Name: setup and execution of the blindfolded code training exercise
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Description: Watch this Scientific Journal Video about Setup and Execution Of the Blindfolded Code Training Exercise at JoVE.com

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1. forberedelse
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Forberede simulation lab forud for begyndelsen af halvnøgne kode øvelse.
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<li>Forberede alle leverancer nødvendige for kode genoplivning, herunder en intravenøs (IV) start kit, IV væsker, en kode vogn, en defibrillator med puder, en pose ventil maske, en ikke-rebreather maske, en nasal kanyle, en pulse oximeter, og intubere forsyninger (herund...

<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>

Halvnøgne kode øvelse består af flere kritiske trin. Først, udoevelse kræver en indledende Fakultet demonstration at nedsætte studerendes intimidering og angst mod udfører en genoplivning, bind for øjnene. Det tjener også til at give eleverne et eksempel på en vellykket præstation af de halvnøgne genoplivning. Vender kode projektlederen fra genoplivning team sikrer, at lederen er i stand til at visualisere scenariet og tvinger dem til at give højt og tydeligt ordrer (figur 1). D...

Halvnøgne kode uddannelse øvelse blev udviklet for at forbedre lukket kredsløb kommunikation, udnyttelse af et begrebsapparat til at organisere forvaltningen af en genoplivning, og kritisk tænkning færdigheder. Tidligere forskere rapporterede, at kommunikation, rolle klarhed og teamwork var forstærket af blindfolding læger under simulerede resuscitations1. Hjemmehørende læger, specielt i intensivbehandling specialiteter, er ofte placeret i høj-acuity situationer. Passende styre disse højrisiko sager, påkrævet bosiddende læger uddannelse i både lederskab strategier og kommunikation i højrisiko miljøer2,3. Simulation bruges almindeligt og er effektiv i at undervise krise ressource management principper og kommunikation færdigheder4.
Der er i øjeblikket begrænset viden om innovative teknikker til at forbedre bosat læge meddelelse og lederskab strategier i høj-acuity situationer. Ineffektiv kommunikation kan fortsætte trods korrekt forvaltning og ledelse observeret i simulering lab. En tidligere undersøgelse fremhæver at halvnøgne kode uddannelse motion, når sammenlignet med typiske kode uddannelse, er mere udfordrende og tvinger eleverne til at bruge kritisk tænkning færdigheder og lukket kredsløb kommunikation. Eleverne følte udøvelsen størknede lederevner og udfordrede dem til at opretholde mental organisation uden visuelle stikord5.
Forberedelse til halvnøgne kode træningsøvelse giver fakultetet en demonstration, forklarer, hvordan denne avancerede fremgangsmåde udføres, for at formindske lærende intimidering af øvelsen. Når demonstrationen er færdig, holdlederen er bind for øjnene. Projektlederen skal bruge lukket loop-kommunikation og giver eksplicit ordrer til genoplivning team med en anmodning om at få alle ordrer gentages tilbage. Holdet kan ikke selvstændigt indlede procedurer eller forvaltning uden klar retning fra holdlederen. Teammedlemmer kan kun udføre ordrer fra holdlederen, som udtrykkeligt er rettet til dem efter navn. Hvis projektlederen ikke identificerer en bestemt person til at udføre handlingen, er det ikke udført. For eksempel, hvis projektlederen hedder, "Start kompression" uden leder det til et bestemt gruppemedlem, afsluttet rækkefølgen ikke. Alle medlemmer af teamet stå ubevægelig. Hvis et gruppemedlem er givet en ordre ved lederen, men ikke anmodes om at gentage rækkefølgen som bekræftelse ordren kan udføres men projektlederen er givet ikke verbale feedback på afslutning af ordren. Dette burde anspore teamleder til, at efterfølgende ordrer er at gentage tilbage, som lederen ikke har visuelle stimuli skal bekræfte fuldførelse af ordre.
Hvis projektlederen spørger teammedlemmer at gentage ordrer tilbage, skal teammedlemmer svare til holdlederen med lukket kredsløb kommunikation. Dette vækker holdlederen, når ordren er modtaget og afsluttet. For eksempel, hvis projektlederen Dr. Jones spørger John til at "Give 1 mg adrenalin intravenøst", John vil svare "Jeg får 1 mg adrenalin. Dr. Jones, 1 mg adrenalin er blevet administreret intravenøst". Projektlederen kan stille spørgsmål om skærmen. Gruppemedlemmer kan kun beskrive udseendet af hjerterytmen i lægmandssprog (tabel 1). For eksempel, vil ventrikulær takykardi betegnes som en bred kompleks regelmæssige rytme til den sats, der vises på skærmen. Gruppemedlemmer kan ikke bruge medicinske termer Hvornår beskriver de cardiac monitor, såsom ventrikulær takykardi eller pulseless elektrisk aktivitet. Fakultet vil endelig verbalt afklare alle fysisk eksamen resultater, hvis kode projektlederen dirigerer et teammedlem til at udføre en fysisk eksamen.
Ved at fjerne visuelle stimuli, halvnøgne koden uddannelse øvelse styrker teamleder til at opretholde mental organisation og bruge lukket loop-kommunikation for effektivt at håndtere en genoplivning. Formålet med beskrivelsen af halvnøgne kode uddannelse øvelse er at give vejledning i, hvordan du udfører denne innovative undervisning teknik til at gennemtvinge kommunikation med lukket kredsløb.

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

setup and execution of the blindfolded code training exercise

Fejlkommunikation er den mest almindelige årsag til forebyggelige patientens skade i medicin. Der er i øjeblikket begrænset viden om innovative teknikker til at forbedre bosat læge meddelelse og lederskab strategier i høj-acuity situationer. Træningsøvelse halvnøgne kode fjerner visuelle stimuli fra projektlederen, tvinger teamleder til effektivt udnytte lukket kredsløb kommunikation. Den simple handling af blindfolding holdlederen skaber et læringsmiljø, hvor lederen skal udnytte en begrebsramme og kritisk tænkning strategier til at organisere holdet og administrere genoplivning. En fordel at denne undervisning teknik er, at det ikke kræver nogen særlig simulation udstyr, hvilket gør det en billig tilgang. Halvnøgne kode uddannelse øvelse kan anvendes til styring af enhver kritisk syge patient, hvor hovedformålet er at fokusere på at udvikle kommunikationsfærdigheder i akut resuscitations. Formålet med beskrivelsen af halvnøgne kode uddannelse øvelse er at give vejledning i, hvordan du udfører denne innovative undervisning teknik for at gennemtvinge effektiv kommunikation med lukket kredsløb.

Som bemærket i Ahmed et al., alle beboere (100%, 27/27) aftalt/kraftigt aftalt at viden opnået under de halvnøgne kode øvelse kunne overføres til den kliniske omgivelser5. Derudover de fleste beboere kraftigt aftalt, at de halvnøgne kode øvelse var mere udfordrende (81,5%, 22/27), tillod dem at anvende kritisk tænkning færdigheder (81,5%, 22/27), og forbedret brug lukket kredsløb kommunikation (88.9%, 24/27) sammenlignet til typiske kode øvelser (tabel 2).
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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

Halvnøgne kode træningsøvelse, som bind for øjnene teamleder i en kode genoplivning simulering, er en avanceret undervisning teknik til at forbedre lukket kredsløb kommunikation, organisatoriske evner og kritisk tænkning.

Opsætning og udførelse af halvnøgne kode træningsøvelse

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

Kommunikationsfejl er den hyppigste årsag til patientskade, der kan forebygges, i al medicin. Den bind for øjnene kode uddannelse teknik var designet til at forbedre lukket kredsløb kommunikation og forbedre kritisk tænkning i høj-skarphed situationer. Den største fordel ved denne undervisning teknik er, at det lærer hjemmehørende læger effektiv kommunikation og lederskab strategier i en høj skarphed situation uden at kræve noget særligt udstyr.Før du begynder den bind for øjnene kode øvelse, samle alle de nødvendige forsyninger og materialer og placere den menneskelige patient simulator på en Emergency Department seng. Tænd simulatoren og tilslut simulatoren til det trådløse netværk. Giv et sæde fem meter væk fra foden af sengen og et bind for øjnene for koden teamleder.Så sæde holdleder vender væk fra holdet. Print kode genoplivning simulering scenarier for fakultetet og uploade eventuelle nødvendige radiografiske billeder og elektrokardiogram for hver patient scenario. Før du begynder øvelsen, skal du gennemgå reglerne med eleverne og få holdlederen sat på bind for øjnene.Få genoplivningsteamets medlemmer til verbalt at præsentere sig selv ved rolle, navn og position i forhold til patienten i sengen til den bind for øjnene kode teamleder. Jeg er Patrick, jeg er medicinstuderende, og jeg er til patientens højre side af sengen. Jeg er Edgar, jeg er akutlægemiddelbeboeren, og jeg vil være i spidsen for sengen.Jeg er Pat, jeg er din sygeplejerske, jeg er på patientens venstre side af sengen og kan administrere medicin. Jeg er Kate, jeg er din seniorbonde, jeg er til venstre for sengen. Når alle teammedlemmerne har introduceret sig selv, kan du læse stilken til sagsscenariet for kodeholdets leder og ændre patientens vitals og hjerterytmer i overensstemmelse med casescenariets skitse.Kør derefter sagsscenariet i otte til 10 minutter. Hej alle, mit navn er Lauren. Jeg vil være din holdleder.Gentag venligst alle ordrer tilbage i en lukket-loop mode. Forstår alle det? Okay, Edgar, hvordan ser vores patient ud?Så det er en midaldrende mand. Han reagerer ikke og har ingen respiratorisk indsats. Okay, hvilken rytme ser jeg på skærmen?Du ser en Y kompleks, uregelmæssig rytme, uden mærkbar P, QRS, eller T bølger. Okay, det lyder som V-fib. Pat, kan du mærke en puls?Okay, Kate, vær sød at starte brystkompressioner. Start bryst kompressioner.Okay, Patrick, oplad venligst vores defibrillator op til 200 joules. Tænde og oplade defibrillatoren til 200 joule. Okay, Edgar, begynd at sække vores patient med to vejrtrækninger for hver 30 kompressioner.Okay, jeg begynder at sække patienten to vejrtrækninger for hver 30 kompressioner. Defibrillator er opladet til 200 joule. Okay, Kate, sæt kompressionerne på pause.Stop bryst kompressioner. Giv et chok, Patrick. Chok leveret.Okay, Kate, fortsæt brystkompressionerne. Genoptage bryst kompressioner. Okay, Edgar ved vores næste pulstjek, jeg vil bede dig om at intubere vores patient.Okay, jeg vil forberede forsyninger til at intubere patienten ved næste puls check. Okay, Pat, vil du venligst udarbejde et milligram adrenalin? Udarbejdelse af et milligram adrenalin.Og vær venlig at levere det, når du er klar. Okay, et milligram adrenalin udarbejdet. Et milligram adrenalin givet til patienten. Okay.Edgar, hvor lang tid er der gået siden vores sidste pulstjek? Det er 90 sekunder siden vores sidste pulskontrol. Edgar, kan du fortælle mig, når to minutter er gået.Jeg vil lade dig vide, når to minutter er gået. Ved afslutningen af sagen scenario, debriefe koden holdet i ca 10 minutter, med fokus på udnyttelsen af lukket kredsløb kommunikation, lederens effektivitet i at lede genoplivning, og ledelsen beslutninger, som de vedrører den avancerede hjerte liv støtte eller avancerede traumer liv støtte algoritmer. Vælg derefter en anden kodeteamleder, og gentag processen ved afslutningen af debriefingen.I denne repræsentative undersøgelse var 100 % af beboerne enige eller stærkt enige i, at den viden, der blev opnået under øvelsen om kode med bind for øjnene, kunne overføres til den kliniske ramme. De fleste beboere var stærkt enige om, at den bind for øjnene kode træning øvelse var mere udfordrende, tillod dem at anvende kritisk tænkning færdigheder, og forbedret brugen af lukket kredsløb kommunikation i forhold til typiske kode øvelser. Beboere følte også, at opretholde mental organisation uden visuelle signaler var den mest udfordrende del af denne øvelse.Det er vigtigt at gennemgå reglerne med eleverne, før du begynder simuleringen, og få alle teammedlemmer til at præsentere sig selv for den bind for øjnene kode teamleder. Denne innovative undervisningsteknik kan anvendes til håndtering af enhver kritisk syg patient med fokus på at udvikle mere effektive kommunikationsstrategier i højrisikomiljøer. Fremtidige anvisninger for denne undersøgelse omfatter anvendelse af validerede vurderingsværktøjer til at evaluere teamwork, kommunikation og lederskab, når man sammenligner bind for øjnene med ikke-persindfoldede teamledere i situationer med høj skarphed.

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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.

Bestemmelse af Elektromyografisk Træthed Threshold Efter et enkelt besøg Motion Test

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

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.

Ultralyd Vurdering af endotel Funktion: En teknisk retningslinje af Flow-medieret 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 ...

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.

Induktion og vurdering af anstrengelses Skeletal Muscle Damage i mennesker

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.

'Boden mad plade': roman interaktive Web-baseret metode til vurdering af indtagelse

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.

Gennemføre maksimal og Submaximal udholdenhedstræning test for at måle fysiologiske og biologiske svar til akut øvelse i mennesker

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.

Transaxillær første ribbenresektion til behandling af thoraxudløbssyndromet

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.

Opsætning og udførelse af rapid cycle deliberate practice død anmeldelse curriculum

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.

En real-world high-intensity interval træningsprotokol til kardiorespiratorisk konditionsforbedring

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

Vurdering af styrketræningsvolumen og dens indvirkning på insulinfølsomhed ved fedme

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.

Forfatter Spotlight: Udforskning af virkningen af reduceret modstandstræningsvolumen på metabolisk sundhed 

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

Randomiseret kontrolleret forsøg for at studere de akutte virkninger af styrketræning på insulinfølsomhed hos overvægtige voksne

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