increase the reproducibility of exercise outputs and measurements of responses to such regimens. To that end, we describe two different cycling exercise regimens that yield different physiologic outputs. In a maximal exercise test, exercise intensity is continually increased with a greater workload resulting in an increasing cardiopulmonary and metabolic response (heart rate, stroke volume, ventilation, oxygen consumption and carbon dioxide production). In contrast, during endurance exercise tests, the demand is increased from that at rest, but is raised to a fixed submaximal exercise intensity resulting in a cardiopulmonary and metabolic response that typically plateaus. Along with the protocols, we provide suggestions on measuring physiologic outputs that include, but are not limited to, heart rate, slow and forced vital capacity, gas exchange metrics, and blood pressure to enable the comparison of exercise outputs between studies. Biospecimens can then be sampled to assess cellular, protein, and/or gene expression responses. Overall, this approach can be easily adapted into both short- and long-term effects of two distinct exercise regimens.

To assess the influence of exercise intensity on physiologic and biologic responses, two different exercise testing protocols were utilized. Methods outlining exercise testing on a cycle ergometer as an incremental maximal oxygen consumption test and endurance, steady state submaximal endurance test are described.

进行最大和次极大耐力运动测试, 测量人类急性运动的生理和生物学反应

Regular physical activity has a positive effect on human health, but the mechanisms controlling these effects remain unclear. The physiologic and biologic ...

Transaxillary First Rib Resection for Treatment of the Thoracic Outlet Syndrome

Thoracic outlet syndrome (TOS) is a common disorder that causes a significant loss of productivity. The transaxillary first rib resection (TFRR) protocol has been used for the decompression of trapped neurovascular structures in the TOS. Among the other surgical procedures, the advantage of the TFRR is that it has the smallest rate of recurrence and better cosmetic outcomes. The disadvantage of TFRR is that it provides a narrow, and deep working corridor that makes obtaining vascular control challenging.

Here, we present a protocol of the transaxillary resection of the first rib for treatment of thoracic outlet syndrome caused by compression of the brachial plexus, subclavian vein and artery.

经腋窝第一肋骨切除术治疗胸廓出口综合征

Thoracic outlet syndrome (TOS) is a common disorder that causes a significant loss of productivity. The transaxillary first rib resection (TFRR) protocol ...

Setup and Execution of the Rapid Cycle Deliberate Practice Death Notification Curriculum

Death notification is an important and challenging aspect of Emergency Medicine. An Emergency Medicine physician must deliver bad news, often sudden and unexpected, to patients and family members without any previous relationship. Unskilled death notification after unexpected events can lead to the development of pathologic grief and posttraumatic stress disorder. It is paramount for Emergency Medicine physicians to be trained in and practice death notification techniques. The GRIEV_ING curriculum provides a conceptual framework for death notification. The curriculum has demonstrated improvement in learners&#8217; confidence and competence when delivering bad news. Rapid Cycle Deliberate Practice is a simulation-based medical education technique that uses within the scenario debriefing. This technique uses the concepts of mastery learning and deliberate practice. It allows educators to pause a scenario, provide directed feedback, and then let learners continue the simulation scenario the &#8220;right way.&#8221; The purpose of this scholarly work is to describe how to apply the Rapid Cycle Deliberate Practice debriefing technique to the GRIEV_ING death notification curriculum to more effectively train learners in the delivery of bad news.

The goal is to demonstrate how to apply the rapid cycle deliberate practice debriefing technique to the GRIEV_ING death notification curriculum.

快速循环故意练习死亡通知课程的设置和执行

Death notification is an important and challenging aspect of Emergency Medicine. An Emergency Medicine physician must deliver bad news, often sudden and ...

A Real-World High-Intensity Interval Training Protocol for Cardiorespiratory Fitness Improvement

High-Intensity Interval Training (HIIT) has emerged as an interesting time-efficient approach to increase exercise adherence and improve health. However, few studies have tested the efficiency of HIIT protocols in a &#34;real world&#34; setting, e.g., HIIT protocols designed for outdoor spaces without specialized equipment. This study presents a &#34;real world&#34; training protocol, named &#34;beep training&#34;, and compares the efficiency of a HIIT regiment versus a traditional long-duration Moderate-Intensity Continuous Training (MICT) regiment using this beep training protocol on VO2 max of overweight untrained men. Twenty-two subjects performed outdoor running with MICT (n = 11) or HIIT (n = 11). Cardiorespiratory fitness was assessed before and after training protocols using a metabolic analyzer. Both training protocols were performed 3 days a week for 8 weeks using the Beep Test results. The MICT group performed the exercise program at 60%-75% of the maximum speed of the 20 m shuttle test (Vmax) and with a progression of the distance of 3,500-5,000 m. The HIIT group performed the interval exercise with 7-10 bouts of 200 m at 85%-100% of the maximum speed of the 20 m shuttle test (Vmax), interspersed with 1 min of passive recovery. Although the HIIT group presented a significantly lower training volume than the MICT group (p &#60; 0.05) after 8 weeks of beep training, HIIT was superior to MICT in improving VO2 max (MICT: ~4.1%; HIIT: ~7.3%; p &#60; 0.05). The &#34;real world&#34; HIIT regiment based on beep training protocol is a time-efficient, low-cost, and easy-to-implement protocol for overweight untrained men.

This study presents a low-cost and easy-to-implement "real world" high-intensity interval training (HIIT) protocol for scientific research and discusses its efficiency for cardiorespiratory fitness.

一种用于改善心肺健康的真实世界高强度间歇训练方案

High-Intensity Interval Training (HIIT) has emerged as an interesting time-efficient approach to increase exercise adherence and improve health. However, ...

评估力量运动量及其对肥胖患者胰岛素敏感性的影响

Randomized Controlled Trial to Study the Acute Effects of Strength Exercise on Insulin Sensitivity in Obese Adults

An acute session of strength exercise (SE) ameliorates insulin sensitivity (IS) for several hours; however, the effects of SE volume (i.e., number of sets) have not been studied thoroughly. Although it is intuitive that some SE is better than none, and more is better than some for the improvement of IS, high-volume sessions might be challenging for diseased populations to complete, especially obese adults, for whom even a brisk walk can be challenging. This protocol details a randomized clinical trial to assess the acute effects of SE on IS in obese adults. The inclusion criteria are body mass index &#62;30 kg/m2, central obesity (waist circumference &#62;88 cm and &#62;102 cm for women and men, respectively), and age &#62;40 years. Participants will be familiarized with the SE (7 exercises targeting major muscle groups) and then will perform three sessions in a randomized order: session 1 - high-volume session (3 sets/exercise); session 2 - low-volume session (1 set/exercise); session 3 - control session (no exercise). Diet will be controlled the day before and on the day of the sessions. Sessions will be completed at night, and an oral glucose tolerance test will be performed the next morning, from which several indexes of IS will be derived, such as the area under the curve (AUC) of glucose and insulin, the Matsuda index, the Cederholm index, the muscle IS index, and the Gutt index. Based on pilot studies, we expect ~15% improvement in IS (insulin AUC, and Matsuda and Cederholm indexes) after the high-volume session, and ~8% improvement after the low-volume session compared to the control session. This study will benefit individuals who find high-volume SE sessions challenging but still aim to improve their IS by investing 1/3 of their time and effort.

作者聚焦：探索阻力运动量减少对代谢健康的影响 

This study describes a randomized controlled trial protocol aiming at assessing the acute effects of strength exercise volume on insulin sensitivity in obese individuals.

研究力量运动对肥胖成人胰岛素敏感性的急性影响的随机对照试验

An acute session of strength exercise (SE) ameliorates insulin sensitivity (IS) for several hours; however, the effects of SE volume (i.e., number of ...