Acute Physiological Responses to an Intensity-And Time-Under-Tension-Equated Single- vs. Multiple-Set Resistance Training Bout in Trained Men.

Cintineo, HP, Freidenreich, DJ, Blaine, CM, Cardaci, TD, Pellegrino, JK, and Arent, SM. Acute physiological responses to an intensity-and time under-under-tension-equated single- vs. multiple-set resistance training bout in trained men. J Strength Cond Res 32(12): 3310-3318, 2018-Regardless of the setting, proper manipulation of resistance training program design variables is pivotal in eliciting the desired physiological adaptations. Furthermore, how these variables, especially volume and intensity, work together to affect training outcomes is a major topic of investigation. The purpose of this study was to compare the acute biochemical, physiological, and hormonal responses of a single-set accentuated eccentric high-intensity training (HIT) protocol to a traditional 3-set protocol to better understand the acute effects of volume. Resistance-trained male college students (N = 19; age = 21.11 ± 2.5 years; height = 174.33 ± 6.83 cm; body mass = 76.72 ± 10.24 kg; %BF = 15.53 ± 6.35%) participated in this study and were randomly assigned to either the 1-set HIT protocol (HIT) or the 3-set traditional (3ST) protocol. Heart rate (HR), blood lactate, salivary testosterone, and salivary cortisol levels were measured before, during, and at multiple time points after the exercise bout. Results showed no differences in average HR or testosterone at any time point between the 2 groups. However, the 3ST group exhibited higher values of peak HR, blood lactate during exercise, and cortisol during and 30 minutes after exercise than the HIT group. This indicated that the 3ST protocol induced greater metabolic stress and disrupted the homeostatic balance to a greater magnitude than the HIT protocol despite similar time under tension. These results show that even when training to momentary muscular failure, volume seems to be a key driver of the training stimulus.

Perspectives on Sedation Among Interdisciplinary Team Members in ICU: A Survey Study.

OBJECTIVE: To explore the interdisciplinary team members' beliefs and attitudes about sedation when caring for mechanically ventilated patients in the ICU. DESIGN: Cross-sectional survey. SETTING: A 17-bed cardiothoracic ICU at a tertiary care academic hospital in Colorado. SUBJECTS: All nurses, physicians, advanced practice providers (APPs), respiratory therapists, physical therapists (PTs), and occupational therapists (OTs) who work in the cardiothoracic ICU. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: We modified a validated survey instrument to evaluate perspectives on sedation across members of the interdisciplinary ICU team. Survey responses were collected anonymously from 111 members (81% response rate). Respondents were predominantly female (70 [63%]). Most respondents across disciplines (94%) believed that their sedation practice made a difference in patients' outcomes. More nurses (48%), APPs (62%), and respiratory therapists (50%) believed that sedation could help alleviate the psychologic stress that patients experience on the ventilator than physicians (19%) and PTs/OTs (0%) (p = 0.008). The proportion of respondents who preferred to be sedated if they were mechanically ventilated themselves varied widely by discipline: respiratory therapists (88%), nurses (83%), APPs (54%), PTs/OTs (38%), and physicians (19%) (p < 0.001). In our exploratory analysis, listeners of an educational podcast had beliefs and attitudes more aligned with best evidence-based practices than nonlisteners. CONCLUSIONS: We discovered significant interdisciplinary differences in the beliefs and attitudes regarding sedation use in the ICU. Since all ICU team members are involved in managing mechanically ventilated patients in the ICU, aligning the mental models of sedation may be essential to enhance interprofessional collaboration and promote sedation best practices.

Epidemiology of Traumatic Brain Injuries at a Major Government Hospital in Cambodia.

BACKGROUND: Traumatic brain injury (TBI) is a critical public health problem worldwide with a significant socioeconomic burden. Although improved safety regulations in high-income countries have resulted in a decline in traffic-related TBI, the incidence of TBI in low-income countries is on the rise. We illustrate the trends and factors involved in TBI in a large Cambodian governmental hospital in Phnom Penh. In addition, suggestions for improvement of the country's road traffic safety are discussed. METHODS: This is a cross-sectional study of all patients who presented with traumatic brain injury to Department of Neurosurgery at Preah Kossamak Hospital in Phnom Penh, Cambodia between November 2013 and March 2016. RESULTS: TBIs in Cambodia are on the rise; 34% occur during rush hour, 5-9 pm, and 40% during the weekend. The vast majority (74%) occur as the result of road traffic accidents, of which 81% are motorcycle related. Helmet wear remains low at 13%, and recent alcohol use was reported as 38%. The most common diagnosis is skull fracture. The subdural to epidural hematoma ratio was 1:1.05. Lastly, in both subdural and epidural hematomas the frontal lobe was most commonly involved, with 60% of epidural hematomas associated with a lucid interval. CONCLUSIONS: Our study suggests prevention and management of TBIs can have a measurable public health impact in Cambodia. Initiative examples include helmet safety awareness campaigns, stricter penalties, improvement of prehospital care, and more efficient triage. A high proportion of unhelmeted motorcycle accidents correlates with an increase in epidural hematomas.