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

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1. forberedelse
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Forberede simulering laboratoriet før begynnelsen øvelse bind for øynene koden.
	<ol>
<li>Forberede alle forsyninger behov for koden resuscitation, inkludert en intravenøs (IV) start kit, IV væsker, en kode cart, defibrillator med pads, en pose ventil maske, en ikke-Rebreatherinstruktør maske, en nese kanyle, en puls oksymeter og intubere forsy...

<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>

Bind for øynene koden øvelsen består av flere viktige trinn. Først krever øvelsen en første fakultetet demonstrasjon for å redusere elevene trusler og angst mot utfører en gjenoppliving blinde. Det tjener også til å gi elever en eksempel av en vellykket ytelse for bind for øynene lungeredning. Overfor teamleder koden fra lungeredning teamet sikrer at leder ikke kan visualisere scenariet og tvinger dem til å gi høyt, tydelig ordre (figur 1). I tillegg begynne senior beboere som k...

Øvelse bind for øynene kode ble utviklet for å forbedre lukket kommunikasjon, bruken av et begrepsmessig rammeverk organisere forvaltningen av en gjenoppliving og kritisk tenkning ferdigheter. Tidligere forskere rapporterte at kommunikasjon, rolle klarhet og samarbeid ble forsterket av blindfolding leger under simulert resuscitations1. Bosatt leger, spesielt i kritiske omsorg spesialiteter, plasseres ofte i høy-skarphet situasjoner. For å riktig behandle disse høyrisiko saker, krever bosatt leger opplæring i både ledelse strategier og kommunikasjon i høyrisiko miljøer2,3. Simulering er vanlig og effektiv i undervisning krisen ressurs styringsprinsipper og kommunikasjon ferdigheter4.
Det er for øyeblikket begrenset kunnskap om innovative teknikker for å forbedre bosatt lege kommunikasjon og ledelse strategier i høy-skarphet situasjoner. Ineffektiv kommunikasjon kan fortsette til tross for riktig administrasjon og ledelse i laboratoriet simulering. En tidligere studie viser at bind for øynene koden trening trening, når sammenlignet med typisk koden trening, er mer utfordrende og styrker elever med kritisk tenkning ferdigheter og lukket kommunikasjon. Elever følte øvelsen styrket ledelse ferdigheter og utfordret dem å opprettholde mental organisasjonen uten varselsignaler5.
I forberedelsene til bind for øynene koden øvelse gir fakultetet en demonstrasjon forklarer hvordan denne avanserte tilnærming er utført, for å redusere elev trusler av øvelsen. Når demonstrasjon er ferdig, er teamleder bind for øynene. Teamlederen må bruke lukket kommunikasjon og gi uklare ordrer til lungeredning laget med en forespørsel til alle ordrer gjentatt tilbake. Teamet kan ikke uavhengig starte ethvert inngrep eller behandling uten klar retning fra teamleder. Gruppemedlemmer kan bare utføre ordrene fra teamleder som er eksplisitt rettet mot dem ved navn. Hvis teamleder ikke identifiserer en bestemt person handlingen, er det ikke utført. For eksempel hvis teamleder sier, "Start sammenntrykking" uten dirigere det til et annet gruppemedlem, er ordren ikke fullført. Alle medlemmer av team stå urørlig. Hvis et gruppemedlem er gitt pålegg av leder, men kreves ikke gjenta rekkefølgen som bekreftelse, rekkefølgen kan utføres men teamleder er ikke gitt muntlig tilbakemelding ved avslutningen av bestillingen. Dette bør be teamleder spørre at påfølgende bestillinger skal gjentas tilbake, som leder ikke har visuelle stimuli å bekrefte bestillingen er fullført.
Hvis teamleder ber å gjenta bestillinger tilbake, må gruppemedlemmer svare til teamlederen bruker lukket kommunikasjon. Dette teamlederen når ordren er mottatt og ferdig. For eksempel, hvis teamleder Dr. Jones spør John til å "Gi 1 mg adrenalin intravenøst", John vil svare "jeg får 1 mg adrenalin. Dr. Jones, 1 mg adrenalin har blitt administrert intravenøst". Teamlederen kan stille spørsmål om skjermen. Imidlertid kan gruppemedlemmer bare beskrive utseendet på cardiac rytmen i lekmann vilkår (tabell 1). For eksempel ville ventrikkel takykardi bli beskrevet som en bred komplekse vanlige rytme frekvensen vises på skjermen. Gruppemedlemmer kan ikke bruke medisinske termer når beskriver cardiac skjermen, for eksempel ventrikkel tachycardia eller pulseless elektrisk aktivitet. Til slutt, fakultetet vil verbalt avklare alle fysisk eksamen funn om teamleder koden leder et gruppemedlem utfører en fysisk eksamen.
Ved å fjerne visuelle stimuli, bind for øynene koden trening trening styrker teamleder å opprettholde mental organisasjonen og bruke lukket kommunikasjon å effektivt håndtere en gjenoppliving. Formålet med beskrivelsen av øvelse bind for øynene koden er å gi veiledning om hvordan du utfører denne nyskapende undervisning teknikken å tvinge lukket kommunikasjon.

<table border="0" cellpadding="0" cellspacing="0" style="width:666px;" width="667">
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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>
			<td style="width:74px;"></td>
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			<td style="width:249px;">endotracheal tube, laryngoscope, stylet, 10 mL syringe, endotracheal tube holder</td>
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		<tr height="42">
			<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

Misforståelser er den vanligste årsaken til forebygges pasienten skade i medisin. Det er for øyeblikket begrenset kunnskap om innovative teknikker for å forbedre bosatt lege kommunikasjon og ledelse strategier i høy-skarphet situasjoner. Øvelse bind for øynene kode fjerner visuelle stimuli fra teamleder, tvinge teamleder å effektivt utnytte lukket kommunikasjon. Den enkle handlingen av blindfolding teamleder oppretter et læringsmiljø der lederen må utnytte et begrepsmessig rammeverk og kritisk tenkning strategier for å organisere laget og administrere lungeredning. En fordel til dette undervisning technique er at den ikke krever noen spesielle simulering utstyr, som gjør det en rimelig tilnærming. Øvelse bind for øynene koden kan brukes til håndtering av noen kritisk syke pasienten der Hovedhensikten er å fokusere på å utvikle kommunikasjonsferdigheter i akutt resuscitations. Formålet med beskrivelsen av øvelse bind for øynene koden er å gi veiledning om hvordan du utfører denne nyskapende undervisning teknikken å tvinge effektiv lukket kommunikasjon.

Som nevnt i Ahmed et al., alle innbyggere (100%, 27/27) avtalt/sterkt enige om at kunnskap fikk under øvelse bind for øynene koden kan overføres til klinisk setting5. Dessuten, de fleste innbyggerne sterkt enige om at bind for øynene koden øvelse var mer utfordrende (81.5%, 22/27) kan bruke kritisk tenkning ferdigheter (81.5%, 22/27), og forbedret bruk lukket kommunikasjon (88.9%, 24/27) sammenlignet til vanlig koden øvelser (tabell 2).
Kvalitativ...

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

Bind for øynene koden øvelse, som bind for øynene teamleder i koden lungeredning simulering, er en avansert undervisning teknikk å forbedre lukket kommunikasjon, organisatoriske evner og kritisk tenkning.

Oppsett og gjennomføring av øvelse bind for øynene kode

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

Kommunikasjonsfeil er den viktigste årsaken til forebygges pasientskade i hele medisin. Kodetreningsteknikken med bind for øynene ble utformet for å forbedre kommunikasjonen med lukket sløyfe og forbedre kritisk tenkning i situasjoner med høy skarphet. Den største fordelen med denne undervisningsteknikken er at den lærer bosatte leger effektive kommunikasjons- og lederstrategier i en høy skarphetssituasjon uten å kreve noe spesielt utstyr.Før du begynner den kodetrening med bind for øynene, samle alle nødvendige forsyninger og materialer og plasser den menneskelige pasientsimulatoren på en legevaktseng. Slå på simulatoren og koble simulatoren til det trådløse nettverket. Gi et sete fem meter fra foten av sengen og en bind for øynene for koden teamleder.Deretter seter laglederen vendt bort fra laget. Skriv ut simuleringsscenarier for kode for fakultetet og last opp eventuelle nødvendige radiografiske bilder og elektrokardiogrammer for hvert pasientscenario. Før du begynner øvelsen, gjennomgå reglene med elevene og få teamlederen satt på bind for øynene.Be gjenopplivingsteammedlemmene verbalt presentere seg ved rolle, navn og posisjon i forhold til pasienten i sengen til den bind for øynene kodeteamleder. Jeg er Patrick, jeg er medisinstudenten, og jeg er ved pasientens rett i sengen. Jeg er Edgar, jeg er akuttmedisiner bosatt, og jeg vil være i spissen av sengen.Jeg er Pat, jeg er sykepleieren din, jeg er ved pasientens venstre side av sengen og kan administrere medisiner. Jeg er Kate, jeg er din senior bosatt, jeg er til venstre for sengen. Når alle teammedlemmene har introdusert seg selv, les stammen for saksscenariet til kodeteamlederen og endre pasientens vitale og hjerterytme i samsvar med case-scenariet.Kjør deretter saksscenariet i åtte til 10 minutter. Hei alle sammen, jeg heter Lauren. Jeg skal være teamleder.Vennligst gjenta alle bestillinger tilbake på en lukket-loop måte. Forstår alle? Ja.Ok, Edgar, hvordan ser pasienten vår ut?Så det er en middelaldrende mann. Han svarer ikke og har ingen åndedrettsinnsats. Ok, hvilken rytme ser jeg på skjermen?Du ser en Y-kompleks, uregelmessig rytme, uten merkbare P-, QRS- eller T-bølger. Det høres ut som V-fib. Pat, føler du puls?Jeg gjør ikke det. Ok, Kate, begynn brystkompresjoner. Starter brystkompresjoner.Greit, Patrick, vennligst lad vår hjertestarter opp til 200 joules. Slå på og lade hjertestarteren til 200 joules. Ok, Edgar, vennligst begynn å pakke pasienten vår med en hastighet på to åndedrag for hver 30 kompresjoner.Greit, jeg skal begynne å pakke pasienten to åndedrag for hver 30 kompresjoner. Defibrillatoren belastes til 200 joule. Ok, Kate, vær så snill å sette brystkompresjonene på pause.Stoppe brystkompresjoner. Lever ett sjokk, Patrick, vær så snill. Sjokk levert.Ok, Kate, fortsett brystkompresjonene. Gjenoppta brystkompresjoner. Greit, Edgar ved vår neste pulssjekk, jeg skal be deg om å intubere pasienten vår.Greit, jeg skal forberede forsyninger for å intubere pasienten ved neste pulskontroll. Greit, Pat, kan du utarbeide ett mg adrenalin? Utarbeide ett mg adrenalin.Og vær så snill å levere det når du er klar. Ok, ett mg adrenalin utarbeidet. Ett mg adrenalin gitt til pasienten. OK.Edgar, hvor mye tid har gått siden vår siste pulssjekk? Det er 90 sekunder siden forrige pulskontroll. Edgar, kan du gi meg beskjed når to minutter har gått.Jeg skal si fra når to minutter har gått. Ved avslutningen av saksscenariet debriefer kodeteamet i ca. 10 minutter, med fokus på utnyttelse av lukket sløyfekommunikasjon, lederens effektivitet i å lede gjenopplivingen, og ledelsesbeslutningene når de gjelder den avanserte hjertelivsstøtten eller avanserte traumelivsstøttealgoritmer. Velg deretter en annen kodeteamleder og gjenta prosessen ved avslutningen av debriefingen.I denne representative studien var 100% av beboerne enige eller sterkt enige om at kunnskapen som ble oppnådd under den bind for øynene kodetreningsøvelsen kunne overføres til den kliniske innstillingen. De fleste beboerne var sterkt enige om at den kodetreningen med bind for øynene var mer utfordrende, tillot dem å bruke kritiske tenkningsferdigheter, og forbedret bruken av lukket sløyfekommunikasjon sammenlignet med typiske kodetreningsøvelser. Beboerne følte også at det å opprettholde mental organisering uten visuelle signaler var den mest utfordrende delen av denne øvelsen.Det er viktig å gå gjennom reglene med elevene før du begynner simuleringen og få alle teammedlemmer til å presentere seg for den kodeteamlederen med bind for øynene. Denne innovative undervisningsteknikken kan brukes på håndtering av enhver kritisk syk pasient med fokus på å utvikle mer effektive kommunikasjonsstrategier i høyrisikomiljøer. Fremtidige retninger for denne studien inkluderer å bruke validerte vurderingsverktøy for å evaluere teamarbeid, kommunikasjon og lederskap når man sammenligner bind for øynene med ikke-for øynene teamledere i situasjoner med høy skarphet.

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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.

Bestemme elektromyografisk Fatigue Threshold Etter ett besøk Exercise 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 av endotelfunksjon: En teknisk Guideline av Flow-mediert dilatasjon 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.

Induksjon og vurdering av anstrengelsesutløst Skeletal Muscle skader hos 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 mat Plate': roman interaktiv Web-basert metode for vurdering av inntak

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.

Gjennomføre maksimal og Submaximal utholdenhet trening Testing for å måle fysiologiske og biologiske svar akutt trening hos 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.

Transaksillær første ribbeinsreseksjon for behandling av thoraxutløpssyndromet

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.

Oppsett og gjennomføring av rapid cycle bevisst praksis død varsling pensum

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-verden høyintensitets intervalltreningsprotokoll for kardiorespiratorisk kondisjonsforbedring

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

Vurdering av styrketreningsvolum og dens innvirkning på insulinfølsomhet 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: Utforske virkningen av redusert motstandstreningsvolum på metabolsk helse 

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

Randomisert kontrollert studie for å studere de akutte effektene av styrketrening på insulinfølsomhet hos overvektige 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 ...