Cardiopulmonary resuscitation; use, training and self-confidence in skills. A self-report study among hospital personnel

<p>Abstract</p> <p>Background</p> <p>Immediate start of basic cardiopulmonary resuscitation (CPR) and early defibrillation have been highlighted as crucial for survival from cardiac arrest, but despite new knowledge, new technology and massive personnel training the survival rates from in-hospital cardiac arrest are still low. National guidelines recommend regular intervals of CPR training to make all hospital personnel able to perform basic CPR till advanced care is available. This study investigates CPR training, resuscitation experience and self-confidence in skills among hospital personnel outside critical care areas.</p> <p>Methods</p> <p>A cross-sectional study was performed at three Norwegian hospitals. Data on CPR training and CPR use were collected by self-reports from 361 hospital personnel.</p> <p>Results</p> <p>A total of 89% reported training in CPR, but only 11% had updated their skills in accordance with the time interval recommended by national guidelines. Real resuscitation experience was reported by one third of the respondents. Both training intervals and use of skills in resuscitation situations differed among the professions. Self-reported confidence decreased only after more than two years since last CPR training.</p> <p>Conclusion</p> <p>There is a gap between recommendations and reality in CPR training among hospital personnel working outside critical care areas.</p

Building landscapes to live in : Hermann Mattern (1902-1971).

This first English biography of Hermann Mattem (1902-1971) discusses in depth the contribution by one of Germany’s principal 20lh-century landscape architects to the development of his profession. It is complemented with an introduction to the two personalities he is most associated with: the landscape architect Herta Hammerbacher (1900-1985) and the horticulturist Karl Foerster (1874-1970). The main theme of the thesis are design ideals and approaches rather than realised works. In addition to this, two temporal foci have been set. One focus lies on the early influences during the inter-war period. This includes Mattem’s unique role as an agent of Bauhaus concepts in landscape architecture. A second focus lies on criticism of his work during the National-Socialist dictatorship, providing new insights into the way the concept of ‘degenerate art’ was applied to garden design. By taking an interpretative perspective that considers form-historical tradition lines along with specific biographical influences, a better understanding of garden modernism is aimed at. As point of departure serves the dualism ‘architectonic vs. landscape mode’. Research was conducted mainly in form of text analysis. It is based in great parts on private correspondence kept at different German archives. Mattem’s fundamental questioning of traditional notions can be deduced from his identification with parts of the avant-garde. As a representative of organic functionalism, he was critical of pure rationalism, often producing experimental, even playful solutions. This contrasts sharply with his ambiguous career during the war. Setting this into perspective means considering how the technological modernism of the Nazi realm fascinated Modernist designers, and that it also entailed certain aspects of aesthetic modernism. Mattem’s aestheticism and his pride made him underestimate the ethical dimension of becoming part of one of the Nazi state’s power centres, the Organisation Todt. After the war Mattem continued to challenge the mainstream in several regards. Firstly, pioneering a particular kind of ecological thinking, he forcefully criticised bad planning legislation and practice from an unusually positivist perspective. Secondly, he initiated a unique course of landscape architecture at an art academy, which linked to his early exposure to reformist concepts in artistic education. The exposition of contradicting facets of Mattem’s personality facilitates a more comprehensive interpretation of his design work. It also demonstrates the diversity of modem garden culture, both with regard to philosophy as well as formal expression

Trends in gastro-oesophageal reflux in a Norwegian general population: the Tromsø Study 1979–2016

Background - The prevalence of overweight and smoking has changed over time. However, whether the changes in the risk factors are reflected in the prevalence of gastro-oesophageal reflux disease (GORD) is unknown. The aims of this study were to assess the changes in prevalence of GORD and the associated risk factors over time in a general population. Methods - This was a population-based study using repeated surveys of the Tromsø Study: Tromsø2 (1979–1980, n = 14,279), Tromsø6 (2007–2008, n = 11,460) and Tromsø7 (2015–2016, n = 20,664). Complaints of heartburn and acid regurgitation and common risk factors were reported, and height and weight were measured. The prevalence of GORD was calculated and the association with risk factors was assessed at each time point by odds ratios (OR) and 95% confidence intervals (CI) using multivariable logistic regression. Results - The prevalence of GORD was 13% in 1979–1980, 6% in 2007–2008 and 11% in 2015–2016. In all three surveys, the risk of GORD was consistently increased with overweight and smoking. However, overweight was a weaker risk factor in the first (OR 1.58, 95% CI 1.42–1.76) compared to the last (OR 2.16, 95% CI 1.94–2.41) survey. Smoking was a stronger risk factor in the first (OR 1.45, 95% CI 1.31–1.60) than at the last (OR 1.14, 95% CI 1.01–2.29) survey. Conclusion - During four decades of follow-up of the same population, no clear change in prevalence of GORD was found. GORD was clearly and consistently associated with overweight and smoking. However, overweight has become a more important risk factor than smoking over time

Using mobile sensors to expand recording of physical activity and increase motivation for prolonged data sharing in a population-based study

Source at http://www.ep.liu.se/ecp/article.asp?issue=145&article=005.Regularly conducted population cohort studies contribute important new knowledge to medical research. A high participation rate is required in these types of studies in order to claim representativeness and validity of study results. Participation rates are declining worldwide, and re-searchers are challenged to develop new data collection strategies and tools to motivate people to participate. The last years of advances in sensor and mobile technology, and the widespread use of activity trackers and smart watches, have made it possible to privately collect physical activity data, in a cheap, easy and prolonged way. The unstructured way of collecting this data can have other applications than just showing users their activity trends. In this paper, we describe our plans for how to use these pervasive sensors as new tools for collecting data on physical activity, in a way that can motivate participants to share more information, for a longer time period and with a renewed motivation to participate in a population study

A novel algorithm to detect non-wear time from raw accelerometer data using deep convolutional neural networks

To date, non-wear detection algorithms commonly employ a 30, 60, or even 90 mins interval or window in which acceleration values need to be below a threshold value. A major drawback of such intervals is that they need to be long enough to prevent false positives (type I errors), while short enough to prevent false negatives (type II errors), which limits detecting both short and longer episodes of non-wear time. In this paper, we propose a novel non-wear detection algorithm that eliminates the need for an interval. Rather than inspecting acceleration within intervals, we explore acceleration right before and right after an episode of non-wear time. We trained a deep convolutional neural network that was able to infer non-wear time by detecting when the accelerometer was removed and when it was placed back on again. We evaluate our algorithm against several baseline and existing non-wear algorithms, and our algorithm achieves a perfect precision, a recall of 0.9962, and an F1 score of 0.9981, outperforming all evaluated algorithms. Although our algorithm was developed using patterns learned from a hip-worn accelerometer, we propose algorithmic steps that can easily be applied to a wrist-worn accelerometer and a retrained classification model

Measuring Physical Activity Using Triaxial Wrist Worn Polar Activity Trackers: A Systematic Review

International Journal of Exercise Science 13(4): 438-454, 2020. Collecting objective physical activity data from research participants are increasingly done using consumer-based activity trackers. Several validation studies of Polar devices are conducted to date, but no systematic review of the current level of accuracy for these devices exist. The aim of this study is therefore to investigate the accuracy of current wrist-worn Polar devices that equips a triaxial accelerometer to measure physical activity. We conducted a systematic review by searching six databases for validation studies on modern Polar activity trackers. Studies were grouped and examined by tested outcome, i.e. energy expenditure, physical activity intensity, and steps. We summarized and reported relevant metrics from each study. The initial search resulted in 157 studies, out of which fourteen studies were included in the final review. Energy expenditure was reviewed in seven studies, physical activity intensity was reviewed in four studies, and steps was reviewed in 11 studies. There is a large difference in study protocols with conflicting results between the identified studies. However, for energy expenditure there is some indication that Polar devices perform better in free-living, compared to lab-based studies. In addition, step counting seems to have less average error compared to energy expenditure and physical activity intensity. There is large heterogeneity between the identified studies, both in terms of study protocols and results, and the accuracy of Polar devices remains unclear. More studies are needed for more recently developed devices, and future studies should take care to follow guidelines for assessment of wearable sensors designed for physical activity monitoring

Body mass index, waist circumference and pre-frailty/frailty: the Tromsø study 1994−2016

Objective This study investigated the association between obesity, assessed using body mass index (BMI) and waist circumference (WC), and pre-frailty/frailty among older adults over 21 years of follow-up. Design Prospective cohort study. Setting Population-based study among communitydwelling adults in Tromsø municipality, Norway. Participants 2340women and 2169 men aged ≥45 years attending the Tromsø study in 1994–1995 (Tromsø4) and 2015–2016 (Tromsø7), with additional BMI and WC measurements in 2001 (Tromsø5) and 2007–2008 (Tromsø6). Primary outcome measure Physical frailty was defined as the presence of three or more and pre-frailty as the presence of one to two of the five frailty components suggested by Fried et al: low grip strength, slow walking speed, exhaustion, unintentional weight loss and low physical activity. Results Participants with baseline obesity (adjusted OR 2.41, 95% CI 1.93 to 3.02), assessed by BMI, were more likely to be pre-frail/frail than those with normal BMI. Participants with high (OR 2.14, 95%CI 1.59 to 2.87) or moderately high (OR 1.57, 95%CI 1.21 to 2.03) baseline WC were more likely to be pre-frail/frail than those with normal WC. Those at baseline with normal BMI but moderately high/high WC or overweight with normal WC had no significantly increased odds for pre-frailty/frailty. However, those with both obesity and moderately high/ high WC had increased odds of pre-frailty/frailty. Higher odds of pre-frailty/frailty were observed among those in ‘overweight to obesity’ or ‘increasing obesity’ trajectories than those with stable normal BMI. Compared with participants in a stable normal WC trajectory, those with high WC throughout follow-up were more likely to be prefrail/frail. Conclusion Both general and abdominal obesity, especially over time during adulthood, is associated with an increased risk of pre-frailty/frailty in later years. Thus maintaining normal BMI and WC throughout adult life is important

Polar Vantage and Oura Physical Activity and Sleep Trackers: Validation and Comparison Study

Background: Consumer-based activity trackers are increasingly used in research, as they have the potential to promote increased physical activity and can be used for estimating physical activity among participants. However, the accuracy of newer consumer-based devices is mostly unknown, and validation studies are needed. Objective: The objective of this study was to compare the Polar Vantage watch (Polar Electro Oy) and Oura ring (generation 2; Ōura Health Oy) activity trackers to research-based instruments for measuring physical activity, total energy expenditure, resting heart rate, and sleep duration in free-living adults. Methods: A total of 21 participants wore 2 consumer-based activity trackers (Polar watch and Oura ring), an ActiGraph accelerometer (ActiGraph LLC), and an Actiheart accelerometer and heart rate monitor (CamNtech Ltd) and completed a sleep diary for up to 7 days. We assessed Polar watch and Oura ring validity and comparability for measuring physical activity, total energy expenditure, resting heart rate (Oura), and sleep duration. We analyzed repeated measures correlations, Bland-Altman plots, and mean absolute percentage errors. Results: The Polar watch and Oura ring values strongly correlated (P<.001) with the ActiGraph values for steps (Polar: r=0.75, 95% CI 0.54-0.92; Oura: r=0.77, 95% CI 0.62-0.87), moderate-to-vigorous physical activity (Polar: r=0.76, 95% CI 0.62-0.88; Oura: r=0.70, 95% CI 0.49-0.82), and total energy expenditure (Polar: r=0.69, 95% CI 0.48-0.88; Oura: r=0.70, 95% CI 0.51-0.83) and strongly or very strongly correlated (P<.001) with the sleep diary–derived sleep durations (Polar: r=0.74, 95% CI 0.56-0.88; Oura: r=0.82, 95% CI 0.68-0.91). Oura ring–derived resting heart rates had a very strong correlation (P<.001) with the Actiheart-derived resting heart rates (r=0.9, 95% CI 0.85-0.96). However, the mean absolute percentage error was high for all variables except Oura ring–derived sleep duration (10%) and resting heart rate (3%), which the Oura ring underreported on average by 1 beat per minute. Conclusions: The Oura ring can potentially be used as an alternative to the Actiheart to measure resting heart rate. As for sleep duration, the Polar watch and Oura ring can potentially be used as replacements for a manual sleep diary, depending on the acceptable error. Neither the Polar watch nor the Oura ring can replace the ActiGraph when it comes to measuring steps, moderate-to-vigorous physical activity, and total energy expenditure, but they may be used as additional sources of physical activity measures in some settings. On average, the Polar Vantage watch reported higher outputs compared to those reported by the Oura ring for steps, moderate-to-vigorous physical activity, and total energy expenditure

Changes in adiposity, physical activity, cardiometabolic risk factors, diet, physical capacity and well-being in inactive women and men aged 57-74 years with obesity and cardiovascular risk – A 6-month complex lifestyle intervention with 6-month follow-up

A key challenge in lifestyle interventions is long-term maintenance of favorable lifestyle changes. Middle-aged and older adults are important target groups. The purpose of this analysis was to investigate changes in adiposity, physical activity, cardiometabolic risk factors, diet, physical capacity, and well-being, in inactive middle-aged and older women and men with obesity and elevated cardiovascular disease risk, participating in an interdisciplinary single-arm complex lifestyle intervention pilot study. Participants were recruited from the population-based Tromsø Study 2015–2016 with inclusion criteria age 55–74 years, body mass index (BMI) ≥30kg/m2, sedentary lifestyle, no prior myocardial infarction and elevated cardiovascular risk. Participants (11 men and 5 women aged 57–74 years) underwent a 6-month intervention of two 1-hour group-sessions per week with instructor-led gradually intensified exercise (endurance and strength), one individual and three 2-hour group counselling sessions with nutritionist (Nordic Nutrition Recommendations) and psychologist (Implementation intention strategies). We investigated changes in adiposity (weight, BMI, body composition, waist circumference), physical activity (self-reported and via physical activity trackers), cardiometabolic risk factors (blood pressure, HbA1c, blood lipids), diet (intake of energy, nutrients, foods), physical capacity (aerobic capacity, muscle strength), and psychological well-being, measured at baseline and end-of-intervention, using mean-comparison paired t-tests. Further, we investigated self-reported healthy lifestyle maintenance six months after end-of-intervention, and monthly changes in daily step count, moderate-to-vigorous physical activity (MVPA) and total energy expenditure. From baseline to end-of-intervention, there was a mean decrease in weight, BMI, fat mass, waist circumference, intake of total- and saturated fat, and increase in lean mass, lateral pulldown and leg press. We detected no changes in mean levels of physical activity, cardiometabolic risk factors or well-being. Six months after end-of-intervention, 25% responded healthy lifestyle achievement and maintenance, while objectively measured physical activity remained unchanged. The results are useful for development of a protocol for a full-scale trial