Interprofessional obstetric simulation training improves postpartum haemorrhage management and decreases maternal morbidity: a before-and-after study.

Objective: To determine the impact of the Obstetric Simulation Training and Teamwork (OB-STaT) curriculum on postpartum haemorrhage (PPH) rates and outcomes.

Design: Before-and-after study.

Setting: Maternity care hospitals within the USA.

Evaluation of Autonomic Nervous System Dysfunction in Childhood Obesity and Prader-Willi Syndrome.

The autonomic nervous system (ANS) may play a role in the distribution of body fat and the development of obesity and its complications. Features of individuals with Prader-Willi syndrome (PWS) impacted by PWS molecular genetic classes suggest alterations in ANS function; however, these have been rarely studied and presented with conflicting results. The aim of this study was to investigate if the ANS function is altered in PWS.

Innovative Use of Cadavers in Perioperative Nursing Orientation.

The Periop 101 program administrator at a US Navy medical center worked with personnel in the facility's simulation and bioskills laboratories to develop an innovative perioperative nurse orientation curriculum that included the use of human cadavers during simulation activities. Participants were able to practice common perioperative nursing skills (eg, surgical skin antisepsis) on human cadavers rather than simulation manikins. The orientation program comprises two three-month phases.

Does sympathetic vasoconstriction contribute to metabolism: Perfusion matching in exercising skeletal muscle?

The process of matching skeletal muscle blood flow to metabolism is complex and multi-factorial. In response to exercise, increases in cardiac output, perfusion pressure and local vasodilation facilitate an intensity-dependent increase in muscle blood flow. Concomitantly, sympathetic nerve activity directed to both exercising and non-active muscles increases as a function of exercise intensity.

Obstetric Simulation Training and Teamwork: Immediate Impact on Knowledge, Teamwork, and Adherence to Hemorrhage Protocols.

Introduction: The Obstetric Simulation Training and Teamwork (OB-STaT) curriculum was an in situ interprofessional program to provide standardized postpartum hemorrhage (PPH) simulation training throughout a health system to decrease PPH morbidity. In this study portion, investigators hypothesized that OB-STaT would increase: (a) team member knowledge in diagnosis and management of PPH, (b) teamwork, (c) adherence to established PPH protocols, and (d) patient satisfaction.

Methods: The OB-STaT was implemented at 8 US Navy hospitals between February 2018 and November 2019.

Sympathetic vasoconstriction in skeletal muscle: modulatory effects of aging, exercise training, and sex.

The sympathetic nervous system (SNS) is a critically important regulator of the cardiovascular system. The SNS controls cardiac output and its distribution, as well as peripheral vascular resistance and blood pressure at rest and during exercise. Aging is associated with increased blood pressure and decreased skeletal muscle blood flow at rest and in response to exercise.

Effectiveness of the Ophthalmological Training Component of the STOMP (Simulation Training for Operational Medical Providers) Curriculum.

Introduction: Simulation has been used in medicine to train clinicians to manage a variety of clinical scenarios. A key adaptation of the use of simulation in military healthcare occurred in 2015 with the development of the STOMP (Simulation Training for Operational Medical Providers) curriculum, a specific curriculum designed for the intern (PGY-1) trained physicians being sent into the military to practice primary care. Despite showing the curriculum's influence on self-perceived comfort scores, no study has determined whether simulation is an effective means of improving general medical officer (GMO) physicians' skills compared to other traditional styles of education.

An Innovative Simulation Curriculum to Train General Surgery Residents and Medical Students on Four Commonly Encountered Obstetric and Gynecologic Procedures.

Introduction: Lack of obstetric and gynecologic (OBGYN) procedure exposure during general surgery residency was recognized as a training gap for military general surgery residents by U.S. Navy trauma and general surgeons serving as simulation leads for the Naval Medical Center Portsmouth general surgery resident program.

Effects of sex and exercise training on β-adrenoreceptor-mediated opposition of evoked sympathetic vasoconstriction in resting and contracting muscle of rats.

This study investigated the hypothesis that β-adrenoreceptor-mediated inhibition of sympathetic vasoconstriction would be enhanced in female compared with male rats, and that endurance exercise training would augment β-adrenoreceptor-mediated inhibition of sympathetic vasoconstriction in male and female rats. Sprague-Dawley rats were randomized into sedentary (male: = 7; female: = 8) and exercise-trained (male: = 9; female: = 9) groups. Following 4 wk of exercise training or being sedentary, rats were anesthetized and surgically instrumented for stimulation of the lumbar sympathetic chain, muscle contraction and measurement of arterial blood pressure and femoral artery blood flow (FBF).

Effect of acute dietary nitrate supplementation on sympathetic vasoconstriction at rest and during exercise.

Dietary nitrate ( ) supplementation has been shown to reduce resting blood pressure. However, the mechanism responsible for the reduction in blood pressure has not been identified. Dietary supplementation may increase nitric oxide (NO) bioavailability, and NO has been shown to inhibit sympathetic vasoconstriction in resting and contracting skeletal muscle.

In-situ Interprofessional Perinatal Drills: The Impact of a Structured Debrief on Maximizing Training While Sensing Patient Safety Threats.

Introduction In-situ interprofessional emergency team training improves participants' with confidence and knowledge and identifies latent safety threats. This study examined the impact of a structured debrief on an interprofessional perinatal team's ability to identify latent safety threats and assess competency in managing perinatal emergencies. It was hypothesized that latent safety threats would be reduced and checklist compliance would increase during subsequent in-situ perinatal team training.

β-Adrenoreceptors do not oppose sympathetic vasoconstriction in resting and contracting skeletal muscle of male rats.

Sympathetic nervous system (SNS) vasoconstriction is primarily achieved through the binding of norepinephrine (NE) to α-adrenoreceptors. However, NE may also bind to β-adrenoreceptors and cause vasodilation that may oppose/blunt SNS-mediated vasoconstriction. Therefore, this study investigated the hypothesis that β-adrenoreceptor-mediated vasodilation opposes evoked vasoconstriction in resting and contracting skeletal muscle.

Simulation Training for Operational Medicine Providers (STOMP): Impact of a Comprehensive Skills-Based Curriculum for Military General Medical Officers.

Introduction: A standardized training curriculum designed for general medical officers (GMO) titled Simulation Training for Operational Medicine Providers (STOMP) was recently developed to educate and improve GMOs' procedural skills through directed feedback prior to assuming duties in an operational environment. This study aimed to determine the impact this novel curriculum had on GMOs'confidence levels in 21 core privileges covering eight different subspecialties while stationed at Naval Medical Center Portsmouth (NMCP).

Materials And Methods: A cohort study from 2015 to 2017 was designed to address our specific aim to examine if the implementation of the STOMP curriculum increased GMOs' confidence levels.

Energy Drink and Nutritional Supplement Beliefs Among Naval Aviation Candidates.

Introduction: The National Academy of Medicine called for increased research on nutritional supplement use among military members. Current research has suggested potential health risks posed by energy drink consumption. The purpose of this study was to examine the relationship of energy drink consumption and beliefs about nutritional supplements in a U.

Effects of high-intensity interval training on fatigue and quality of life in testicular cancer survivors.

Background: Testicular cancer survivors (TCS) are at increased risk of cancer-related fatigue (CRF), psychosocial impairment, and poor mental health-related quality of life (HRQoL). Here, we examine the effects of high-intensity interval training (HIIT) on patient-reported outcomes (PROs) in TCS. Secondarily, we explore cardiorespiratory fitness as a mediator of intervention effects and select baseline characteristics as moderators of intervention effects.

Effects of high-intensity aerobic interval training on cardiovascular disease risk in testicular cancer survivors: A phase 2 randomized controlled trial.

Background: Testicular cancer survivors (TCS) have an increased risk of treatment-related cardiovascular disease (CVD), which may limit their overall survival. We evaluated the effects of high-intensity aerobic interval training (HIIT) on traditional and novel CVD risk factors and surrogate markers of mortality in a population-based sample of TCS.

Methods: This phase 2 trial (ClinicalTrials.

Caffeine Consumption Among Naval Aviation Candidates.

Introduction: Education frequently dictates students need to study for prolonged periods of time to adequately prepare for examinations. This is especially true with aviation preflight indoctrination (API) candidates who have to assimilate large volumes of information in a limited amount of time during API training. The purpose of this study was to assess caffeine consumption patterns (frequency, type, and volume) among naval aviation candidates attending API to determine the most frequently consumed caffeinated beverage and to examine if the consumption of a nonenergy drink caffeinated beverage was related to energy drink consumption.

Sex differences in sympathetic vasoconstrictor responsiveness and sympatholysis.

Sex differences in the neurovascular control of blood pressure and vascular resistance have been reported. However, the mechanisms underlying the modulatory influence of sex have not been fully elucidated. Nitric oxide (NO) has been shown to inhibit sympathetic vasoconstriction in resting and contracting skeletal muscle, and estrogen modulates NO synthase (NOS) expression and NO bioavailability.

Energy Beverage Consumption Among Naval Aviation Candidates.

Introduction: Since the debut of energy beverages, the consumption of energy beverages has been immensely popular with young adults. Research regarding energy beverage consumption has included college students, European Union residents, and U.S.

Lack of correlation between cerebral vasomotor reactivity and dynamic cerebral autoregulation during stepwise increases in inspired CO2 concentration.

Cerebral vasomotor reactivity (CVMR) and dynamic cerebral autoregulation (CA) are measured extensively in clinical and research studies. However, the relationship between these measurements of cerebrovascular function is not well understood. In this study, we measured changes in cerebral blood flow velocity (CBFV) and arterial blood pressure (BP) in response to stepwise increases in inspired CO2 concentrations of 3 and 6% to assess CVMR and dynamic CA in 13 healthy young adults [2 women, 32 ± 9 (SD) yr].

Exercise training and α1-adrenoreceptor-mediated sympathetic vasoconstriction in resting and contracting skeletal muscle.

Exercise training (ET) increases sympathetic vasoconstrictor responsiveness and enhances contraction-mediated inhibition of sympathetic vasoconstriction (i.e., sympatholysis) through a nitric oxide (NO)-dependent mechanism.

Hindlimb unweighting does not alter vasoconstrictor responsiveness and nitric oxide-mediated inhibition of sympathetic vasoconstriction.

Key Points: Physical inactivity increases the risk of cardiovascular disease and may alter sympathetic nervous system control of vascular resistance. Hindlimb unweighting (HU), a rodent model of physical inactivity, has been shown to diminish sympathetic vasoconstrictor responsiveness and reduce NO synthase expression in isolated skeletal muscle blood vessels. Our understanding of the effects of HU on sympathetic vascular regulation in vivo is very limited.

Vascular effects of aerobic exercise training in rat adult offspring exposed to hypoxia-induced intrauterine growth restriction.

Key Points: Prenatal hypoxia, one of the most common consequences of complicated pregnancies, leads to intrauterine growth restriction (IUGR) and impairs later-life endothelium-dependent vascular function. Early interventions are needed to ultimately reduce later-life risk for cardiovascular disease. Aerobic exercise training has been shown to prevent cardiovascular diseases.