RESUMO
Acute aerobic exercise exerts a small beneficial effect on cognition. Previous research primarily examines cognitive changes following a bout of exercise, while little is currently known about changes in cognitive performance during exercise. The primary purpose of this study was to examine the effects of low-intensity cycling on cognitive function indexed by behavioral (response accuracy; reaction time) and neurocognitive (P3 mean amplitude; P3 centroid latency) responses. Twenty-seven (Mage = 22.9 ± 3.0 years old) individuals were counterbalanced into low-intensity exercise (EX) and seated control (SC) conditions spread across two testing sessions. During each condition, participants completed a 10 min resting baseline period, 20 min of either sustained cycling or seated rest, and a 20 min recovery period. Primary outcomes were assessed at 10 min intervals (five blocks total) throughout each condition via a modified visual oddball task while electroencephalography (EEG) responses were measured. Across time blocks, both conditions exhibited faster reaction times on frequent trials but reduced accuracy to rare trials, suggesting a speed-accuracy tradeoff. There were no differences between conditions in P3 centroid latency, whereas a significant reduction in P3 amplitude was observed during the 20 min exercise period compared to the control condition. Taken together, results suggest that exercise at lower doses may have minimal influence on behavioral outcomes of cognitive performance but may impact more basic measures of brain function. Information gathered from this study may aid in the development of appropriate exercise prescriptions for populations looking to specifically target cognitive function deficits.
RESUMO
OBJECTIVE: National guidelines recommend prophylactic anticoagulation for all hospitalized patients with cancer to prevent hospital-acquired venous thromboembolism (VTE). However, adherence to these evidence-based recommended practice patterns remains low. We performed a quality improvement (QI) project to increase VTE pharmacologic prophylaxis rates among patients with gynecologic malignancies hospitalized for nonsurgical indications and evaluated the resulting effect on rates of development of VTE. MATERIALS AND METHODS: In June 2011, departmental VTE practice guidelines were implemented for patients with gynecologic malignancies who were hospitalized for nonsurgical indications. A standardized VTE prophylaxis module was added to the admission electronic order sets. Outcome measures included number of admissions receiving VTE pharmacologic prophylaxis within 24 hours of admission; and number of potentially preventable hospital-acquired VTEs diagnosed within 30 and 90 days of discharge. Outcomes were compared between a preguideline implementation cohort (n = 99), a postguideline implementation cohort (n = 127), and a sustainability cohort assessed 2 years after implementation (n = 109). Patients were excluded if upon admission they had a VTE, were considered low risk for VTE, or had a documented contraindication to pharmacologic prophylaxis. RESULTS: Administration of pharmacologic prophylaxis within 24 hours of admission increased from 20.8% to 88.2% immediately following the implementation of guidelines, but declined to 71.8% in our sustainability cohort (P < 0.001). There was no difference in VTE incidence among the 3 cohorts [n = 2 (4.2%) vs n = 3 (3.9%) vs n = 3 (4.2%), respectively; P = 1.00]. CONCLUSIONS: Our QI project improved pharmacologic VTE prophylaxis rates. A small decrease in prophylaxis during the subsequent 2 years suggests a need for continued surveillance to optimize QI initiatives. Despite increased adherence to guidelines, VTE rates did not decline in this high-risk population.
