Vibration Training Elicits a Mixed Aerobic and Resistance-type Exercise in Sedentary Subjects

PURPOSE: We hypothesize that untrained subjects can benefit from a greater cardiovascular stimulation than trained athletes, resembling classical aerobic-type activity, in addition to eliciting strength gains.METHODS: 3 groups of male subjects, inactive (SED), endurance trained (END) and strength trained (STR) underwent fitness (VO2max) and lower-body strength tests (isokinetic). Subjects were submitted to a session of oscillating VT, composed of 3 exercises (isometric half-squat, dynamic squat, dynamic squat with added load), each of 3 minutes duration, and repeated at 3 vibration frequencies (20, 26 and 32 Hz). VO2, heart rate and Borg scale were monitored.RESULTS: 27 healthy subjects (10 SED, 9 END and 8 STR), mean age 24.5 (SED), 25.0 (STR) and 29.8 (END) were included. VO2max was significantly different as expected (47.9 vs. 52.9 vs. 63.9 mL?min-1?kg-1, resp. for SED, STR and END). Isokinetic dominant leg extensors strength was higher in STR (3.32 N?m?kg-1 vs. 2.60 and 2.74 in SED and END). During VT, peak oxygen consumption (% of VO2max) attained was 59.3 in SED, 50.8 in STR and 48.0 in END (P<0.001 between SED and other subjects). Peak heart rate (% of heart rate max) was 82.7 in SED, 80.4 in STR and 72.4 in END. In SED, dynamic exercises without extra load elicited 51.0 % of VO2max and 72.1 % of heart rate max, and perceived effort reached 15.1/20.CONCLUSIONS: VT is an unconventional type of exercise, known to enhance strength, bone density, balance and flexibility. Users are attracted by the relative passivity. In SED, VT elicits sufficient cardiovascular response to benefit overall fitness in addition to the strength effects. VT's higher acceptance as an exercise in sedentary people, compared to jogging or cycling, can lead to better adherence to physical activity. Although long-term effects of VT on health are not available, we believe this type of mixed aerobic and resistance-type exercise can be beneficial on multiple health parameters, especially cardiovascular health.

The future of patient safety: Surgical trainees accept virtual reality as a new training tool.

BACKGROUND: The use of virtual reality (VR) has gained increasing interest to acquire laparoscopic skills outside the operating theatre and thus increasing patients' safety. The aim of this study was to evaluate trainees' acceptance of VR for assessment and training during a skills course and at their institution. METHODS: All 735 surgical trainees of the International Gastrointestinal Surgery Workshop 2006-2008, held in Davos, Switzerland, were given a minimum of 45 minutes for VR training during the course. Participants' opinion on VR was analyzed with a standardized questionnaire. RESULTS: Fivehundred-twenty-seven participants (72%) from 28 countries attended the VR sessions and answered the questionnaires. The possibility of using VR at the course was estimated as excellent or good in 68%, useful in 21%, reasonable in 9% and unsuitable or useless in 2%. If such VR simulators were available at their institution, most course participants would train at least one hour per week (46%), two or more hours (42%) and only 12% wouldn't use VR. Similarly, 63% of the participants would accept to operate on patients only after VR training and 55% to have VR as part of their assessment. CONCLUSION: Residents accept and appreciate VR simulation for surgical assessment and training. The majority of the trainees are motivated to regularly spend time for VR training if accessible.

A competency framework in cardiothoracic surgery for training and revalidation - an international comparison.

The conventional methods of education, certification and recertification in cardiothoracic surgery face a paradigm shift in line with recent innovations in diagnostics and therapeutics. The attributes of a competent clinician entail proficiency in knowledge, communication, teamwork, management, health advocacy, professionalism and technical skills. This article investigates the skills required for a cardiothoracic surgeon to be competent. The relevant practice of certification and recertification across various regions has also been explored. Validated and competency-based curricula should be designed to develop core competencies to successfully integrate them into practice. Challenges to the implementation of such curricula and potential solutions are explored. Patient safety remains the ultimate aim to ensure excellence of both competency and performance.

Nouveau programme de formation en médecine interne générale: implications pour les médecins de premier recours [The new postgraduate training program in general internal medicine: implications for the primary care physician].

The Swiss postgraduate training program in general internal medicine is now designed as a competency-based curriculum. In other words, by the end of their training, the residents should demonstrate a set of predefined competences. Many of those competences have to be learnt in outpatient settings. Thus, the primary care physicians have more than ever an important role to play in educating tomorrows doctors. A competency-based model of training requires a regular assessment of the residents. The mini-CEX (mini-Clinical Evaluation eXercise) is the assessment tool proposed by the Swiss institute for postgraduate and continuing education. The mini-CEX is based on the direct observation of the trainees performing a specific task, as well as on the ensuing feedback. This article aims at introducing our colleagues in charge of residents to the mini-CEX, which is a useful tool promoting the culture of feedback in medical education.

Radiation protection education and training in several ionising radiation applications

Ionising radiation (IR) applications are quiet common among several areas of knowledge, medicine or industry. Medical X-rays, Nuclear Medicine, Xrays used in non-destructive testing or applications in research are a few examples. These radiations originate from radioactive materials or radiation emitting devices. Radiation Protection education and training (E&T) is of paramount importance to work safely in areas that imply the use of IR. TheTechnical Unit for Radiation Protection at the University of Barcelona has anextensive expertise in basic, initial and refresher training, in general or specificareas, as well as in courses validated by the Spanish Nuclear Safety Council orto satisfy specific needs with bespoke courses. These specific customer needsare evaluated and on-site courses can also be carried out.

Enseignement prégradué de la médecine ambulatoire a la PMU: quelques repères [Pregraduate training in ambulatory care: a Swiss perspective].

The current lack of general practitioners in Switzerland is the result of health care policy which aimed in the past years to reduce the number of medical students and physicians in private practice. Furthermore, during the past decades, the Swiss Medical Schools emphasized on the transmission of medical care by specialists and neglected primary care medicine. The Faculty of medicine at the University of Lausanne recently decided to renew the curriculum. The Department of ambulatory care and community medicine (Policlinique Médicale Universitaire) of Lausanne is committed to the elaboration of this move. The biomedical model, essential to the acquisition of clinical competence, is still taught to the students. Nevertheless, from the beginning to the end of the curriculum, an emphasis is now put on the clinical skills and the clinical reasoning.

Chronic low-frequency rTMS of primary motor cortex diminishes exercise training-induced gains in maximal voluntary force in humans.

Although there is consensus that the central nervous system mediates the increases in maximal voluntary force (maximal voluntary contraction, MVC) produced by resistance exercise, the involvement of the primary motor cortex (M1) in these processes remains controversial. We hypothesized that 1-Hz repetitive transcranial magnetic stimulation (rTMS) of M1 during resistance training would diminish strength gains. Forty subjects were divided equally into five groups. Subjects voluntarily (Vol) abducted the first dorsal interosseus (FDI) (5 bouts x 10 repetitions, 10 sessions, 4 wk) at 70-80% MVC. Another group also exercised but in the 1-min-long interbout rest intervals they received rTMS [Vol+rTMS, 1 Hz, FDI motor area, 300 pulses/session, 120% of the resting motor threshold (rMT)]. The third group also exercised and received sham rTMS (Vol+Sham). The fourth group received only rTMS (rTMS_only). The 37.5% and 33.3% gains in MVC in Vol and Vol+Sham groups, respectively, were greater (P = 0.001) than the 18.9% gain in Vol+rTMS, 1.9% in rTMS_only, and 2.6% in unexercised control subjects who received no stimulation. Acutely, within sessions 5 and 10, single-pulse TMS revealed that motor-evoked potential size and recruitment curve slopes were reduced in Vol+rTMS and rTMS_only groups and accumulated to chronic reductions by session 10. There were no changes in rMT, maximum compound action potential amplitude (M(max)), and peripherally evoked twitch forces in the trained FDI and the untrained abductor digiti minimi. Although contributions from spinal sources cannot be excluded, the data suggest that M1 may play a role in mediating neural adaptations to strength training.

Interhospital aeromedical transfers: need for a specific training

Introduction: The interhospital aeromedical transfers concern mainly unstable patients presenting with multiple organ failure and among whom the intensity, as well as the difficulty of care are often underestimated. Material and method: Retrospective analysis of 2094 interhospital transfers made by the Rega helicopter of Lausanne between 2003 and 2008, with description of the pathologies, the demographic characteristics, as well as the medical and technical difficulties. Results: Male patient are overrepresented (65 vs 35%), their age being 40-80 years old. On the other hand, we note an important number (10%) of patients less than 10 years. The average time of flight is 13 minutes, with a high rate of night transfers (34%). In 73% of the cases, the transfers concern medical, especially cardiovascular and neurological situations. Trauma and surgical situations account for less than 20%. The transferred patients often require mechanical ventilation (27%), as well as invasive measure of blood pressure (11%), particularly in cases of neurological, pulmonary or cardiac diseases. In 6% of the cases, we note a haemodynamic instability, requiring the use of catecholamines. In 1% a cardiopulmonary resuscitation was initiated during the flight. The overall mortality at 48 hours is about 5%. Conclusions: In spite of relatively brief flights, the complexity and the variety of the pathologies require a specific training for the medical teams involved in the transfers, concerning the aspects of resuscitation, mechanical ventilation, and the knowledge of advanced life support in paediatrics, traumatology and cardiopulmonary intensive care.

Open source software in translator training

La formació de traductors implica l´ús de procediments i eines que permetin els estudiants familiaritzar-se amb contextos professionals. El software lliure especialitzat inclou eines de qualitat professional i procediments accessibles per a les institucions acadèmiques i els estudiants a distància que treballen a casa seva. Els projectes reals que utilitzen software lliure i traducció col·laborativa (crowdsourcing) constitueixen recursos indispensables en la formació de traductors.

Iowa's People: a resource for extension educators, June 1989

Statistics about people and their families interest community planners, social scientists, Extension educators, and others because the family is the fundamental social institution in our society. The purpose of this publication is to bring together in one reference many statistics about people in Iowa counties that have been published separately elsewhere. Most of the data presented are limited to only one year. This cross-sectional view is similar to a photograph that shows only one point in time. At an earlier or later time it might appear differently. Although the statistics reported in the various tables and figures represent different years, the data presented were the most recent available at the time this publication was prepared.

Training Aids to Reduce Potential County Liability, HR-289, Draft, 1987

Iowans who travel secondary roads regard these roads as a very important part of their lives. These highways provide a means of transporting products to market and children to school. They are also links to nearby cities and towns. Nearly 3.8 billion vehicle miles of travel occur each year on Iowa's nearly 90,000 mile secondary road system. Accidents do happen. However, improvements in highways, in vehicles, in driver education, in legislation, and in enforcement have combined to make driving in Iowa very safe. If our highways are to remain safe, these efforts need to be continued. This presentation was developed to help county highway department personnel in their effort to maintain and improve highway safety. The presentation is not a standard, specification or regulation.

Maximal lipid oxidation during exercise: a target for individualizing endurance training in obesity and diabetes?

This review summarizes the rationale for personalized exercise training in obesity and diabetes, targeted at the level of maximal lipid oxidation as can be determined by exercise calorimetry. This measurement is reproducible and reflects muscles' ability to oxidize lipids. Targeted training at this level is well tolerated, increases the ability to oxidize lipids during exercise and improves body composition, lipid and inflammatory status, and glycated hemoglobin, thus representing a possible future strategy for exercise prescription in patients suffering from obesity and diabetes.