The Acute Effects of Aerobic Exercise on the Functional Connectivity of Human Brain Networks.

Although there is promising evidence that regular physical activity could counteract age-related decline in cognitive and brain function, the mechanisms for this neuroprotection remain unclear. The acute effects of exercise can provide insight into the mechanisms by which the brain adapts to habitual exercise by reflecting transient modulations of systems that would subsequently accumulate long-term adaptations through repeated training sessions. However, methodological limitations have hindered the mechanistic insight gained from previous studies examining acute exercise effects on the human brain. In the current study, we tested the plasticity of functional brain networks in response to a single stimulus of aerobic exercise using resting-state functional connectivity analyses. In a sample of healthy younger (N = 12; age = 23.2 years; 6 females) and older adults (N = 13; age = 66.3 years; 6 females), we found that 30 minutes of moderate-intensity aerobic cycling selectively increased synchrony among brain regions associated with affect and reward processing, learning and memory, and in regions important for attention and executive control. Importantly, these changes did not occur when the same participants completed a passive, motor-driven control condition. Our results suggest that these transient increases in synchrony serve as a possible avenue for systematically investigating the effects of various exercise parameters on specific brain systems, which may accelerate mechanistic discoveries about the benefits of exercise on brain and cognitive function.

How lapse and slip errors influence head-of-bed angle compliance rates as measured by a portable, wireless data collection system.

The recommended protocols to prevent ventilator-associated pneumonia include keeping ventilated patients' head and upper body elevated to an angle between 30 and 45 degrees. These recommendations are largely based on a study that has been difficult to replicate, because studies that have attempted to replicate the original conditions have failed to achieve the necessary bed angles consistently. This work suggests the possibility that two specific types of human error, slips and lapses, contribute to non-compliant bed angles. A novel device provided 83,655 samples of bed angles over a period of 1579 hours. The bed angle was out of compliance 64.2% of the time analyzed. Slips, the accident of raising the bed to an angle slightly less than the desired angle, accounted for most of the out-of-compliance measurements, or 55.9% of the time analyzed. It appears that stochastic variation in the bed adjustments results in the bed being out of compliance. Interventions should be investigated such as increasing the target angle and providing feedback at the moment the bed is raised to close to, but less than, the target angle.

The costs of critical care telemedicine programs: a systematic review and analysis.

BACKGROUND: Implementation of telemedicine programs in ICUs (tele-ICUs) may improve patient outcomes, but the costs of these programs are unknown. We performed a systematic literature review to summarize existing data on the costs of tele-ICUs and collected detailed data on the costs of implementing a tele-ICU in a network of Veterans Health Administration (VHA) hospitals. METHODS: We conducted a systematic review of studies published between January 1, 1990, and July 1, 2011, reporting costs of tele-ICUs. Studies were summarized, and key cost data were abstracted. We then obtained the costs of implementing a tele-ICU in a network of seven VHA hospitals and report these costs in light of the existing literature. RESULTS: Our systematic review identified eight studies reporting tele-ICU costs. These studies suggested combined implementation and first year of operation costs for a tele-ICU of $50,000 to $100,000 per monitored ICU-bed. Changes in patient care costs after tele-ICU implementation ranged from a $3,000 reduction to a $5,600 increase in hospital cost per patient. VHA data suggested a cost for implementation and first year of operation of $70,000 to $87,000 per ICU-bed, depending on the depreciation methods applied. CONCLUSIONS: The cost of tele-ICU implementation is substantial, and the impact of these programs on hospital costs or profits is unclear. Until additional data become available, clinicians and administrators should carefully weigh the clinical and economic aspects of tele-ICUs when considering investing in this technology.