Modelling and regulating of cardio-respiratory response for the enhancement of interval training

PubMed Central

2014-01-01

Background The interval training method has been a well known exercise protocol which helps strengthen and improve one’s cardiovascular fitness. Purpose To develop an effective training protocol to improve cardiovascular fitness based on modelling and analysis of Heart Rate (HR) and Oxygen Uptake (VO2) dynamics. Methods In order to model the cardiorespiratory response to the onset and offset exercises, the (K4b2, Cosmed) gas analyzer was used to monitor and record the heart rate and oxygen uptake for ten healthy male subjects. An interval training protocol was developed for young health users and was simulated using a proposed RC switching model which was presented to accommodate the variations of the cardiorespiratory dynamics to running exercises. A hybrid system model was presented to describe the adaptation process and a multi-loop PI control scheme was designed for the tuning of interval training regime. Results By observing the original data for each subject, we can clearly identify that all subjects have similar HR and VO2 profiles. The proposed model is capable to simulate the exercise responses during onset and offset exercises; it ensures the continuity of the outputs within the interval training protocol. Under some mild assumptions, a hybrid system model can describe the adaption process and accordingly a multi-loop PI controller can be designed for the tuning of interval training protocol. The self-adaption feature of the proposed controller gives the exerciser the opportunity to reach his desired setpoints after a certain number of training sessions. Conclusions The established interval training protocol targets a range of 70-80% of HRmax which is mainly a training zone for the purpose of cardiovascular system development and improvement. Furthermore, the proposed multi-loop feedback controller has the potential to tune the interval training protocol according to the feedback from an individual exerciser. PMID:24499131

Testing an empirically derived mental health training model featuring small groups, distributed practice and patient discussion.

PubMed

Murrihy, Rachael C; Byrne, Mitchell K; Gonsalvez, Craig J

2009-02-01

Internationally, family doctors seeking to enhance their skills in evidence-based mental health treatment are attending brief training workshops, despite clear evidence in the literature that short-term, massed formats are not likely to improve skills in this complex area. Reviews of the educational literature suggest that an optimal model of training would incorporate distributed practice techniques; repeated practice over a lengthy time period, small-group interactive learning, mentoring relationships, skills-based training and an ongoing discussion of actual patients. This study investigates the potential role of group-based training incorporating multiple aspects of good pedagogy for training doctors in basic competencies in brief cognitive behaviour therapy (BCBT). Six groups of family doctors (n = 32) completed eight 2-hour sessions of BCBT group training over a 6-month period. A baseline control design was utilised with pre- and post-training measures of doctors' BCBT skills, knowledge and engagement in BCBT treatment. Family doctors' knowledge, skills in and actual use of BCBT with patients improved significantly over the course of training compared with the control period. This research demonstrates preliminary support for the efficacy of an empirically derived group training model for family doctors. Brief CBT group-based training could prove to be an effective and viable model for future doctor training.

A systematic review of evidence for education and training interventions in microsurgery.

PubMed

Ghanem, Ali M; Hachach-Haram, Nadine; Leung, Clement Chi Ming; Myers, Simon Richard

2013-07-01

Over the past decade, driven by advances in educational theory and pressures for efficiency in the clinical environment, there has been a shift in surgical education and training towards enhanced simulation training. Microsurgery is a technical skill with a steep competency learning curve on which the clinical outcome greatly depends. This paper investigates the evidence for educational and training interventions of traditional microsurgical skills courses in order to establish the best evidence practice in education and training and curriculum design. A systematic review of MEDLINE, EMBASE, and PubMed databases was performed to identify randomized control trials looking at educational and training interventions that objectively improved microsurgical skill acquisition, and these were critically appraised using the BestBETs group methodology. The databases search yielded 1,148, 1,460, and 2,277 citations respectively. These were then further limited to randomized controlled trials from which abstract reviews reduced the number to 5 relevant randomised controlled clinical trials. The best evidence supported a laboratory based low fidelity model microsurgical skills curriculum. There was strong evidence that technical skills acquired on low fidelity models transfers to improved performance on higher fidelity human cadaver models and that self directed practice leads to improved technical performance. Although there is significant paucity in the literature to support current microsurgical education and training practices, simulated training on low fidelity models in microsurgery is an effective intervention that leads to acquisition of transferable skills and improved technical performance. Further research to identify educational interventions associated with accelerated skill acquisition is required.

Does Academic Training Change Intentions? Drawing upon the Theory of Planned Behaviour to Improve Academic Performance

ERIC Educational Resources Information Center

Hodge, Brad; Wright, Brad; Bennett, Pauleen

2017-01-01

In order to improve transfer following training, it is important to understand what the training alters for each individual. We sought to develop a better understanding of the underlying mechanisms implicated in successful training. A questionnaire modelled on the Theory of Planned Behaviour (ToPB) was used to compare two distinct, academic skills…

Speech sound discrimination training improves auditory cortex responses in a rat model of autism

PubMed Central

Engineer, Crystal T.; Centanni, Tracy M.; Im, Kwok W.; Kilgard, Michael P.

2014-01-01

Children with autism often have language impairments and degraded cortical responses to speech. Extensive behavioral interventions can improve language outcomes and cortical responses. Prenatal exposure to the antiepileptic drug valproic acid (VPA) increases the risk for autism and language impairment. Prenatal exposure to VPA also causes weaker and delayed auditory cortex responses in rats. In this study, we document speech sound discrimination ability in VPA exposed rats and document the effect of extensive speech training on auditory cortex responses. VPA exposed rats were significantly impaired at consonant, but not vowel, discrimination. Extensive speech training resulted in both stronger and faster anterior auditory field (AAF) responses compared to untrained VPA exposed rats, and restored responses to control levels. This neural response improvement generalized to non-trained sounds. The rodent VPA model of autism may be used to improve the understanding of speech processing in autism and contribute to improving language outcomes. PMID:25140133

Improving CNN Performance Accuracies With Min-Max Objective.

PubMed

Shi, Weiwei; Gong, Yihong; Tao, Xiaoyu; Wang, Jinjun; Zheng, Nanning

2017-06-09

We propose a novel method for improving performance accuracies of convolutional neural network (CNN) without the need to increase the network complexity. We accomplish the goal by applying the proposed Min-Max objective to a layer below the output layer of a CNN model in the course of training. The Min-Max objective explicitly ensures that the feature maps learned by a CNN model have the minimum within-manifold distance for each object manifold and the maximum between-manifold distances among different object manifolds. The Min-Max objective is general and able to be applied to different CNNs with insignificant increases in computation cost. Moreover, an incremental minibatch training procedure is also proposed in conjunction with the Min-Max objective to enable the handling of large-scale training data. Comprehensive experimental evaluations on several benchmark data sets with both the image classification and face verification tasks reveal that employing the proposed Min-Max objective in the training process can remarkably improve performance accuracies of a CNN model in comparison with the same model trained without using this objective.

Semiconductor Manufacturing Comes to Virginia: Developing Partnerships for Workforce Education and Training.

ERIC Educational Resources Information Center

Cantor, Jeffrey A.

1998-01-01

In Virginia, a community college consortium for semiconductor education and training programs works with a semiconductor manufacturers' partnership to review programs based on a national core curriculum model. The results are being used to improve curriculum development, faculty training, facility improvement, and student recruitment. (SK)

The European Academy laparoscopic “Suturing Training and Testing’’ (SUTT) significantly improves surgeons’ performance

PubMed Central

Sleiman, Z.; Tanos, V.; Van Belle, Y.; Carvalho, J.L.; Campo, R.

2015-01-01

The efficiency of suturing training and testing (SUTT) model by laparoscopy was evaluated, measuring the suturingskill acquisition of trainee gynecologists at the beginning and at the end of a teaching course. During a workshop organized by the European Academy of Gynecological Surgery (EAGS), 25 participants with three different experience levels in laparoscopy (minor, intermediate and major) performed the 4 exercises of the SUTT model (Ex 1: both hands stitching and continuous suturing, Ex 2: right hand stitching and intracorporeal knotting, Ex 3: left hand stitching and intracorporeal knotting, Ex 4: dominant hand stitching, tissue approximation and intracorporeal knotting). The time needed to perform the exercises is recorded for each trainee and group and statistical analysis used to note the differences. Overall, all trainees achieved significant improvement in suturing time (p < 0.005) as measured before and after completion of the training. Similar significantly improved suturing time differences (p < 0.005) were noted among the groups of trainees with different laparoscopic experience. In conclusion a short well-guided training course, using the SUTT model, improves significantly surgeon’s laparoscopic suturing ability, independently of the level of experience in laparoscopic surgery. Key words: Endoscopy, laparoscopic suturing, psychomotor skills, surgery, teaching, training suturing model. PMID:26977264

Multi-Objective Aerodynamic Optimization of the Streamlined Shape of High-Speed Trains Based on the Kriging Model.

PubMed

Xu, Gang; Liang, Xifeng; Yao, Shuanbao; Chen, Dawei; Li, Zhiwei

2017-01-01

Minimizing the aerodynamic drag and the lift of the train coach remains a key issue for high-speed trains. With the development of computing technology and computational fluid dynamics (CFD) in the engineering field, CFD has been successfully applied to the design process of high-speed trains. However, developing a new streamlined shape for high-speed trains with excellent aerodynamic performance requires huge computational costs. Furthermore, relationships between multiple design variables and the aerodynamic loads are seldom obtained. In the present study, the Kriging surrogate model is used to perform a multi-objective optimization of the streamlined shape of high-speed trains, where the drag and the lift of the train coach are the optimization objectives. To improve the prediction accuracy of the Kriging model, the cross-validation method is used to construct the optimal Kriging model. The optimization results show that the two objectives are efficiently optimized, indicating that the optimization strategy used in the present study can greatly improve the optimization efficiency and meet the engineering requirements.

A comparison of two coaching approaches to enhance implementation of a recovery-oriented service model.

PubMed

Deane, Frank P; Andresen, Retta; Crowe, Trevor P; Oades, Lindsay G; Ciarrochi, Joseph; Williams, Virginia

2014-09-01

Moving to recovery-oriented service provision in mental health may entail retraining existing staff, as well as training new staff. This represents a substantial burden on organisations, particularly since transfer of training into practice is often poor. Follow-up supervision and/or coaching have been found to improve the implementation and sustainment of new approaches. We compared the effect of two coaching conditions, skills-based and transformational coaching, on the implementation of a recovery-oriented model following training. Training followed by coaching led to significant sustained improvements in the quality of care planning in accordance with the new model over the 12-month study period. No interaction effect was observed between the two conditions. However, post hoc analyses suggest that transformational coaching warrants further exploration. The results support the provision of supervision in the form of coaching in the implementation of a recovery-oriented service model, and suggest the need to better elucidate the mechanisms within different coaching approaches that might contribute to improved care.

Assessing Predictive Properties of Genome-Wide Selection in Soybeans

PubMed Central

Xavier, Alencar; Muir, William M.; Rainey, Katy Martin

2016-01-01

Many economically important traits in plant breeding have low heritability or are difficult to measure. For these traits, genomic selection has attractive features and may boost genetic gains. Our goal was to evaluate alternative scenarios to implement genomic selection for yield components in soybean (Glycine max L. merr). We used a nested association panel with cross validation to evaluate the impacts of training population size, genotyping density, and prediction model on the accuracy of genomic prediction. Our results indicate that training population size was the factor most relevant to improvement in genome-wide prediction, with greatest improvement observed in training sets up to 2000 individuals. We discuss assumptions that influence the choice of the prediction model. Although alternative models had minor impacts on prediction accuracy, the most robust prediction model was the combination of reproducing kernel Hilbert space regression and BayesB. Higher genotyping density marginally improved accuracy. Our study finds that breeding programs seeking efficient genomic selection in soybeans would best allocate resources by investing in a representative training set. PMID:27317786

Elementary School Teacher Training Based on Needs and Interests of Teachers and The Effectiveness of The Improvement of Students Competence

NASA Astrophysics Data System (ADS)

Suyitno, A.; Sugiharti, E.; Pujiastuti, E.

2017-04-01

Teachers need always to improve their competence because of the growth of science very rapidly as well as elementary school teachers. However, the provision of training will not produce an increase in the competence effectively if it is implemented without considering the needs and interests of teachers. The novelty factor which is highlighted through this research results, want to answer a problem, namely: how to conduct an effective training based on the needs and interests of teachers so that the effects of training can improve the competence of teachers? After going through research for two years with a qualitative approach which was preceded by a visit to the school and a series of interviews, treatment of training model, FGD, and triangulation then have been produced a way to implement of training based on the needs and interests of teachers. The training model includes face to face training which structured and scheduled according to the needs of elementary school teachers, followed by workshops, simulations, then the coach holds guidance in the classroom, and ends with reflections.

Training Inference Making Skills Using a Situation Model Approach Improves Reading Comprehension

PubMed Central

Bos, Lisanne T.; De Koning, Bjorn B.; Wassenburg, Stephanie I.; van der Schoot, Menno

2016-01-01

This study aimed to enhance third and fourth graders’ text comprehension at the situation model level. Therefore, we tested a reading strategy training developed to target inference making skills, which are widely considered to be pivotal to situation model construction. The training was grounded in contemporary literature on situation model-based inference making and addressed the source (text-based versus knowledge-based), type (necessary versus unnecessary for (re-)establishing coherence), and depth of an inference (making single lexical inferences versus combining multiple lexical inferences), as well as the type of searching strategy (forward versus backward). Results indicated that, compared to a control group (n = 51), children who followed the experimental training (n = 67) improved their inference making skills supportive to situation model construction. Importantly, our training also resulted in increased levels of general reading comprehension and motivation. In sum, this study showed that a ‘level of text representation’-approach can provide a useful framework to teach inference making skills to third and fourth graders. PMID:26913014

Improving Sibling Relationships among Young Children: A Social Skills Training Model.

ERIC Educational Resources Information Center

Kramer, Laurie; Radey, Chad

1997-01-01

Evaluates a new approach to improving sibling relationships in which social skills training was used to coach small groups of children (n=21) in prosocial sibling behaviors. Results show that children in the training group exhibited increased warmth, decreased rivalry, fewer problematic sibling behaviors, and a reduced status/power differential…

Primary care emergency team training in situ means learning in real context

PubMed Central

Brandstorp, Helen; Halvorsen, Peder A.; Sterud, Birgitte; Haugland, Bjørgun; Kirkengen, Anna Luise

2016-01-01

Objective The purpose of our study was to explore the local learning processes and to improve in situ team training in the primary care emergency teams with a focus on interaction. Design, setting and subjects As participating observers, we investigated locally organised trainings of teams constituted ad hoc, involving nurses, paramedics and general practitioners, in rural Norway. Subsequently, we facilitated focus discussions with local participants. We investigated what kinds of issues the participants chose to elaborate in these learning situations, why they did so, and whether and how local conditions improved during the course of three and a half years. In addition, we applied learning theories to explore and challenge our own and the local participants’ understanding of team training. Results In situ team training was experienced as challenging, engaging, and enabling. In the training sessions and later focus groups, the participants discussed a wide range of topics constitutive for learning in a sociocultural perspective, and topics constitutive for patient safety culture. The participants expanded the types of training sites, themes and the structures for participation, improved their understanding of communication and developed local procedures. The flexible structure of the model mirrors the complexity of medicine and provides space for the participants’ own sense of responsibility. Conclusion Challenging, monthly in situ team trainings organised by local health personnel facilitate many types of learning. The flexible training model provides space for the participants’ own sense of responsibility and priorities. Outcomes involve social and structural improvements, including a sustainable culture of patient safety. Key Points Challenging, monthly in situ team trainings, organised by local health personnel, facilitate many types of learning.The flexible structure of the training model mirrors the complexity of medicine and the realism of the simulation sessions.Providing room for the participants’ own priorities and sense of responsibility allows for improvement on several levels.The participants demonstrated a consistent, long-term motivation to strengthen safety, both for their patients and for themselves. PMID:27442268

Primary care emergency team training in situ means learning in real context.

PubMed

Brandstorp, Helen; Halvorsen, Peder A; Sterud, Birgitte; Haugland, Bjørgun; Kirkengen, Anna Luise

2016-09-01

The purpose of our study was to explore the local learning processes and to improve in situ team training in the primary care emergency teams with a focus on interaction. As participating observers, we investigated locally organised trainings of teams constituted ad hoc, involving nurses, paramedics and general practitioners, in rural Norway. Subsequently, we facilitated focus discussions with local participants. We investigated what kinds of issues the participants chose to elaborate in these learning situations, why they did so, and whether and how local conditions improved during the course of three and a half years. In addition, we applied learning theories to explore and challenge our own and the local participants' understanding of team training. In situ team training was experienced as challenging, engaging, and enabling. In the training sessions and later focus groups, the participants discussed a wide range of topics constitutive for learning in a sociocultural perspective, and topics constitutive for patient safety culture. The participants expanded the types of training sites, themes and the structures for participation, improved their understanding of communication and developed local procedures. The flexible structure of the model mirrors the complexity of medicine and provides space for the participants' own sense of responsibility. Challenging, monthly in situ team trainings organised by local health personnel facilitate many types of learning. The flexible training model provides space for the participants' own sense of responsibility and priorities. Outcomes involve social and structural improvements, including a sustainable culture of patient safety. KEY POINTS Challenging, monthly in situ team trainings, organised by local health personnel, facilitate many types of learning. The flexible structure of the training model mirrors the complexity of medicine and the realism of the simulation sessions. Providing room for the participants' own priorities and sense of responsibility allows for improvement on several levels. The participants demonstrated a consistent, long-term motivation to strengthen safety, both for their patients and for themselves.

Can visual arts training improve physician performance?

PubMed

Katz, Joel T; Khoshbin, Shahram

2014-01-01

Clinical educators use medical humanities as a means to improve patient care by training more self-aware, thoughtful, and collaborative physicians. We present three examples of integrating fine arts - a subset of medical humanities - into the preclinical and clinical training as models that can be adapted to other medical environments to address a wide variety of perceived deficiencies. This novel teaching method has promise to improve physician skills, but requires further validation.

Do pre-trained deep learning models improve computer-aided classification of digital mammograms?

NASA Astrophysics Data System (ADS)

Aboutalib, Sarah S.; Mohamed, Aly A.; Zuley, Margarita L.; Berg, Wendie A.; Luo, Yahong; Wu, Shandong

2018-02-01

Digital mammography screening is an important exam for the early detection of breast cancer and reduction in mortality. False positives leading to high recall rates, however, results in unnecessary negative consequences to patients and health care systems. In order to better aid radiologists, computer-aided tools can be utilized to improve distinction between image classifications and thus potentially reduce false recalls. The emergence of deep learning has shown promising results in the area of biomedical imaging data analysis. This study aimed to investigate deep learning and transfer learning methods that can improve digital mammography classification performance. In particular, we evaluated the effect of pre-training deep learning models with other imaging datasets in order to boost classification performance on a digital mammography dataset. Two types of datasets were used for pre-training: (1) a digitized film mammography dataset, and (2) a very large non-medical imaging dataset. By using either of these datasets to pre-train the network initially, and then fine-tuning with the digital mammography dataset, we found an increase in overall classification performance in comparison to a model without pre-training, with the very large non-medical dataset performing the best in improving the classification accuracy.

Rationale and Resources for Teaching the Mathematical Modeling of Athletic Training and Performance

ERIC Educational Resources Information Center

Clarke, David C.; Skiba, Philip F.

2013-01-01

A number of professions rely on exercise prescription to improve health or athletic performance, including coaching, fitness/personal training, rehabilitation, and exercise physiology. It is therefore advisable that the professionals involved learn the various tools available for designing effective training programs. Mathematical modeling of…

Enhancing performance of P300-Speller under mental workload by incorporating dual-task data during classifier training.

PubMed

Chen, Yuqian; Ke, Yufeng; Meng, Guifang; Jiang, Jin; Qi, Hongzhi; Jiao, Xuejun; Xu, Minpeng; Zhou, Peng; He, Feng; Ming, Dong

2017-12-01

As one of the most important brain-computer interface (BCI) paradigms, P300-Speller was shown to be significantly impaired once applied in practical situations due to effects of mental workload. This study aims to provide a new method of building training models to enhance performance of P300-Speller under mental workload. Three experiment conditions based on row-column P300-Speller paradigm were performed including speller-only, 3-back-speller and mental-arithmetic-speller. Data under dual-task conditions were introduced to speller-only data respectively to build new training models. Then performance of classifiers with different models was compared under the same testing condition. The results showed that when tasks of imported training data and testing data were the same, character recognition accuracies and round accuracies of P300-Speller with mixed-data training models significantly improved (FDR, p < 0.005). When they were different, performance significantly improved when tested on mental-arithmetic-speller (FDR, p < 0.05) while the improvement was modest when tested on n-back-speller (FDR, p < 0.1). The analysis of ERPs revealed that ERP difference between training data and testing data was significantly diminished when the dual-task data was introduced to training data (FDR, p < 0.05). The new method of training classifier on mixed data proved to be effective in enhancing performance of P300-Speller under mental workload, confirmed the feasibility to build a universal training model and overcome the effects of mental workload in its practical applications. Copyright © 2017 Elsevier B.V. All rights reserved.

Performance Improvement: Applying a Human Performance Model to Organizational Processes in a Military Training Environment

ERIC Educational Resources Information Center

Aaberg, Wayne; Thompson, Carla J.; West, Haywood V.; Swiergosz, Matthew J.

2009-01-01

This article provides a description and the results of a study that utilized the human performance (HP) model and methods to explore and analyze a training organization. The systemic and systematic practices of the HP model are applicable to military training organizations as well as civilian organizations. Implications of the study for future…

Relative effectiveness of worker safety and health training methods.

PubMed

Burke, Michael J; Sarpy, Sue Ann; Smith-Crowe, Kristin; Chan-Serafin, Suzanne; Salvador, Rommel O; Islam, Gazi

2006-02-01

We sought to determine the relative effectiveness of different methods of worker safety and health training aimed at improving safety knowledge and performance and reducing negative outcomes (accidents, illnesses, and injuries). Ninety-five quasi-experimental studies (n=20991) were included in the analysis. Three types of intervention methods were distinguished on the basis of learners' participation in the training process: least engaging (lecture, pamphlets, videos), moderately engaging (programmed instruction, feedback interventions), and most engaging (training in behavioral modeling, hands-on training). As training methods became more engaging (i.e., requiring trainees' active participation), workers demonstrated greater knowledge acquisition, and reductions were seen in accidents, illnesses, and injuries. All methods of training produced meaningful behavioral performance improvements. Training involving behavioral modeling, a substantial amount of practice, and dialogue is generally more effective than other methods of safety and health training. The present findings challenge the current emphasis on more passive computer-based and distance training methods within the public health workforce.

Relative Effectiveness of Worker Safety and Health Training Methods

PubMed Central

Burke, Michael J.; Sarpy, Sue Ann; Smith-Crowe, Kristin; Chan-Serafin, Suzanne; Salvador, Rommel O.; Islam, Gazi

2006-01-01

Objectives. We sought to determine the relative effectiveness of different methods of worker safety and health training aimed at improving safety knowledge and performance and reducing negative outcomes (accidents, illnesses, and injuries). Methods. Ninety-five quasi-experimental studies (n=20991) were included in the analysis. Three types of intervention methods were distinguished on the basis of learners’ participation in the training process: least engaging (lecture, pamphlets, videos), moderately engaging (programmed instruction, feedback interventions), and most engaging (training in behavioral modeling, hands-on training). Results. As training methods became more engaging (i.e., requiring trainees’ active participation), workers demonstrated greater knowledge acquisition, and reductions were seen in accidents, illnesses, and injuries. All methods of training produced meaningful behavioral performance improvements. Conclusions. Training involving behavioral modeling, a substantial amount of practice, and dialogue is generally more effective than other methods of safety and health training. The present findings challenge the current emphasis on more passive computer-based and distance training methods within the public health workforce. PMID:16380566

Preventing and De-Escalating Ethical Conflict: A Communication-Training Mediation Model.

PubMed

Levin, Tomer T; Parker, Patricia A

2015-01-01

While ethical conflicts in the provision of healthcare are common, the current third-party mediator model is limited by a lack of expert ethical mediators, who are often not on site when conflict escalates. In order to improve clinical outcomes in situations such as conflicts at the end of life, we suggest that clinicians-physicians, nurses and social workers-be trained to prevent and de-escalate emerging conflicts. This can be achieved using a mediation model framed by a communication-training approach. A case example is presented and the model is discussed. The implication of this preventative/early intervention model for improving clinical outcomes, in particular end-of life conflict, is considered. Copyright 2015 The Journal of Clinical Ethics. All rights reserved.

A Model of Cooperative Education--"Group Leader Training Program" for Industry Employees

ERIC Educational Resources Information Center

Arslan, Ridvan; Kus, Abdil; Mumcu, Haldun; Uzaslan, N. Tufan

2008-01-01

Studies on continuous education and alteration are highly significant in order to improve the technical and social abilities of the industry employees. Generally, these kinds of educational facilities are carried on in the range of in-house training. Besides in-house training, it is also possible to improve the abilities of the employees with the…

Building Tobacco Cessation Capacity in the US-Affiliated Pacific Islands

PubMed Central

David, Annette M.; Cruz, Peter J.; Mercado, Susan P.; Dan, Li

2013-01-01

Tobacco control stakeholders in priority populations are searching for culturally appropriate cessation training models to strengthen cessation capacity and infrastructure. We adapted the University of Arizona model for Brief Tobacco Cessation Interventions (BTI) training for Pacific Islanders and pilot-tested it in four Pacific Islands - Palau, the Federated States of Micronesia, the Northern Mariana Islands and the Marshall Islands. All participants completed a post-training knowledge assessment exam, pre- and post-confidence assessments and a quality improvement evaluation. Of 70 participants, 65 (93%) completed the training. Forty-one (63%) passed the post-training knowledge assessment exam at the 1st attempt; an additional 9 (14%) successfully passed on their 2nd attempt, for a total pass rate of 77%. The pre and post confidence surveys demonstrated a statistically significant increase in confidence across all competency areas for delivering brief advice. The quality improvement survey revealed high acceptance and approval for the content and delivery of the locally adapted training model. As Pacific Island communities enact tobacco control policies, cessation demand is growing. The Guam cessation training model used culturally relevant data, materials and training approaches and appeared effective in four different Pacific island countries. This underscores the importance of culturally competent adaptation of cessation training for priority populations like Pacific Islanders. PMID:23632079

Can Visual Arts Training Improve Physician Performance?

PubMed Central

Katz, Joel T.; Khoshbin, Shahram

2014-01-01

Clinical educators use medical humanities as a means to improve patient care by training more self-aware, thoughtful, and collaborative physicians. We present three examples of integrating fine arts — a subset of medical humanities — into the preclinical and clinical training as models that can be adapted to other medical environments to address a wide variety of perceived deficiencies. This novel teaching method has promise to improve physician skills, but requires further validation. PMID:25125749

Development and Evaluation of a Model-Supported Scientific Inquiry Training Program for Elementary Teachers in Indonesia

ERIC Educational Resources Information Center

Ertikanto, Chandra; Herpratiwi; Yunarti, Tina; Saputra, Andrian

2017-01-01

A teacher training program, named Model-Supported Scientific Inquiry Training Program (MSSITP) has been successfully developed to improve the inquiry skills of Indonesian elementary teachers. The skills enhanced by MSSITP are defining problems, formulating hypotheses, planning and doing investigations, drawing conclusions, and communicating the…

Data-driven train set crash dynamics simulation

NASA Astrophysics Data System (ADS)

Tang, Zhao; Zhu, Yunrui; Nie, Yinyu; Guo, Shihui; Liu, Fengjia; Chang, Jian; Zhang, Jianjun

2017-02-01

Traditional finite element (FE) methods are arguably expensive in computation/simulation of the train crash. High computational cost limits their direct applications in investigating dynamic behaviours of an entire train set for crashworthiness design and structural optimisation. On the contrary, multi-body modelling is widely used because of its low computational cost with the trade-off in accuracy. In this study, a data-driven train crash modelling method is proposed to improve the performance of a multi-body dynamics simulation of train set crash without increasing the computational burden. This is achieved by the parallel random forest algorithm, which is a machine learning approach that extracts useful patterns of force-displacement curves and predicts a force-displacement relation in a given collision condition from a collection of offline FE simulation data on various collision conditions, namely different crash velocities in our analysis. Using the FE simulation results as a benchmark, we compared our method with traditional multi-body modelling methods and the result shows that our data-driven method improves the accuracy over traditional multi-body models in train crash simulation and runs at the same level of efficiency.

Evaluation of Veterinary Student Surgical Skills Preparation for Ovariohysterectomy Using Simulators: A Pilot Study.

PubMed

Read, Emma K; Vallevand, Andrea; Farrell, Robin M

2016-01-01

This paper describes the development and evaluation of training intended to enhance students' performance on their first live-animal ovariohysterectomy (OVH). Cognitive task analysis informed a seven-page lab manual, 30-minute video, and 46-item OVH checklist (categorized into nine surgery components and three phases of surgery). We compared two spay simulator models (higher-fidelity silicone versus lower-fidelity cloth and foam). Third-year veterinary students were randomly assigned to a training intervention: lab manual and video only; lab manual, video, and $675 silicone-based model; lab manual, video, and $64 cloth and foam model. We then assessed transfer of training to a live-animal OVH. Chi-square analyses determined statistically significant differences between the interventions on four of nine surgery components, all three phases of surgery, and overall score. Odds ratio analyses indicated that training with a spay model improved the odds of attaining an excellent or good rating on 25 of 46 checklist items, six of nine surgery components, all three phases of surgery, and the overall score. Odds ratio analyses comparing the spay models indicated an advantage for the $675 silicon-based model on only 6 of 46 checklist items, three of nine surgery components, and one phase of surgery. Training with a spay model improved performance when compared to training with a manual and video only. Results suggested that training with a lower-fidelity/cost model might be as effective when compared to a higher-fidelity/cost model. Further research is required to investigate simulator fidelity and costs on transfer of training to the operational environment.

Computer-based multisensory learning in children with developmental dyslexia.

PubMed

Kast, Monika; Meyer, Martin; Vögeli, Christian; Gross, Markus; Jäncke, Lutz

2007-01-01

Several attempts have been made to remediate developmental dyslexia using various training environments. Based on the well-known retrieval structure model, the memory strength of phonemes and graphemes should be strengthened by visual and auditory associations between graphemes and phonemes. Using specifically designed training software, we examined whether establishing a multitude of visuo-auditory associations might help to mitigate writing errors in children with developmental dyslexia. Forty-three children with developmental dyslexia and 37 carefully matched normal reading children performed a computer-based writing training (15-20 minutes 4 days a week) for three months with the aim to recode a sequential textual input string into a multi-sensory representation comprising visual and auditory codes (including musical tones). The study included four matched groups: a group of children with developmental dyslexia (n=20) and a control group (n=18) practiced with the training software in the first period (3 months, 15-20 minutes 4 days a week), while a second group of children with developmental dyslexia (n=23) (waiting group) and a second control group (n=19) received no training during the first period. In the second period the children with developmental dyslexia and controls who did not receive training during the first period now took part in the training. Children with developmental dyslexia who did not perform computer-based training during the first period hardly improved their writing skills (post-pre improvement of 0-9%), the dyslexic children receiving training strongly improved their writing skills (post-pre improvement of 19-35%). The group who did the training during the second period also revealed improvement of writing skills (post-pre improvement of 27-35%). Interestingly, we noticed a strong transfer from trained to non-trained words in that the children who underwent the training were also better able to write words correctly that were not part of the training software. In addition, even non-impaired readers and writers (controls) benefited from this training. Three-month of visual-auditory multimedia training strongly improved writing skills in children with developmental dyslexia and non-dyslexic children. Thus, according to the retrieval structure model, multi-sensory training using visual and auditory cues enhances writing performance in children with developmental dyslexia and non-dyslexic children.

Vagus Nerve Stimulation Delivered During Motor Rehabilitation Improves Recovery in a Rat Model of Stroke

PubMed Central

Khodaparast, Navid; Hays, Seth A.; Sloan, Andrew M.; Fayyaz, Tabbassum; Hulsey, Daniel R.; Rennaker, Robert L.; Kilgard, Michael P.

2014-01-01

Neural plasticity is widely believed to support functional recovery following brain damage. Vagus nerve stimulation paired with different forelimb movements causes long-lasting map plasticity in rat primary motor cortex that is specific to the paired movement. We tested the hypothesis that repeatedly pairing vagus nerve stimulation with upper forelimb movements would improve recovery of motor function in a rat model of stroke. Rats were separated into three groups: vagus nerve stimulation during rehab, vagus nerve stimulation after rehab, and rehab alone. Animals underwent 4 training stages: shaping (motor skill learning), pre-lesion training, post-lesion training, and therapeutic training. Rats were given a unilateral ischemic lesion within motor cortex and implanted with a left vagus nerve cuff. Animals were allowed one week of recovery before post-lesion baseline training. During the therapeutic training stage, rats received vagus nerve stimulation paired with each successful trial. All seventeen trained rats demonstrated significant contralateral forelimb impairment when performing a bradykinesia assessment task. Forelimb function was recovered completely to pre-lesion levels when vagus nerve stimulation was delivered during rehab training. Alternatively, intensive rehab training alone (without stimulation) failed to restore function to pre-lesion levels. Delivering the same amount of stimulation after rehab training did not yield improvements compared to rehab alone. These results demonstrate that vagus nerve stimulation repeatedly paired with successful forelimb movements can improve recovery after motor cortex ischemia and may be a viable option for stroke rehabilitation. PMID:24553102

Learning from Past Classification Errors: Exploring Methods for Improving the Performance of a Deep Learning-based Building Extraction Model through Quantitative Analysis of Commission Errors for Optimal Sample Selection

NASA Astrophysics Data System (ADS)

Swan, B.; Laverdiere, M.; Yang, L.

2017-12-01

In the past five years, deep Convolutional Neural Networks (CNN) have been increasingly favored for computer vision applications due to their high accuracy and ability to generalize well in very complex problems; however, details of how they function and in turn how they may be optimized are still imperfectly understood. In particular, their complex and highly nonlinear network architecture, including many hidden layers and self-learned parameters, as well as their mathematical implications, presents open questions about how to effectively select training data. Without knowledge of the exact ways the model processes and transforms its inputs, intuition alone may fail as a guide to selecting highly relevant training samples. Working in the context of improving a CNN-based building extraction model used for the LandScan USA gridded population dataset, we have approached this problem by developing a semi-supervised, highly-scalable approach to select training samples from a dataset of identified commission errors. Due to the large scope this project, tens of thousands of potential samples could be derived from identified commission errors. To efficiently trim those samples down to a manageable and effective set for creating additional training sample, we statistically summarized the spectral characteristics of areas with rates of commission errors at the image tile level and grouped these tiles using affinity propagation. Highly representative members of each commission error cluster were then used to select sites for training sample creation. The model will be incrementally re-trained with the new training data to allow for an assessment of how the addition of different types of samples affects the model performance, such as precision and recall rates. By using quantitative analysis and data clustering techniques to select highly relevant training samples, we hope to improve model performance in a manner that is resource efficient, both in terms of training process and in sample creation.

The importance of continuing education for transplant coordination staff.

PubMed

Tokalak, Ibrahim; Emiroğlu, Remzi; Karakayali, Hamdi; Bilgin, Nevzat; Haberal, Mehmet

2005-06-01

Continuous quality improvement activities are necessary to achieve excellence at any institution. The Başkent University Hospitals have implemented continuous in-service training programs to improve all health services provided. Also, continuing medical education programs are being instituted in organ procurement and transplantation centers. In addition to receiving basic orientation and training upon hiring, transplant coordination staff complete forms that detail their current training status, further job training needed, and other courses of interest. The information is used to monitor skill levels, to determine the success of educational programs, and to identify further education that is needed. Our aim is to improve the quality of transplant coordination activities and increase organ donation at the hospitals in our network through effective monitoring and evaluation of continuous in-service training. These training programs enhance staff members' understanding of and participation in procedures related to transplantation and improves the total quality of the transplantation process. In the near future, this training model may be used to improve the donor hospital education program in Turkey.

Study of medical education in 3D surgical modeling by surgeons with free open-source software: Example of mandibular reconstruction with fibula free flap and creation of its surgical guides.

PubMed

Ganry, L; Hersant, B; Bosc, R; Leyder, P; Quilichini, J; Meningaud, J P

2018-02-27

Benefits of 3D printing techniques, biomodeling and surgical guides are well known in surgery, especially when the same surgeon who performed the surgery participated in the virtual surgical planning. Our objective was to evaluate the transfer of know how of a neutral 3D surgical modeling free open-source software protocol to surgeons with different surgical specialities. A one-day training session was organised in 3D surgical modeling applied to one mandibular reconstruction case with fibula free flap and creation of its surgical guides. Surgeon satisfaction was analysed before and after the training. Of 22 surgeons, 59% assessed the training as excellent or very good and 68% considered changing their daily surgical routine and would try to apply our open-source software protocol in their department after a single training day. The mean capacity in using the software improved from 4.13 on 10 before to 6.59 on 10 after training for OsiriX ® software, from 1.14 before to 5.05 after training for Meshlab ® , from 0.45 before to 4.91 after training for Netfabb ® and from 1.05 before and 4.41 after training for Blender ® . According to surgeons, using the software Blender ® became harder as the day went on. Despite improvement in the capacity in using software for all participants, more than a single training day is needed for the transfer of know how on 3D modeling with open-source software. Although the know-how transfer, overall satisfaction, actual learning outcomes and relevance of this training were appropriated, a longer training including different topics will be needed to improve training quality. Copyright © 2018 Elsevier Masson SAS. All rights reserved.

Simulator training to automaticity leads to improved skill transfer compared with traditional proficiency-based training: a randomized controlled trial.

PubMed

Stefanidis, Dimitrios; Scerbo, Mark W; Montero, Paul N; Acker, Christina E; Smith, Warren D

2012-01-01

We hypothesized that novices will perform better in the operating room after simulator training to automaticity compared with traditional proficiency based training (current standard training paradigm). Simulator-acquired skill translates to the operating room, but the skill transfer is incomplete. Secondary task metrics reflect the ability of trainees to multitask (automaticity) and may improve performance assessment on simulators and skill transfer by indicating when learning is complete. Novices (N = 30) were enrolled in an IRB-approved, blinded, randomized, controlled trial. Participants were randomized into an intervention (n = 20) and a control (n = 10) group. The intervention group practiced on the FLS suturing task until they achieved expert levels of time and errors (proficiency), were tested on a live porcine fundoplication model, continued simulator training until they achieved expert levels on a visual spatial secondary task (automaticity) and were retested on the operating room (OR) model. The control group participated only during testing sessions. Performance scores were compared within and between groups during testing sessions. : Intervention group participants achieved proficiency after 54 ± 14 and automaticity after additional 109 ± 57 repetitions. Participants achieved better scores in the OR after automaticity training [345 (range, 0-537)] compared with after proficiency-based training [220 (range, 0-452; P < 0.001]. Simulator training to automaticity takes more time but is superior to proficiency-based training, as it leads to improved skill acquisition and transfer. Secondary task metrics that reflect trainee automaticity should be implemented during simulator training to improve learning and skill transfer.

Evaluation of Problem- and Simulator-Based Learning in Lumbar Puncture in Adult Neurology Residency Training.

PubMed

Sun, Chenjing; Qi, Xiaokun

2018-01-01

Lumbar puncture (LP) is an essential part of adult neurology residency training. Technologic as well as nontechnologic training is needed. However, current assessment tools mostly focus on the technologic aspects of LP. We propose a training method-problem- and simulator-based learning (PSBL)-in LP residency training to develop overall skills of neurology residents. We enrolled 60 neurology postgraduate-year-1 residents from our standardized residents training center and randomly divided them into 2 groups: traditional teaching group and PSBL group. After training, we assessed the extent that the residents were ready to perform LP and tracked successful LPs performed by the residents. We then asked residents to complete questionnaires about the training models. Performance scores and the results of questionnaires were compared between the 2 groups. Students and faculty concluded that PSBL provided a more effective learning experience than the traditional teaching model. Although no statistical difference was found in the pretest, posttest, and improvement rate scores between the 2 groups, based on questionnaire scores and number of successful LPs after training, the PSBL group showed a statistically significant improvement compared with the traditional group. Findings indicated that nontechnical elements, such as planning before the procedure and controlling uncertainties during the procedure, are more crucial than technical elements. Compared with traditional teaching model, PSBL for LP training can develop overall surgical skills, including technical and nontechnical elements, improving performance. Residents in the PSBL group were more confident and effective in performing LP. Copyright © 2017 Elsevier Inc. All rights reserved.

Cross-Participant EEG-Based Assessment of Cognitive Workload Using Multi-Path Convolutional Recurrent Neural Networks.

PubMed

Hefron, Ryan; Borghetti, Brett; Schubert Kabban, Christine; Christensen, James; Estepp, Justin

2018-04-26

Applying deep learning methods to electroencephalograph (EEG) data for cognitive state assessment has yielded improvements over previous modeling methods. However, research focused on cross-participant cognitive workload modeling using these techniques is underrepresented. We study the problem of cross-participant state estimation in a non-stimulus-locked task environment, where a trained model is used to make workload estimates on a new participant who is not represented in the training set. Using experimental data from the Multi-Attribute Task Battery (MATB) environment, a variety of deep neural network models are evaluated in the trade-space of computational efficiency, model accuracy, variance and temporal specificity yielding three important contributions: (1) The performance of ensembles of individually-trained models is statistically indistinguishable from group-trained methods at most sequence lengths. These ensembles can be trained for a fraction of the computational cost compared to group-trained methods and enable simpler model updates. (2) While increasing temporal sequence length improves mean accuracy, it is not sufficient to overcome distributional dissimilarities between individuals’ EEG data, as it results in statistically significant increases in cross-participant variance. (3) Compared to all other networks evaluated, a novel convolutional-recurrent model using multi-path subnetworks and bi-directional, residual recurrent layers resulted in statistically significant increases in predictive accuracy and decreases in cross-participant variance.

Cross-Participant EEG-Based Assessment of Cognitive Workload Using Multi-Path Convolutional Recurrent Neural Networks

PubMed Central

Hefron, Ryan; Borghetti, Brett; Schubert Kabban, Christine; Christensen, James; Estepp, Justin

2018-01-01

Applying deep learning methods to electroencephalograph (EEG) data for cognitive state assessment has yielded improvements over previous modeling methods. However, research focused on cross-participant cognitive workload modeling using these techniques is underrepresented. We study the problem of cross-participant state estimation in a non-stimulus-locked task environment, where a trained model is used to make workload estimates on a new participant who is not represented in the training set. Using experimental data from the Multi-Attribute Task Battery (MATB) environment, a variety of deep neural network models are evaluated in the trade-space of computational efficiency, model accuracy, variance and temporal specificity yielding three important contributions: (1) The performance of ensembles of individually-trained models is statistically indistinguishable from group-trained methods at most sequence lengths. These ensembles can be trained for a fraction of the computational cost compared to group-trained methods and enable simpler model updates. (2) While increasing temporal sequence length improves mean accuracy, it is not sufficient to overcome distributional dissimilarities between individuals’ EEG data, as it results in statistically significant increases in cross-participant variance. (3) Compared to all other networks evaluated, a novel convolutional-recurrent model using multi-path subnetworks and bi-directional, residual recurrent layers resulted in statistically significant increases in predictive accuracy and decreases in cross-participant variance. PMID:29701668

Improving communication with palliative care cancer patients at home - A pilot study of SAGE & THYME communication skills model.

PubMed

Griffiths, Jane; Wilson, Charlotte; Ewing, Gail; Connolly, Michael; Grande, Gunn

2015-10-01

To pilot an evidence-based communication skills model (SAGE & THYME) with UK District Nurses (DNs) who visit patients with advanced cancer early in the dying trajectory. Evidence suggests that DNs lack confidence in communication skills and in assessing cancer patients' psycho-social needs; also that they lack time. SAGE & THYME is a highly structured model for teaching patient centred interactions. It addresses concerns about confidence and time. Mixed methods. 33 DNs were trained in SAGE & THYME in a three hour workshop and interviewed in focus groups on three occasions: pre-training, immediately post-training and two months post-training. Questionnaires measuring perceived outcomes of communication, confidence in communication and motivation to use SAGE & THYME were administered at the focus groups. SAGE & THYME provided a structure for conversations and facilitated opening and closing of interactions. The main principle of patient centeredness was reportedly used by all. Knowledge about communication behaviours helpful to patients improved and was sustained two months after training. Increased confidence in communication skills was also sustained. Motivation to use SAGE & THYME was high and remained so at two months, and some said the model saved them time. Challenges with using the model included controlling the home environment and a change in style of communication which was so marked some DNs preferred to use it with new patients. Training DNs in SAGE & THYME in a three hour workshop appears to be a promising model for improving communication skills when working with cancer patients. Crown Copyright © 2015. Published by Elsevier Ltd. All rights reserved.

[Training of health personnel in the framework of humanitarian action. Choosing an assessment model].

PubMed

Marchand, C; Gagnayre, R; d'Ivernois, J F

1996-01-01

There are very few examples of health training assessment in developing countries. Such an undertaking faces a number of difficulties concerning the problems inherent to assessment, the particular and unstable nature of the environment, and the problems associated with humanitarian action and development aid. It is difficult to choose between a formal and a natural approach. Indeed, a dual approach, combining quantitative and qualitative data seems best suited to a variety of cultural contexts of variable stability. Faced with these difficulties, a criteria-based, formative, quality-oriented assessment aimed at improving teaching and learning methods should be able to satisfy the needs of training professionals. We propose a training assessment guide based on an assessment model which aims to improve training techniques using comprehensive, descriptive and prescriptive approaches.

Can training improve the quality of inferences made by raters in competency modeling? A quasi-experiment.

PubMed

Lievens, Filip; Sanchez, Juan I

2007-05-01

A quasi-experiment was conducted to investigate the effects of frame-of-reference training on the quality of competency modeling ratings made by consultants. Human resources consultants from a large consulting firm were randomly assigned to either a training or a control condition. The discriminant validity, interrater reliability, and accuracy of the competency ratings were significantly higher in the training group than in the control group. Further, the discriminant validity and interrater reliability of competency inferences were highest among an additional group of trained consultants who also had competency modeling experience. Together, these results suggest that procedural interventions such as rater training can significantly enhance the quality of competency modeling. 2007 APA, all rights reserved

An evaluation of Knowledge and Understanding Framework personality disorder awareness training: can a co-production model be effective in a local NHS mental health Trust?

PubMed

Davies, Julie; Sampson, Mark; Beesley, Frank; Smith, Debra; Baldwin, Victoria

2014-05-01

5 Boroughs Partnership NHS Foundation Trust, in the Northwest of England, has trained over 500 staff in the Knowledge and Understanding Framework, level 1 personality disorder awareness training. This is a 3-day nationally devised training programme delivered via an innovative co-production model (i.e. co-delivery and partnership working with service users who have lived experience). This paper provides quantitative and qualitative information on the effectiveness of training delivery and also serves to provide some insight into the impact of service-user involvement via such a co-production model. Information on 162 participants using the Knowledge and Understanding Framework bespoke questionnaire (Personality Disorder Knowledge, Attitudes and Skills Questionnaire) suggests that the training can be effectively delivered by and within a local NHS Mental Health Trust. Results immediately post-training suggest an improvement in levels of understanding and capability efficacy and a reduction in negative emotional reactions. Indications from a 3-month follow-up suggest that while understanding and emotional reaction remain improved, capability efficacy regresses back to pre-training levels, suggesting the need for ongoing supervision and/or support to consolidate skills. Discussion includes guidelines for the implementation of a truly integrated co-production model of training provision, as well as advice relating to the maximization of long-term benefits. Copyright © 2014 John Wiley & Sons, Ltd.

The effectiveness of a training method using self-modeling webcam photos for reducing musculoskeletal risk among office workers using computers.

PubMed

Taieb-Maimon, Meirav; Cwikel, Julie; Shapira, Bracha; Orenstein, Ido

2012-03-01

An intervention study was conducted to examine the effectiveness of an innovative self-modeling photo-training method for reducing musculoskeletal risk among office workers using computers. Sixty workers were randomly assigned to either: 1) a control group; 2) an office training group that received personal, ergonomic training and workstation adjustments or 3) a photo-training group that received both office training and an automatic frequent-feedback system that displayed on the computer screen a photo of the worker's current sitting posture together with the correct posture photo taken earlier during office training. Musculoskeletal risk was evaluated using the Rapid Upper Limb Assessment (RULA) method before, during and after the six weeks intervention. Both training methods provided effective short-term posture improvement; however, sustained improvement was only attained with the photo-training method. Both interventions had a greater effect on older workers and on workers suffering more musculoskeletal pain. The photo-training method had a greater positive effect on women than on men. Copyright © 2011 Elsevier Ltd and The Ergonomics Society. All rights reserved.

Process Improvements in Training Device Acceptance Testing: A Study in Total Quality Management

DTIC Science & Technology

1990-12-12

Quality Management , a small group of Government and industry specialists examined the existing training device acceptance test process for potential improvements. The agreed-to mission of the Air Force/Industry partnership was to continuously identify and promote implementable approaches to minimize the cost and time required for acceptance testing while ensuring that validated performance supports the user training requirements. Application of a Total Quality process improvement model focused on the customers and their requirements, analyzed how work was accomplished, and

Improvement of Spatial Ability Using Innovative Tools: Alternative View Screen and Physical Model Rotator

ERIC Educational Resources Information Center

Kinsey, Brad L.; Towle, Erick; Onyancha, Richard M.

2008-01-01

Spatial ability, which is positively correlated with retention and achievement in engineering, mathematics, and science disciplines, has been shown to improve over the course of a Computer-Aided Design course or through targeted training. However, which type of training provides the most beneficial improvements to spatial ability and whether other…

Informatics Approach to Improving Surgical Skills Training

ERIC Educational Resources Information Center

Islam, Gazi

2013-01-01

Surgery as a profession requires significant training to improve both clinical decision making and psychomotor proficiency. In the medical knowledge domain, tools have been developed, validated, and accepted for evaluation of surgeons' competencies. However, assessment of the psychomotor skills still relies on the Halstedian model of…

Anti-predator behaviour of adult red-legged partridge (Alectoris rufa) tutors improves the defensive responses of farm-reared broods.

PubMed

Sánchez-García, C; Alonso, M E; Tizado, E J; Pérez, J A; Armenteros, J A; Gaudioso, V R

2016-06-01

The aim of this work was to improve natural anti-predator behaviour of farm-reared gamebirds. We evaluated the anti-predator behaviour of reared red-legged partridge Alectoris rufa chicks kept in brooder houses in large groups (>350 chicks), trained and not trained by parent red-legged partridges acting as experienced tutors. The experiment consisted of two conditioned tests (a raptor model and a human) and two control tests, which were conducted during three consecutive phases of life (1-4, 15-17 and 30-32 d after hatching). The motor anti-predator behaviour, its duration, the intensity of response in chicks and alarm calls elicited by adults were recorded. Tutors elicited aerial alarm calls (76% of tests) and showed prolonged crouching (59% of tests) in response to the raptor model whereas uttering the ground alarm call (73% of tests) and showing vigilance behaviour (78% of tests) was the main pattern during the human test. Trained and not trained chicks showed similar motor behaviour in response to the raptor model (crouching) and the human test (escaping), but frequency of strong responses (all chicks responding) from chicks trained with tutors was double that of chicks trained without them, and chicks trained with tutors showed a higher frequency of long responses (41-60 s). This study indicates that anti-predator training programmes before release may improve behaviour of farm-reared partridges which may confer benefits to survival of birds.

Innovative integrative bedside teaching model improves tutors’ self-assessments of teaching skills and attitudes

PubMed Central

Gat, Itai; Pessach-Gelblum, Liat; Givati, Gili; Haim, Nadav; Paluch-Shimon, Shani; Unterman, Avraham; Bar-Shavit, Yochay; Grabler, Galit; Sagi, Doron; Achiron, Anat; Ziv, Amitai

2016-01-01

Introduction Patient bedside is the ideal setting for teaching physical examination, medical interviewing, and interpersonal skills. Herein we describe a novel model for bedside teaching (BST) practiced during tutor training workshop and its resulting effect on practitioners’ self assessment of teaching skills and perceptions. Methods One-day tutor training workshop included theoretical knowledge supplementation regarding tutors’ roles as well as implementing practical tools for clinical education, mainly BST model. The model, which emphasizes simultaneous clinical and communication teaching in a stepwise approach, was practiced by consecutive simulations with a gradual escalation of difficulty and adjusted instruction approaches. Pre- and post-workshop-adjusted questionnaires using a Likert scale of 1 to 4 were completed by participants and compared. Results Analysis was based on 25 out of 48 participants who completed both questionnaires. Significantly improved teaching skills were demonstrated upon workshop completion (mean 3.3, SD 0.5) compared with pre-training (mean 2.6, SD 0.6; p<0.001) with significant increase in most examined parameters. Significantly improved tutor's roles internalization was demonstrated after training completion (mean 3.7, SD 0.3) compared with pre-workshop (mean 3.5 SD 0.5; p=0.002). Discussion Successful BST involves combination of clinical and communication skills. BST model practiced during the workshop may contribute to improved teaching skills in this challenging environment. PMID:26894587

Combinatorial Motor Training Results in Functional Reorganization of Remaining Motor Cortex after Controlled Cortical Impact in Rats

PubMed Central

Combs, Hannah L.; Jones, Theresa A.; Kozlowski, Dorothy A.

2016-01-01

Abstract Cortical reorganization subsequent to post-stroke motor rehabilitative training (RT) has been extensively examined in animal models and humans. However, similar studies focused on the effects of motor training after traumatic brain injury (TBI) are lacking. We previously reported that after a moderate/severe TBI in adult male rats, functional improvements in forelimb use were accomplished only with a combination of skilled forelimb reach training and aerobic exercise, with or without nonimpaired forelimb constraint. Thus, the current study was designed to examine the relationship between functional motor cortical map reorganization after experimental TBI and the behavioral improvements resulting from this combinatorial rehabilitative regime. Adult male rats were trained to proficiency on a skilled reaching task, received a unilateral controlled cortical impact (CCI) over the forelimb area of the caudal motor cortex (CMC). Three days post-CCI, animals began RT (n = 13) or no rehabilitative training (NoRT) control procedures (n = 13). The RT group participated in daily skilled reach training, voluntary aerobic exercise, and nonimpaired forelimb constraint. This RT regimen significantly improved impaired forelimb reaching success and normalized reaching strategies, consistent with previous findings. RT also enlarged the area of motor cortical wrist representation, derived by intracortical microstimulation, compared to NoRT. These findings indicate that sufficient RT can greatly improve motor function and improve the functional integrity of remaining motor cortex after a moderate/severe CCI. When compared with findings from stroke models, these findings also suggest that more intense RT may be needed to improve motor function and remodel the injured cortex after TBI. PMID:26421759

Combinatorial Motor Training Results in Functional Reorganization of Remaining Motor Cortex after Controlled Cortical Impact in Rats.

PubMed

Combs, Hannah L; Jones, Theresa A; Kozlowski, Dorothy A; Adkins, DeAnna L

2016-04-15

Cortical reorganization subsequent to post-stroke motor rehabilitative training (RT) has been extensively examined in animal models and humans. However, similar studies focused on the effects of motor training after traumatic brain injury (TBI) are lacking. We previously reported that after a moderate/severe TBI in adult male rats, functional improvements in forelimb use were accomplished only with a combination of skilled forelimb reach training and aerobic exercise, with or without nonimpaired forelimb constraint. Thus, the current study was designed to examine the relationship between functional motor cortical map reorganization after experimental TBI and the behavioral improvements resulting from this combinatorial rehabilitative regime. Adult male rats were trained to proficiency on a skilled reaching task, received a unilateral controlled cortical impact (CCI) over the forelimb area of the caudal motor cortex (CMC). Three days post-CCI, animals began RT (n = 13) or no rehabilitative training (NoRT) control procedures (n = 13). The RT group participated in daily skilled reach training, voluntary aerobic exercise, and nonimpaired forelimb constraint. This RT regimen significantly improved impaired forelimb reaching success and normalized reaching strategies, consistent with previous findings. RT also enlarged the area of motor cortical wrist representation, derived by intracortical microstimulation, compared to NoRT. These findings indicate that sufficient RT can greatly improve motor function and improve the functional integrity of remaining motor cortex after a moderate/severe CCI. When compared with findings from stroke models, these findings also suggest that more intense RT may be needed to improve motor function and remodel the injured cortex after TBI.

Improving Domain-specific Machine Translation by Constraining the Language Model

DTIC Science & Technology

2012-07-01

performance. To make up for the lack of parallel training data, one assumption is that more monolingual target language data should be used in building the...target language model. Prior work on domain-specific MT has focused on training target language models with monolingual 2 domain-specific data...showed that the using a large dictionary extracted from medical domain documents in a statistical MT system to generalize the training data significantly

Simulation based teaching in interventional radiology training: is it effective?

PubMed

Patel, R; Dennick, R

2017-03-01

To establish the educational effectiveness of simulation teaching in interventional radiology training. Electronic databases (MEDLINE, ERIC, Embase, OvidSP, and Cochrane Library) were searched (January 2000 to May 2015). Studies specifically with educational outcomes conducted on radiologists were eligible. All forms of simulation in interventional training were included. Data were extracted based on the population, intervention, comparison, and outcome (PICO) model. Kirkpatrick's hierarchy was used to establish educational intervention effectiveness. The quality of studies was assessed using the Cochrane risk of bias tool. Search resulted in 377 articles, of which 15 met the inclusion criteria. Thirteen of the 15 studies achieved level 2 of Kirkpatrick's hierarchy with only one reaching level 4. Statistically significant improvements in performance metrics as objective measures, demonstrating trainee competence were seen in 12/15 studies. Subjective improvements in confidence were noted in 13/15. Only one study demonstrated skills transferability and improvements in patient outcomes. Results demonstrate the relevance of simulated training to current education models in improving trainee competence; however, this is limited to the simulated environment as there is a lack of literature investigating its predictive validity and the effect on patient outcomes. The requirement for further research in this field is highlighted. Simulation is thus currently only deemed useful as an adjunct to current training models with the potential to play an influential role in the future of the interventional radiology training curriculum. Copyright © 2016. Published by Elsevier Ltd.

Participant and Symbolic Modelling Training Programmes: Changes in Self-Efficacy of Youth Counselors.

ERIC Educational Resources Information Center

Romi, Shlomo; Teichman, Meir

1995-01-01

Discusses a training program for youth counselors aimed to improve counselors' self-efficacy and ability to cope with stressful situations. Two versions of the program were evaluated: one based on participant modeling, the other on symbolic modeling. Self-efficacy of subjects on the participant modeling increased compared to that of the subjects…

Virtual Laparoscopic Training System Based on VCH Model.

PubMed

Tang, Jiangzhou; Xu, Lang; He, Longjun; Guan, Songluan; Ming, Xing; Liu, Qian

2017-04-01

Laparoscopy has been widely used to perform abdominal surgeries, as it is advantageous in that the patients experience lower post-surgical trauma, shorter convalescence, and less pain as compared to traditional surgery. Laparoscopic surgeries require precision; therefore, it is imperative to train surgeons to reduce the risk of operation. Laparoscopic simulators offer a highly realistic surgical environment by using virtual reality technology, and it can improve the training efficiency of laparoscopic surgery. This paper presents a virtual Laparoscopic surgery system. The proposed system utilizes the Visible Chinese Human (VCH) to construct the virtual models and simulates real-time deformation with both improved special mass-spring model and morph target animation. Meanwhile, an external device that integrates two five-degrees-of-freedom (5-DOF) manipulators was designed and made to interact with the virtual system. In addition, the proposed system provides a modular tool based on Unity3D to define the functions and features of instruments and organs, which could help users to build surgical training scenarios quickly. The proposed virtual laparoscopic training system offers two kinds of training mode, skills training and surgery training. In the skills training mode, the surgeons are mainly trained for basic operations, such as laparoscopic camera, needle, grasp, electric coagulation, and suturing. In the surgery-training mode, the surgeons can practice cholecystectomy and removal of hepatic cysts by guided or non-guided teaching.

Cardiovascular Surgery Residency Program: Training Coronary Anastomosis Using the Arroyo Simulator and UNIFESP Models.

PubMed

Maluf, Miguel Angel; Gomes, Walter José; Bras, Ademir Massarico; Araújo, Thiago Cavalcante Vila Nova de; Mota, André Lupp; Cardoso, Caio Cesar; Coutinho, Rafael Viana dos S

2015-01-01

Engage the UNIFESP Cardiovascular Surgery residents in coronary anastomosis, assess their skills and certify results, using the Arroyo Anastomosis Simulator and UNIFESP surgical models. First to 6th year residents attended a weekly program of technical training in coronary anastomosis, using 4 simulation models: 1. Arroyo simulator; 2. Dummy with a plastic heart; 3. Dummy with a bovine heart; and 4. Dummy with a beating pig heart. The assessment test was comprised of 10 items, using a scale from 1 to 5 points in each of them, creating a global score of 50 points maximum. The technical performance of the candidate showed improvement in all items, especially manual skill and technical progress, critical sense of the work performed, confidence in the procedure and reduction of the time needed to perform the anastomosis after 12 weeks practice. In response to the multiplicity of factors that currently influence the cardiovascular surgeon training, there have been combined efforts to reform the practices of surgical medical training. 1 - The four models of simulators offer a considerable contribution to the field of cardiovascular surgery, improving the skill and dexterity of the surgeon in training. 2 - Residents have shown interest in training and cooperate in the development of innovative procedures for surgical medical training in the art.

Cardiovascular Surgery Residency Program: Training Coronary Anastomosis Using the Arroyo Simulator and UNIFESP Models

PubMed Central

Maluf, Miguel Angel; Gomes, Walter José; Bras, Ademir Massarico; de Araújo, Thiago Cavalcante Vila Nova; Mota, André Lupp; Cardoso, Caio Cesar; Coutinho, Rafael Viana dos S.

2015-01-01

OBJECTIVE Engage the UNIFESP Cardiovascular Surgery residents in coronary anastomosis, assess their skills and certify results, using the Arroyo Anastomosis Simulator and UNIFESP surgical models. METHODS First to 6th year residents attended a weekly program of technical training in coronary anastomosis, using 4 simulation models: 1. Arroyo simulator; 2. Dummy with a plastic heart; 3. Dummy with a bovine heart; and 4. Dummy with a beating pig heart. The assessment test was comprised of 10 items, using a scale from 1 to 5 points in each of them, creating a global score of 50 points maximum. RESULTS The technical performance of the candidate showed improvement in all items, especially manual skill and technical progress, critical sense of the work performed, confidence in the procedure and reduction of the time needed to perform the anastomosis after 12 weeks practice. In response to the multiplicity of factors that currently influence the cardiovascular surgeon training, there have been combined efforts to reform the practices of surgical medical training. CONCLUSION 1 - The four models of simulators offer a considerable contribution to the field of cardiovascular surgery, improving the skill and dexterity of the surgeon in training. 2 - Residents have shown interest in training and cooperate in the development of innovative procedures for surgical medical training in the art. PMID:26735604

Building tobacco cessation capacity in the U.S.-affiliated Pacific Islands.

PubMed

David, Annette M; Cruz, Peter J; Mercado, Susan P; Li, Dan

2013-09-01

Tobacco control stakeholders in priority populations are searching for culturally appropriate cessation training models to strengthen cessation capacity and infrastructure. We adapted the University of Arizona model for Brief Tobacco Cessation Interventions training for Pacific Islanders and pilot-tested it in four Pacific Islands-Palau, the Federated States of Micronesia, the Northern Mariana Islands and the Marshall Islands. All participants completed a posttraining knowledge assessment exam, pre- and posttraining confidence assessments, and a quality improvement evaluation. Of 70 participants, 65 (93%) completed the training. Forty-one (63%) passed the posttraining knowledge assessment exam at the first attempt; an additional 9 (14%) successfully passed on their second attempt, for a total pass rate of 77%. The pre- and posttraining confidence surveys demonstrated a statistically significant increase in confidence across all competency areas for delivering brief advice. The quality improvement survey revealed high acceptance and approval for the content and delivery of the locally adapted training model. As Pacific Island communities enact tobacco control policies, cessation demand is growing. The Guam cessation training model used culturally relevant data, materials, and training approaches and appeared effective in four different Pacific island countries. This underscores the importance of culturally competent adaptation of cessation training for priority populations such as Pacific Islanders.

High Tech Training at Arthur Andersen and Co.

ERIC Educational Resources Information Center

Dennis, Verl E.

1984-01-01

Discusses Arthur Andersen and Company's reasons for using high technology in job training, including its ability to improve productivity, provide training on demand, reduce training costs, and keep educational quality consistent. A Life Cycle Model which is used to integrate high technology into this accounting company's educational programs is…

Training for Quality: Improving Early Childhood Programs through Systematic Inservice Training. Monographs of the High/Scope Educational Research Foundation, Number Nine.

ERIC Educational Resources Information Center

Epstein, Ann S.

The Training of Trainers (ToT) Evaluation investigated the efficacy of the High/Scope model for improving the quality of early childhood programs on a national scale. To address this question, the High/Scope Foundation undertook a multimethod evaluation that collected anecdotal records from the consultants and 793 participants in 40 ToT projects,…

Evaluation of a Trauma-Focused CBT Training Programme for IAPT services.

PubMed

Murray, Hannah

2017-09-01

Therapists in Improving Access to Psychological Therapies (IAPT) services are often expected to treat complex presentations of post-traumatic stress disorder (PTSD), such as individuals with multiple, prolonged or early life trauma histories and significant co-morbidity, for which they have received minimal training. Although high recovery rates for PTSD have been demonstrated in randomized controlled trials, these are not always replicated in routine practice, suggesting that training interventions are required to fill the research-practice gap. This study investigated the outcomes of a therapist training programme on treating PTSD with trauma-focused cognitive behavioural therapy (TF-CBT). Twenty therapists from ten IAPT services participated in the training, which consisted of workshops, webinars and consultation sessions over a 6-month period. Feedback indicated that participants found the training highly acceptable. PTSD knowledge and self- and supervisor-rated competence on TF-CBT measures improved following the training and improvements were maintained a year later. Client outcomes on a PTSD measure improved following the training. Participants reported attempts to disseminate learning from the course back to their teams. The findings indicate that the training programme was successful in improving TF-CBT knowledge, skills and outcomes for IAPT therapists. Tentative support for training 'trauma experts' within IAPT services was found, although institutional constraints and staff turnover may limit the sustainability of the model.

The Use of Constructive Modeling and Virtual Simulation in Large-Scale Team Training: A Military Case Study.

ERIC Educational Resources Information Center

Andrews, Dee H.; Dineen, Toni; Bell, Herbert H.

1999-01-01

Discusses the use of constructive modeling and virtual simulation in team training; describes a military application of constructive modeling, including technology issues and communication protocols; considers possible improvements; and discusses applications in team-learning environments other than military, including industry and education. (LRW)

Training versus engagement as paths to cognitive enrichment with aging.

PubMed

Stine-Morrow, Elizabeth A L; Payne, Brennan R; Roberts, Brent W; Kramer, Arthur F; Morrow, Daniel G; Payne, Laura; Hill, Patrick L; Jackson, Joshua J; Gao, Xuefei; Noh, Soo Rim; Janke, Megan C; Parisi, Jeanine M

2014-12-01

While a training model of cognitive intervention targets the improvement of particular skills through instruction and practice, an engagement model is based on the idea that being embedded in an intellectually and socially complex environment can impact cognition, perhaps even broadly, without explicit instruction. We contrasted these 2 models of cognitive enrichment by randomly assigning healthy older adults to a home-based inductive reasoning training program, a team-based competitive program in creative problem solving, or a wait-list control. As predicted, those in the training condition showed selective improvement in inductive reasoning. Those in the engagement condition, on the other hand, showed selective improvement in divergent thinking, a key ability exercised in creative problem solving. On average, then, both groups appeared to show ability-specific effects. However, moderators of change differed somewhat for those in the engagement and training interventions. Generally, those who started either intervention with a more positive cognitive profile showed more cognitive growth, suggesting that cognitive resources enabled individuals to take advantage of environmental enrichment. Only in the engagement condition did initial levels of openness and social network size moderate intervention effects on cognition, suggesting that comfort with novelty and an ability to manage social resources may be additional factors contributing to the capacity to take advantage of the environmental complexity associated with engagement. Collectively, these findings suggest that training and engagement models may offer alternative routes to cognitive resilience in late life. (PsycINFO Database Record (c) 2014 APA, all rights reserved).

Training versus Engagement as Paths to Cognitive Enrichment with Aging

PubMed Central

Stine-Morrow, Elizabeth A. L.; Payne, Brennan R.; Roberts, Brent W.; Kramer, Arthur F.; Morrow, Daniel G.; Payne, Laura; Hill, Patrick L.; Jackson, Joshua J.; Gao, Xuefei; Noh, Soo Rim; Janke, Megan C.; Parisi, Jeanine M.

2015-01-01

While a training model of cognitive intervention targets the improvement of particular skills through instruction and practice, an engagement model is based on the idea that being embedded in an intellectually and socially complex environment can impact cognition, perhaps even broadly, without explicit instruction. We contrasted these two models of cognitive enrichment by randomly assigning healthy older adults to a home-based inductive reasoning training program, a team-based competitive program in creative problem solving, or to a wait-list control. As predicted, those in the training condition showed selective improvement in inductive reasoning. Those in the engagement condition, on the other hand, showed selective improvement in divergent thinking, a key ability exercised in creative problem solving. On average, then, both groups appeared to show ability-specific effects. However, moderators of change differed somewhat for those in the engagement and training interventions. Generally, those who started either intervention with a more positive cognitive profile showed more cognitive growth, suggesting that cognitive resources enabled individuals to take advantage of environmental enrichment. Only in the engagement condition did initial levels of openness and social network size moderate intervention effects on cognition, suggesting that comfort with novelty and an ability to manage social resources may be additional factors contributing to the capacity to take advantage of the environmental complexity associated with engagement. Collectively, these findings suggest that training and engagement models may offer alternative routes to cognitive resilience in late life. PMID:25402337

Utilizing Improvisation to Teach Empathy Skills in Counselor Education

ERIC Educational Resources Information Center

Bayne, Hannah B.; Jangha, Awa

2016-01-01

Empathy development is foundational to counselor training, yet there is scant research on techniques for teaching empathy aside from traditional microskills models. The authors discuss empathy as a skill set, highlight how improvisation (improv) can be used to enhance training, and describe how to incorporate improv activities within the classroom.

Cultural competence in mental health care: a review of model evaluations

PubMed Central

Bhui, Kamaldeep; Warfa, Nasir; Edonya, Patricia; McKenzie, Kwame; Bhugra, Dinesh

2007-01-01

Background Cultural competency is now a core requirement for mental health professionals working with culturally diverse patient groups. Cultural competency training may improve the quality of mental health care for ethnic groups. Methods A systematic review that included evaluated models of professional education or service delivery. Results Of 109 potential papers, only 9 included an evaluation of the model to improve the cultural competency practice and service delivery. All 9 studies were located in North America. Cultural competency included modification of clinical practice and organizational performance. Few studies published their teaching and learning methods. Only three studies used quantitative outcomes. One of these showed a change in attitudes and skills of staff following training. The cultural consultation model showed evidence of significant satisfaction by clinicians using the service. No studies investigated service user experiences and outcomes. Conclusion There is limited evidence on the effectiveness of cultural competency training and service delivery. Further work is required to evaluate improvement in service users' experiences and outcomes. PMID:17266765

Training evaluation final report

NASA Technical Reports Server (NTRS)

Sepulveda, Jose A.

1992-01-01

In the area of management training, 'evaluation' refers both to the specific evaluation instrument used to determine whether a training effort was considered effective, and to the procedures followed to evaluate specific training requests. This report recommends to evaluate new training requests in the same way new procurement or new projects are evaluated. This includes examining training requests from the perspective of KSC goals and objectives, and determining expected ROI of proposed training program (does training result in improved productivity, through savings of time, improved outputs, and/or personnel reduction?). To determine whether a specific training course is effective, a statement of what constitutes 'good performance' is required. The user (NOT the Training Branch) must define what is 'required level of performance'. This 'model' will be the basis for the design and development of an objective, performance-based, training evaluation instrument.

Resistance to Aerobic Exercise Training Causes Metabolic Dysfunction and Reveals Novel Exercise-Regulated Signaling Networks

PubMed Central

Lessard, Sarah J.; Rivas, Donato A.; Alves-Wagner, Ana B.; Hirshman, Michael F.; Gallagher, Iain J.; Constantin-Teodosiu, Dumitru; Atkins, Ryan; Greenhaff, Paul L.; Qi, Nathan R.; Gustafsson, Thomas; Fielding, Roger A.; Timmons, James A.; Britton, Steven L.; Koch, Lauren G.; Goodyear, Laurie J.

2013-01-01

Low aerobic exercise capacity is a risk factor for diabetes and a strong predictor of mortality, yet some individuals are “exercise-resistant” and unable to improve exercise capacity through exercise training. To test the hypothesis that resistance to aerobic exercise training underlies metabolic disease risk, we used selective breeding for 15 generations to develop rat models of low and high aerobic response to training. Before exercise training, rats selected as low and high responders had similar exercise capacities. However, after 8 weeks of treadmill training, low responders failed to improve their exercise capacity, whereas high responders improved by 54%. Remarkably, low responders to aerobic training exhibited pronounced metabolic dysfunction characterized by insulin resistance and increased adiposity, demonstrating that the exercise-resistant phenotype segregates with disease risk. Low responders had impaired exercise-induced angiogenesis in muscle; however, mitochondrial capacity was intact and increased normally with exercise training, demonstrating that mitochondria are not limiting for aerobic adaptation or responsible for metabolic dysfunction in low responders. Low responders had increased stress/inflammatory signaling and altered transforming growth factor-β signaling, characterized by hyperphosphorylation of a novel exercise-regulated phosphorylation site on SMAD2. Using this powerful biological model system, we have discovered key pathways for low exercise training response that may represent novel targets for the treatment of metabolic disease. PMID:23610057

[A new low-cost webcam-based laparoscopic training model].

PubMed

Langeron, A; Mercier, G; Lima, S; Chauleur, C; Golfier, F; Seffert, P; Chêne, G

2012-01-01

To validate a new laparoscopy home training model (GYN Trainer®) in order to practise and learn basic laparoscopic surgery. Ten junior surgical residents and six experienced operators were timed and assessed during six laparoscopic exercises performed on the home training model. Acquisition of skill was 35%. All the novices significantly improved performance in surgical skills despite an 8% partial loss of acquisition between two training sessions. Qualitative evaluation of the system was good (3.8/5). This low-cost personal laparoscopic model seems to be a useful tool to assist surgical novices in learning basic laparoscopic skills. Copyright © 2012 Elsevier Masson SAS. All rights reserved.

A practical model for the train-set utilization: The case of Beijing-Tianjin passenger dedicated line in China

PubMed Central

Li, Xiaomeng; Yang, Zhuo

2017-01-01

As a sustainable transportation mode, high-speed railway (HSR) has become an efficient way to meet the huge travel demand. However, due to the high acquisition and maintenance cost, it is impossible to build enough infrastructure and purchase enough train-sets. Great efforts are required to improve the transport capability of HSR. The utilization efficiency of train-sets (carrying tools of HSR) is one of the most important factors of the transport capacity of HSR. In order to enhance the utilization efficiency of the train-sets, this paper proposed a train-set circulation optimization model to minimize the total connection time. An innovative two-stage approach which contains segments generation and segments combination was designed to solve this model. In order to verify the feasibility of the proposed approach, an experiment was carried out in the Beijing-Tianjin passenger dedicated line, to fulfill a 174 trips train diagram. The model results showed that compared with the traditional Ant Colony Algorithm (ACA), the utilization efficiency of train-sets can be increased from 43.4% (ACA) to 46.9% (Two-Stage), and 1 train-set can be saved up to fulfill the same transportation tasks. The approach proposed in the study is faster and more stable than the traditional ones, by using which, the HSR staff can draw up the train-sets circulation plan more quickly and the utilization efficiency of the HSR system is also improved. PMID:28489933

Participant Modelling Training Programme: Tutoring the Paraprofessional.

ERIC Educational Resources Information Center

Romi, Shlomo; Teichman, Meir

1998-01-01

A participant-modeling training program designed to improve self-efficacy and the ability to cope effectively with stressful situations was implemented with young paraprofessional counselors who work in conjunction with youth-advancement counselors. Results are presented for self-efficacy and motivation variables. Unexpected findings are…

Training in Cerebral Aneurysm Clipping Using Self-Made 3-Dimensional Models.

PubMed

Mashiko, Toshihiro; Kaneko, Naoki; Konno, Takehiko; Otani, Keisuke; Nagayama, Rie; Watanabe, Eiju

Recently, there have been increasingly fewer opportunities for junior surgeons to receive on-the-job training. Therefore, we created custom-built three-dimensional (3D) surgical simulators for training in connection with cerebral aneurysm clipping. Three patient-specific models were composed of a trimmed skull, retractable brain, and a hollow elastic aneurysm with its parent artery. The brain models were created using 3D printers via a casting technique. The artery models were made by 3D printing and a lost-wax technique. Four residents and 2 junior neurosurgeons attended the training courses. The trainees retracted the brain, observed the parent arteries and aneurysmal neck, selected the clip(s), and clipped the neck of an aneurysm. The duration of simulation was recorded. A senior neurosurgeon then assessed the trainee's technical skill and explained how to improve his/her performance for the procedure using a video of the actual surgery. Subsequently, the trainee attempted the clipping simulation again, using the same model. After the course, the senior neurosurgeon assessed each trainee's technical skill. The trainee critiqued the usefulness of the model and the effectiveness of the training course. Trainees succeeded in performing the simulation in line with an actual surgery. Their skills tended to improve upon completion of the training. These simulation models are easy to create, and we believe that they are very useful for training junior neurosurgeons in the surgical techniques needed for cerebral aneurysm clipping. Copyright © 2017 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

The Rat Model in Microsurgery Education: Classical Exercises and New Horizons

PubMed Central

Shurey, Sandra; Akelina, Yelena; Legagneux, Josette; Malzone, Gerardo; Jiga, Lucian

2014-01-01

Microsurgery is a precise surgical skill that requires an extensive training period and the supervision of expert instructors. The classical training schemes in microsurgery have started with multiday experimental courses on the rat model. These courses have offered a low threat supervised high fidelity laboratory setting in which students can steadily and rapidly progress. This simulated environment allows students to make and recognise mistakes in microsurgery techniques and thus shifts any related risks of the early training period from the operating room to the lab. To achieve a high level of skill acquisition before beginning clinical practice, students are trained on a comprehensive set of exercises the rat model can uniquely provide, with progressive complexity as competency improves. This paper presents the utility of the classical rat model in three of the earliest microsurgery training centres and the new prospects that this versatile and expansive training model offers. PMID:24883268

The Effectiveness of a ‘Train the Trainer’ Model of Resuscitation Education for Rural Peripheral Hospital Doctors in Sri Lanka

PubMed Central

Rajapakse, Bishan N.; Neeman, Teresa; Dawson, Andrew H.

2013-01-01

Background Sri Lankan rural doctors based in isolated peripheral hospitals routinely resuscitate critically ill patients but have difficulty accessing training. We tested a train-the-trainer model that could be utilised in isolated rural hospitals. Methods Eight selected rural hospital non-specialist doctors attended a 2-day instructor course. These “trained trainers” educated their colleagues in advanced cardiac life support at peripheral hospital workshops and we tested their students in resuscitation knowledge and skills pre and post training, and at 6- and 12-weeks. Knowledge was assessed through 30 multiple choice questions (MCQ), and resuscitation skills were assessed by performance in a video recorded simulated scenario of a cardiac arrest using a Resuci Anne Skill Trainer mannequin. Results/Discussion/Conclusion Fifty seven doctors were trained. Pre and post training assessment was possible in 51 participants, and 6-week and 12-week follow up was possible for 43, and 38 participants respectively. Mean MCQ scores significantly improved over time (p<0.001), and a significant improvement was noted in “average ventilation volume”, “compression count”, and “compressions with no error”, “adequate depth”, “average depth”, and “compression rate” (p<0.01). The proportion of participants with compression depth ≥40mm increased post intervention (p<0.05) and at 12-week follow up (p<0.05), and proportion of ventilation volumes between 400-1000mls increased post intervention (p<0.001). A significant increase in the proportion of participants who “checked for responsiveness”, “opened the airway”, “performed a breathing check”, who used the “correct compression ratio”, and who used an “appropriate facemask technique” was also noted (p<0.001). A train-the-trainer model of resuscitation education was effective in improving resuscitation knowledge and skills in Sri Lankan rural peripheral hospital doctors. Improvement was sustained to 12 weeks for most components of resuscitation knowledge and skills. Further research is needed to identify which components of training are most effective in leading to sustained improvement in resuscitation. PMID:24255702

Competency-Based Education in Low Resource Settings: Development of a Novel Surgical Training Program.

PubMed

McCullough, Meghan; Campbell, Alex; Siu, Armando; Durnwald, Libby; Kumar, Shubha; Magee, William P; Swanson, Jordan

2018-03-01

The unmet burden of surgical disease represents a major global health concern, and a lack of trained providers is a critical component of the inadequacy of surgical care worldwide. Competency-based training has been advanced in high-income countries, improving technical skills and decreasing training time, but it is poorly understood how this model might be applied to low- and middle-income countries. We describe the development of a competency-based program to accelerate specialty training of in-country providers in cleft surgery techniques. The program was designed and piloted among eight trainees at five international cleft lip and palate surgical mission sites in Latin America and Africa. A competency-based evaluation form, designed for the program, was utilized to grade general technical and procedure-specific competencies, and pre- and post-training scores were analyzed using a paired t test. Trainees demonstrated improvement in average procedure-specific competency scores for both lip repairs (60.4-71.0%, p < 0.01) and palate (50.6-66.0%, p < 0.01). General technical competency scores also improved (63.6-72.0%, p < 0.01). Among the procedural competencies assessed, surgical markings showed the greatest improvement (19.0 and 22.8% for lip and palate, respectively), followed by nasal floor/mucosal approximation (15.0%) and hard palate dissection (17.1%). Surgical delivery models in LMICs are varied, and trade-offs often exist between goals of case throughput, quality and training. Pilot program results show that procedure-specific and general technical competencies can be improved over a relatively short time and demonstrate the feasibility of incorporating such a training program into surgical outreach missions.

Training model for control of an internal carotid artery injury during transsphenoidal surgery.

PubMed

Muto, Jun; Carrau, Ricardo L; Oyama, Kenichi; Otto, Brad A; Prevedello, Daniel M

2017-01-01

As the adoption of endoscopic endonasal approaches (EEA) continues to proliferate, increasing numbers of internal carotid artery (ICA) injuries are reported. The objective of this study was to develop a synthetic ICA injury-training model that could mimic this clinical scenario and be portable, repeatable, reproducible, and without risk of biological contamination. Based on computed tomography of a human head, we constructed a synthetic model using selective laser sintering with polyamide nylon and glass beads. Subsequently, the model was connected to a pulsatile pump using 6-mm silicon tubing. The pump maintains a pulsatile flow of an artificial blood-like fluid at a variable pressure to simulate heart beats. Volunteer surgeons with different levels of training and experience were provided simulation training sessions with the models. Pre- and posttraining questionnaires were completed by each of the participants. Pre- and posttraining questionnaires suggest that repeated simulation sessions improve the surgical skills and self-confidence of trainees. This ICA injury model is portable; reproducible; and avoids ethical, biohazard, religious, and legal problems associated with cadaveric models. A synthetic ICA injury model for EEA allows recurring training that may improve the surgeon's ability to maintain endoscopic visualization, control catastrophic bleeding, decrease psychomotor stress, and develop effective team strategies to achieve hemostasis. NA Laryngoscope, 127:38-43, 2017. © 2016 The American Laryngological, Rhinological and Otological Society, Inc.

Self-Regulation and Recall: Growth Curve Modeling of Intervention Outcomes for Older Adults

PubMed Central

West, Robin L.; Hastings, Erin C.

2013-01-01

Memory training has often been supported as a potential means to improve performance for older adults. Less often studied are the characteristics of trainees that benefit most from training. Using a self-regulatory perspective, the current project examined a latent growth curve model to predict training-related gains for middle-aged and older adult trainees from individual differences (e.g., education), information processing skills (strategy use) and self-regulatory factors such as self-efficacy, control, and active engagement in training. For name recall, a model including strategy usage and strategy change as predictors of memory gain, along with self-efficacy and self-efficacy change, showed comparable fit to a more parsimonious model including only self-efficacy variables as predictors. The best fit to the text recall data was a model focusing on self-efficacy change as the main predictor of memory change, and that model showed significantly better fit than a model also including strategy usage variables as predictors. In these models, overall performance was significantly predicted by age and memory self-efficacy, and subsequent training-related gains in performance were best predicted directly by change in self-efficacy (text recall), or indirectly through the impact of active engagement and self-efficacy on gains (name recall). These results underscore the benefits of targeting self-regulatory factors in intervention programs designed to improve memory skills. PMID:21604891

Self-regulation and recall: growth curve modeling of intervention outcomes for older adults.

PubMed

West, Robin L; Hastings, Erin C

2011-12-01

Memory training has often been supported as a potential means to improve performance for older adults. Less often studied are the characteristics of trainees that benefit most from training. Using a self-regulatory perspective, the current project examined a latent growth curve model to predict training-related gains for middle-aged and older adult trainees from individual differences (e.g., education), information processing skills (strategy use) and self-regulatory factors such as self-efficacy, control, and active engagement in training. For name recall, a model including strategy usage and strategy change as predictors of memory gain, along with self-efficacy and self-efficacy change, showed comparable fit to a more parsimonious model including only self-efficacy variables as predictors. The best fit to the text recall data was a model focusing on self-efficacy change as the main predictor of memory change, and that model showed significantly better fit than a model also including strategy usage variables as predictors. In these models, overall performance was significantly predicted by age and memory self-efficacy, and subsequent training-related gains in performance were best predicted directly by change in self-efficacy (text recall), or indirectly through the impact of active engagement and self-efficacy on gains (name recall). These results underscore the benefits of targeting self-regulatory factors in intervention programs designed to improve memory skills.

Using the Cascade Model to Improve Antenatal Screening for the Hemoglobin Disorders

ERIC Educational Resources Information Center

Gould, Dinah; Papadopoulos, Irena; Kelly, Daniel

2012-01-01

Introduction: The inherited hemoglobin disorders constitute a major public health problem. Facilitators (experienced hemoglobin counselors) were trained to deliver knowledge and skills to "frontline" practitioners to enable them to support parents during antenatal screening via a cascade (train-the-trainer) model. Objectives of…

The Efficacy of an 8-Week Concurrent Strength and Endurance Training Programme on Hand Cycling Performance.

PubMed

Nevin, Jonpaul; Waldron, Mark; Patterson, Stephen; Smith, Paul; Price, Mike; Hunt, Alex

2018-03-20

The aim of the present study was to investigate the effects of an 8-week concurrent strength and endurance training programme in comparison to endurance training only on several key determinants of hand cycling performance. Five H4 and five H3 classified hand cyclists with at least one year's hand cycling training history consented to participate in the study. Subjects underwent a battery of tests to establish body mass, body composition, VO2peak, maximum aerobic power, gross mechanical efficiency, maximal upper body strength, and 30 km time trial performance. Subjects were matched into pairs based upon 30 km time trial performance and randomly allocated to either a concurrent strength and endurance or endurance training only, intervention group. Following an 8-week training programme based upon a conjugated block periodisation model, subjects completed a second battery of tests. A mixed model, 2-way analysis of variance (ANOVA) revealed no significant changes between groups. However, the calculation of effect sizes (ES) revealed that both groups demonstrated a positive improvement in most physiological and performance measures with subjects in the concurrent group demonstrating a greater magnitude of improvement in body composition (ES -0.80 vs. -0.22) maximal aerobic power (ES 0.97 vs. 0.28), gross mechanical efficiency (ES 0.87 vs. 0.63), bench press 1 repetition maximum (ES 0.53 vs. 0.33), seated row 1 repetition maximum (ES 1.42 vs. 0.43), and 30 km time trial performance (ES -0.66 vs. -0.30). In comparison to endurance training only, an 8-week concurrent training intervention based upon a conjugated block periodisation model appears to be a more effective training regime for improving the performance capabilities of hand cyclists.

[Improvement of emergency physician education through simulator training. Consideration on the basis of the model project "NASimSaar25"].

PubMed

Armbruster, W; Kubulus, D; Schlechtriemen, T; Adler, J; Höhn, M; Schmidt, D; Duchêne, S; Steiner, P; Volk, T; Wrobel, M

2014-09-01

Prehospital emergency medicine is a challenge for trainee emergency physicians. Rare injuries and diseases as well as patients in extreme age groups can unexpectedly face emergency physicians. In the regulations on medical education the German Medical Association requires participation in 50 emergency missions under the supervision of an experienced emergency physician. This needs to be improved because on-the-job training does not generally represent the whole spectrum of emergency medicine and a good and structured training under on call conditions is nearly impossible. The subject of the model project described was whether practical training for emergency physicians can be achieved by participation in simulation training instead of real emergency situations. After modification of the Saarland regulations on medical education it was possible to replace up to 25 participations in emergency missions by simulation training. The concept of the course NASimSaar25 requires participants to complete 25 simulator cases in 3 days in small training groups. Emergency situations from all medical disciplines need to be treated. A special focus is on the treatment of life-threatening and rare diseases and injuries. Modern simulators and actors are used. The debriefings are conducted by experienced tutors based on approved principles. Medical contents, learning targets from the field of crew resource management (CRM) and soft skills are discussed in these debriefings. Education in the field of emergency medicine can be improved by simulator-based learning and training. However, practical work under a tutor in real and clinical experience cannot be completely replaced by simulation. Simulator training can only be successful if theoretical knowledge has already been acquired. A simulator-based course concept can result in an improvement of emergency medical education. The model project NASimSaar25 was well received by the target audience and mostly very well evaluated in terms of learning and reality. If this project becomes established the demand on simulation-based training will increase. The training should achieve a consistent standard of quality.

Use of 3D models of congenital heart disease as an education tool for cardiac nurses.

PubMed

Biglino, Giovanni; Capelli, Claudio; Koniordou, Despina; Robertshaw, Di; Leaver, Lindsay-Kay; Schievano, Silvia; Taylor, Andrew M; Wray, Jo

2017-01-01

Nurse education and training are key to providing congenital heart disease (CHD) patients with consistent high standards of care as well as enabling career progression. One approach for improving educational experience is the use of 3D patient-specific models. To gather pilot data to assess the feasibility of using 3D models of CHD during a training course for cardiac nurses; to evaluate the potential of 3D models in this context, from the nurses' perspective; and to identify possible improvements to optimise their use for teaching. A cross-sectional survey. A national training week for cardiac nurses. One hundred cardiac nurses (of which 65 pediatric and 35 adult). Nurses were shown nine CHD models within the context of a specialized course, following a lecture on the process of making the models themselves, starting from medical imaging. Participants were asked about their general learning experience, if models were more/less informative than diagrams/drawings and lesion-specific/generic models, and their overall reaction to the models. Possible differences between adult and pediatric nurses were investigated. Written feedback was subjected to content analysis and quantitative data were analyzed using nonparametric statistics. Generally models were well liked and nurses considered them more informative than diagrams. Nurses found that 3D models helped in the appreciation of overall anatomy (86%), spatial orientation (70%), and anatomical complexity after treatment (66%). There was no statistically significant difference between adult and pediatric nurses' responses. Thematic analysis highlighted the need for further explanation, use of labels and use of colors to highlight the lesion of interest amongst improvements for optimizing 3D models for teaching/training purposes. 3D patient-specific models are useful tools for training adult and pediatric cardiac nurses and are particularly helpful for understanding CHD anatomy after repair. © 2016 Wiley Periodicals, Inc.

The learning effect of intraoperative video-enhanced surgical procedure training.

PubMed

van Det, M J; Meijerink, W J H J; Hoff, C; Middel, L J; Koopal, S A; Pierie, J P E N

2011-07-01

The transition from basic skills training in a skills lab to procedure training in the operating theater using the traditional master-apprentice model (MAM) lacks uniformity and efficiency. When the supervising surgeon performs parts of a procedure, training opportunities are lost. To minimize this intervention by the supervisor and maximize the actual operating time for the trainee, we created a new training method called INtraoperative Video-Enhanced Surgical Training (INVEST). Ten surgical residents were trained in laparoscopic cholecystectomy either by the MAM or with INVEST. Each trainee performed six cholecystectomies that were objectively evaluated on an Objective Structured Assessment of Technical Skills (OSATS) global rating scale. Absolute and relative improvements during the training curriculum were compared between the groups. A questionnaire evaluated the trainee's opinion on this new training method. Skill improvement on the OSATS global rating scale was significantly greater for the trainees in the INVEST curriculum compared to the MAM, with mean absolute improvement 32.6 versus 14.0 points and mean relative improvement 59.1 versus 34.6% (P=0.02). INVEST significantly enhances technical and procedural skill development during the early learning curve for laparoscopic cholecystectomy. Trainees were positive about the content and the idea of the curriculum.

The Development and Evaluation of a Professional Development Model to Build Meaningful and Effective IEPs for Transition-Aged Students

ERIC Educational Resources Information Center

Doren, Bonnie; Flannery, K. Brigid; Lombardi, Allison

2012-01-01

The purpose of the study was to examine the potential efficacy of a professional development training model targeting IEP case managers of transition-age students. A training model was developed and a pilot study conducted to understand the promise of the model to improve the development of critical components within the IEP document that support…

Are short-term focused training courses on a phantom model using porcine gall bladder useful for trainees in acquiring basic laparoscopic skills?

PubMed

Bansal, Virinder Kumar; Panwar, Rajesh; Misra, Mahesh C; Bhattacharjee, Hemanga K; Jindal, Vikas; Loli, Athiko; Goswami, Amit; Krishna, Asuri; Tamang, Tseten

2012-04-01

The best training method in laparoscopic surgery has not been defined. We evaluated the efficacy of laparoscopic skills acquisition in a short-term focused program. Two hundred fifty-six participants undergoing training on a phantom model were divided into 2 groups. Group 1 had no exposure and group 2 had performed a few laparoscopic surgeries. Acquisition of laparoscopic skills was assessed by operation time and the modified Global Operative Assessment of Laparoscopic Skills (GOALS) scale. A questionnaire was sent to the participants after 3 to 6 months for assessment of impact of training. There was a statistically significant improvement in the assessed parameters and in the mean score of all 5 domains of GOALS. The participants in group 2 performed better than those in group 1 in the first case. The difference between both the groups disappeared after the training. Participants who responded to the questionnaire felt that training helped them in improving their performance in the operation theater.

Mock ECHO: A Simulation-Based Medical Education Method.

PubMed

Fowler, Rebecca C; Katzman, Joanna G; Comerci, George D; Shelley, Brian M; Duhigg, Daniel; Olivas, Cynthia; Arnold, Thomas; Kalishman, Summers; Monnette, Rebecca; Arora, Sanjeev

2018-04-16

This study was designed to develop a deeper understanding of the learning and social processes that take place during the simulation-based medical education for practicing providers as part of the Project ECHO® model, known as Mock ECHO training. The ECHO model is utilized to expand access to care of common and complex diseases by supporting the education of primary care providers with an interprofessional team of specialists via videoconferencing networks. Mock ECHO trainings are conducted through a train the trainer model targeted at leaders replicating the ECHO model at their organizations. Trainers conduct simulated teleECHO clinics while participants gain skills to improve communication and self-efficacy. Three focus groups, conducted between May 2015 and January 2016 with a total of 26 participants, were deductively analyzed to identify common themes related to simulation-based medical education and interdisciplinary education. Principal themes generated from the analysis included (a) the role of empathy in community development, (b) the value of training tools as guides for learning, (c) Mock ECHO design components to optimize learning, (d) the role of interdisciplinary education to build community and improve care delivery, (e) improving care integration through collaboration, and (f) development of soft skills to facilitate learning. Mock ECHO trainings offer clinicians the freedom to learn in a noncritical environment while emphasizing real-time multidirectional feedback and encouraging knowledge and skill transfer. The success of the ECHO model depends on training interprofessional healthcare providers in behaviors needed to lead a teleECHO clinic and to collaborate in the educational process. While building a community of practice, Mock ECHO provides a safe opportunity for a diverse group of clinician experts to practice learned skills and receive feedback from coparticipants and facilitators.

The effect of the training program on the quality of life in patients with asthma based on the Precede model in Ahvaz, Iran.

PubMed

Nejad, Mina Motaghi; Nejad, Ghodratollah Shakeri; Tavakol, Heshmatollah; Cheraghi, Maria

2017-06-01

The aim of the study was to determine the effect of the training program based on the Precede model and its main components on improving the quality of life in patients with asthma. It was a randomized quasi-experimental study done on 120 patients with asthma who were referred to the Imam Khomeini hospital in Ahvaz who were selected using the convenience sampling method and were randomly divided into intervention and control groups. The data collection tool consisted of two questionnaires. The first questionnaire evaluated the quality of life in patients with asthma and the other one was developed by the researcher based on the structures of the Precede model. Training intervention was conducted during four sessions twice a week and each session was carried out for an hour based on the structures of the Precede model. In order to achieve the results, SPSS software, even t -test, and χ 2 were used. The results showed that after the training intervention in the experimental group, the mean scores of predisposing factors ( p < 0.001), enabling factors, reinforcing factors and behavioral factors were significantly increased ( p < 0.001) as compared to the control group. A significant difference was observed in the mean scores of quality of life in two groups after the intervention ( p < 0.001), and the quality of life of patients in the experimental group was improved after the training intervention. The design and implementation of the training program based on the Precede model can have a positive effect on the improvement of quality of life in patients with asthma.

Efficacy of the "HealthMatters Program" Train-the-Trainer Model

ERIC Educational Resources Information Center

Marks, Beth; Sisirak, Jasmina; Chang, Yen-Ching

2013-01-01

Background: This study examines the efficacy of a staff-led, health promotion intervention entitled "HealthMatters Program: Train-the-Trainer" Model to improve health among adults with intellectual disabilities. While data support the benefits of health promotion for adults with intellectual disabilities in controlled settings, little…

Learning to recognize letters in the periphery: Effects of repeated exposure, letter frequency, and letter complexity

PubMed Central

Husk, Jesse S.; Yu, Deyue

2017-01-01

Patients with central vision loss must rely on their peripheral vision for reading. Unfortunately, limitations of peripheral vision, such as crowding, pose significant challenges to letter recognition. As a result, there is a need for developing effective training methods for improving crowded letter recognition in the periphery. Several studies have shown that extensive practice with letter stimuli is beneficial to peripheral letter recognition. Here, we explore stimulus-related factors that might influence the effectiveness of peripheral letter recognition training. Specifically, we examined letter exposure (number of letter occurrences), frequency of letter use in English print, and letter complexity and evaluated their contributions to the amount of improvement observed in crowded letter recognition following training. We analyzed data collected across a range of training protocols. Using linear regression, we identified the best-fitting model and observed that all three stimulus-related factors contributed to improvement in peripheral letter recognition with letter exposure being the most important factor. As an important explanatory variable, pretest accuracy was included in the model as well to avoid estimate biases and was shown to have influence on the relationship between training improvement and letter exposure. When developing training protocols for peripheral letter recognition, it may be beneficial to not only consider the overall length of training, but also to tailor the number of stimulus occurrences for each letter according to its initial performance level, frequency, and complexity. PMID:28265651

Does a web-based feedback training program result in improved reliability in clinicians' ratings of the Global Assessment of Functioning (GAF) Scale?

PubMed

Støre-Valen, Jakob; Ryum, Truls; Pedersen, Geir A F; Pripp, Are H; Jose, Paul E; Karterud, Sigmund

2015-09-01

The Global Assessment of Functioning (GAF) Scale is used in routine clinical practice and research to estimate symptom and functional severity and longitudinal change. Concerns about poor interrater reliability have been raised, and the present study evaluated the effect of a Web-based GAF training program designed to improve interrater reliability in routine clinical practice. Clinicians rated up to 20 vignettes online, and received deviation scores as immediate feedback (i.e., own scores compared with expert raters) after each rating. Growth curves of absolute SD scores across the vignettes were modeled. A linear mixed effects model, using the clinician's deviation scores from expert raters as the dependent variable, indicated an improvement in reliability during training. Moderation by content of scale (symptoms; functioning), scale range (average; extreme), previous experience with GAF rating, profession, and postgraduate training were assessed. Training reduced deviation scores for inexperienced GAF raters, for individuals in clinical professions other than nursing and medicine, and for individuals with no postgraduate specialization. In addition, training was most beneficial for cases with average severity of symptoms compared with cases with extreme severity. The results support the use of Web-based training with feedback routines as a means to improve the reliability of GAF ratings performed by clinicians in mental health practice. These results especially pertain to clinicians in mental health practice who do not have a masters or doctoral degree. (c) 2015 APA, all rights reserved.

Exploration of Two Training Paradigms Using Forced Induced Weight Shifting With the Tethered Pelvic Assist Device to Reduce Asymmetry in Individuals After Stroke: Case Reports.

PubMed

Bishop, Lauri; Khan, Moiz; Martelli, Dario; Quinn, Lori; Stein, Joel; Agrawal, Sunil

2017-10-01

Many robotic devices in rehabilitation incorporate an assist-as-needed haptic guidance paradigm to promote training. This error reduction model, while beneficial for skill acquisition, could be detrimental for long-term retention. Error augmentation (EA) models have been explored as alternatives. A robotic Tethered Pelvic Assist Device has been developed to study force application to the pelvis on gait and was used here to induce weight shift onto the paretic (error reduction) or nonparetic (error augmentation) limb during treadmill training. The purpose of these case reports is to examine effects of training with these two paradigms to reduce load force asymmetry during gait in two individuals after stroke (>6 mos). Participants presented with baseline gait asymmetry, although independent community ambulators. Participants underwent 1-hr trainings for 3 days using either the error reduction or error augmentation model. Outcomes included the Borg rating of perceived exertion scale for treatment tolerance and measures of force and stance symmetry. Both participants tolerated training. Force symmetry (measured on treadmill) improved from pretraining to posttraining (36.58% and 14.64% gains), however, with limited transfer to overground gait measures (stance symmetry gains of 9.74% and 16.21%). Training with the Tethered Pelvic Assist Device device proved feasible to improve force symmetry on the treadmill irrespective of training model. Future work should consider methods to increase transfer to overground gait.

Training Community Modeling and Simulation Business Plan: 2009 Edition

DTIC Science & Technology

2010-04-01

strategic information assurance 33 33 Provide crisis action procedures training 34 34 Provide the IC SOF-specific training at the operational level... information and products • Collaborative analysis processes • Dissemination of information throughout a command and to subordinates by redundant means...centric M&S capabilities will improve training for information warfare, assist with training for homeland defense operations, crisis -management plan- ning

Motivation Coaching Training for Instructional Coaches: A Pilot Study of Motivational Interviewing Skills Training

ERIC Educational Resources Information Center

Lyons, Michael D.; Jones, Sara J.; Smith, Bradley H.; McQuillin, Samuel D.; Richardson, Georgette; Reid, Erin; McClellan, Anne

2017-01-01

In our paper we describe a newly developed teacher coaching model that provides training on motivational interviewing (MI) to improve instructional coaches' effectiveness with classroom teachers. Participants were 38 coaches who completed a three-day coaching training. At pre- and post-test, the participants completed role plays with an actor who…

Multilingual Twitter Sentiment Classification: The Role of Human Annotators

PubMed Central

Mozetič, Igor; Grčar, Miha; Smailović, Jasmina

2016-01-01

What are the limits of automated Twitter sentiment classification? We analyze a large set of manually labeled tweets in different languages, use them as training data, and construct automated classification models. It turns out that the quality of classification models depends much more on the quality and size of training data than on the type of the model trained. Experimental results indicate that there is no statistically significant difference between the performance of the top classification models. We quantify the quality of training data by applying various annotator agreement measures, and identify the weakest points of different datasets. We show that the model performance approaches the inter-annotator agreement when the size of the training set is sufficiently large. However, it is crucial to regularly monitor the self- and inter-annotator agreements since this improves the training datasets and consequently the model performance. Finally, we show that there is strong evidence that humans perceive the sentiment classes (negative, neutral, and positive) as ordered. PMID:27149621

Getting governance right for a sustainable regionalised business model.

PubMed

Laurence, Caroline O; Black, Linda E; Rowe, Mark; Pearce, Rod

2011-06-06

The 1998 Ministerial Review of General Practice Training identified several areas for improvement that led to major changes in the provision of general practice training, including the establishment of General Practice Education and Training (GPET) and the regionalisation of training. The regionalised training business model has been in place for nearly 10 years, and several key organisations have been involved in its evolution, including the Australian Government, speciality colleges, GPET and regionalised training providers. Both the college-focused and regionalised-focused models have had some successes. These include recognition and support of general practice as a vocational specialty, increased numbers of junior doctors undertaking placements in general practice, and increased numbers of registrars training in rural areas. This period has also seen changes in the governance and decision-making processes with creation of a new framework that is inclusive of all the key players in the new regionalised training system. The future holds challenges for the regionalised training business model as the general practice education and training landscape becomes more complex. The framework in the current model will provide a base to help meet these challenges and allow for further sustainable expansion.

Using Internet Technologies To Enhance Training.

ERIC Educational Resources Information Center

Pollock, Carl; Masters, Robert

1997-01-01

Describes how to use Internet technologies to create an intranet, or an online training database system, for improving company communications, effectiveness, and job performance. Topics include technology and performance; educating managers and key decision makers; creating a graphic model of the training system; and fitting into the existing…

Neural correlates of face gender discrimination learning.

PubMed

Su, Junzhu; Tan, Qingleng; Fang, Fang

2013-04-01

Using combined psychophysics and event-related potentials (ERPs), we investigated the effect of perceptual learning on face gender discrimination and probe the neural correlates of the learning effect. Human subjects were trained to perform a gender discrimination task with male or female faces. Before and after training, they were tested with the trained faces and other faces with the same and opposite genders. ERPs responding to these faces were recorded. Psychophysical results showed that training significantly improved subjects' discrimination performance and the improvement was specific to the trained gender, as well as to the trained identities. The training effect indicates that learning occurs at two levels-the category level (gender) and the exemplar level (identity). ERP analyses showed that the gender and identity learning was associated with the N170 latency reduction at the left occipital-temporal area and the N170 amplitude reduction at the right occipital-temporal area, respectively. These findings provide evidence for the facilitation model and the sharpening model on neuronal plasticity from visual experience, suggesting a faster processing speed and a sparser representation of face induced by perceptual learning.

Study of the 5E Instructional Model to Improve the Instructional Design Process of Novice Teachers

ERIC Educational Resources Information Center

Hu, Jiuhua; Gao, Chong; Liu, Yang

2017-01-01

This study investigated the effects of 5E instructional model on the teaching processes of novice teachers. First, we conducted a teaching design training project based on the 5E model for 40 novice teachers, and compared pre-texts of the teachers' teaching process from before the training with post-texts obtained immediately following the…

Improving the Use of a Group Counseling Scale and Related Model To Teach Theory and Skills Integration.

ERIC Educational Resources Information Center

Zimmick, Renee; Smaby, Marlowe H.; Maddux, Cleborne D.

2000-01-01

Study tests the Skilled Group Counseling Training Model (SGCTM). Results reveal that students in a group counseling class who were trained in the model used at least 80% of the SGCTM skills during three simulated group counseling sessions. During these sessions, the students adhered to one of three counseling theories (Person-Centered, Gestalt,…

Meta-analysis of learning design on sciences to develop a teacher’s professionalism training model

NASA Astrophysics Data System (ADS)

Alimah, S.; Anggraito, Y. U.; Prasetyo, A. P. B.; Saptono, S.

2018-03-01

This research explored a meta-analysis ofthe teaching design on sciences teachers’ lesson plans to develop the training model in achieving 21st-century learning competence and the implementation of the scientifically literate school model. This is a qualitative research with descriptively qualitative analysis. The sample was the members of sciences teacher’s organizations in Brebes Central Java Indonesia. Data was collected by documentation, observation, interviews, and questionnaires scale understanding. Analysis of the lesson plans focused on the correctness of development concept and integration of Strengthening Character Education; School Literacy Movement; Communication, Collaboration, Critical Thinking and Creativity; and Higher Order Thinking Skill. The sciences teachers had a good understanding of the components of the lesson plan, but needed further training. The integration of the character education by the teacher was not explicitly written into their lesson plan. The teachers’ skill to integrate the components was still needed improvements. It is found that training and mentoring of lesson plan development to improve the skills of science teachers in achieving 21st-century learning competencies are still urgent to be done. The training and mentoring model proposed here is Peretipe model, to help teachers skillfully design good lesson plans based on Technological Pedagogical, and Content Knowledge.

Parent Training Occupational Therapy Program for Parents of Children with Autism in Korea.

PubMed

An, Sun-Joung L

2017-01-01

Attitudes and beliefs about parent participation in occupational therapy are shifting toward family-centered practice worldwide. However, adopting a family-centered approach in a society such as Korea, where a Confucian culture of hierarchical roles is reflected in a strong medical model, can prove to be very difficult. A parent training program was developed at the HOPE Center, a pediatric occupational therapy center, to bridge the gap between the traditional medical model and the ideal family-centered model. This study examined the effectiveness of the parent training and gauged parents' perceptions and experiences of a more family-centered approach to therapy. Four parent-child dyads living with autism participated in five months of parent training at the HOPE center. The results on the Canadian Occupational Performance Measure showed that the parent training improved the occupational performance of both children and parents. Six open-ended questions were used to investigate parents' perceptions and experiences of parent training. Two broad themes emerged: improved self-efficacy and the cultural reality of living with autism in Korea. This study demonstrates that building parent training into an occupational therapy program may optimize the effectiveness of any therapy and introduce a more family-centered approach to therapy while maintaining cultural integrity.

Parent Training Occupational Therapy Program for Parents of Children with Autism in Korea

PubMed Central

2017-01-01

Attitudes and beliefs about parent participation in occupational therapy are shifting toward family-centered practice worldwide. However, adopting a family-centered approach in a society such as Korea, where a Confucian culture of hierarchical roles is reflected in a strong medical model, can prove to be very difficult. A parent training program was developed at the HOPE Center, a pediatric occupational therapy center, to bridge the gap between the traditional medical model and the ideal family-centered model. This study examined the effectiveness of the parent training and gauged parents' perceptions and experiences of a more family-centered approach to therapy. Four parent-child dyads living with autism participated in five months of parent training at the HOPE center. The results on the Canadian Occupational Performance Measure showed that the parent training improved the occupational performance of both children and parents. Six open-ended questions were used to investigate parents' perceptions and experiences of parent training. Two broad themes emerged: improved self-efficacy and the cultural reality of living with autism in Korea. This study demonstrates that building parent training into an occupational therapy program may optimize the effectiveness of any therapy and introduce a more family-centered approach to therapy while maintaining cultural integrity. PMID:29097966

Competency in health care management: a training model in epidemiologic methods for assessing and improving the quality of clinical practice through evidence-based decision making.

PubMed

Hudak, R P; Jacoby, I; Meyer, G S; Potter, A L; Hooper, T I; Krakauer, H

1997-01-01

This article describes a training model that focuses on health care management by applying epidemiologic methods to assess and improve the quality of clinical practice. The model's uniqueness is its focus on integrating clinical evidence-based decision making with fundamental principles of resource management to achieve attainable, cost-effective, high-quality health outcomes. The target students are current and prospective clinical and administrative executives who must optimize decision making at the clinical and managerial levels of health care organizations.

How to interpret cognitive training studies: A reply to Lindskog & Winman

PubMed Central

Park, Joonkoo; Brannon, Elizabeth M.

2017-01-01

In our previous studies, we demonstrated that repeated training on an approximate arithmetic task selectively improves symbolic arithmetic performance (Park & Brannon, 2013, 2014). We proposed that mental manipulation of quantity is the common cognitive component between approximate arithmetic and symbolic arithmetic, driving the causal relationship between the two. In a commentary to our work, Lindskog and Winman argue that there is no evidence of performance improvement during approximate arithmetic training and that this challenges the proposed causal relationship between approximate arithmetic and symbolic arithmetic. Here, we argue that causality in cognitive training experiments is interpreted from the selectivity of transfer effects and does not hinge upon improved performance in the training task. This is because changes in the unobservable cognitive elements underlying the transfer effect may not be observable from performance measures in the training task. We also question the validity of Lindskog and Winman’s simulation approach for testing for a training effect, given that simulations require a valid and sufficient model of a decision process, which is often difficult to achieve. Finally we provide an empirical approach to testing the training effects in adaptive training. Our analysis reveals new evidence that approximate arithmetic performance improved over the course of training in Park and Brannon (2014). We maintain that our data supports the conclusion that approximate arithmetic training leads to improvement in symbolic arithmetic driven by the common cognitive component of mental quantity manipulation. PMID:26972469

Self-organization of head-centered visual responses under ecological training conditions.

PubMed

Mender, Bedeho M W; Stringer, Simon M

2014-01-01

We have studied the development of head-centered visual responses in an unsupervised self-organizing neural network model which was trained under ecological training conditions. Four independent spatio-temporal characteristics of the training stimuli were explored to investigate the feasibility of the self-organization under more ecological conditions. First, the number of head-centered visual training locations was varied over a broad range. Model performance improved as the number of training locations approached the continuous sampling of head-centered space. Second, the model depended on periods of time where visual targets remained stationary in head-centered space while it performed saccades around the scene, and the severity of this constraint was explored by introducing increasing levels of random eye movement and stimulus dynamics. Model performance was robust over a range of randomization. Third, the model was trained on visual scenes where multiple simultaneous targets where always visible. Model self-organization was successful, despite never being exposed to a visual target in isolation. Fourth, the duration of fixations during training were made stochastic. With suitable changes to the learning rule, it self-organized successfully. These findings suggest that the fundamental learning mechanism upon which the model rests is robust to the many forms of stimulus variability under ecological training conditions.

Neural and Behavioral Correlates of Attentional Inhibition Training and Perceptual Discrimination Training in a Visual Flanker Task

PubMed Central

Melara, Robert D.; Singh, Shalini; Hien, Denise A.

2018-01-01

Two groups of healthy young adults were exposed to 3 weeks of cognitive training in a modified version of the visual flanker task, one group trained to discriminate the target (discrimination training) and the other group to ignore the flankers (inhibition training). Inhibition training, but not discrimination training, led to significant reductions in both Garner interference, indicating improved selective attention, and in Stroop interference, indicating more efficient resolution of stimulus conflict. The behavioral gains from training were greatest in participants who showed the poorest selective attention at pretest. Electrophysiological recordings revealed that inhibition training increased the magnitude of Rejection Positivity (RP) to incongruent distractors, an event-related potential (ERP) component associated with inhibitory control. Source modeling of RP uncovered a dipole in the medial frontal gyrus for those participants receiving inhibition training, but in the cingulate gyrus for those participants receiving discrimination training. Results suggest that inhibitory control is plastic; inhibition training improves conflict resolution, particularly in individuals with poor attention skills. PMID:29875644

Neural and Behavioral Correlates of Attentional Inhibition Training and Perceptual Discrimination Training in a Visual Flanker Task.

PubMed

Melara, Robert D; Singh, Shalini; Hien, Denise A

2018-01-01

Two groups of healthy young adults were exposed to 3 weeks of cognitive training in a modified version of the visual flanker task, one group trained to discriminate the target (discrimination training) and the other group to ignore the flankers (inhibition training). Inhibition training, but not discrimination training, led to significant reductions in both Garner interference, indicating improved selective attention, and in Stroop interference, indicating more efficient resolution of stimulus conflict. The behavioral gains from training were greatest in participants who showed the poorest selective attention at pretest. Electrophysiological recordings revealed that inhibition training increased the magnitude of Rejection Positivity (RP) to incongruent distractors, an event-related potential (ERP) component associated with inhibitory control. Source modeling of RP uncovered a dipole in the medial frontal gyrus for those participants receiving inhibition training, but in the cingulate gyrus for those participants receiving discrimination training. Results suggest that inhibitory control is plastic; inhibition training improves conflict resolution, particularly in individuals with poor attention skills.

Prostate segmentation in MRI using a convolutional neural network architecture and training strategy based on statistical shape models.

PubMed

Karimi, Davood; Samei, Golnoosh; Kesch, Claudia; Nir, Guy; Salcudean, Septimiu E

2018-05-15

Most of the existing convolutional neural network (CNN)-based medical image segmentation methods are based on methods that have originally been developed for segmentation of natural images. Therefore, they largely ignore the differences between the two domains, such as the smaller degree of variability in the shape and appearance of the target volume and the smaller amounts of training data in medical applications. We propose a CNN-based method for prostate segmentation in MRI that employs statistical shape models to address these issues. Our CNN predicts the location of the prostate center and the parameters of the shape model, which determine the position of prostate surface keypoints. To train such a large model for segmentation of 3D images using small data (1) we adopt a stage-wise training strategy by first training the network to predict the prostate center and subsequently adding modules for predicting the parameters of the shape model and prostate rotation, (2) we propose a data augmentation method whereby the training images and their prostate surface keypoints are deformed according to the displacements computed based on the shape model, and (3) we employ various regularization techniques. Our proposed method achieves a Dice score of 0.88, which is obtained by using both elastic-net and spectral dropout for regularization. Compared with a standard CNN-based method, our method shows significantly better segmentation performance on the prostate base and apex. Our experiments also show that data augmentation using the shape model significantly improves the segmentation results. Prior knowledge about the shape of the target organ can improve the performance of CNN-based segmentation methods, especially where image features are not sufficient for a precise segmentation. Statistical shape models can also be employed to synthesize additional training data that can ease the training of large CNNs.

Three Reflections on Assessing Safety Training Needs: A Case Study

ERIC Educational Resources Information Center

Sleezer, Catherine M.; Kelsey, Kathleen D.; Wood, Thomas E.

2008-01-01

Needs assessment plays an important role in training and human performance improvement efforts, but the literature contains little research on this topic. This study extended previous research on the Performance Analysis for Training (PAT) model of needs assessment by examining its implementation to determine environmental and occupational health…

Adaptive model predictive process control using neural networks

DOEpatents

Buescher, K.L.; Baum, C.C.; Jones, R.D.

1997-08-19

A control system for controlling the output of at least one plant process output parameter is implemented by adaptive model predictive control using a neural network. An improved method and apparatus provides for sampling plant output and control input at a first sampling rate to provide control inputs at the fast rate. The MPC system is, however, provided with a network state vector that is constructed at a second, slower rate so that the input control values used by the MPC system are averaged over a gapped time period. Another improvement is a provision for on-line training that may include difference training, curvature training, and basis center adjustment to maintain the weights and basis centers of the neural in an updated state that can follow changes in the plant operation apart from initial off-line training data. 46 figs.

Adaptive model predictive process control using neural networks

DOEpatents

Buescher, Kevin L.; Baum, Christopher C.; Jones, Roger D.

1997-01-01

A control system for controlling the output of at least one plant process output parameter is implemented by adaptive model predictive control using a neural network. An improved method and apparatus provides for sampling plant output and control input at a first sampling rate to provide control inputs at the fast rate. The MPC system is, however, provided with a network state vector that is constructed at a second, slower rate so that the input control values used by the MPC system are averaged over a gapped time period. Another improvement is a provision for on-line training that may include difference training, curvature training, and basis center adjustment to maintain the weights and basis centers of the neural in an updated state that can follow changes in the plant operation apart from initial off-line training data.

Simulation training for breast and pelvic physical examination: a systematic review and meta-analysis.

PubMed

Dilaveri, C A; Szostek, J H; Wang, A T; Cook, D A

2013-09-01

Breast and pelvic examinations are challenging intimate examinations. Technology-based simulation may help to overcome these challenges. To synthesise the evidence regarding the effectiveness of technology-based simulation training for breast and pelvic examination. Our systematic search included MEDLINE, EMBASE, CINAHL, PsychINFO, Scopus, and key journals and review articles; the date of the last search was January 2012. Original research studies evaluating technology-enhanced simulation of breast and pelvic examination to teach learners, compared with no intervention or with other educational activities. The reviewers evaluated study eligibility and abstracted data on methodological quality, learners, instructional design, and outcomes, and used random-effects models to pool weighted effect sizes. In total, 11 272 articles were identified for screening, and 22 studies were eligible, enrolling 2036 trainees. In eight studies comparing simulation for breast examination training with no intervention, simulation was associated with a significant improvement in skill, with a pooled effect size of 0.86 (95% CI 0.52-1.19; P < 0.001). Four studies comparing simulation training for pelvic examination with no intervention had a large and significant benefit, with a pooled effect size of 1.18 (95% CI 0.40-1.96; P = 0.003). Among breast examination simulation studies, dynamic models providing feedback were associated with improved outcomes. In pelvic examination simulation studies, the addition of a standardised patient to the simulation model and the use of an electronic model with enhanced feedback improved outcomes. In comparison with no intervention, breast and pelvic examination simulation training is associated with moderate to large effects for skills outcomes. Enhanced feedback appears to improve learning. © 2013 RCOG.

Modeling habitat for Marbled Murrelets on the Siuslaw National Forest, Oregon, using lidar data

USGS Publications Warehouse

Hagar, Joan C.; Aragon, Ramiro; Haggerty, Patricia; Hollenbeck, Jeff P.

2018-03-28

Habitat models using lidar-derived variables that quantify fine-scale variation in vegetation structure can improve the accuracy of occupancy estimates for canopy-dwelling species over models that use variables derived from other remote sensing techniques. However, the ability of models developed at such a fine spatial scale to maintain accuracy at regional or larger spatial scales has not been tested. We tested the transferability of a lidar-based habitat model for the threatened Marbled Murrelet (Brachyramphus marmoratus) between two management districts within a larger regional conservation zone in coastal western Oregon. We compared the performance of the transferred model against models developed with data from the application location. The transferred model had good discrimination (AUC = 0.73) at the application location, and model performance was further improved by fitting the original model with coefficients from the application location dataset (AUC = 0.79). However, the model selection procedure indicated that neither of these transferred models were considered competitive with a model trained on local data. The new model trained on data from the application location resulted in the selection of a slightly different set of lidar metrics from the original model, but both transferred and locally trained models consistently indicated positive relationships between the probability of occupancy and lidar measures of canopy structural complexity. We conclude that while the locally trained model had superior performance for local application, the transferred model could reasonably be applied to the entire conservation zone.

Training Fathers To Develop Reading and Writing Skills in Young Children with Disabilities.

ERIC Educational Resources Information Center

Ortiz, Robert W.; Stile, Stephen W.

The potential benefits of father participation in their children's reading and writing activities include improved literacy skills, increased bonding, and heightened self-esteem of both fathers and children. This paper identifies a training model for working with fathers--Project DADS. Using this model, early childhood professionals can foster…

Model Curriculum for Academic Child and Adolescent Psychiatry Training

ERIC Educational Resources Information Center

Stubbe, Dorothy; Martin, Andres; Bloch, Michael; Belitsky, Richard; Carter, Debbie; Ebert, Michael; Friedman, Alan; Giese, Alexis; Kirwin, Paul; Ross, Randal G.; Leckman, James F.

2008-01-01

Objective: The United States is facing a severe shortage of academic child and adolescent psychiatrists. This article reviews a model integrated pathway to improve recruitment. Methods: The authors review training portals for research in child and adolescent psychiatry. There is a summary of a focus group discussion of the advantages and…

Measuring movement towards improved emergency obstetric care in rural Kenya with implementation of the PRONTO simulation and team training program.

PubMed

Dettinger, Julia C; Kamau, Stephen; Calkins, Kimberly; Cohen, Susanna R; Cranmer, John; Kibore, Minnie; Gachuno, Onesmus; Walker, Dilys

2018-02-01

As the proportion of facility-based births increases, so does the need to ensure that mothers and their newborns receive quality care. Developing facility-oriented obstetric and neonatal training programs grounded in principles of teamwork utilizing simulation-based training for emergency response is an important strategy for improving the quality care. This study uses 3 dimensions of the Kirkpatrick Model to measure the impact of PRONTO International (PRONTO) simulation-based training as part of the Linda Afya ya Mama na Mtoto (LAMMP, Protect the Health of mother and child) in Kenya. Changes in knowledge of obstetric and neonatal emergency response, self-efficacy, and teamwork were analyzed using longitudinal, fixed-effects, linear regression models. Participants from 26 facilities participated in the training between 2013 and 2014. The results demonstrate improvements in knowledge, self-efficacy, and teamwork self-assessment. When comparing pre-Module I scores with post-training scores, improvements range from 9 to 24 percentage points (p values < .0001 to .026). Compared to baseline, post-Module I and post-Module II (3 months later) scores in these domains were similar. The intervention not only improved participant teamwork skills, obstetric and neonatal knowledge, and self-efficacy but also fostered sustained changes at 3 months. The proportion of facilities achieving self-defined strategic goals was high: 95.8% of the 192 strategic goals. Participants rated the PRONTO intervention as extremely useful, with an overall score of 1.4 out of 5 (1, extremely useful; 5, not at all useful). Evaluation of how these improvements affect maternal and perinatal clinical outcomes is forthcoming. © 2018 John Wiley & Sons Ltd.

Experiences in disaster-related mental health relief work: An exploratory model for the interprofessional training of psychological relief workers.

PubMed

Ren, ZhengJia; Wang, HongTao; Zhang, Wei

2017-01-01

The purpose of this study was to begin to generate an exploratory model of the disaster-related mental health education process associated with the training experiences of psychological relief workers active during the Sichuan earthquake in China. The data consisted of semi-structured interviews with 20 psychological relief workers from four different professions (social workers, psychiatric nurses, psychiatrists, and counsellors) regarding their experiences in training and ideas for improvement. The model explains the need to use a people-centred community interprofessional education approach, which focuses on role-modelling of the trainer, caring for relief workers, paying attention to the needs of the trainee, and building systematic interprofessional education strategies. The proposed model identifies areas for the comprehensive training of relief workers and aims to address the importance of people-centred mental health service provisions, ensure intentional and strategic training of relief workers using interprofessional concepts and strategies, and use culturally attuned and community-informed strategies in mental health training practices.

The application of the Practitioners in Applied Practice Model during breaking bad news communication training for medical students: a case study.

PubMed

Dunning, Rose; Laidlaw, Anita

2015-11-01

Breaking bad news is a key skill within clinical communication and one which can impact outcomes for both the patient and practitioner. The evidence base for effective clinical communication training in breaking bad news is scarce. Frameworks have been found to assist the practitioner, such as SPIKES; however, the pedagogical approach used alongside such frameworks can vary. This study sought to examine the impact of utilising the Practitioners in Applied Practice Model (PAPM) alongside the SPIKES framework for training undergraduate medical students in breaking bad news. A case study approach is used to highlight the impact of training based on the PAPM and SPIKES on patient-centred communication and simulated patient satisfaction with the clinical communication behaviour. Results showed that following training, both patient-centred behaviour and patient satisfaction improved. With detailed communication behaviour changes, a balance was established between rapport building behaviour, lifestyle and psychosocial talk alongside biomedical information. This case study shows how the PAPM could be utilised alongside the SPIKES framework to improve breaking bad news communication in medical undergraduate students and describes the behavioural basis of the improvement. Further research is required to show the generalisability of this training intervention. © The Author(s) 2015.

Development of a diabetes care management curriculum in a family practice residency program.

PubMed

Nuovo, Jim; Balsbaugh, Thomas; Barton, Sue; Davidson, Ellen; Fox-Garcia, Jane; Gandolfo, Angela; Levich, Bridget; Seibles, Joann

2004-01-01

Improving the quality of care for patients with chronic illness has become a high priority. Implementing training programs in disease management (DM) so the next generation of physicians can manage chronic illness more effectively is challenging. Residency training programs have no specific mandate to implement DM training. Additional barriers at the training facility include: 1) lack of a population-based perspective for service delivery; 2) weak support for self-management of illness; 3) incomplete implementation due to physician resistance or inertia; and 4) few incentives to change practices and behaviors. In order to overcome these barriers, training programs must take the initiative to implement DM training that addresses each of these issues. We report the implementation of a chronic illness management curriculum based on the Improving Chronic Illness Care (ICIC) Model. Features of this process included both patient care and learner objectives. These were: development of a multidisciplinary diabetes DM team; development of a patient registry; development of diabetes teaching clinics in the family practice center (nutrition, general management classes, and one-on-one teaching); development of a group visit model; and training the residents in the elements of the ICIC Model, ie, the community, the health system, self-management support, delivery system design, decision support, and clinical information systems. Barriers to implementing these curricular changes were: the development of a patient registry; buy-in from faculty, residents, clinic leadership, staff, and patients for the chronic care model; the ability to bill for services and maintain clinical productivity; and support from the health system key stakeholders for sustainability. Unique features of each training site will dictate differences in emphasis and structure; however, the core principles of the ICIC Model in enhancing self-management may be generalized to all sites.

Boosting drug named entity recognition using an aggregate classifier.

PubMed

Korkontzelos, Ioannis; Piliouras, Dimitrios; Dowsey, Andrew W; Ananiadou, Sophia

2015-10-01

Drug named entity recognition (NER) is a critical step for complex biomedical NLP tasks such as the extraction of pharmacogenomic, pharmacodynamic and pharmacokinetic parameters. Large quantities of high quality training data are almost always a prerequisite for employing supervised machine-learning techniques to achieve high classification performance. However, the human labour needed to produce and maintain such resources is a significant limitation. In this study, we improve the performance of drug NER without relying exclusively on manual annotations. We perform drug NER using either a small gold-standard corpus (120 abstracts) or no corpus at all. In our approach, we develop a voting system to combine a number of heterogeneous models, based on dictionary knowledge, gold-standard corpora and silver annotations, to enhance performance. To improve recall, we employed genetic programming to evolve 11 regular-expression patterns that capture common drug suffixes and used them as an extra means for recognition. Our approach uses a dictionary of drug names, i.e. DrugBank, a small manually annotated corpus, i.e. the pharmacokinetic corpus, and a part of the UKPMC database, as raw biomedical text. Gold-standard and silver annotated data are used to train maximum entropy and multinomial logistic regression classifiers. Aggregating drug NER methods, based on gold-standard annotations, dictionary knowledge and patterns, improved the performance on models trained on gold-standard annotations, only, achieving a maximum F-score of 95%. In addition, combining models trained on silver annotations, dictionary knowledge and patterns are shown to achieve comparable performance to models trained exclusively on gold-standard data. The main reason appears to be the morphological similarities shared among drug names. We conclude that gold-standard data are not a hard requirement for drug NER. Combining heterogeneous models build on dictionary knowledge can achieve similar or comparable classification performance with that of the best performing model trained on gold-standard annotations. Copyright © 2015 The Authors. Published by Elsevier B.V. All rights reserved.

Laparoscopic surgical box model training for surgical trainees with no prior laparoscopic experience.

PubMed

Nagendran, Myura; Toon, Clare D; Davidson, Brian R; Gurusamy, Kurinchi Selvan

2014-01-17

Surgical training has traditionally been one of apprenticeship, where the surgical trainee learns to perform surgery under the supervision of a trained surgeon. This is time consuming, costly, and of variable effectiveness. Training using a box model physical simulator - either a video box or a mirrored box - is an option to supplement standard training. However, the impact of this modality on trainees with no prior laparoscopic experience is unknown. To compare the benefits and harms of box model training versus no training, another box model, animal model, or cadaveric model training for surgical trainees with no prior laparoscopic experience. We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, and Science Citation Index Expanded to May 2013. We included all randomised clinical trials comparing box model trainers versus no training in surgical trainees with no prior laparoscopic experience. We also included trials comparing different methods of box model training. Two authors independently identified trials and collected data. We analysed the data with both the fixed-effect and the random-effects models using Review Manager for analysis. For each outcome, we calculated the standardised mean difference (SMD) with 95% confidence intervals (CI) based on intention-to-treat analysis whenever possible. Twenty-five trials contributed data to the quantitative synthesis in this review. All but one trial were at high risk of bias. Overall, 16 trials (464 participants) provided data for meta-analysis of box training (248 participants) versus no supplementary training (216 participants). All the 16 trials in this comparison used video trainers. Overall, 14 trials (382 participants) provided data for quantitative comparison of different methods of box training. There were no trials comparing box model training versus animal model or cadaveric model training. Box model training versus no training: The meta-analysis showed that the time taken for task completion was significantly shorter in the box trainer group than the control group (8 trials; 249 participants; SMD -0.48 seconds; 95% CI -0.74 to -0.22). Compared with the control group, the box trainer group also had lower error score (3 trials; 69 participants; SMD -0.69; 95% CI -1.21 to -0.17), better accuracy score (3 trials; 73 participants; SMD 0.67; 95% CI 0.18 to 1.17), and better composite performance scores (SMD 0.65; 95% CI 0.42 to 0.88). Three trials reported movement distance but could not be meta-analysed as they were not in a format for meta-analysis. There was significantly lower movement distance in the box model training compared with no training in one trial, and there were no significant differences in the movement distance between the two groups in the other two trials. None of the remaining secondary outcomes such as mortality and morbidity were reported in the trials when animal models were used for assessment of training, error in movements, and trainee satisfaction. Different methods of box training: One trial (36 participants) found significantly shorter time taken to complete the task when box training was performed using a simple cardboard box trainer compared with the standard pelvic trainer (SMD -3.79 seconds; 95% CI -4.92 to -2.65). There was no significant difference in the time taken to complete the task in the remaining three comparisons (reverse alignment versus forward alignment box training; box trainer suturing versus box trainer drills; and single incision versus multiport box model training). There were no significant differences in the error score between the two groups in any of the comparisons (box trainer suturing versus box trainer drills; single incision versus multiport box model training; Z-maze box training versus U-maze box training). The only trial that reported accuracy score found significantly higher accuracy score with Z-maze box training than U-maze box training (1 trial; 16 participants; SMD 1.55; 95% CI 0.39 to 2.71). One trial (36 participants) found significantly higher composite score with simple cardboard box trainer compared with conventional pelvic trainer (SMD 0.87; 95% CI 0.19 to 1.56). Another trial (22 participants) found significantly higher composite score with reverse alignment compared with forward alignment box training (SMD 1.82; 95% CI 0.79 to 2.84). There were no significant differences in the composite score between the intervention and control groups in any of the remaining comparisons. None of the secondary outcomes were adequately reported in the trials. The results of this review are threatened by both risks of systematic errors (bias) and risks of random errors (play of chance). Laparoscopic box model training appears to improve technical skills compared with no training in trainees with no previous laparoscopic experience. The impacts of this decreased time on patients and healthcare funders in terms of improved outcomes or decreased costs are unknown. There appears to be no significant differences in the improvement of technical skills between different methods of box model training. Further well-designed trials of low risk of bias and random errors are necessary. Such trials should assess the impacts of box model training on surgical skills in both the short and long term, as well as clinical outcomes when the trainee becomes competent to operate on patients.

Evaluation of a training program of hypertension for accredited social health activists (ASHA) in rural India.

PubMed

Abdel-All, Marwa; Thrift, Amanda Gay; Riddell, Michaela; Thankappan, Kavumpurathu Raman Thankappan; Mini, Gomathyamma Krishnakurup; Chow, Clara K; Maulik, Pallab Kumar; Mahal, Ajay; Guggilla, Rama; Kalyanram, Kartik; Kartik, Kamakshi; Suresh, Oduru; Evans, Roger George; Oldenburg, Brian; Thomas, Nihal; Joshi, Rohina

2018-05-02

Hypertension is a major risk factor for cardiovascular disease, a leading cause of premature death and disability in India. Since access to health services is poor in rural India and Accredited Social Health Activists (ASHAs) are available throughout India for maternal and child health, a potential solution for improving hypertension control is by utilising this available workforce. We aimed to develop and implement a training package for ASHAs to identify and control hypertension in the community, and evaluate the effectiveness of the training program using the Kirkpatrick Evaluation Model. The training program was part of a cluster randomised feasibility trial of a 3-month intervention to improve hypertension outcomes in South India. Training materials incorporated details on managing hypertension, goal setting, facilitating group meetings, and how to measure blood pressure and weight. The 15 ASHAs attended a five-day training workshop that was delivered using interactive instructional strategies. ASHAs then led community-based education support groups for 3 months. Training was evaluated using Kirkpatrick's evaluation model for measuring reactions, learning, behaviour and results using tests on knowledge at baseline, post-training and post-intervention, observation of performance during meetings and post-intervention interviews. The ASHAs' knowledge of hypertension improved from a mean score of 64% at baseline to 76% post-training and 84% after the 3-month intervention. Research officers, who observed the community meetings, reported that ASHAs delivered the self-management content effectively without additional assistance. The ASHAs reported that the training materials were easy to understand and useful in educating community members. ASHAs can be trained to lead community-based group educational discussions and support individuals for the management of high blood pressure. The feasibility trial is registered with the Clinical Trials Registry - India (CTRI) CTRI/2016/02/006678 (25/02/2016).

An organizational process for promoting home fire safety in two community settings.

PubMed

Lehna, Carlee; Twyman, Stephanie; Fahey, Erin; Coty, Mary-Beth; Williams, Joe; Scrivener, Drane; Wishnia, Gracie; Myers, John

2017-02-01

The purpose of this study was to describe the home fire safety quality improvement model designed to aid organizations in achieving institutional program goals. The home fire safety model was developed from community-based participatory research (CBPR) applying training-the-trainer methods and is illustrated by an institutional case study. The model is applicable to other types of organizations to improve home fire safety in vulnerable populations. Utilizing the education model leaves trained employees with guided experience to build upon, adapt, and modify the home fire safety intervention to more effectively serve their clientele, promote safety, and meet organizational objectives. Copyright © 2016 Elsevier Ltd and ISBI. All rights reserved.

Modelling of optimal training load patterns during the 11 weeks preceding major competition in elite swimmers.

PubMed

Hellard, Philippe; Scordia, Charlotte; Avalos, Marta; Mujika, Inigo; Pyne, David B

2017-10-01

Periodization of swim training in the final training phases prior to competition and its effect on performance have been poorly described. We modeled the relationships between the final 11 weeks of training and competition performance in 138 elite sprint, middle-distance, and long-distance swimmers over 20 competitive seasons. Total training load (TTL), strength training (ST), and low- to medium-intensity and high-intensity training variables were monitored. Training loads were scaled as a percentage of the maximal volume measured at each intensity level. Four training periods (meso-cycles) were defined: the taper (weeks 1 to 2 before competition), short-term (weeks 3 to 5), medium-term (weeks 6 to 8), and long-term (weeks 9 to 11). Mixed-effects models were used to analyze the association between training loads in each training meso-cycle and end-of-season major competition performance. For sprinters, a 10% increase between ∼20% and 70% of the TTL in medium- and long-term meso-cycles was associated with 0.07 s and 0.20 s faster performance in the 50 m and 100 m events, respectively (p < 0.01). For middle-distance swimmers, a higher TTL in short-, medium-, and long-term training yielded faster competition performance (e.g., a 10% increase in TTL was associated with improvements of 0.1-1.0 s in 200 m events and 0.3-1.6 s in 400 m freestyle, p < 0.01). For sprinters, a 60%-70% maximal ST load 6-8 weeks before competition induced the largest positive effects on performance (p < 0.01). An increase in TTL during the medium- and long-term preparation (6-11 weeks to competition) was associated with improved performance. Periodization plans should be adapted to the specialty of swimmers.

456 Hours to Train the Reserve Component: Analysis of the Impact of Increased Annual Training Requirements on 4th Assault Amphibian Battalion

DTIC Science & Technology

2016-12-01

contends with to accomplish annual general military training requirements and mission essential tasks. Currently, there are 18 annual general military...training model that can be used to improve training effectiveness and efficiency. We believe that adjusting how reserve units conduct 11 of the 18 ...PRICE CODE 17. SECURITY CLASSIFICATION OF REPORT Unclassified 18 . SECURITY CLASSIFICATION OF THIS PAGE Unclassified 19. SECURITY

Transforming the Primary Care Training Clinic: New York State's Hospital Medical Home Demonstration Pilot.

PubMed

Angelotti, Marietta; Bliss, Kathryn; Schiffman, Dana; Weaver, Erin; Graham, Laura; Lemme, Thomas; Pryor, Veronica; Gesten, Foster C

2015-06-01

Training in patient-centered medical home (PCMH) settings may prepare new physicians to measure quality of care, manage the health of populations, work in teams, and include cost information in decision making. Transforming resident clinics to PCMHs requires funding for additional staff, electronic health records, training, and other resources not typically available to residency programs. Describe how a 1115 Medicaid waiver was used to transform the majority of primary care training sites in New York State to the PCMH model and improve the quality of care provided. The 2013-2014 Hospital Medical Home Program provided awards to 60 hospitals and 118 affiliated residency programs (training more than 5000 residents) to transform outpatient sites into PCMHs and provide high-quality, coordinated care. Site visits, coaching calls, resident surveys, data reporting, and feedback were used to promote and monitor change in resident continuity and quality of care. Descriptive analyses measured improvements in these areas. A total of 156 participating outpatient sites (100%) received PCMH recognition. All sites enhanced resident education using PCMH principles through patient empanelment, development of quality dashboards, and transforming resident scheduling and training. Clinical quality outcomes showed improvement across the demonstration, including better performance on colorectal and breast cancer screening rates (rate increases of 13%, P≤.001, and 11%, P=.011, respectively). A 1115 Medicaid waiver is a viable mechanism for states to transform residency clinics to reflect new primary care models. The PCMH transformation of 156 sites led to improvements in resident continuity and clinical outcomes.

Lack of quantitative training among early-career ecologists: a survey of the problem and potential solutions

PubMed Central

Ezard, Thomas H.G.; Jørgensen, Peter S.; Zimmerman, Naupaka; Chamberlain, Scott; Salguero-Gómez, Roberto; Curran, Timothy J.; Poisot, Timothée

2014-01-01

Proficiency in mathematics and statistics is essential to modern ecological science, yet few studies have assessed the level of quantitative training received by ecologists. To do so, we conducted an online survey. The 937 respondents were mostly early-career scientists who studied biology as undergraduates. We found a clear self-perceived lack of quantitative training: 75% were not satisfied with their understanding of mathematical models; 75% felt that the level of mathematics was “too low” in their ecology classes; 90% wanted more mathematics classes for ecologists; and 95% more statistics classes. Respondents thought that 30% of classes in ecology-related degrees should be focused on quantitative disciplines, which is likely higher than for most existing programs. The main suggestion to improve quantitative training was to relate theoretical and statistical modeling to applied ecological problems. Improving quantitative training will require dedicated, quantitative classes for ecology-related degrees that contain good mathematical and statistical practice. PMID:24688862

Learning to Identify Near-Threshold Luminance-Defined and Contrast-Defined Letters in Observers with Amblyopia

PubMed Central

Chung, Susana T.L.; Li, Roger W.; Levi, Dennis M.

2008-01-01

We assessed whether or not the sensitivity for identifying luminance-defined and contrast-defined letters improved with training in a group of amblyopic observers who have passed the critical period of development. In Experiment 1, we tracked the contrast threshold for identifying luminance-defined letters with training in a group of 11 amblyopic observers. Following training, six observers showed a reduction in thresholds, averaging 20%, for identifying luminance-defined letters. This improvement transferred extremely well to the untrained task of identifying contrast-defined letters (average improvement = 38%) but did not transfer to an acuity measurement. Seven of the 11 observers were subsequently trained on identifying contrast-defined letters in Experiment 2. Following training, five of these seven observers demonstrated a further improvement, averaging 17%, for identifying contrast-defined letters. This improvement did not transfer to the untrained task of identifying luminance-defined letters. Our findings are consistent with predictions based on the locus of learning for first- and second-order stimuli according to the filter-rectifier-filter model for second-order visual processing. PMID:18824189

Real-time fMRI training-induced changes in regional connectivity mediating verbal working memory behavioral performance.

PubMed

Shen, J; Zhang, G; Yao, L; Zhao, X

2015-03-19

Working memory refers to the ability to temporarily store and manipulate information that is necessary for complex cognition activities. Previous studies have demonstrated that working memory capacity can be improved by behavioral training, and brain activities in the frontal and parietal cortices and the connections between these regions are also altered by training. Our recent neurofeedback training has proven that the regulation of the left dorsal lateral prefrontal cortex (DLPFC) activity using real-time functional magnetic resonance imaging (rtfMRI) can improve working memory performance. However, how working memory training promotes interaction between brain regions and whether this promotion correlates with performance improvement remain unclear. In this study, we employed structural equation modeling (SEM) to calculate the interactions between the regions within the working memory network during neurofeedback training. The results revealed that the direct effect of the frontoparietal connection in the left hemisphere was enhanced by the rtfMRI training. Specifically, the increase in the path from the left DLPFC to the left inferior parietal lobule (IPL) was positively correlated with improved performance in verbal working memory. These findings demonstrate the important role of the frontoparietal connection in working memory training and suggest that increases in frontoparietal connectivity might be a key factor associated with behavioral improvement. Copyright © 2015 IBRO. Published by Elsevier Ltd. All rights reserved.

The Strategic Impact Model: An Integrative Approach to Performance Improvement and Instructional Systems Design

ERIC Educational Resources Information Center

Molenda, Michael; Pershing, James A.

2004-01-01

Training in business settings and instruction in academic settings have never taken place in a vacuum, but in earlier times many instructional technology professionals behaved as though they did. Models of instructional systems design (ISD) placed training and instruction at the center of the universe ignoring the impact of the external…

External locus of control contributes to racial disparities in memory and reasoning training gains in ACTIVE

PubMed Central

Zahodne, Laura B.; Meyer, Oanh L.; Choi, Eunhee; Thomas, Michael L.; Willis, Sherry L.; Marsiske, Michael; Gross, Alden L.; Rebok, George W.; Parisi, Jeanine M.

2015-01-01

Racial disparities in cognitive outcomes may be partly explained by differences in locus of control. African Americans report more external locus of control than non-Hispanic Whites, and external locus of control is associated with poorer health and cognition. The aims of this study were to compare cognitive training gains between African American and non-Hispanic White participants in the Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE) study and determine whether racial differences in training gains are mediated by locus of control. The sample comprised 2,062 (26% African American) adults aged 65 and older who participated in memory, reasoning, or speed training. Latent growth curve models evaluated predictors of 10-year cognitive trajectories separately by training group. Multiple group modeling examined associations between training gains and locus of control across racial groups. Compared to non-Hispanic Whites, African Americans evidenced less improvement in memory and reasoning performance after training. These effects were partially mediated by locus of control, controlling for age, sex, education, health, depression, testing site, and initial cognitive ability. African Americans reported more external locus of control, which was associated with smaller training gains. External locus of control also had a stronger negative association with reasoning training gain for African Americans than for Whites. No racial difference in training gain was identified for speed training. Future intervention research with African Americans should test whether explicitly targeting external locus of control leads to greater cognitive improvement following cognitive training. PMID:26237116

Review of Modelling Techniques for In Vivo Muscle Force Estimation in the Lower Extremities during Strength Training

PubMed Central

Schellenberg, Florian; Oberhofer, Katja; Taylor, William R.

2015-01-01

Background. Knowledge of the musculoskeletal loading conditions during strength training is essential for performance monitoring, injury prevention, rehabilitation, and training design. However, measuring muscle forces during exercise performance as a primary determinant of training efficacy and safety has remained challenging. Methods. In this paper we review existing computational techniques to determine muscle forces in the lower limbs during strength exercises in vivo and discuss their potential for uptake into sports training and rehabilitation. Results. Muscle forces during exercise performance have almost exclusively been analysed using so-called forward dynamics simulations, inverse dynamics techniques, or alternative methods. Musculoskeletal models based on forward dynamics analyses have led to considerable new insights into muscular coordination, strength, and power during dynamic ballistic movement activities, resulting in, for example, improved techniques for optimal performance of the squat jump, while quasi-static inverse dynamics optimisation and EMG-driven modelling have helped to provide an understanding of low-speed exercises. Conclusion. The present review introduces the different computational techniques and outlines their advantages and disadvantages for the informed usage by nonexperts. With sufficient validation and widespread application, muscle force calculations during strength exercises in vivo are expected to provide biomechanically based evidence for clinicians and therapists to evaluate and improve training guidelines. PMID:26417378

Review of Modelling Techniques for In Vivo Muscle Force Estimation in the Lower Extremities during Strength Training.

PubMed

Schellenberg, Florian; Oberhofer, Katja; Taylor, William R; Lorenzetti, Silvio

2015-01-01

Knowledge of the musculoskeletal loading conditions during strength training is essential for performance monitoring, injury prevention, rehabilitation, and training design. However, measuring muscle forces during exercise performance as a primary determinant of training efficacy and safety has remained challenging. In this paper we review existing computational techniques to determine muscle forces in the lower limbs during strength exercises in vivo and discuss their potential for uptake into sports training and rehabilitation. Muscle forces during exercise performance have almost exclusively been analysed using so-called forward dynamics simulations, inverse dynamics techniques, or alternative methods. Musculoskeletal models based on forward dynamics analyses have led to considerable new insights into muscular coordination, strength, and power during dynamic ballistic movement activities, resulting in, for example, improved techniques for optimal performance of the squat jump, while quasi-static inverse dynamics optimisation and EMG-driven modelling have helped to provide an understanding of low-speed exercises. The present review introduces the different computational techniques and outlines their advantages and disadvantages for the informed usage by nonexperts. With sufficient validation and widespread application, muscle force calculations during strength exercises in vivo are expected to provide biomechanically based evidence for clinicians and therapists to evaluate and improve training guidelines.

Fuel for the Work Required: A Theoretical Framework for Carbohydrate Periodization and the Glycogen Threshold Hypothesis.

PubMed

Impey, Samuel G; Hearris, Mark A; Hammond, Kelly M; Bartlett, Jonathan D; Louis, Julien; Close, Graeme L; Morton, James P

2018-05-01

Deliberately training with reduced carbohydrate (CHO) availability to enhance endurance-training-induced metabolic adaptations of skeletal muscle (i.e. the 'train low, compete high' paradigm) is a hot topic within sport nutrition. Train-low studies involve periodically training (e.g., 30-50% of training sessions) with reduced CHO availability, where train-low models include twice per day training, fasted training, post-exercise CHO restriction and 'sleep low, train low'. When compared with high CHO availability, data suggest that augmented cell signalling (73% of 11 studies), gene expression (75% of 12 studies) and training-induced increases in oxidative enzyme activity/protein content (78% of 9 studies) associated with 'train low' are especially apparent when training sessions are commenced within a specific range of muscle glycogen concentrations. Nonetheless, such muscle adaptations do not always translate to improved exercise performance (e.g. 37 and 63% of 11 studies show improvements or no change, respectively). Herein, we present our rationale for the glycogen threshold hypothesis, a window of muscle glycogen concentrations that simultaneously permits completion of required training workloads and activation of the molecular machinery regulating training adaptations. We also present the 'fuel for the work required' paradigm (representative of an amalgamation of train-low models) whereby CHO availability is adjusted in accordance with the demands of the upcoming training session(s). In order to strategically implement train-low sessions, our challenge now is to quantify the glycogen cost of habitual training sessions (so as to inform the attainment of any potential threshold) and ensure absolute training intensity is not compromised, while also creating a metabolic milieu conducive to facilitating the endurance phenotype.

Improving Acoustic Models by Watching Television

NASA Technical Reports Server (NTRS)

Witbrock, Michael J.; Hauptmann, Alexander G.

1998-01-01

Obtaining sufficient labelled training data is a persistent difficulty for speech recognition research. Although well transcribed data is expensive to produce, there is a constant stream of challenging speech data and poor transcription broadcast as closed-captioned television. We describe a reliable unsupervised method for identifying accurately transcribed sections of these broadcasts, and show how these segments can be used to train a recognition system. Starting from acoustic models trained on the Wall Street Journal database, a single iteration of our training method reduced the word error rate on an independent broadcast television news test set from 62.2% to 59.5%.

Improving Safe Sleep Modeling in the Hospital through Policy Implementation.

PubMed

Heitmann, Rachel; Nilles, Ester K; Jeans, Ashley; Moreland, Jackie; Clarke, Chris; McDonald, Morgan F; Warren, Michael D

2017-11-01

Introduction Sleep-related infant deaths are major contributors to Tennessee's high infant mortality rate. The purpose of this initiative was to evaluate the impact of policy-based efforts to improve modeling of safe sleep practices by health care providers in hospital settings across Tennessee. Methods Safe sleep policies were developed and implemented at 71 hospitals in Tennessee. Policies, at minimum, were required to address staff training on the American Academy of Pediatrics' safe sleep recommendations, correct modeling of infant safe sleep practices, and parent education. Hospital data on process measures related to training and results of crib audits were compiled for analysis. Results The overall observance of infants who were found with any risk factors for unsafe sleep decreased 45.6% (p ≤ 0.001) from the first crib audit to the last crib audit. Significant decreases were noted for specific risk factors, including infants found asleep not on their back, with a toy or object in the crib, and not sleeping in a crib. Significant improvements were observed at hospitals where printed materials or video were utilized for training staff compared to face-to-face training. Discussion Statewide implementation of the hospital policy intervention resulted in significant reductions in infants found in unsafe sleep situations. The most common risk factors for sleep-related infant deaths can be modeled in hospitals. This effort has the potential to reduce sleep-related infant deaths and ultimately infant mortality.

Validation and Use of a Predictive Modeling Tool: Employing Scientific Findings to Improve Responsible Conduct of Research Education.

PubMed

Mulhearn, Tyler J; Watts, Logan L; Todd, E Michelle; Medeiros, Kelsey E; Connelly, Shane; Mumford, Michael D

2017-01-01

Although recent evidence suggests ethics education can be effective, the nature of specific training programs, and their effectiveness, varies considerably. Building on a recent path modeling effort, the present study developed and validated a predictive modeling tool for responsible conduct of research education. The predictive modeling tool allows users to enter ratings in relation to a given ethics training program and receive instantaneous evaluative information for course refinement. Validation work suggests the tool's predicted outcomes correlate strongly (r = 0.46) with objective course outcomes. Implications for training program development and refinement are discussed.

Two Validated Ways of Improving the Ability of Decision-Making in Emergencies; Results from a Literature Review

PubMed Central

Khorram-Manesh, Amir; Berlin, Johan; Carlström, Eric

2016-01-01

The aim of the current review wasto study the existing knowledge about decision-making and to identify and describe validated training tools.A comprehensive literature review was conducted by using the following keywords: decision-making, emergencies, disasters, crisis management, training, exercises, simulation, validated, real-time, command and control, communication, collaboration, and multi-disciplinary in combination or as an isolated word. Two validated training systems developed in Sweden, 3 level collaboration (3LC) and MacSim, were identified and studied in light of the literature review in order to identify how decision-making can be trained. The training models fulfilled six of the eight identified characteristics of training for decision-making.Based on the results, these training models contained methods suitable to train for decision-making. PMID:27878123

The relationship between quality management practices and organisational performance: A structural equation modelling approach

NASA Astrophysics Data System (ADS)

Jamaluddin, Z.; Razali, A. M.; Mustafa, Z.

2015-02-01

The purpose of this paper is to examine the relationship between the quality management practices (QMPs) and organisational performance for the manufacturing industry in Malaysia. In this study, a QMPs and organisational performance framework is developed according to a comprehensive literature review which cover aspects of hard and soft quality factors in manufacturing process environment. A total of 11 hypotheses have been put forward to test the relationship amongst the six constructs, which are management commitment, training, process management, quality tools, continuous improvement and organisational performance. The model is analysed using Structural Equation Modeling (SEM) with AMOS software version 18.0 using Maximum Likelihood (ML) estimation. A total of 480 questionnaires were distributed, and 210 questionnaires were valid for analysis. The results of the modeling analysis using ML estimation indicate that the fits statistics of QMPs and organisational performance model for manufacturing industry is admissible. From the results, it found that the management commitment have significant impact on the training and process management. Similarly, the training had significant effect to the quality tools, process management and continuous improvement. Furthermore, the quality tools have significant influence on the process management and continuous improvement. Likewise, the process management also has a significant impact to the continuous improvement. In addition the continuous improvement has significant influence the organisational performance. However, the results of the study also found that there is no significant relationship between management commitment and quality tools, and between the management commitment and continuous improvement. The results of the study can be used by managers to prioritize the implementation of QMPs. For instances, those practices that are found to have positive impact on organisational performance can be recommended to managers so that they can allocate resources to improve these practices to get better performance.

Modelling the isometric force response to multiple pulse stimuli in locust skeletal muscle.

PubMed

Wilson, Emma; Rustighi, Emiliano; Mace, Brian R; Newland, Philip L

2011-02-01

An improved model of locust skeletal muscle will inform on the general behaviour of invertebrate and mammalian muscle with the eventual aim of improving biomedical models of human muscles, embracing prosthetic construction and muscle therapy. In this article, the isometric response of the locust hind leg extensor muscle to input pulse trains is investigated. Experimental data was collected by stimulating the muscle directly and measuring the force at the tibia. The responses to constant frequency stimulus trains of various frequencies and number of pulses were decomposed into the response to each individual stimulus. Each individual pulse response was then fitted to a model, it being assumed that the response to each pulse could be approximated as an impulse response and was linear, no assumption were made about the model order. When the interpulse frequency (IPF) was low and the number of pulses in the train small, a second-order model provided a good fit to each pulse. For moderate IPF or for long pulse trains a linear third-order model provided a better fit to the response to each pulse. The fit using a second-order model deteriorated with increasing IPF. When the input comprised higher IPFs with a large number of pulses the assumptions that the response was linear could not be confirmed. A generalised model is also presented. This model is second-order, and contains two nonlinear terms. The model is able to capture the force response to a range of inputs. This includes cases where the input comprised of higher frequency pulse trains and the assumption of quasi-linear behaviour could not be confirmed.

Modelling, simulation and applications of longitudinal train dynamics

NASA Astrophysics Data System (ADS)

Cole, Colin; Spiryagin, Maksym; Wu, Qing; Sun, Yan Quan

2017-10-01

Significant developments in longitudinal train simulation and an overview of the approaches to train models and modelling vehicle force inputs are firstly presented. The most important modelling task, that of the wagon connection, consisting of energy absorption devices such as draft gears and buffers, draw gear stiffness, coupler slack and structural stiffness is then presented. Detailed attention is given to the modelling approaches for friction wedge damped and polymer draft gears. A significant issue in longitudinal train dynamics is the modelling and calculation of the input forces - the co-dimensional problem. The need to push traction performances higher has led to research and improvement in the accuracy of traction modelling which is discussed. A co-simulation method that combines longitudinal train simulation, locomotive traction control and locomotive vehicle dynamics is presented. The modelling of other forces, braking propulsion resistance, curve drag and grade forces are also discussed. As extensions to conventional longitudinal train dynamics, lateral forces and coupler impacts are examined in regards to interaction with wagon lateral and vertical dynamics. Various applications of longitudinal train dynamics are then presented. As an alternative to the tradition single wagon mass approach to longitudinal train dynamics, an example incorporating fully detailed wagon dynamics is presented for a crash analysis problem. Further applications of starting traction, air braking, distributed power, energy analysis and tippler operation are also presented.

Delivering a sustainable trauma management training programme tailored for low-resource settings in East, Central and Southern African countries using a cascading course model.

PubMed

Peter, N A; Pandit, H; Le, G; Nduhiu, M; Moro, E; Lavy, C

2016-05-01

Injuries cause five million deaths and 279 Disability Adjusted Life Years (DALYS) each year worldwide. The COSECSA Oxford Orthopaedic Link (COOL) is a multi-country partnership programme that has delivered training in trauma management to nine sub-Saharan countries across a wide-cadre of health-workers using a model of "primary" courses delivered by UK instructors, followed by "cascading" courses led by local faculty. This study examines the impact on knowledge and clinical confidence among health-workers, and compares the performance of "cascading" and "primary" courses delivered in low-resource settings. Data was collated from 1030 candidates (119 Clinical Officers, 540 Doctors, 260 Nurses and 111 Medical Students) trained over 28 courses (9 "primary" and 19 "cascading" courses) in nine sub-Saharan countries between 2012 and 2013. Knowledge and clinical confidence of candidates were assessed using pre- and post-course MCQs and confidence matrix rating of clinical scenarios. Changes were measured in relation to co-variants of gender, job roles and primary versus cascading courses. Multivariate regression modelling and cost analysis was performed to examine the impact of primary versus cascading courses on candidates' performance. There was a significant improvement in knowledge (58% to 77%, p<0.05) and clinical confidence (68% to 90%, p<0.05) post-course. "Non-doctors" demonstrated a greater improvement in knowledge (22%) and confidence (24%) following the course (p<0.05). The degree of improvement of MCQ scores differed significantly, with the cascading courses (21%) outperforming primary courses (15%) (p<0.002). This is further supported by multivariate regression modelling where cascading courses are a strong predictor for improvement in MCQ scores (Coef=4.83, p<0.05). Trauma management training of health-workers plays a pivotal role in tackling the ever-growing trauma burden in Africa. Our study suggests cascading PTC courses may be an effective model in delivering trauma training in low-resource settings, however further studies are required to determine its efficacy in improving clinical competence and retention of knowledge and skills in the long term. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

An implementation of cellular automaton model for single-line train working diagram

NASA Astrophysics Data System (ADS)

Hua, Wei; Liu, Jun

2006-04-01

According to the railway transportation system's characteristics, a new cellular automaton model for the single-line railway system is presented in this paper. Based on this model, several simulations were done to imitate the train operation under three working diagrams. From a different angle the results show how the organization of train operation impacts on the railway carrying capacity. By using the non-parallel train working diagram the influence of fast-train on slow-train is found to be the strongest. Many slow-trains have to wait in-between neighbouring stations to let the fast-train(s) pass through first. So the slow-train will advance like a wave propagating from the departure station to the arrival station. This also resembles the situation of a highway jammed traffic flow. Furthermore, the nonuniformity of travel times between the sections also greatly limits the railway carrying capacity. After converting the nonuniform sections into the sections with uniform travel times while the total travel time is kept unchanged, all three carrying capacities are improved greatly as shown by simulation. It also shows that the cellular automaton model is an effective and feasible way to investigate the railway transportation system.

A Systemwide Approach to Improving Early Childhood Program Quality in the Detroit Metropolitan Area. Final Report.

ERIC Educational Resources Information Center

Shouse, A. Clay; Epstein, Ann S.

This document is the final report of the McGregor-funded High/Scope training initiative, a system-wide approach to improving the quality of early childhood programs in the Detroit metropolitan area. The 3-year project was based on the validated High/Scope educational approach and training model, which advocates hands-on active learning for both…

Establishment and verification of three-dimensional dynamic model for heavy-haul train-track coupled system

NASA Astrophysics Data System (ADS)

Liu, Pengfei; Zhai, Wanming; Wang, Kaiyun

2016-11-01

For the long heavy-haul train, the basic principles of the inter-vehicle interaction and train-track dynamic interaction are analysed firstly. Based on the theories of train longitudinal dynamics and vehicle-track coupled dynamics, a three-dimensional (3-D) dynamic model of the heavy-haul train-track coupled system is established through a modularised method. Specifically, this model includes the subsystems such as the train control, the vehicle, the wheel-rail relation and the line geometries. And for the calculation of the wheel-rail interaction force under the driving or braking conditions, the large creep phenomenon that may occur within the wheel-rail contact patch is considered. For the coupler and draft gear system, the coupler forces in three directions and the coupler lateral tilt angles in curves are calculated. Then, according to the characteristics of the long heavy-haul train, an efficient solving method is developed to improve the computational efficiency for such a large system. Some basic principles which should be followed in order to meet the requirement of calculation accuracy are determined. Finally, the 3-D train-track coupled model is verified by comparing the calculated results with the running test results. It is indicated that the proposed dynamic model could simulate the dynamic performance of the heavy-haul train well.

Is high-intensity interval training a time-efficient exercise strategy to improve health and fitness?

PubMed

Gillen, Jenna B; Gibala, Martin J

2014-03-01

Growing research suggests that high-intensity interval training (HIIT) is a time-efficient exercise strategy to improve cardiorespiratory and metabolic health. "All out" HIIT models such as Wingate-type exercise are particularly effective, but this type of training may not be safe, tolerable or practical for many individuals. Recent studies, however, have revealed the potential for other models of HIIT, which may be more feasible but are still time-efficient, to stimulate adaptations similar to more demanding low-volume HIIT models and high-volume endurance-type training. As little as 3 HIIT sessions per week, involving ≤10 min of intense exercise within a time commitment of ≤30 min per session, including warm-up, recovery between intervals and cool down, has been shown to improve aerobic capacity, skeletal muscle oxidative capacity, exercise tolerance and markers of disease risk after only a few weeks in both healthy individuals and people with cardiometabolic disorders. Additional research is warranted, as studies conducted have been relatively short-term, with a limited number of measurements performed on small groups of subjects. However, given that "lack of time" remains one of the most commonly cited barriers to regular exercise participation, low-volume HIIT is a time-efficient exercise strategy that warrants consideration by health practitioners and fitness professionals.

Quiet eye training improves surgical knot tying more than traditional technical training: a randomized controlled study.

PubMed

Causer, Joe; Harvey, Adrian; Snelgrove, Ryan; Arsenault, Gina; Vickers, Joan N

2014-08-01

We examined the effectiveness of technical training (TT) and quiet eye training (QE) on the performance of one-handed square knot tying in surgical residents. Twenty surgical residents were randomly assigned to the 2 groups and completed pretest, training, retention, and transfer tests. Participants wore a mobile eye tracker that simultaneously recorded their gaze and hand movements. Dependent variables were knot tying performance (%), QE duration (%), number of fixations, total movement time (s), and hand movement phase time (s). The QE training group had significantly higher performance scores, a longer QE duration, fewer fixations, faster total knot tying times, and faster movement phase times compared with the TT group. The QE group maintained performance in the transfer test, whereas the TT group significantly decreased performance from retention to transfer. QE training significantly improved learning, retention, and transfer of surgical knot tying compared with a traditional technical approach. Both performance effectiveness (performance outcome) and movement efficiency (hand movement times) were improved using QE modeling, instruction, and feedback. Copyright © 2014 Elsevier Inc. All rights reserved.

Comparative study of surrogate models for groundwater contamination source identification at DNAPL-contaminated sites

NASA Astrophysics Data System (ADS)

Hou, Zeyu; Lu, Wenxi

2018-05-01

Knowledge of groundwater contamination sources is critical for effectively protecting groundwater resources, estimating risks, mitigating disaster, and designing remediation strategies. Many methods for groundwater contamination source identification (GCSI) have been developed in recent years, including the simulation-optimization technique. This study proposes utilizing a support vector regression (SVR) model and a kernel extreme learning machine (KELM) model to enrich the content of the surrogate model. The surrogate model was itself key in replacing the simulation model, reducing the huge computational burden of iterations in the simulation-optimization technique to solve GCSI problems, especially in GCSI problems of aquifers contaminated by dense nonaqueous phase liquids (DNAPLs). A comparative study between the Kriging, SVR, and KELM models is reported. Additionally, there is analysis of the influence of parameter optimization and the structure of the training sample dataset on the approximation accuracy of the surrogate model. It was found that the KELM model was the most accurate surrogate model, and its performance was significantly improved after parameter optimization. The approximation accuracy of the surrogate model to the simulation model did not always improve with increasing numbers of training samples. Using the appropriate number of training samples was critical for improving the performance of the surrogate model and avoiding unnecessary computational workload. It was concluded that the KELM model developed in this work could reasonably predict system responses in given operation conditions. Replacing the simulation model with a KELM model considerably reduced the computational burden of the simulation-optimization process and also maintained high computation accuracy.

[Virtual reality simulation training in gynecology: review and perspectives].

PubMed

Ricard-Gauthier, Dominique; Popescu, Silvia; Benmohamed, Naida; Petignat, Patrick; Dubuisson, Jean

2016-10-26

Laparoscopic simulation has rapidly become an important tool for learning and acquiring technical skills in surgery. It is based on two different complementary pedagogic tools : the box model trainer and the virtual reality simulator. The virtual reality simulator has shown its efficiency by improving surgical skills, decreasing operating time, improving economy of movements and improving self-confidence. The main objective of this tool is the opportunity to easily organize a regular, structured and uniformed training program enabling an automated individualized feedback.

Understanding Teaching Assistant Self-Efficacy in Role and in Training: Its Susceptibility to Influence

ERIC Educational Resources Information Center

Higgins, Helen; Gulliford, Anthea

2014-01-01

There has been a noted growth in the number of teaching assistants (TAs) in mainstream schools. Research is inconclusive about their efficacy at changing outcomes for children and has proposed more training for TAs. Generic training models have suggested that enhancing self-efficacy in turn improves performance. This exploratory study investigated…

Didactic Conditions of Improvement of Pedagogical Personnel Training at Higher Education Institutions to Dual Education in the System of VET

ERIC Educational Resources Information Center

Zholdasbekova, Saule; Nurzhanbayeva, Zhanet; Mavedov, Rixsibai; Saipov, Amangeldi; Zhiyentayeva, Begaim; Tlemissova, Alja

2016-01-01

The purpose of the article consists in representation to discussion by specialists of the revealed didactic conditions of enhancement of preparation of the pedagogical personnel in higher education institution to dual training in the system of vocational and educational training. Modeling, aspect system, comparative and structural analyses…

Improving Student Employee Training: A Study of Web 2.0 Social Media Tools as a Delivery Model

ERIC Educational Resources Information Center

Smith, Sharon D.

2012-01-01

Training student employees in Educational Outreach and Student Services (EOSS) at Arizona State University's West campus is important to maintaining a knowledgeable and productive workforce. This dissertation describes the results of an action research study in which social media tools were utilized as a delivery mechanism for training student…

Impact of a Teacher-as-Coach Model: Improving Paraprofessionals Fidelity of Implementation of Discrete Trial Training for Students with Moderate-to-Severe Developmental Disabilities

ERIC Educational Resources Information Center

Mason, Rose A.; Schnitz, Alana G.; Wills, Howard P.; Rosenbloom, Raia; Kamps, Debra M.; Bast, Darcey

2017-01-01

Ensuring educational progress for students with moderate-to-severe developmental disabilities requires exposure to well executed evidence-based practices. This necessitates that the special education workforce, including paraprofessionals, be well-trained. Yet evidence regarding effective training mechanisms for paraprofessionals is limited. A…

Can Video Self-Modeling Improve Affected Limb Reach and Grasp Ability in Stroke Patients?

PubMed

Steel, Kylie Ann; Mudie, Kurt; Sandoval, Remi; Anderson, David; Dogramaci, Sera; Rehmanjan, Mohammad; Birznieks, Ingvars

2018-01-01

The authors examined whether feedforward video self-modeling (FF VSM) would improve control over the affected limb, movement self-confidence, movement self-consciousness, and well-being in 18 stroke survivors. Participants completed a cup transport task and 2 questionnaires related to psychological processes pre- and postintervention. Pretest video footage of the unaffected limb performing the task was edited to create a best-of or mirror-reversed training DVD, creating the illusion that patients were performing proficiently with the affected limb. The training yielded significant improvements for the forward movement of the affected limb compared to the unaffected limb. Significant improvements were also seen in movement self-confidence, movement self-consciousness, and well-being. FF VSM appears to be a viable way to improve motor ability in populations with movement disorders.

The Boston Safe Shops Project--preliminary findings of a case study in applying the 10 essential services of public health to building environmental health capacity.

PubMed

Shoemaker, Paul A; Skogstrom, Tiffany; Shea, John; Bethune, Leon

2007-01-01

Boston's more than 500 automotive shops, located primarily in low-income communities of color, are a source both of well-paying jobs and of potential hazardous exposures to employees and residents. The Safe Shops Project works to reduce occupational and environmental health hazards without having to close these businesses. Combining inspections, in-shop trainings, outreach, and technical/financial assistance, it brings shops into compliance with laws and promotes use of safer practices and alternative products. After 18 months, 254 workers at 61 of 124 participating shops had received training. Surveys showed improved worker knowledge: Pre-training, 24.2 percent of the worker survey respondents stated that they knew what an MSDS was, and post-training, 75 percent stated that they knew. The surveys also found improvement in work practices: Pre-training, 48 percent of workers indicated that they used safety goggles in their work, while post-training, 70 percent indicated proper use of safety goggles. The results also showed shops investing in capital improvements such as replacement of PCE-based brake cleaners with aqueous cleaners. The Safe Shops Project has a successfully modeled application of the 10-essential-services framework to the building of public health capacity and community collaboration, and this model can be adapted to other locations and industries.

Mental models: an alternative evaluation of a sensemaking approach to ethics instruction.

PubMed

Brock, Meagan E; Vert, Andrew; Kligyte, Vykinta; Waples, Ethan P; Sevier, Sydney T; Mumford, Michael D

2008-09-01

In spite of the wide variety of approaches to ethics training it is still debatable which approach has the highest potential to enhance professionals' integrity. The current effort assesses a novel curriculum that focuses on metacognitive reasoning strategies researchers use when making sense of day-to-day professional practices that have ethical implications. The evaluated trainings effectiveness was assessed by examining five key sensemaking processes, such as framing, emotion regulation, forecasting, self-reflection, and information integration that experts and novices apply in ethical decision-making. Mental models of trained and untrained graduate students, as well as faculty, working in the field of physical sciences were compared using a think-aloud protocol 6 months following the ethics training. Evaluation and comparison of the mental models of participants provided further validation evidence for sensemaking training. Specifically, it was found that trained students applied metacognitive reasoning strategies learned during training in their ethical decision-making that resulted in complex mental models focused on the objective assessment of the situation. Mental models of faculty and untrained students were externally-driven with a heavy focus on autobiographical processes. The study shows that sensemaking training has a potential to induce shifts in researchers' mental models by making them more cognitively complex via the use of metacognitive reasoning strategies. Furthermore, field experts may benefit from sensemaking training to improve their ethical decision-making framework in highly complex, novel, and ambiguous situations.

Enhancing the competitiveness of skilled construction workers through collaborative education and training

NASA Astrophysics Data System (ADS)

Dardiri, Ahmad; Sutrisno, Kuncoro, Tri; Ichwanto, Muhamad Aris; Suparji

2017-09-01

Professionalism of construction workers is one of the keys to the success of infrastructure development projects. The professionalism of the workforce is demonstrated through the possession of expertise competence certificate (SKA) and/or certificates of skills (SKT) issued formally through competency tests by the National Construction Cervices Development Agency (LPJKN). The magnitude of the national skilled manpower needs has not been able to meet the availability of professional workforce. Strategies to develop the quality of resources require sufficient information on the characteristics of the resources themselves, facilities, constraints, stakeholder support, regulations, and socioeconomic as well as cultural conditions. The problems faced by Indonesia in improving the competitiveness of skilled construction workers are (1) how the level of professionalism of skill workers in construction field, (2) what the constrains on improving the quality of skilled construction workers,and(3) how the appropriate model of education and training skillfull construction work. The study was designed with quantitative and qualitative approaches. Quantitative methods were used to describe the profile of sklill constructions worker. Qualitative methods were used toidentify constraintsin improving the qualityof skilled labor, as well as formulate a viable collaborative education and training model for improving the quality of skill labor. Data were collected by documentation, observation, and interview. The result of the study indicate theat (1) the professionalism knowledge of skilled constructions worker are in still low condition, (2) the constrain faced in developing the quality of skilled construction labor cover economic and structural constrains, and (3) collaborative eduction and training model can improve the quality ods skilld labor contructions.

Training health and safety committees to use control banding: lessons learned and opportunities for the United States.

PubMed

Bracker, Anne L; Morse, Timothy F; Simcox, Nancy J

2009-05-01

Control banding (CB) is a control-focused risk management model that has received international attention. CB strategies are designed to control workplace chemical exposures after the completion of a qualitative risk assessment. Connecticut was one of the first states to provide training on how to use this control-focused tool. Joint labor/management teams and individuals from 34 workplaces attended a control banding workshop and learned how to use one CB model, the United Kingdom (UK) Health and Safety Executive's Control of Substances Hazardous to Health (COSHH) Essentials Toolkit. After the initial training program the investigators used follow-up workshops, questionnaires, site visit data, and case studies to evaluate the training curriculum and assess the utility and effectiveness of this CB strategy. We found that the model is easily learned, although several areas for improvement were identified. Participants from 10 workplaces used COSHH Essentials to evaluate at least one task. The training curriculum was effective in that the agreement between the exposure variables coded by these workplaces and one of the workshop instructors, a certified industrial hygienist (CIH), were highly concordant. The training curriculum and the model promoted a discussion of risk between workers and managers and resulted in the implementation of improvements in the work environment. The model agreed with both the CIH's and the worksites' qualitative risk assessments 65% of the time, and likely over-controlled for 71% (5/7) of the cases of nonagreement. Feedback from workshop participants benefits the current dialogue on the implications of implementing CB in the United States.

An Emotional ANN (EANN) approach to modeling rainfall-runoff process

NASA Astrophysics Data System (ADS)

Nourani, Vahid

2017-01-01

This paper presents the first hydrological implementation of Emotional Artificial Neural Network (EANN), as a new generation of Artificial Intelligence-based models for daily rainfall-runoff (r-r) modeling of the watersheds. Inspired by neurophysiological form of brain, in addition to conventional weights and bias, an EANN includes simulated emotional parameters aimed at improving the network learning process. EANN trained by a modified version of back-propagation (BP) algorithm was applied to single and multi-step-ahead runoff forecasting of two watersheds with two distinct climatic conditions. Also to evaluate the ability of EANN trained by smaller training data set, three data division strategies with different number of training samples were considered for the training purpose. The overall comparison of the obtained results of the r-r modeling indicates that the EANN could outperform the conventional feed forward neural network (FFNN) model up to 13% and 34% in terms of training and verification efficiency criteria, respectively. The superiority of EANN over classic ANN is due to its ability to recognize and distinguish dry (rainless days) and wet (rainy days) situations using hormonal parameters of the artificial emotional system.

Comparison of Periodized and Non-Periodized Resistance Training on Maximal Strength: A Meta-Analysis.

PubMed

Williams, Tyler D; Tolusso, Danilo V; Fedewa, Michael V; Esco, Michael R

2017-10-01

Periodization is a logical method of organizing training into sequential phases and cyclical time periods in order to increase the potential for achieving specific performance goals while minimizing the potential for overtraining. Periodized resistance training plans are proposed to be superior to non-periodized training plans for enhancing maximal strength. The primary aim of this study was to examine the previous literature comparing periodized resistance training plans to non-periodized resistance training plans and determine a quantitative estimate of effect on maximal strength. All studies included in the meta-analysis met the following inclusion criteria: (1) peer-reviewed publication; (2) published in English; (3) comparison of a periodized resistance training group to a non-periodized resistance training group; (4) maximal strength measured by 1-repetition maximum (1RM) squat, bench press, or leg press. Data were extracted and independently coded by two authors. Random-effects models were used to aggregate a mean effect size (ES), 95% confidence intervals (CIs) and potential moderators. The cumulative results of 81 effects gathered from 18 studies published between 1988 and 2015 indicated that the magnitude of improvement in 1RM following periodized resistance training was greater than non-periodized resistance training (ES = 0.43, 95% CI 0.27-0.58; P < 0.001). Periodization model (β = 0.51; P = 0.0010), training status (β = -0.59; P = 0.0305), study length (β = 0.03; P = 0.0067), and training frequency (β = 0.46; P = 0.0123) were associated with a change in 1RM. These results indicate that undulating programs were more favorable for strength gains. Improvements in 1RM were greater among untrained participants. Additionally, higher training frequency and longer study length were associated with larger improvements in 1RM. These results suggest that periodized resistance training plans have a moderate effect on 1RM compared to non-periodized training plans. Variation in training stimuli appears to be vital for increasing maximal strength, and longer periods of higher training frequency may be preferred.

Virtual Reality and Computer-Enhanced Training Devices Equally Improve Laparoscopic Surgical Skill in Novices

PubMed Central

Kanumuri, Prathima; Ganai, Sabha; Wohaibi, Eyad M.; Bush, Ronald W.; Grow, Daniel R.

2008-01-01

Background: The study aim was to compare the effectiveness of virtual reality and computer-enhanced video-scopic training devices for training novice surgeons in complex laparoscopic skills. Methods: Third-year medical students received instruction on laparoscopic intracorporeal suturing and knot tying and then underwent a pretraining assessment of the task using a live porcine model. Students were then randomized to objectives-based training on either the virtual reality (n=8) or computer-enhanced (n=8) training devices for 4 weeks, after which the assessment was repeated. Results: Posttraining performance had improved compared with pretraining performance in both task completion rate (94% versus 18%; P<0.001*) and time [181±58 (SD) versus 292±24*]. Performance of the 2 groups was comparable before and after training. Of the subjects, 88% thought that haptic cues were important in simulators. Both groups agreed that their respective training systems were effective teaching tools, but computer-enhanced device trainees were more likely to rate their training as representative of reality (P<0.01). Conclusions: Training on virtual reality and computer-enhanced devices had equivalent effects on skills improvement in novices. Despite the perception that haptic feedback is important in laparoscopic simulation training, its absence in the virtual reality device did not impede acquisition of skill. PMID:18765042

Head and neck surgical subspecialty training in Africa: Sustainable models to improve cancer care in developing countries.

PubMed

Fagan, Johannes J; Zafereo, Mark; Aswani, Joyce; Netterville, James L; Koch, Wayne

2017-03-01

Cancer poses a health crisis in the developing world where surgery is the mainstay of treatment for head and neck cancers. However, a shortage of surgeons with appropriate skills exists. How do we train head and neck surgeons in developing countries and avoid a brain drain? The ideal model provides appropriate affordable training leading to establishment of head and neck cancer centers that teach and train others. Different head and neck surgery training models are presented based on the personal experiences of the authors. Surgical exposure of head and neck fellows in Cape Town and (potentially) in Nairobi is benchmarked against programs in the United States. Surgical exposure in Cape Town is equivalent to that in the United States, but more appropriate to a developing world setting. Training can be achieved in a number of ways, which may be complimentary. Fellowship training is possible in developing countries. © 2016 Wiley Periodicals, Inc. Head Neck 39: 605-611, 2017. © 2016 Wiley Periodicals, Inc.

The effect of two kinds of role playing on self-evaluation of improved assertiveness.

PubMed

Kipper, D A

1992-03-01

The study investigated the "differential effect of role-playing enactments" hypothesis through self-evaluations of improvement in assertiveness by participants in an assertive training program. Twenty-two nonassertive Israeli students were trained in two groups: mimetic-replications (action modeling, n = 12) and spontaneous (self-produced action, n = 10) role-playing interventions. Comparisons of their scores on the Self-Expression College Scale (CSES) before and after the training showed that both groups significantly improved their self-evaluations, but the mimetic-replication group did better. In particular, this group scored significantly higher on the CSES first factor (the willingness to take risks in situations that involved other, significant persons).

Training for laparoscopic Nissen fundoplication with a newly designed model: a replacement for animal tissue models?

PubMed Central

Christie, Lorna; Goossens, Richard; Jakimowicz, Jack J.

2010-01-01

Background To bridge the early learning curve for laparoscopic Nissen fundoplication from the clinical setting to a safe environment, training models can be used. This study aimed to develop a reusable, low-cost model to be used for training in laparoscopic Nissen fundoplication procedure as an alternative to the use of animal tissue models. Methods From artificial organs and tissue, an anatomic model of the human upper abdomen was developed for training in performing laparoscopic Nissen fundoplication. The 20 participants and tutors in the European Association for Endoscopic Surgery (EAES) upper gastrointestinal surgery course completed four complementary tasks of laparoscopic Nissen fundoplication with the artificial model, then compared the realism, haptic feedback, and training properties of the model with those of animal tissue models. Results The main difference between the two training models was seen in the properties of the stomach. The wrapping of the stomach in the artificial model was rated significantly lower than that in the animal tissue model (mean, 3.6 vs. 4.2; p = 0.010). The main criticism of the stomach of the artificial model was that it was too rigid for making a proper wrap. The suturing of the stomach wall, however, was regarded as fairly realistic (mean, 3.6). The crura on the artificial model were rated better (mean, 4.3) than those on the animal tissue (mean, 4.0), although the difference was not significant. The participants regarded the model as a good to excellent (mean, 4.3) training tool. Conclusion The newly developed model is regarded as a good tool for training in laparoscopic Nissen fundoplication procedure. It is cheaper, more durable, and more readily available for training and can therefore be used in every training center. The stomach of this model, however, still needs improvement because it is too rigid for making the wrap. PMID:20526629

Optimization of DRASTIC method by supervised committee machine artificial intelligence to assess groundwater vulnerability for Maragheh-Bonab plain aquifer, Iran

NASA Astrophysics Data System (ADS)

Fijani, Elham; Nadiri, Ata Allah; Asghari Moghaddam, Asghar; Tsai, Frank T.-C.; Dixon, Barnali

2013-10-01

Contamination of wells with nitrate-N (NO3-N) poses various threats to human health. Contamination of groundwater is a complex process and full of uncertainty in regional scale. Development of an integrative vulnerability assessment methodology can be useful to effectively manage (including prioritization of limited resource allocation to monitor high risk areas) and protect this valuable freshwater source. This study introduces a supervised committee machine with artificial intelligence (SCMAI) model to improve the DRASTIC method for groundwater vulnerability assessment for the Maragheh-Bonab plain aquifer in Iran. Four different AI models are considered in the SCMAI model, whose input is the DRASTIC parameters. The SCMAI model improves the committee machine artificial intelligence (CMAI) model by replacing the linear combination in the CMAI with a nonlinear supervised ANN framework. To calibrate the AI models, NO3-N concentration data are divided in two datasets for the training and validation purposes. The target value of the AI models in the training step is the corrected vulnerability indices that relate to the first NO3-N concentration dataset. After model training, the AI models are verified by the second NO3-N concentration dataset. The results show that the four AI models are able to improve the DRASTIC method. Since the best AI model performance is not dominant, the SCMAI model is considered to combine the advantages of individual AI models to achieve the optimal performance. The SCMAI method re-predicts the groundwater vulnerability based on the different AI model prediction values. The results show that the SCMAI outperforms individual AI models and committee machine with artificial intelligence (CMAI) model. The SCMAI model ensures that no water well with high NO3-N levels would be classified as low risk and vice versa. The study concludes that the SCMAI model is an effective model to improve the DRASTIC model and provides a confident estimate of the pollution risk.

A Model for Catalyzing Educational and Clinical Transformation in Primary Care: Outcomes From a Partnership Among Family Medicine, Internal Medicine, and Pediatrics.

PubMed

Eiff, M Patrice; Green, Larry A; Holmboe, Eric; McDonald, Furman S; Klink, Kathleen; Smith, David Gary; Carraccio, Carol; Harding, Rose; Dexter, Eve; Marino, Miguel; Jones, Sam; Caverzagie, Kelly; Mustapha, Mumtaz; Carney, Patricia A

2016-09-01

To report findings from a national effort initiated by three primary care certifying boards to catalyze change in primary care training. In this mixed-method pilot study (2012-2014), 36 faculty in 12 primary care residencies (family medicine, internal medicine, pediatrics) from four institutions participated in a professional development program designed to prepare faculty to accelerate change in primary care residency training by uniting them in a common mission to create effective ambulatory clinical learning environments. Surveys administered at baseline and 12 months after initial training measured changes in faculty members' confidence and skills, continuity clinics, and residency training programs. Feasibility evaluation involved assessing participation. The authors compared quantitative data using Wilcoxon signed-rank and Bhapkar tests. Observational field notes underwent narrative analysis. Most participants attended two in-person training sessions (92% and 72%, respectively). Between baseline and 12 months, faculty members' confidence in leadership improved significantly for 15/19 (79%) variables assessed; their self-assessed skills improved significantly for 21/22 (95%) competencies. Two medical home domains ("Continuity of Care," "Support/Care Coordination") improved significantly (P < .05) between the two time periods. Analyses of qualitative data revealed that interdisciplinary learning communities formed during the program and served to catalyze transformational change. Results suggest that improvements in faculty perceptions of confidence and skills occurred and that the creation of interdisciplinary learning communities catalyzed transformation. Lengthening the intervention period, engaging other professions involved in training the primary care workforce, and a more discriminating evaluation design are needed to scale this model nationally.

Evaluation of training programme uptake in an attempt to reduce obstetric anal sphincter injuries: the SUPPORT programme.

PubMed

Rahman, Nadia; Vinayakarao, Latha; Pathak, Sangeeta; Minden, Dawn; Melson, Louise; Vitue, Ella; Pradhan, A

2017-03-01

The objective was to assess the feedback from a quality improvement training programme to reduce obstetric anal sphincter injuries (OASIS). Training sessions were organised that included evidence-based information on OASIS risk factors and training on models to measure perineal body length (PBL), perform episiotomies with standard and 60° fixed angle scissors (EPISCISSORS-60®), and measure post-delivery episiotomy suture angles with protractor transparencies. Feedback forms using a Likert scale (1-4) were completed and analysed. The setting was an evidence-based quality improvement programme (Strategy for Using Practical aids for Prevention of OASIS, Recording episiotomies and clinician Training [SUPPORT]) at two National Health Service (NHS) Hospitals in the UK. The participants were midwives and doctors attending the SUPPORT training programme RESULTS: All of the participants (100 %) would recommend the training programme to a friend or colleague. 92 % felt that the training session improved their knowledge of the impact of PBL and perineal distension and their knowledge of the relationship between episiotomy angle and OASIS "a lot" or "somewhat". Based on this feedback, we recommend the addition of the knowledge content of the SUPPORT programme to other centres providing perineal assessment and repair courses.

[Thinking on the Training of Uniportal Video-assisted Thoracic Surgery].

PubMed

Zhu, Yuming; Jiang, Gening

2018-04-20

Recently, uniportal video-assisted thoracic surgery (VATS) has developed rapidly and has become the main theme of global surgical development. The specific, standardized and systematic training of this technology has become an important topic. Specific training in the uniportal VATS approach is crucial to ensure safety and radical treatment. Such training approach, including a direct interaction with experienced surgeons in high-volume centers, is crucial and represents an indispensable step. Another form of training that usually occurs after preceptorship is proctorship: an experienced mentor can be invited to a trainee's own center to provide specific on-site tutelage. Videos published online are commonly used as training material. Technology has allowed the use of different models of simulators for training. The most common model is the use of animal wet laboratory training. Other models, however, have been used mostrecently, such as the use of 3D and VR Technology, virtual reality simulators, and completely artificial models of the human thorax with synthetic lung, vessel, airway, and nodal tissues. A short-duration, high-volume, clinical immersion training, and a long term systematic training in high-volume centers are getting more and more attention. According to the evaluation of students' grading, a diversified training mode is adopted and the targeted training in accordance with different students helps to improve the training effect. We have done some work in systematic and standardized training of uniportal VATS in single center. We believe such training is feasible and absolutely necessary.

Modeling Aircraft Wing Loads from Flight Data Using Neural Networks

NASA Technical Reports Server (NTRS)

Allen, Michael J.; Dibley, Ryan P.

2003-01-01

Neural networks were used to model wing bending-moment loads, torsion loads, and control surface hinge-moments of the Active Aeroelastic Wing (AAW) aircraft. Accurate loads models are required for the development of control laws designed to increase roll performance through wing twist while not exceeding load limits. Inputs to the model include aircraft rates, accelerations, and control surface positions. Neural networks were chosen to model aircraft loads because they can account for uncharacterized nonlinear effects while retaining the capability to generalize. The accuracy of the neural network models was improved by first developing linear loads models to use as starting points for network training. Neural networks were then trained with flight data for rolls, loaded reversals, wind-up-turns, and individual control surface doublets for load excitation. Generalization was improved by using gain weighting and early stopping. Results are presented for neural network loads models of four wing loads and four control surface hinge moments at Mach 0.90 and an altitude of 15,000 ft. An average model prediction error reduction of 18.6 percent was calculated for the neural network models when compared to the linear models. This paper documents the input data conditioning, input parameter selection, structure, training, and validation of the neural network models.

Transfer of learning between unimanual and bimanual rhythmic movement coordination: transfer is a function of the task dynamic.

PubMed

Snapp-Childs, Winona; Wilson, Andrew D; Bingham, Geoffrey P

2015-07-01

Under certain conditions, learning can transfer from a trained task to an untrained version of that same task. However, it is as yet unclear what those certain conditions are or why learning transfers when it does. Coordinated rhythmic movement is a valuable model system for investigating transfer because we have a model of the underlying task dynamic that includes perceptual coupling between the limbs being coordinated. The model predicts that (1) coordinated rhythmic movements, both bimanual and unimanual, are organised with respect to relative motion information for relative phase in the coupling function, (2) unimanual is less stable than bimanual coordination because the coupling is unidirectional rather than bidirectional, and (3) learning a new coordination is primarily about learning to perceive and use the relevant information which, with equal perceptual improvement due to training, yields equal transfer of learning from bimanual to unimanual coordination and vice versa [but, given prediction (2), the resulting performance is also conditioned by the intrinsic stability of each task]. In the present study, two groups were trained to produce 90° either unimanually or bimanually, respectively, and tested in respect to learning (namely improved performance in the trained 90° coordination task and improved visual discrimination of 90°) and transfer of learning (to the other, untrained 90° coordination task). Both groups improved in the task condition in which they were trained and in their ability to visually discriminate 90°, and this learning transferred to the untrained condition. When scaled by the relative intrinsic stability of each task, transfer levels were found to be equal. The results are discussed in the context of the perception-action approach to learning and performance.

Diabetes training for community health workers on an American Indian reservation.

PubMed

Policicchio, Judith M; Dontje, Katherine

2018-01-01

To improve the knowledge and skills of community health workers (CHWs) on an American Indian (AI) Reservation related to the management of diabetes to allow CHWs, with no prior formal diabetes education to work more effectively with individuals in the community with diabetes. Training was provided in six "face-to-face" sessions with the CHWs using the Centers for Disease Control and Prevention CHW Training Resource on Heart Disease and Stroke. This is a quality improvement program guided by the Model for Improvement: Plan, Do, Study, Act and using a pre-post evaluation design. Ten AI CHWs were recruited for the training. Knowledge and attitudes, participation rates, and participant satisfaction were measured. Knowledge increased overall with largest changes in diabetes, depression and cholesterol. Diabetes attitudes were high and consistent with those found in caregivers who support patient-centered care. Participants reported learning, liking the class, and finding the materials helpful. This QI program provided by a public health nurse improved CHW's knowledge of diabetes and the management of diabetes. Next steps include formalizing the Reservation's CHW training program, expanding this training to other AI Health Service areas, and measuring the impact of CHWs in the community. © 2017 Wiley Periodicals, Inc.

Improving Pediatric Rapid Response Team Performance Through Crew Resource Management Training of Team Leaders.

PubMed

Siems, Ashley; Cartron, Alexander; Watson, Anne; McCarter, Robert; Levin, Amanda

2017-02-01

Rapid response teams (RRTs) improve the detection of and response to deteriorating patients. Professional hierarchies and the multidisciplinary nature of RRTs hinder team performance. This study assessed whether an intervention involving crew resource management training of team leaders could improve team performance. In situ observations of RRT activations were performed pre- and post-training intervention. Team performance and dynamics were measured by observed adherence to an ideal task list and by the Team Emergency Assessment Measure tool, respectively. Multiple quartile (median) and logistic regression models were developed to evaluate change in performance scores or completion of specific tasks. Team leader and team introductions (40% to 90%, P = .004; 7% to 45%, P = .03), floor team presentations in Situation Background Assessment Recommendation format (20% to 65%, P = .01), and confirmation of the plan (7% to 70%, P = .002) improved after training in patients transferred to the ICU (n = 35). The Team Emergency Assessment Measure metric was improved in all 4 categories: leadership (2.5 to 3.5, P < .001), teamwork (2.7 to 3.7, P < .001), task management (2.9 to 3.8, P < .001), and global scores (6.0 to 9.0, P < .001) for teams caring for patients who required transfer to the ICU. Targeted crew resource management training of the team leader resulted in improved team performance and dynamics for patients requiring transfer to the ICU. The intervention demonstrated that training the team leader improved behavior in RRT members who were not trained. Copyright © 2017 by the American Academy of Pediatrics.

External locus of control contributes to racial disparities in memory and reasoning training gains in ACTIVE.

PubMed

Zahodne, Laura B; Meyer, Oanh L; Choi, Eunhee; Thomas, Michael L; Willis, Sherry L; Marsiske, Michael; Gross, Alden L; Rebok, George W; Parisi, Jeanine M

2015-09-01

Racial disparities in cognitive outcomes may be partly explained by differences in locus of control. African Americans report more external locus of control than non-Hispanic Whites, and external locus of control is associated with poorer health and cognition. The aims of this study were to compare cognitive training gains between African American and non-Hispanic White participants in the Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE) study and determine whether racial differences in training gains are mediated by locus of control. The sample comprised 2,062 (26% African American) adults aged 65 and older who participated in memory, reasoning, or speed training. Latent growth curve models evaluated predictors of 10-year cognitive trajectories separately by training group. Multiple group modeling examined associations between training gains and locus of control across racial groups. Compared to non-Hispanic Whites, African Americans evidenced less improvement in memory and reasoning performance after training. These effects were partially mediated by locus of control, controlling for age, sex, education, health, depression, testing site, and initial cognitive ability. African Americans reported more external locus of control, which was associated with smaller training gains. External locus of control also had a stronger negative association with reasoning training gain for African Americans than for Whites. No racial difference in training gain was identified for speed training. Future intervention research with African Americans should test whether explicitly targeting external locus of control leads to greater cognitive improvement following cognitive training. (c) 2015 APA, all rights reserved).

[Role of the INAIL].

PubMed

Benedetti, F

2006-01-01

This report has to describe the activity of INAIL for improve information and training in the field of occupational health and safety. The discussion start from accident and professional illness data and gives evidence about social and economic cost of this phenomenon. INAIL want work together with other institution, social body, professional association for promote the integration of occupational health and safety in businesses management. The principal target are SMEs - Small and Medium size Enterprises. Information and training must follow this approach and sustain it. Information and training have to develop knowledge, competence and awareness like value for the organisations. This report describe models and tools for information and training which INAIL's improving even for the building sector.

Enrichment and Training Improve Cognition in Rats with Cortical Malformations

PubMed Central

Jenks, Kyle R.; Lucas, Marcella M.; Duffy, Ben A.; Robbins, Ashlee A.; Gimi, Barjor; Barry, Jeremy M.; Scott, Rod C.

2013-01-01

Children with malformations of cortical development (MCD) frequently have associated cognitive impairments which reduce quality of life. We hypothesized that cognitive deficits associated with MCD can be improved with environmental manipulation or additional training. The E17 methylazoxymethanol acetate (MAM) exposure model bears many anatomical hallmarks seen in human MCDs as well as similar behavioral and cognitive deficits. We divided control and MAM exposed Sprague-Dawley rats into enriched and non-enriched groups and tested performance in the Morris water maze. Another group similarly divided underwent sociability testing and also underwent Magnetic Resonance Imaging (MRI) scans pre and post enrichment. A third group of control and MAM rats without enrichment were trained until they reached criterion on the place avoidance task. MAM rats had impaired performance on spatial tasks and enrichment improved performance of both control and MAM animals. Although MAM rats did not have a deficit in sociability they showed similar improvement with enrichment as controls. MRI revealed a whole brain volume decrease with MAM exposure, and an increase in both MAM and control enriched volumes in comparison to non-enriched animals. In the place avoidance task, MAM rats required approximately 3 times as long to reach criterion as control animals, but with additional training were able to reach control performance. Environmental manipulation and additional training can improve cognition in a rodent MCD model. We therefore suggest that patients with MCD may benefit from appropriate alterations in educational strategies, social interaction and environment. These factors should be considered in therapeutic strategies. PMID:24358362

Communication in palliative care: the applicability of the SAGE and THYME model in Singapore.

PubMed

Martin, Ang Seng Hock; Costello, John; Griffiths, Jane

2017-06-02

Majority of the progress and development in palliative care in the last decade has been improvements in physical aspects of treatment, namely pain and symptom management. Psychosocial aspects of care have improved, although not enough to meet the needs of many patients and family members. This is evident in many parts of the world and notably in Singapore, where palliative care is seen as an emerging medical and nursing specialty. To discuss the implementation of the SAGE and THYME communication model in a palliative care context. The article examines the use of the model and how its implementation can improve communication between patients and nurses. The model works by reviewing contemporary developments made in relation to improving communication in palliative care. These include, highlighting the importance of meeting individual needs, therapeutic relationship building, and advanced communication training within a Singaporean context. The implementation of the SAGE and THYME model can be a useful way of enabling nurses to improve and maintain effective communication in a medically dominated health care system. The challenges and constraints in educating and training nurses with limited skills in palliative care, forms part of the review, including the cultural and attitude constraints specific to Singaporean palliative care.

Alexander Technique Training Coupled With an Integrative Model of Behavioral Prediction in Teachers With Low Back Pain.

PubMed

Kamalikhah, Tahereh; Morowatisharifabad, Mohammad Ali; Rezaei-Moghaddam, Farid; Ghasemi, Mohammad; Gholami-Fesharaki, Mohammad; Goklani, Salma

2016-09-01

Individuals suffering from chronic low back pain (CLBP) experience major physical, social, and occupational disruptions. Strong evidence confirms the effectiveness of Alexander technique (AT) training for CLBP. The present study applied an integrative model (IM) of behavioral prediction for improvement of AT training. This was a quasi-experimental study of female teachers with nonspecific LBP in southern Tehran in 2014. Group A contained 42 subjects and group B had 35 subjects. In group A, AT lessons were designed based on IM constructs, while in group B, AT lessons only were taught. The validity and reliability of the AT questionnaire were confirmed using content validity (CVR 0.91, CVI 0.96) and Cronbach's α (0.80). The IM constructs of both groups were measured after the completion of training. Statistical analysis used independent and paired samples t-tests and the univariate generalized linear model (GLM). Significant differences were recorded before and after intervention (P < 0.001) for the model constructs of intention, perceived risk, direct attitude, behavioral beliefs, and knowledge in both groups. Direct attitude and behavioral beliefs in group A were higher than in group B after the intervention (P < 0.03). The educational framework provided by IM for AT training improved attitude and behavioral beliefs that can facilitate the adoption of AT behavior and decreased CLBP.

Evaluation and impact of cardiotocography training programmes: a systematic review.

PubMed

Pehrson, C; Sorensen, J L; Amer-Wåhlin, I

2011-07-01

The interpretation and management of cardiotocography (CTG) tracings are often criticised in obstetric malpractice cases. As a consequence, regular CTG training has been recommended, even though little is known about the effect of CTG training. To perform a systematic review of the existing literature on studies on CTG training in order to assess educational strategies, evaluation of training programmes, and impact of training programmes. The Medline database was searched to identify studies describing and/or evaluating CTG training programmes. The literature search resulted in 409 citations. Twenty studies describing and evaluating CTG training programmes were included. There was no restriction on study design. Data regarding study design, study quality, educational strategies used for training in CTG interpretation and decision making, target groups, number of participants, methods used for evaluation, quality of evaluation, level of evaluation and results of training was extracted from 20 articles, and analysed using Kirkpatrick's four-level model for the evaluation of education. Training was associated with improvements on all Kirkpatrick levels, resulting in increased CTG knowledge and interpretive skills, higher interobserver agreement, better management of intrapartum CTG, and improved quality of care. Computer-based training (CBT) might be less time-consuming than classroom teaching. Clinical skills seem to decrease faster than theoretical knowledge. Training can improve CTG competence and clinical practise. Further research on CBT, test-enhanced learning and long-term retention, evaluation of training and impact on clinical outcomes is recommended. © 2011 The Authors BJOG An International Journal of Obstetrics and Gynaecology © 2011 RCOG.

Mutations in gp41 are correlated with coreceptor tropism but do not improve prediction methods substantially.

PubMed

Thielen, Alexander; Lengauer, Thomas; Swenson, Luke C; Dong, Winnie W Y; McGovern, Rachel A; Lewis, Marilyn; James, Ian; Heera, Jayvant; Valdez, Hernan; Harrigan, P Richard

2011-01-01

The main determinants of HIV-1 coreceptor usage are located in the V3-loop of gp120, although mutations in V2 and gp41 are also known. Incorporation of V2 is known to improve prediction algorithms; however, this has not been confirmed for gp41 mutations. Samples with V3 and gp41 genotypes and Trofile assay (Monogram Biosciences, South San Francisco, CA, USA) results were taken from the HOMER cohort (n=444) and from patients screened for the MOTIVATE studies (n=1,916; 859 with maraviroc outcome data). Correlations of mutations with tropism were assessed using Fisher's exact test and prediction models trained using support vector machines. Models were validated by cross-validation, by testing models from one dataset on the other, and by analysing virological outcome. Several mutations within gp41 were highly significant for CXCR4 usage; most strikingly an insertion occurring in 7.7% of HOMER-R5 and 46.3% of HOMER-X4 samples (MOTIVATE 5.7% and 25.2%, respectively). Models trained on gp41 sequence alone achieved relatively high areas under the receiver-operating characteristic curve (AUCs; HOMER 0.713 and MOTIVATE 0.736) that were almost as good as V3 models (0.773 and 0.884, respectively). However, combining the two regions improved predictions only marginally (0.813 and 0.902, respectively). Similar results were found when models were trained on HOMER and validated on MOTIVATE or vice versa. The difference in median log viral load decrease at week 24 between patients with R5 and X4 virus was 1.65 (HOMER 2.45 and MOTIVATE 0.79) for V3 models, 1.59 for gp41-models (2.42 and 0.83, respectively) and 1.58 for the combined predictor (2.44 and 0.86, respectively). Several mutations within gp41 showed strong correlation with tropism in two independent datasets. However, incorporating gp41 mutations into prediction models is not mandatory because they do not improve substantially on models trained on V3 sequences alone.

Virtual reality bronchoscopy simulation: a revolution in procedural training.

PubMed

Colt, H G; Crawford, S W; Galbraith, O

2001-10-01

In the airline industry, training is costly and operator error must be avoided. Therefore, virtual reality (VR) is routinely used to learn manual and technical skills through simulation before pilots assume flight responsibilities. In the field of medicine, manual and technical skills must also be acquired to competently perform invasive procedures such as flexible fiberoptic bronchoscopy (FFB). Until recently, training in FFB and other endoscopic procedures has occurred on the job in real patients. We hypothesized that novice trainees using a VR skill center could rapidly acquire basic skills, and that results would compare favorably with those of senior trainees trained in the conventional manner. We prospectively studied five novice bronchoscopists entering a pulmonary and critical care medicine training program. They were taught to perform inspection flexible bronchoscopy using a VR bronchoscopy skill center; dexterity, speed, and accuracy were tested using the skill center and an inanimate airway model before and after 4 h of group instruction and 4 h of individual unsupervised practice. Results were compared to those of a control group of four skilled physicians who had performed at least 200 bronchoscopies during 2 years of training. Student's t tests were used to compare mean scores of study and control groups for the inanimate model and VR bronchoscopy simulator. Before-training and after-training test scores were compared using paired t tests. For comparisons between after-training novice and skilled physician scores, unpaired two-sample t tests were used. Novices significantly improved their dexterity and accuracy in both models. They missed fewer segments after training than before training, and had fewer contacts with the bronchial wall. There was no statistically significant improvement in speed or total time spent not visualizing airway anatomy. After training, novice performance equaled or surpassed that of the skilled physicians. Novices performed more thorough examinations and missed significantly fewer segments in both the inanimate and virtual simulation models. A short, focused course of instruction and unsupervised practice using a virtual bronchoscopy simulator enabled novice trainees to attain a level of manual and technical skill at performing diagnostic bronchoscopic inspection similar to those of colleagues with several years of experience. These skills were readily reproducible in a conventional inanimate airway-training model, suggesting they would also be translatable to direct patient care.

Implementing Trauma-Informed Treatment for Youth in a Residential Facility: First-Year Outcomes

ERIC Educational Resources Information Center

Greenwald, Ricky; Siradas, Lynn; Schmitt, Thomas A.; Reslan, Summar; Fierle, Julia; Sande, Brad

2012-01-01

Training in the Fairy Tale model of trauma-informed treatment was provided to clinical and direct care staff working with 53 youth in a residential treatment facility. Compared to the year prior to training, in the year of the training the average improvement in presenting problems was increased by 34%, time to discharge was reduced by 39%, and…

Experiential instruction in graduate-level preparation of speech-language pathology students in outer and middle ear screening.

PubMed

Serpanos, Yula C; Senzer, Deborah

2015-05-01

This study presents a piloted training model of experiential instruction in outer and middle ear (OE-ME) screening for graduate speech-language pathology students with peer teaching by doctor of audiology (AuD) students. Six individual experiential training sessions in screening otoscopy and tympanometry were conducted for 36 graduate-level speech-language pathology students led by a supervised AuD student. Postexperiential training, survey outcomes from 24 speech-language pathology students revealed a significant improvement (p = .01) in perceptions of attaining adequate knowledge and comfort in performing screening otoscopy (handheld and video otoscopy) and tympanometry. In a group of matched controls who did not receive experiential training in OE-ME screening (n = 24), ratings on the same learning outcomes survey in otoscopy and tympanometry were significantly poorer (p = .01) compared with students who did receive experiential training. A training model of experiential instruction for speech-language pathology students by AuD students improved learning outcomes, illustrating its promise in affecting clinical practices. The instructional model also meets the Council on Academic Accreditation in Audiology and Speech-Language Pathology (CAA; American Speech-Language-Hearing Association, 2008) and American Speech-Language-Hearing Association (2014) Certificate of Clinical Competence (ASHA CCC) standards for speech-language pathology in OE-ME screening and CAA (2008) and ASHA (2012) CCC standards in the supervisory process for audiology.

The effects of videotape modeling on staff acquisition of functional analysis methodology.

PubMed

Moore, James W; Fisher, Wayne W

2007-01-01

Lectures and two types of video modeling were compared to determine their relative effectiveness in training 3 staff members to conduct functional analysis sessions. Video modeling that contained a larger number of therapist exemplars resulted in mastery-level performance eight of the nine times it was introduced, whereas neither lectures nor partial video modeling produced significant improvements in performance. Results demonstrated that video modeling provided an effective training strategy but only when a wide range of exemplars of potential therapist behaviors were depicted in the videotape.

The Effects of Videotape Modeling on Staff Acquisition of Functional Analysis Methodology

PubMed Central

Moore, James W; Fisher, Wayne W

2007-01-01

Lectures and two types of video modeling were compared to determine their relative effectiveness in training 3 staff members to conduct functional analysis sessions. Video modeling that contained a larger number of therapist exemplars resulted in mastery-level performance eight of the nine times it was introduced, whereas neither lectures nor partial video modeling produced significant improvements in performance. Results demonstrated that video modeling provided an effective training strategy but only when a wide range of exemplars of potential therapist behaviors were depicted in the videotape. PMID:17471805

Exploring the effects of transducer models when training convolutional neural networks to eliminate reflection artifacts in experimental photoacoustic images

NASA Astrophysics Data System (ADS)

Allman, Derek; Reiter, Austin; Bell, Muyinatu

2018-02-01

We previously proposed a method of removing reflection artifacts in photoacoustic images that uses deep learning. Our approach generally relies on using simulated photoacoustic channel data to train a convolutional neural network (CNN) that is capable of distinguishing sources from artifacts based on unique differences in their spatial impulse responses (manifested as depth-based differences in wavefront shapes). In this paper, we directly compare a CNN trained with our previous continuous transducer model to a CNN trained with an updated discrete acoustic receiver model that more closely matches an experimental ultrasound transducer. These two CNNs were trained with simulated data and tested on experimental data. The CNN trained using the continuous receiver model correctly classified 100% of sources and 70.3% of artifacts in the experimental data. In contrast, the CNN trained using the discrete receiver model correctly classified 100% of sources and 89.7% of artifacts in the experimental images. The 19.4% increase in artifact classification accuracy indicates that an acoustic receiver model that closely mimics the experimental transducer plays an important role in improving the classification of artifacts in experimental photoacoustic data. Results are promising for developing a method to display CNN-based images that remove artifacts in addition to only displaying network-identified sources as previously proposed.

[An analysis of the questionnaire survey about the first year residency training in internal medicine in Peking Union Medical College Hospital].

PubMed

Zhang, Yun; Wang, Wei; Zeng, Xuejun; Huang, Xiaoming; Li, Hang; Zhang, Fengchun; Shen, Ti

2015-09-01

To evaluate the effects of medical residency training program in postgraduate-year-one (PGY-1) residents at Peking Union Medical College (PUMC) Hospital. PGY-1 medical residents at PUMC Hospital were surveyed by a self-administered questionnaire after they completed their first year residency. Forty-nine residents who completed their first year residency training participated in the survey with a 100% response rate. Before training, only a few had bedside (n = 18) and on-call experiences (n = 10). At the end of the one-year-training, all the residents (100%) considered themselves being improved to certain degrees, especially in clinical practice capability, and passed all the examinations. However, 53.1% and 8.2% of all the residents agreed that they need to improve their abilities in teaching (n = 26) and doctor-patient communication (n = 4), respectively. All residents hoped to get further improved by taking part in various forms of teaching activities, including experience summary/sharing and basic skills training. During the first year, 95.9% of them participated in all teaching activities in medicine actively. The tradition and current models of medical residency training program at PUMC Hospital had a significant impact on professional development of the 1st year resident physicians. It is critical to focus on basic skill training and multi-level teaching to improve residents' clinical competency.

High Intensity Interval Training Leads to Greater Improvements in Acute Heart Rate Recovery and Anaerobic Power as High Volume Low Intensity Training.

PubMed

Stöggl, Thomas L; Björklund, Glenn

2017-01-01

The purpose of the current study was to explore if training regimes utilizing diverse training intensity distributions result in different responses on neuromuscular status, anaerobic capacity/power and acute heart rate recovery (HRR) in well-trained endurance athletes. Methods: Thirty-six male ( n = 33) and female ( n = 3) runners, cyclists, triathletes and cross-country skiers [peak oxygen uptake: (VO 2peak ): 61.9 ± 8.0 mL·kg -1 ·min -1 ] were randomly assigned to one of three groups (blocked high intensity interval training HIIT; polarized training POL; high volume low intensity oriented control group CG/HVLIT applying no HIIT). A maximal anaerobic running/cycling test (MART/MACT) was performed prior to and following a 9-week training period. Results: Only the HIIT group achieved improvements in peak power/velocity (+6.4%, P < 0.001) and peak lactate ( P = 0.001) during the MART/MACT, while, unexpectedly, in none of the groups the performance at the established lactate concentrations (4, 6, 10 mmol·L -1 ) was changed ( P > 0.05). Acute HRR was improved in HIIT (11.2%, P = 0.002) and POL (7.9%, P = 0.023) with no change in the HVLIT oriented control group. Conclusion: Only a training regime that includes a significant amount of HIIT improves the neuromuscular status, anaerobic power and the acute HRR in well-trained endurance athletes. A training regime that followed more a low and moderate intensity oriented model (CG/HVLIT) had no effect on any performance or HRR outcomes.

High Intensity Interval Training Leads to Greater Improvements in Acute Heart Rate Recovery and Anaerobic Power as High Volume Low Intensity Training

PubMed Central

Stöggl, Thomas L.; Björklund, Glenn

2017-01-01

The purpose of the current study was to explore if training regimes utilizing diverse training intensity distributions result in different responses on neuromuscular status, anaerobic capacity/power and acute heart rate recovery (HRR) in well-trained endurance athletes. Methods: Thirty-six male (n = 33) and female (n = 3) runners, cyclists, triathletes and cross-country skiers [peak oxygen uptake: (VO2peak): 61.9 ± 8.0 mL·kg−1·min−1] were randomly assigned to one of three groups (blocked high intensity interval training HIIT; polarized training POL; high volume low intensity oriented control group CG/HVLIT applying no HIIT). A maximal anaerobic running/cycling test (MART/MACT) was performed prior to and following a 9-week training period. Results: Only the HIIT group achieved improvements in peak power/velocity (+6.4%, P < 0.001) and peak lactate (P = 0.001) during the MART/MACT, while, unexpectedly, in none of the groups the performance at the established lactate concentrations (4, 6, 10 mmol·L−1) was changed (P > 0.05). Acute HRR was improved in HIIT (11.2%, P = 0.002) and POL (7.9%, P = 0.023) with no change in the HVLIT oriented control group. Conclusion: Only a training regime that includes a significant amount of HIIT improves the neuromuscular status, anaerobic power and the acute HRR in well-trained endurance athletes. A training regime that followed more a low and moderate intensity oriented model (CG/HVLIT) had no effect on any performance or HRR outcomes. PMID:28824457

Corticospinal excitability as a predictor of functional gains at the affected upper limb following robotic training in chronic stroke survivors

PubMed Central

Milot, Marie-Hélène; Spencer, Steven J.; Chan, Vicky; Allington, James P.; Klein, Julius; Chou, Cathy; Pearson-Fuhrhop, Kristin; Bobrow, James E.; Reinkensmeyer, David J.; Cramer, Steven C.

2014-01-01

Background Robotic training can help improve function of a paretic limb following a stroke, but individuals respond differently to the training. A predictor of functional gains might improve the ability to select those individuals more likely to benefit from robot based therapy. Studies evaluating predictors of functional improvement after a robotic training are scarce. One study has found that white matter tract integrity predicts functional gains following a robotic training of the hand and wrist. Objective Determine the predictive ability of behavioral and brain measures to improve selection of individuals for robotic training. Methods Twenty subjects with chronic stroke participated in an 8-week course of robotic exoskeletal training for the arm. Before training, a clinical evaluation, fMRI, diffusion tensor imaging, and transcranial magnetic stimulation (TMS) were each measured as predictors. Final functional gain was defined as change in the Box and Block Test (BBT). Measures significant in bivariate analysis were fed into a multivariate linear regression model. Results Training was associated with an average gain of 6±5 blocks on the BBT (p<0.0001). Bivariate analysis revealed that lower baseline motor evoked potential (MEP) amplitude on TMS, and lower laterality M1 index on fMRI each significantly correlated with greater BBT change. In the multivariate linear regression analysis, baseline MEP magnitude was the only measure that remained significant. Conclusion Subjects with lower baseline MEP magnitude benefited the most from robotic training of the affected arm. These subjects might have reserve remaining for the training to boost corticospinal excitability, translating into functional gains. PMID:24642382

Efficacy of a Process Improvement Intervention on Delivery of HIV Services to Offenders: A Multisite Trial

PubMed Central

Shafer, Michael S.; Dembo, Richard; del Mar Vega-Debién, Graciela; Pankow, Jennifer; Duvall, Jamieson L.; Belenko, Steven; Frisman, Linda K.; Visher, Christy A.; Pich, Michele; Patterson, Yvonne

2014-01-01

Objectives. We tested a modified Network for the Improvement of Addiction Treatment (NIATx) process improvement model to implement improved HIV services (prevention, testing, and linkage to treatment) for offenders under correctional supervision. Methods. As part of the Criminal Justice Drug Abuse Treatment Studies, Phase 2, the HIV Services and Treatment Implementation in Corrections study conducted 14 cluster-randomized trials in 2011 to 2013 at 9 US sites, where one correctional facility received training in HIV services and coaching in a modified NIATx model and the other received only HIV training. The outcome measure was the odds of successful delivery of an HIV service. Results. The results were significant at the .05 level, and the point estimate for the odds ratio was 2.14. Although overall the results were heterogeneous, the experiments that focused on implementing HIV prevention interventions had a 95% confidence interval that exceeded the no-difference point. Conclusions. Our results demonstrate that a modified NIATx process improvement model can effectively implement improved rates of delivery of some types of HIV services in correctional environments. PMID:25322311

Efficacy of a process improvement intervention on delivery of HIV services to offenders: a multisite trial.

PubMed

Pearson, Frank S; Shafer, Michael S; Dembo, Richard; Del Mar Vega-Debién, Graciela; Pankow, Jennifer; Duvall, Jamieson L; Belenko, Steven; Frisman, Linda K; Visher, Christy A; Pich, Michele; Patterson, Yvonne

2014-12-01

We tested a modified Network for the Improvement of Addiction Treatment (NIATx) process improvement model to implement improved HIV services (prevention, testing, and linkage to treatment) for offenders under correctional supervision. As part of the Criminal Justice Drug Abuse Treatment Studies, Phase 2, the HIV Services and Treatment Implementation in Corrections study conducted 14 cluster-randomized trials in 2011 to 2013 at 9 US sites, where one correctional facility received training in HIV services and coaching in a modified NIATx model and the other received only HIV training. The outcome measure was the odds of successful delivery of an HIV service. The results were significant at the .05 level, and the point estimate for the odds ratio was 2.14. Although overall the results were heterogeneous, the experiments that focused on implementing HIV prevention interventions had a 95% confidence interval that exceeded the no-difference point. Our results demonstrate that a modified NIATx process improvement model can effectively implement improved rates of delivery of some types of HIV services in correctional environments.

A cluster-randomised quality improvement study to improve two inpatient stroke quality indicators.

PubMed

Williams, Linda; Daggett, Virginia; Slaven, James E; Yu, Zhangsheng; Sager, Danielle; Myers, Jennifer; Plue, Laurie; Woodward-Hagg, Heather; Damush, Teresa M

2016-04-01

Quality indicator collection and feedback improves stroke care. We sought to determine whether quality improvement training plus indicator feedback was more effective than indicator feedback alone in improving inpatient stroke indicators. We conducted a cluster-randomised quality improvement trial, randomising hospitals to quality improvement training plus indicator feedback versus indicator feedback alone to improve deep vein thrombosis (DVT) prophylaxis and dysphagia screening. Intervention sites received collaborative-based quality improvement training, external facilitation and indicator feedback. Control sites received only indicator feedback. We compared indicators pre-implementation (pre-I) to active implementation (active-I) and post-implementation (post-I) periods. We constructed mixed-effect logistic models of the two indicators with a random intercept for hospital effect, adjusting for patient, time, intervention and hospital variables. Patients at intervention sites (1147 admissions), had similar race, gender and National Institutes of Health Stroke Scale scores to control sites (1017 admissions). DVT prophylaxis improved more in intervention sites during active-I period (ratio of ORs 4.90, p<0.001), but did not differ in post-I period. Dysphagia screening improved similarly in both groups during active-I, but control sites improved more in post-I period (ratio of ORs 0.67, p=0.04). In logistic models, the intervention was independently positively associated with DVT performance during active-I period, and negatively associated with dysphagia performance post-I period. Quality improvement training was associated with early DVT improvement, but the effect was not sustained over time and was not seen with dysphagia screening. External quality improvement programmes may quickly boost performance but their effect may vary by indicator and may not sustain over time. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Disaster response team FAST skills training with a portable ultrasound simulator compared to traditional training: pilot study.

PubMed

Paddock, Michael T; Bailitz, John; Horowitz, Russ; Khishfe, Basem; Cosby, Karen; Sergel, Michelle J

2015-03-01

Pre-hospital focused assessment with sonography in trauma (FAST) has been effectively used to improve patient care in multiple mass casualty events throughout the world. Although requisite FAST knowledge may now be learned remotely by disaster response team members, traditional live instructor and model hands-on FAST skills training remains logistically challenging. The objective of this pilot study was to compare the effectiveness of a novel portable ultrasound (US) simulator with traditional FAST skills training for a deployed mixed provider disaster response team. We randomized participants into one of three training groups stratified by provider role: Group A. Traditional Skills Training, Group B. US Simulator Skills Training, and Group C. Traditional Skills Training Plus US Simulator Skills Training. After skills training, we measured participants' FAST image acquisition and interpretation skills using a standardized direct observation tool (SDOT) with healthy models and review of FAST patient images. Pre- and post-course US and FAST knowledge were also assessed using a previously validated multiple-choice evaluation. We used the ANOVA procedure to determine the statistical significance of differences between the means of each group's skills scores. Paired sample t-tests were used to determine the statistical significance of pre- and post-course mean knowledge scores within groups. We enrolled 36 participants, 12 randomized to each training group. Randomization resulted in similar distribution of participants between training groups with respect to provider role, age, sex, and prior US training. For the FAST SDOT image acquisition and interpretation mean skills scores, there was no statistically significant difference between training groups. For US and FAST mean knowledge scores, there was a statistically significant improvement between pre- and post-course scores within each group, but again there was not a statistically significant difference between training groups. This pilot study of a deployed mixed-provider disaster response team suggests that a novel portable US simulator may provide equivalent skills training in comparison to traditional live instructor and model training. Further studies with a larger sample size and other measures of short- and long-term clinical performance are warranted.

Projecting future expansion of invasive species: comparing and improving methodologies for species distribution modeling.

PubMed

Mainali, Kumar P; Warren, Dan L; Dhileepan, Kunjithapatham; McConnachie, Andrew; Strathie, Lorraine; Hassan, Gul; Karki, Debendra; Shrestha, Bharat B; Parmesan, Camille

2015-12-01

Modeling the distributions of species, especially of invasive species in non-native ranges, involves multiple challenges. Here, we developed some novel approaches to species distribution modeling aimed at reducing the influences of such challenges and improving the realism of projections. We estimated species-environment relationships for Parthenium hysterophorus L. (Asteraceae) with four modeling methods run with multiple scenarios of (i) sources of occurrences and geographically isolated background ranges for absences, (ii) approaches to drawing background (absence) points, and (iii) alternate sets of predictor variables. We further tested various quantitative metrics of model evaluation against biological insight. Model projections were very sensitive to the choice of training dataset. Model accuracy was much improved using a global dataset for model training, rather than restricting data input to the species' native range. AUC score was a poor metric for model evaluation and, if used alone, was not a useful criterion for assessing model performance. Projections away from the sampled space (i.e., into areas of potential future invasion) were very different depending on the modeling methods used, raising questions about the reliability of ensemble projections. Generalized linear models gave very unrealistic projections far away from the training region. Models that efficiently fit the dominant pattern, but exclude highly local patterns in the dataset and capture interactions as they appear in data (e.g., boosted regression trees), improved generalization of the models. Biological knowledge of the species and its distribution was important in refining choices about the best set of projections. A post hoc test conducted on a new Parthenium dataset from Nepal validated excellent predictive performance of our 'best' model. We showed that vast stretches of currently uninvaded geographic areas on multiple continents harbor highly suitable habitats for parthenium. However, discrepancies between model predictions and parthenium invasion in Australia indicate successful management for this globally significant weed. © 2015 John Wiley & Sons Ltd.

Co-streaming classes: a follow-up study in improving the user experience to better reach users.

PubMed

Hayes, Barrie E; Handler, Lara J; Main, Lindsey R

2011-01-01

Co-streaming classes have enabled library staff to extend open classes to distance education students and other users. Student evaluations showed that the model could be improved. Two areas required attention: audio problems experienced by online participants and staff teaching methods. Staff tested equipment and adjusted software configuration to improve user experience. Staff training increased familiarity with specialized teaching techniques and troubleshooting procedures. Technology testing and staff training were completed, and best practices were developed and applied. Class evaluations indicate improvements in classroom experience. Future plans include expanding co-streaming to more classes and on-going data collection, evaluation, and improvement of classes.

Work-based learning: A training model for state wide system changes.

PubMed

Clay, Zakia; Barrett, Nora; Reilly, Ann; Zazzarino, Anthony

2016-12-01

Despite the substantial amount of money invested in staff training each year, many people trained fail to transfer what they learn to the workplace. We document a training initiative that was implemented to develop and maintain a competent workforce. A work-based learning (WBL) model was used as a guide to teach the knowledge and skills necessary to effectively deliver psychiatric rehabilitation services. This training framework afforded practitioners an opportunity to acquire the critical knowledge and skills to improve the quality of life for individuals living with serious mental illnesses. Preliminary pre and posttest results show an overall increase in practitioner knowledge. Additionally, individualized technical assistance has the potential to increase positive learning outcomes. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Improving clinician competency in communication about schizophrenia: a pilot educational program for psychiatry trainees.

PubMed

Loughland, Carmel; Kelly, Brian; Ditton-Phare, Philippa; Sandhu, Harsimrat; Vamos, Marina; Outram, Sue; Levin, Tomer

2015-04-01

Important gaps are observed in clinicians' communication with patients and families about psychiatric disorders such as schizophrenia. Communication skills can be taught, and models for education in these skills have been developed in other fields of medicine, such as oncology, providing a framework for training communication skills relevant to psychiatric practice. This study evaluated a pilot communication skills education program for psychiatry trainees, focusing on discussing schizophrenia diagnosis and prognosis. Communication skills training modules were developed based on an existing theoretical framework (ComSkil), adapted for discussing a schizophrenia diagnosis and prognosis. Pre-post training rating of self-reported confidence in a range of communication tasks was obtained, along with trainee views on the training methods. Thirty-eight participants completed the training. Significant improvements in confidence were reported post training for discussing schizophrenia prognosis, including an increased capacity to critically evaluate their own communication skills. Participants reported high levels of satisfaction with the program. This preliminary study provides support for the translation of a well-established educational model to psychiatric training addressing core clinical communication tasks and provides the foundation for the development of a more comprehensive evaluation and an extended curriculum regarding other aspects of care for patients with schizophrenia: ongoing management and recovery, dealing with conflict, and conducting a family interview.

A conceptual model for worksite intelligent physical exercise training--IPET--intervention for decreasing life style health risk indicators among employees: a randomized controlled trial.

PubMed

Sjøgaard, Gisela; Justesen, Just Bendix; Murray, Mike; Dalager, Tina; Søgaard, Karen

2014-06-26

Health promotion at the work site in terms of physical activity has proven positive effects but optimization of relevant exercise training protocols and implementation for high adherence are still scanty. The aim of this paper is to present a study protocol with a conceptual model for planning the optimal individually tailored physical exercise training for each worker based on individual health check, existing guidelines and state of the art sports science training recommendations in the broad categories of cardiorespiratory fitness, muscle strength in specific body parts, and functional training including balance training. The hypotheses of this research are that individually tailored worksite-based intelligent physical exercise training, IPET, among workers with inactive job categories will: 1) Improve cardiorespiratory fitness and/or individual health risk indicators, 2) Improve muscle strength and decrease musculoskeletal disorders, 3) Succeed in regular adherence to worksite and leisure physical activity training, and 3) Reduce sickness absence and productivity losses (presenteeism) in office workers. The present RCT study enrolled almost 400 employees with sedentary jobs in the private as well as public sectors. The training interventions last 2 years with measures at baseline as well as one and two years follow-up. If proven effective, the intelligent physical exercise training scheduled as well as the information for its practical implementation can provide meaningful scientifically based information for public health policy. ClinicalTrials.gov, number: NCT01366950.

A conceptual model for worksite intelligent physical exercise training - IPET - intervention for decreasing life style health risk indicators among employees: a randomized controlled trial

PubMed Central

2014-01-01

Background Health promotion at the work site in terms of physical activity has proven positive effects but optimization of relevant exercise training protocols and implementation for high adherence are still scanty. Methods/Design The aim of this paper is to present a study protocol with a conceptual model for planning the optimal individually tailored physical exercise training for each worker based on individual health check, existing guidelines and state of the art sports science training recommendations in the broad categories of cardiorespiratory fitness, muscle strength in specific body parts, and functional training including balance training. The hypotheses of this research are that individually tailored worksite-based intelligent physical exercise training, IPET, among workers with inactive job categories will: 1) Improve cardiorespiratory fitness and/or individual health risk indicators, 2) Improve muscle strength and decrease musculoskeletal disorders, 3) Succeed in regular adherence to worksite and leisure physical activity training, and 3) Reduce sickness absence and productivity losses (presenteeism) in office workers. The present RCT study enrolled almost 400 employees with sedentary jobs in the private as well as public sectors. The training interventions last 2 years with measures at baseline as well as one and two years follow-up. Discussion If proven effective, the intelligent physical exercise training scheduled as well as the information for its practical implementation can provide meaningful scientifically based information for public health policy. Trial Registration ClinicalTrials.gov, number: NCT01366950. PMID:24964869

Consistency of QSAR models: Correct split of training and test sets, ranking of models and performance parameters.

PubMed

Rácz, A; Bajusz, D; Héberger, K

2015-01-01

Recent implementations of QSAR modelling software provide the user with numerous models and a wealth of information. In this work, we provide some guidance on how one should interpret the results of QSAR modelling, compare and assess the resulting models, and select the best and most consistent ones. Two QSAR datasets are applied as case studies for the comparison of model performance parameters and model selection methods. We demonstrate the capabilities of sum of ranking differences (SRD) in model selection and ranking, and identify the best performance indicators and models. While the exchange of the original training and (external) test sets does not affect the ranking of performance parameters, it provides improved models in certain cases (despite the lower number of molecules in the training set). Performance parameters for external validation are substantially separated from the other merits in SRD analyses, highlighting their value in data fusion.

Short-Term Effect of Two Semi-Occluded Vocal Tract Training Programs on the Vocal Quality of Future Occupational Voice Users: "Resonant Voice Training Using Nasal Consonants" Versus "Straw Phonation".

PubMed

Meerschman, Iris; Van Lierde, Kristiane; Peeters, Karen; Meersman, Eline; Claeys, Sofie; D'haeseleer, Evelien

2017-09-18

The purpose of this study was to determine the short-term effect of 2 semi-occluded vocal tract training programs, "resonant voice training using nasal consonants" versus "straw phonation," on the vocal quality of vocally healthy future occupational voice users. A multigroup pretest-posttest randomized control group design was used. Thirty healthy speech-language pathology students with a mean age of 19 years (range: 17-22 years) were randomly assigned into a resonant voice training group (practicing resonant exercises across 6 weeks, n = 10), a straw phonation group (practicing straw phonation across 6 weeks, n = 10), or a control group (receiving no voice training, n = 10). A voice assessment protocol consisting of both subjective (questionnaire, participant's self-report, auditory-perceptual evaluation) and objective (maximum performance task, aerodynamic assessment, voice range profile, acoustic analysis, acoustic voice quality index, dysphonia severity index) measurements and determinations was used to evaluate the participants' voice pre- and posttraining. Groups were compared over time using linear mixed models and generalized linear mixed models. Within-group effects of time were determined using post hoc pairwise comparisons. No significant time × group interactions were found for any of the outcome measures, indicating no differences in evolution over time among the 3 groups. Within-group effects of time showed a significant improvement in dysphonia severity index in the resonant voice training group, and a significant improvement in the intensity range in the straw phonation group. Results suggest that the semi-occluded vocal tract training programs using resonant voice training and straw phonation may have a positive impact on the vocal quality and vocal capacities of future occupational voice users. The resonant voice training caused an improved dysphonia severity index, and the straw phonation training caused an expansion of the intensity range in this population.

Video Salient Object Detection via Fully Convolutional Networks.

PubMed

Wang, Wenguan; Shen, Jianbing; Shao, Ling

This paper proposes a deep learning model to efficiently detect salient regions in videos. It addresses two important issues: 1) deep video saliency model training with the absence of sufficiently large and pixel-wise annotated video data and 2) fast video saliency training and detection. The proposed deep video saliency network consists of two modules, for capturing the spatial and temporal saliency information, respectively. The dynamic saliency model, explicitly incorporating saliency estimates from the static saliency model, directly produces spatiotemporal saliency inference without time-consuming optical flow computation. We further propose a novel data augmentation technique that simulates video training data from existing annotated image data sets, which enables our network to learn diverse saliency information and prevents overfitting with the limited number of training videos. Leveraging our synthetic video data (150K video sequences) and real videos, our deep video saliency model successfully learns both spatial and temporal saliency cues, thus producing accurate spatiotemporal saliency estimate. We advance the state-of-the-art on the densely annotated video segmentation data set (MAE of .06) and the Freiburg-Berkeley Motion Segmentation data set (MAE of .07), and do so with much improved speed (2 fps with all steps).This paper proposes a deep learning model to efficiently detect salient regions in videos. It addresses two important issues: 1) deep video saliency model training with the absence of sufficiently large and pixel-wise annotated video data and 2) fast video saliency training and detection. The proposed deep video saliency network consists of two modules, for capturing the spatial and temporal saliency information, respectively. The dynamic saliency model, explicitly incorporating saliency estimates from the static saliency model, directly produces spatiotemporal saliency inference without time-consuming optical flow computation. We further propose a novel data augmentation technique that simulates video training data from existing annotated image data sets, which enables our network to learn diverse saliency information and prevents overfitting with the limited number of training videos. Leveraging our synthetic video data (150K video sequences) and real videos, our deep video saliency model successfully learns both spatial and temporal saliency cues, thus producing accurate spatiotemporal saliency estimate. We advance the state-of-the-art on the densely annotated video segmentation data set (MAE of .06) and the Freiburg-Berkeley Motion Segmentation data set (MAE of .07), and do so with much improved speed (2 fps with all steps).

Training Classifiers with Shadow Features for Sensor-Based Human Activity Recognition.

PubMed

Fong, Simon; Song, Wei; Cho, Kyungeun; Wong, Raymond; Wong, Kelvin K L

2017-02-27

In this paper, a novel training/testing process for building/using a classification model based on human activity recognition (HAR) is proposed. Traditionally, HAR has been accomplished by a classifier that learns the activities of a person by training with skeletal data obtained from a motion sensor, such as Microsoft Kinect. These skeletal data are the spatial coordinates (x, y, z) of different parts of the human body. The numeric information forms time series, temporal records of movement sequences that can be used for training a classifier. In addition to the spatial features that describe current positions in the skeletal data, new features called 'shadow features' are used to improve the supervised learning efficacy of the classifier. Shadow features are inferred from the dynamics of body movements, and thereby modelling the underlying momentum of the performed activities. They provide extra dimensions of information for characterising activities in the classification process, and thereby significantly improve the classification accuracy. Two cases of HAR are tested using a classification model trained with shadow features: one is by using wearable sensor and the other is by a Kinect-based remote sensor. Our experiments can demonstrate the advantages of the new method, which will have an impact on human activity detection research.

Training Classifiers with Shadow Features for Sensor-Based Human Activity Recognition

PubMed Central

Fong, Simon; Song, Wei; Cho, Kyungeun; Wong, Raymond; Wong, Kelvin K. L.

2017-01-01

In this paper, a novel training/testing process for building/using a classification model based on human activity recognition (HAR) is proposed. Traditionally, HAR has been accomplished by a classifier that learns the activities of a person by training with skeletal data obtained from a motion sensor, such as Microsoft Kinect. These skeletal data are the spatial coordinates (x, y, z) of different parts of the human body. The numeric information forms time series, temporal records of movement sequences that can be used for training a classifier. In addition to the spatial features that describe current positions in the skeletal data, new features called ‘shadow features’ are used to improve the supervised learning efficacy of the classifier. Shadow features are inferred from the dynamics of body movements, and thereby modelling the underlying momentum of the performed activities. They provide extra dimensions of information for characterising activities in the classification process, and thereby significantly improve the classification accuracy. Two cases of HAR are tested using a classification model trained with shadow features: one is by using wearable sensor and the other is by a Kinect-based remote sensor. Our experiments can demonstrate the advantages of the new method, which will have an impact on human activity detection research. PMID:28264470

Proficiency-based cervical cancer brachytherapy training.

PubMed

Zhao, Sherry; Francis, Louise; Todor, Dorin; Fields, Emma C

2018-04-25

Although brachytherapy increases the local control rate for cervical cancer, there has been a progressive decline in its use. Furthermore, the training among residency programs for gynecologic brachytherapy varies considerably, with some residents receiving little to no training. This trend is especially concerning given the association between poor applicator placement and decline in local control. Considering the success of proficiency-based training in other procedural specialties, we developed and implemented a proficiency-based cervical brachytherapy training curriculum for our residents. Each resident placed tandem and ovoid applicators with attending guidance and again alone 2 weeks later using a pelvic model that was modified to allow for cervical brachytherapy. Plain films were taken of the pelvic model, and applicator placement quality was evaluated. Other evaluated metrics included retention of key procedural details, the time taken for each procedure and presession and postsession surveys to assess confidence. During the initial session, residents on average met 4.5 of 5 placement criteria, which improved to 5 the second session. On average, residents were able to remember 7.6 of the 8 key procedural steps. Execution time decreased by an average of 10.5%. Resident confidence with the procedure improved dramatically, from 2.6 to 4.6 of 5. Residents who had previously never performed a tandem and ovoid procedure showed greater improvements in these criteria than those who had. All residents strongly agreed that the training was helpful and wanted to participate again the following year. Residents participating in this simulation training had measurable improvements in the time to perform the procedure, applicator placement quality, and confidence. This curriculum is easy to implement and is of great value for training residents, and would be particularly beneficial in programs with low volume of cervical brachytherapy cases. Simulation programs could also be created for other technically challenging radiation oncology procedures. Copyright © 2018 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.

Rasmussen's model of human behavior in laparoscopy training.

PubMed

Wentink, M; Stassen, L P S; Alwayn, I; Hosman, R J A W; Stassen, H G

2003-08-01

Compared to aviation, where virtual reality (VR) training has been standardized and simulators have proven their benefits, the objectives, needs, and means of VR training in minimally invasive surgery (MIS) still have to be established. The aim of the study presented is to introduce Rasmussen's model of human behavior as a practical framework for the definition of the training objectives, needs, and means in MIS. Rasmussen distinguishes three levels of human behavior: skill-, rule-, and knowledge-based behaviour. The training needs of a laparoscopic novice can be determined by identifying the specific skill-, rule-, and knowledge-based behavior that is required for performing safe laparoscopy. Future objectives of VR laparoscopy trainers should address all three levels of behavior. Although most commercially available simulators for laparoscopy aim at training skill-based behavior, especially the training of knowledge-based behavior during complications in surgery will improve safety levels. However, the cost and complexity of a training means increases when the training objectives proceed from the training of skill-based behavior to the training of complex knowledge-based behavior. In aviation, human behavior models have been used successfully to integrate the training of skill-, rule-, and knowledge-based behavior in a full flight simulator. Understanding surgeon behavior is one of the first steps towards a future full-scale laparoscopy simulator.

Development of a novel ex vivo porcine laparoscopic Heller myotomy and Nissen fundoplication training model (Toronto lap-Nissen simulator).

PubMed

Ujiie, Hideki; Kato, Tatsuya; Hu, Hsin-Pei; Bauer, Patrycja; Patel, Priya; Wada, Hironobu; Lee, Daiyoon; Fujino, Kosuke; Schieman, Colin; Pierre, Andrew; Waddell, Thomas K; Keshavjee, Shaf; Darling, Gail E; Yasufuku, Kazuhiro

2017-06-01

Surgical trainees are required to develop competency in a variety of laparoscopic operations. Developing laparoscopic technical skills can be difficult as there has been a decrease in the number of procedures performed. This study aims to develop an inexpensive and anatomically relevant model for training in laparoscopic foregut procedures. An ex vivo , anatomic model of the human upper abdomen was developed using intact porcine esophagus, stomach, diaphragm and spleen. The Toronto lap-Nissen simulator was contained in a laparoscopic box-trainer and included an arch system to simulate the normal radial shape and tension of the diaphragm. We integrated the use of this training model as a part of our laparoscopic skills laboratory-training curriculum. Afterwards, we surveyed trainees to evaluate the observed benefit of the learning session. Twenty-five trainees and five faculty members completed a survey regarding the use of this model. Among the trainees, only 4 (16%) had experience with laparoscopic Heller myotomy and Nissen fundoplication. They reported that practicing with the model was a valuable use of their limited time, repeating the exercise would be of additional benefit, and that the exercise improved their ability to perform or assist in an actual case in the operating room. Significant improvements were found in the following subjective measures comparing pre- vs. post-training: (I) knowledge level (5.6 vs. 8.0, P<0.001); (II) comfort level in assisting (6.3 vs. 7.6, P<0.001); and (III) comfort level in performing as the primary surgeon (4.9 vs. 7.1, P<0.001). The trainees and faculty members agreed that this model was of adequate fidelity and was a representative simulation of actual human anatomy. We developed an easily reproducible training model for laparoscopic procedures. This simulator reproduces human anatomy and increases the trainees' comfort level in performing and assisting with myotomy and fundoplication.

Development of a novel ex vivo porcine laparoscopic Heller myotomy and Nissen fundoplication training model (Toronto lap-Nissen simulator)

PubMed Central

Ujiie, Hideki; Kato, Tatsuya; Hu, Hsin-Pei; Bauer, Patrycja; Patel, Priya; Wada, Hironobu; Lee, Daiyoon; Fujino, Kosuke; Schieman, Colin; Pierre, Andrew; Waddell, Thomas K.; Keshavjee, Shaf; Darling, Gail E.

2017-01-01

Background Surgical trainees are required to develop competency in a variety of laparoscopic operations. Developing laparoscopic technical skills can be difficult as there has been a decrease in the number of procedures performed. This study aims to develop an inexpensive and anatomically relevant model for training in laparoscopic foregut procedures. Methods An ex vivo, anatomic model of the human upper abdomen was developed using intact porcine esophagus, stomach, diaphragm and spleen. The Toronto lap-Nissen simulator was contained in a laparoscopic box-trainer and included an arch system to simulate the normal radial shape and tension of the diaphragm. We integrated the use of this training model as a part of our laparoscopic skills laboratory-training curriculum. Afterwards, we surveyed trainees to evaluate the observed benefit of the learning session. Results Twenty-five trainees and five faculty members completed a survey regarding the use of this model. Among the trainees, only 4 (16%) had experience with laparoscopic Heller myotomy and Nissen fundoplication. They reported that practicing with the model was a valuable use of their limited time, repeating the exercise would be of additional benefit, and that the exercise improved their ability to perform or assist in an actual case in the operating room. Significant improvements were found in the following subjective measures comparing pre- vs. post-training: (I) knowledge level (5.6 vs. 8.0, P<0.001); (II) comfort level in assisting (6.3 vs. 7.6, P<0.001); and (III) comfort level in performing as the primary surgeon (4.9 vs. 7.1, P<0.001). The trainees and faculty members agreed that this model was of adequate fidelity and was a representative simulation of actual human anatomy. Conclusions We developed an easily reproducible training model for laparoscopic procedures. This simulator reproduces human anatomy and increases the trainees’ comfort level in performing and assisting with myotomy and fundoplication. PMID:28740664

Training quality job interviews with adults with developmental disabilities.

PubMed

Mozingo, D; Ackley, G B; Bailey, J S

1994-01-01

Supported work models of vocational integration have increased the employability of individuals with developmental disabilities. Interview questions most frequently used and corresponding responses considered most beneficial to job applicants were derived from an empirical analysis of the "hiring community" and served as a basis for the development of the verbal job interview skills training package evaluated in this research. Dependent measures were objective, behavioral indices of the quality of job interview responses. One-to-one training by a direct training staff, job coach, and a trained behavior analyst resulted in improved responding by all subjects as indicated in a multiple baseline design across interview questions. Improved quality in responding to questions generalized to variations in interview questions, to a novel interviewer, and in an in vivo interview situation. Finally, global measures of social validity support the value of the quality-of-response training.

Case Managers' Perspectives On What They Need To Do Their Job

PubMed Central

Eack, Shaun M.; Greeno, Catherine G.; Christian-Michaels, Stephen; Dennis, Amy; Anderson, Carol M.

2013-01-01

Objective To identify the perceived training needs of case managers working on community support teams in a community mental health center serving a semi-rural/suburban area. Methods Semi-structured interviews were conducted with 18 case managers and 3 supervisors to inquire about areas of training need in case management. Interviews were coded and analyzed for common themes regarding training needs and methods of training improvement. Results Identified training needs called for a hands-on, back to basics approach that included education on the symptoms of severe mental illness, co-morbid substance use problems, and methods of engaging consumers. A mentoring model was proposed as a potential vehicle for disseminating knowledge in these domains. Conclusions Case managers identify significant training needs that would address their basic understanding of severe mental illness. Programs targeting these needs may result in improved outcomes for case managers and the individuals with psychiatric disabilities. PMID:19346211

A transfer learning approach for classification of clinical significant prostate cancers from mpMRI scans

NASA Astrophysics Data System (ADS)

Chen, Quan; Xu, Xiang; Hu, Shiliang; Li, Xiao; Zou, Qing; Li, Yunpeng

2017-03-01

Deep learning has shown a great potential in computer aided diagnosis. However, in many applications, large dataset is not available. This makes the training of a sophisticated deep learning neural network (DNN) difficult. In this study, we demonstrated that with transfer learning, we can quickly retrain start-of-the-art DNN models with limited data provided by the prostateX challenge. The training data consists of 330 lesions, only 78 were clinical significant. Efforts were made to balance the data during training. We used ImageNet pre-trained inceptionV3 and Vgg-16 model and obtained AUC of 0.81 and 0.83 respectively on the prostateX test data, good for a 4th place finish. We noticed that models trained for different prostate zone has different sensitivity. Applying scaling factors before merging the result improves the AUC for the final result.

Instructional Design for Accelerated Macrocognitive Expertise in the Baseball Workplace

PubMed Central

Fadde, Peter J.

2016-01-01

The goal of accelerating expertise can leave researchers and trainers in human factors, naturalistic decision making, sport science, and expertise studies concerned about seemingly insufficient application of expert performance theories, findings and methods for training macrocognitive aspects of human performance. Video-occlusion methods perfected by sports expertise researchers have great instructional utility, in some cases offering an effective and inexpensive alternative to high-fidelity simulation. A key problem for instructional designers seems to be that expertise research done in laboratory and field settings doesn't get adequately translated into workplace training. Therefore, this article presents a framework for better linkage of expertise research/training across laboratory, field, and workplace settings. It also uses a case study to trace the development and implementation of a macrocognitive training program in the very challenging workplace of the baseball batters' box. This training, which was embedded for a full season in a college baseball team, targeted the perceptual-cognitive skill of pitch recognition that allows expert batters to circumvent limitations of human reaction time in order to hit a 90 mile-per-hour slider. While baseball batting has few analogous skills outside of sports, the instructional design principles of the training program developed to improve batting have wider applicability and implications. Its core operational principle, supported by information processing models but challenged by ecological models, decouples the perception-action link for targeted part-task training of the perception component, in much the same way that motor components routinely are isolated to leverage instructional efficiencies. After targeted perceptual training, perception and action were recoupled via transfer-appropriate tasks inspired by in situ research tasks. Using NCAA published statistics as performance measures, the cooperating team improved from middling performance to first in their conference in Runs Scored and team Batting Average. This case suggests that, beyond the usual considerations of effectiveness and efficiency, there are four challenges to embedded training in the workplace setting —namely: duration, curriculum, limited resources, and buy in. In the case reported here, and potentially in many domains beyond sports, part-task perceptual-cognitive training can improve targeted macrocognitive skills and thereby improve full-skill performance. PMID:26973581

The UIC Therapeutic Partnership Project. Final Report.

ERIC Educational Resources Information Center

Lawlor, Mary C.; Cada, Elizabeth A.

This interdisciplinary inservice training project at the University of Illinois at Chicago was designed to improve early childhood occupational and physical therapy services by developing, implementing, evaluating, and disseminating a comprehensive training model. The competency-based program was designed to address the developmental needs of…

Canopy Temperature and Vegetation Indices from High-Throughput Phenotyping Improve Accuracy of Pedigree and Genomic Selection for Grain Yield in Wheat

PubMed Central

Rutkoski, Jessica; Poland, Jesse; Mondal, Suchismita; Autrique, Enrique; Pérez, Lorena González; Crossa, José; Reynolds, Matthew; Singh, Ravi

2016-01-01

Genomic selection can be applied prior to phenotyping, enabling shorter breeding cycles and greater rates of genetic gain relative to phenotypic selection. Traits measured using high-throughput phenotyping based on proximal or remote sensing could be useful for improving pedigree and genomic prediction model accuracies for traits not yet possible to phenotype directly. We tested if using aerial measurements of canopy temperature, and green and red normalized difference vegetation index as secondary traits in pedigree and genomic best linear unbiased prediction models could increase accuracy for grain yield in wheat, Triticum aestivum L., using 557 lines in five environments. Secondary traits on training and test sets, and grain yield on the training set were modeled as multivariate, and compared to univariate models with grain yield on the training set only. Cross validation accuracies were estimated within and across-environment, with and without replication, and with and without correcting for days to heading. We observed that, within environment, with unreplicated secondary trait data, and without correcting for days to heading, secondary traits increased accuracies for grain yield by 56% in pedigree, and 70% in genomic prediction models, on average. Secondary traits increased accuracy slightly more when replicated, and considerably less when models corrected for days to heading. In across-environment prediction, trends were similar but less consistent. These results show that secondary traits measured in high-throughput could be used in pedigree and genomic prediction to improve accuracy. This approach could improve selection in wheat during early stages if validated in early-generation breeding plots. PMID:27402362

[Introduction of a Clinical Research Experience Program in Hospital Practical Training for Pharmacy Students and Its Evaluation].

PubMed

Takahashi, Katsuyuki; Suda, Yasuki; Kawaguchi, Hiroshi; Nakamura, Yasutaka; Kawabata, Shiho; Kawakami, Noriko; Nishikawa, Takeshi; Nagayama, Katsuya

2015-01-01

Long-term clinical training based on a model core curriculum was conducted to nurture highly competent pharmacists in the clinical field. Pharmacists' responsibilities are expanding, and a system has been developed to help pharmacists gain accreditation, identify specialties, and improve their training. However, this system requires research competency. Therefore clinical research should be considered a part of clinical training to encourage high competency among pharmacists. Because the model core curriculum does not include a section on clinical research. Osaka City University Hospital introduced a hands-on clinical research experience program and evaluated its usefulness. A significant improvement in the level of knowledge and awareness of clinical research was seen among students who underwent the clinical research experience program. In addition, the level of student satisfaction was higher. These findings suggest that a clinical research experience program may be useful to nurture a greater awareness of clinical research and knowledge acquisition among pharmacists.

Closing the loop on improvement: Packaging experience in the Software Engineering Laboratory

NASA Technical Reports Server (NTRS)

Waligora, Sharon R.; Landis, Linda C.; Doland, Jerry T.

1994-01-01

As part of its award-winning software process improvement program, the Software Engineering Laboratory (SEL) has developed an effective method for packaging organizational best practices based on real project experience into useful handbooks and training courses. This paper shares the SEL's experience over the past 12 years creating and updating software process handbooks and training courses. It provides cost models and guidelines for successful experience packaging derived from SEL experience.

Two different mechanisms support selective attention at different phases of training.

PubMed

Itthipuripat, Sirawaj; Cha, Kexin; Byers, Anna; Serences, John T

2017-06-01

Selective attention supports the prioritized processing of relevant sensory information to facilitate goal-directed behavior. Studies in human subjects demonstrate that attentional gain of cortical responses can sufficiently account for attention-related improvements in behavior. On the other hand, studies using highly trained nonhuman primates suggest that reductions in neural noise can better explain attentional facilitation of behavior. Given the importance of selective information processing in nearly all domains of cognition, we sought to reconcile these competing accounts by testing the hypothesis that extensive behavioral training alters the neural mechanisms that support selective attention. We tested this hypothesis using electroencephalography (EEG) to measure stimulus-evoked visual responses from human subjects while they performed a selective spatial attention task over the course of ~1 month. Early in training, spatial attention led to an increase in the gain of stimulus-evoked visual responses. Gain was apparent within ~100 ms of stimulus onset, and a quantitative model based on signal detection theory (SDT) successfully linked the magnitude of this gain modulation to attention-related improvements in behavior. However, after extensive training, this early attentional gain was eliminated even though there were still substantial attention-related improvements in behavior. Accordingly, the SDT-based model required noise reduction to account for the link between the stimulus-evoked visual responses and attentional modulations of behavior. These findings suggest that training can lead to fundamental changes in the way attention alters the early cortical responses that support selective information processing. Moreover, these data facilitate the translation of results across different species and across experimental procedures that employ different behavioral training regimes.

Two different mechanisms support selective attention at different phases of training

PubMed Central

Cha, Kexin; Byers, Anna; Serences, John T.

2017-01-01

Selective attention supports the prioritized processing of relevant sensory information to facilitate goal-directed behavior. Studies in human subjects demonstrate that attentional gain of cortical responses can sufficiently account for attention-related improvements in behavior. On the other hand, studies using highly trained nonhuman primates suggest that reductions in neural noise can better explain attentional facilitation of behavior. Given the importance of selective information processing in nearly all domains of cognition, we sought to reconcile these competing accounts by testing the hypothesis that extensive behavioral training alters the neural mechanisms that support selective attention. We tested this hypothesis using electroencephalography (EEG) to measure stimulus-evoked visual responses from human subjects while they performed a selective spatial attention task over the course of ~1 month. Early in training, spatial attention led to an increase in the gain of stimulus-evoked visual responses. Gain was apparent within ~100 ms of stimulus onset, and a quantitative model based on signal detection theory (SDT) successfully linked the magnitude of this gain modulation to attention-related improvements in behavior. However, after extensive training, this early attentional gain was eliminated even though there were still substantial attention-related improvements in behavior. Accordingly, the SDT-based model required noise reduction to account for the link between the stimulus-evoked visual responses and attentional modulations of behavior. These findings suggest that training can lead to fundamental changes in the way attention alters the early cortical responses that support selective information processing. Moreover, these data facilitate the translation of results across different species and across experimental procedures that employ different behavioral training regimes. PMID:28654635

Segmentation of knee cartilage by using a hierarchical active shape model based on multi-resolution transforms in magnetic resonance images

NASA Astrophysics Data System (ADS)

León, Madeleine; Escalante-Ramirez, Boris

2013-11-01

Knee osteoarthritis (OA) is characterized by the morphological degeneration of cartilage. Efficient segmentation of cartilage is important for cartilage damage diagnosis and to support therapeutic responses. We present a method for knee cartilage segmentation in magnetic resonance images (MRI). Our method incorporates the Hermite Transform to obtain a hierarchical decomposition of contours which describe knee cartilage shapes. Then, we compute a statistical model of the contour of interest from a set of training images. Thereby, our Hierarchical Active Shape Model (HASM) captures a large range of shape variability even from a small group of training samples, improving segmentation accuracy. The method was trained with a training set of 16- MRI of knee and tested with leave-one-out method.

Can a virtual reality surgical simulation training provide a self-driven and mentor-free skills learning? Investigation of the practical influence of the performance metrics from the virtual reality robotic surgery simulator on the skill learning and associated cognitive workloads.

PubMed

Lee, Gyusung I; Lee, Mija R

2018-01-01

While it is often claimed that virtual reality (VR) training system can offer self-directed and mentor-free skill learning using the system's performance metrics (PM), no studies have yet provided evidence-based confirmation. This experimental study investigated what extent to which trainees achieved their self-learning with a current VR simulator and whether additional mentoring improved skill learning, skill transfer and cognitive workloads in robotic surgery simulation training. Thirty-two surgical trainees were randomly assigned to either the Control-Group (CG) or Experiment-Group (EG). While the CG participants reviewed the PM at their discretion, the EG participants had explanations about PM and instructions on how to improve scores. Each subject completed a 5-week training using four simulation tasks. Pre- and post-training data were collected using both a simulator and robot. Peri-training data were collected after each session. Skill learning, time spent on PM (TPM), and cognitive workloads were compared between groups. After the simulation training, CG showed substantially lower simulation task scores (82.9 ± 6.0) compared with EG (93.2 ± 4.8). Both groups demonstrated improved physical model tasks performance with the actual robot, but the EG had a greater improvement in two tasks. The EG exhibited lower global mental workload/distress, higher engagement, and a better understanding regarding using PM to improve performance. The EG's TPM was initially long but substantially shortened as the group became familiar with PM. Our study demonstrated that the current VR simulator offered limited self-skill learning and additional mentoring still played an important role in improving the robotic surgery simulation training.

Prototyping of cerebral vasculature physical models.

PubMed

Khan, Imad S; Kelly, Patrick D; Singer, Robert J

2014-01-01

Prototyping of cerebral vasculature models through stereolithographic methods have the ability to accurately depict the 3D structures of complicated aneurysms with high accuracy. We describe the method to manufacture such a model and review some of its uses in the context of treatment planning, research, and surgical training. We prospectively used the data from the rotational angiography of a 40-year-old female who presented with an unruptured right paraclinoid aneurysm. The 3D virtual model was then converted to a physical life-sized model. The model constructed was shown to be a very accurate depiction of the aneurysm and its associated vasculature. It was found to be useful, among other things, for surgical training and as a patient education tool. With improving and more widespread printing options, these models have the potential to become an important part of research and training modalities.

Improvements in Resilience, Stress, and Somatic Symptoms Following Online Resilience Training

PubMed Central

Smith, Brad; Shatté, Andrew; Perlman, Adam; Siers, Michael; Lynch, Wendy D.

2018-01-01

Objective: To determine if participation in an online resilience program impacts resilience, stress, and somatic symptoms. Methods: Approximately 600 enrollees in the meQuilibrium resilience program received a series of brief, individually prescribed video, and text training modules in a user-friendly format. Regression models tested how time in the program affected change in resilience from baseline and how changes in resilience affected change in stress and reported symptoms. Results: A significant dose–response was detected, where increases in the time spent in training corresponded to greater improvements in resilience. Degree of change in resilience predicted the magnitude of reduction in stress and symptoms. Participants with the lowest resilience level at baseline experienced greater improvements. Conclusion: Interaction with the online resilience training program had a positive effect on resilience, stress, and symptoms in proportion to the time of use. PMID:28820863

Auditory Training: Evidence for Neural Plasticity in Older Adults

PubMed Central

Anderson, Samira; Kraus, Nina

2014-01-01

Improvements in digital amplification, cochlear implants, and other innovations have extended the potential for improving hearing function; yet, there remains a need for further hearing improvement in challenging listening situations, such as when trying to understand speech in noise or when listening to music. Here, we review evidence from animal and human models of plasticity in the brain’s ability to process speech and other meaningful stimuli. We considered studies targeting populations of younger through older adults, emphasizing studies that have employed randomized controlled designs and have made connections between neural and behavioral changes. Overall results indicate that the brain remains malleable through older adulthood, provided that treatment algorithms have been modified to allow for changes in learning with age. Improvements in speech-in-noise perception and cognition function accompany neural changes in auditory processing. The training-related improvements noted across studies support the need to consider auditory training strategies in the management of individuals who express concerns about hearing in difficult listening situations. Given evidence from studies engaging the brain’s reward centers, future research should consider how these centers can be naturally activated during training. PMID:25485037

Improving child protection: a systematic review of training and procedural interventions.

PubMed

Carter, Y H; Bannon, M J; Limbert, C; Docherty, A; Barlow, J

2006-09-01

To synthesise published evidence regarding the effectiveness of training and procedural interventions aimed at improving the identification and management of child abuse and neglect by health professionals. Systematic review for the period 1994 to 2005 of studies that evaluated child protection training and procedural interventions. Main outcome measures were learning achievement, attitudinal change, and clinical behaviour. Seven papers that examined the effectiveness of procedural interventions and 15 papers that evaluated training programmes met the inclusion criteria. Critical appraisal showed that evaluation of interventions was on the whole poor. It was found that certain procedural interventions (such as the use of checklists and structured forms) can result in improved recording of important clinical information and may also alert clinical staff to the possibility of abuse. While a variety of innovative training programmes were identified, there was an absence of rigorous evaluation of their impact. However a small number of one-group pre- and post-studies suggest improvements in a range of attitudes necessary for successful engagement in the child protection process. Current evidence supports the use of procedural changes that improve the documentation of suspected child maltreatment and that enhance professional awareness. The lack of an evidence based approach to the implementation of child protection training may restrict the ability of all health professionals to fulfil their role in the child protection process. Formal evaluation of a variety of models for the delivery of this training is urgently needed with subsequent dissemination of results that highlight those found to be most effective.

Effectiveness of the clinical teaching associate model to improve clinical learning outcomes: a randomized controlled trial.

PubMed

Parchebafieh, Samaneh; Gholizadeh, Leila; Lakdizaji, Sima; Ghiasvandiyan, Shahrzad; Davoodi, Arefeh

2014-01-01

This study examined the effectiveness of the clinical teaching associate (CTA) model to improve clinical learning outcomes in nursing students. Students were randomly allocated to either the CTA (n = 28) or traditional training group (n = 32), and their clinical knowledge, skills, and satisfaction with the learning experience were assessed and compared. The results showed that the CTA model was equally effective in improving clinical knowledge, skills, and satisfaction of nursing students.

Teaching a Model of Social Skills Training to Child Care Workers at a Group Home for Adolescents, for Improvement of Treatment Planning.

ERIC Educational Resources Information Center

Gramling, Lyle T.

This practicum study implemented a training program in the teaching of social skills for 4 child care workers at a group home for 12 adolescents having moderate to severe emotional and behavioral problems. The inservice training program involved teaching concepts, techniques, and social skills terminology during the first four sessions, with…

Altitude Training in Elite Swimmers for Sea Level Performance (Altitude Project).

PubMed

Rodríguez, Ferran A; Iglesias, Xavier; Feriche, Belén; Calderón-Soto, Carmen; Chaverri, Diego; Wachsmuth, Nadine B; Schmidt, Walter; Levine, Benjamin D

2015-09-01

This controlled, nonrandomized, parallel-groups trial investigated the effects on performance, V˙O2 and hemoglobin mass (tHbmass) of four preparatory in-season training interventions: living and training at moderate altitude for 3 and 4 wk (Hi-Hi3, Hi-Hi), living high and training high and low (Hi-HiLo, 4 wk), and living and training at sea level (SL) (Lo-Lo, 4 wk). From 61 elite swimmers, 54 met all inclusion criteria and completed time trials over 50- and 400-m crawl (TT50, TT400), and 100 (sprinters) or 200 m (nonsprinters) at best stroke (TT100/TT200). Maximal oxygen uptake (V˙O2max) and HR were measured with an incremental 4 × 200 m test. Training load was estimated using cumulative training impulse method and session RPE. Initial measures (PRE) were repeated immediately (POST) and once weekly on return to SL (PostW1 to PostW4). tHbmass was measured in duplicate at PRE and once weekly during the camp with CO rebreathing. Effects were analyzed using mixed linear modeling. TT100 or TT200 was worse or unchanged immediately at POST, but improved by approximately 3.5% regardless of living or training at SL or altitude after at least 1 wk of SL recovery. Hi-HiLo achieved greater improvement 2 (5.3%) and 4 wk (6.3%) after the camp. Hi-HiLo also improved more in TT400 and TT50 2 (4.2% and 5.2%, respectively) and 4 wk (4.7% and 5.5%) from return. This performance improvement was not linked linearly to changes in V˙O2max or tHbmass. A well-implemented 3- or 4-wk training camp may impair performance immediately but clearly improves performance even in elite swimmers after a period of SL recovery. Hi-HiLo for 4 wk improves performance in swimming above and beyond altitude and SL controls through complex mechanisms involving altitude living and SL training effects.

Development of a human cadaver model for training in laparoscopic donor nephrectomy.

PubMed

Sutton, Erica R H; Billeter, Adrian; Druen, Devin; Roberts, Henry; Rice, Jonathan

2017-06-01

The organ procurement network recommends a surgeon record 15 cases as surgeon or assistant for laparoscopic donor nephrectomies (LDN) prior to independent practice. The literature suggests that the learning curve for improved perioperative and patient outcomes is closer to 35 cases. In this article, we describe our development of a model utilizing fresh tissue and objective, quantifiable endpoints to document surgical progress, and efficiency in each of the major steps involved in LDN. Phase I of model development focused on the modifications necessary to maintain visualization for laparoscopic surgery in a human cadaver. Phase II tested proposed learner-based metrics of procedural competency for multiport LDN by timing procedural steps of LDN in a novice learner. Phases I and II required 12 and nine cadavers, with a total of 35 kidneys utilized. The following metrics improved with trial number for multiport LDN: time taken for dissection of the gonadal vein, ureter, renal hilum, adrenal and lumbrical veins, simulated warm ischemic time (WIT), and operative time. Human cadavers can be used for training in LDN as evidenced by improvements in timed learner-based metrics. This simulation-based model fills a gap in available training options for surgeons. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

"It's about Improving My Practice": The Learner Experience of Real-Time Coaching

ERIC Educational Resources Information Center

Sharplin, Erica J.; Stahl, Garth; Kehrwald, Ben

2016-01-01

This article reports on pre-service teachers' experience of the Real-Time Coaching model, an innovative technology-based approach to teacher training. The Real-Time Coaching model uses multiple feedback cycles via wireless technology to develop within pre-service teachers the specific skills and mindset toward continual improvement. Results of…

The Chrysler-Weldtech Approach to Retraining Displaced Workers. A Model Project to Develop Specialized Welding Skills Required for Modern Auto Assembly Operations. Final Technical Report.

ERIC Educational Resources Information Center

Lyons, Thomas M.; Knight, Glen A.

A model project was conducted to demonstrate how Chrysler, in partnership with the education community and the government, could provide technical training to enable displaced workers to contribute to the "H-Body" car launch, to improve their job skills, and to enhance their future employability. The training was conducted on a pilot…

Does computerized working memory training with game elements enhance motivation and training efficacy in children with ADHD?

PubMed

Prins, Pier J M; Dovis, Sebastiaan; Ponsioen, Albert; ten Brink, Esther; van der Oord, Saskia

2011-03-01

This study examined the benefits of adding game elements to standard computerized working memory (WM) training. Specifically, it examined whether game elements would enhance motivation and training performance of children with ADHD, and whether it would improve training efficacy. A total of 51 children with ADHD aged between 7 and 12 years were randomly assigned to WM training in a gaming format or to regular WM training that was not in a gaming format. Both groups completed three weekly sessions of WM training. Children using the game version of the WM training showed greater motivation (i.e., more time training), better training performance (i.e., more sequences reproduced and fewer errors), and better WM (i.e., higher scores on a WM task) at post-training than children using the regular WM training. Results are discussed in terms of executive functions and reinforcement models of ADHD. It is concluded that WM training with game elements significantly improves the motivation, training performance, and working memory of children with ADHD. The findings of this study are encouraging and may have wide-reaching practical implications in terms of the role of game elements in the design and implementation of new intervention efforts for children with ADHD.

Improving Training Results through Behavior Modeling.

ERIC Educational Resources Information Center

Arwady, Joseph W.

1984-01-01

Contains a partial inventory of sales training strategies and video techniques that heighten viewer involvement and promote transfer of learning to performance situations such as selling. These strategies have been used by Monroe Systems for Business, a manufacturer and distributor of business calculating equipment which recently expanded its…

Combination of support vector machine, artificial neural network and random forest for improving the classification of convective and stratiform rain using spectral features of SEVIRI data

NASA Astrophysics Data System (ADS)

Lazri, Mourad; Ameur, Soltane

2018-05-01

A model combining three classifiers, namely Support vector machine, Artificial neural network and Random forest (SAR) is designed for improving the classification of convective and stratiform rain. This model (SAR model) has been trained and then tested on a datasets derived from MSG-SEVIRI (Meteosat Second Generation-Spinning Enhanced Visible and Infrared Imager). Well-classified, mid-classified and misclassified pixels are determined from the combination of three classifiers. Mid-classified and misclassified pixels that are considered unreliable pixels are reclassified by using a novel training of the developed scheme. In this novel training, only the input data corresponding to the pixels in question to are used. This whole process is repeated a second time and applied to mid-classified and misclassified pixels separately. Learning and validation of the developed scheme are realized against co-located data observed by ground radar. The developed scheme outperformed different classifiers used separately and reached 97.40% of overall accuracy of classification.

Beyond crisis resource management: new frontiers in human factors training for acute care medicine.

PubMed

Petrosoniak, Andrew; Hicks, Christopher M

2013-12-01

Error is ubiquitous in medicine, particularly during critical events and resuscitation. A significant proportion of adverse events can be attributed to inadequate team-based skills such as communication, leadership, situation awareness and resource utilization. Aviation-based crisis resource management (CRM) training using high-fidelity simulation has been proposed as a strategy to improve team behaviours. This review will address key considerations in CRM training and outline recommendations for the future of human factors education in healthcare. A critical examination of the current literature yields several important considerations to guide the development and implementation of effective simulation-based CRM training. These include defining a priori domain-specific objectives, creating an immersive environment that encourages deliberate practice and transfer-appropriate processing, and the importance of effective team debriefing. Building on research from high-risk industry, we suggest that traditional CRM training may be augmented with new training techniques that promote the development of shared mental models for team and task processes, address the effect of acute stress on team performance, and integrate strategies to improve clinical reasoning and the detection of cognitive errors. The evolution of CRM training involves a 'Triple Threat' approach that integrates mental model theory for team and task processes, training for stressful situations and metacognition and error theory towards a more comprehensive training paradigm, with roots in high-risk industry and cognitive psychology. Further research is required to evaluate the impact of this approach on patient-oriented outcomes.

Enhanced response inhibition during intensive meditation training predicts improvements in self-reported adaptive socioemotional functioning.

PubMed

Sahdra, Baljinder K; MacLean, Katherine A; Ferrer, Emilio; Shaver, Phillip R; Rosenberg, Erika L; Jacobs, Tonya L; Zanesco, Anthony P; King, Brandon G; Aichele, Stephen R; Bridwell, David A; Mangun, George R; Lavy, Shiri; Wallace, B Alan; Saron, Clifford D

2011-04-01

We examined the impact of training-induced improvements in self-regulation, operationalized in terms of response inhibition, on longitudinal changes in self-reported adaptive socioemotional functioning. Data were collected from participants undergoing 3 months of intensive meditation training in an isolated retreat setting (Retreat 1) and a wait-list control group that later underwent identical training (Retreat 2). A 32-min response inhibition task (RIT) was designed to assess sustained self-regulatory control. Adaptive functioning (AF) was operationalized as a single latent factor underlying self-report measures of anxious and avoidant attachment, mindfulness, ego resilience, empathy, the five major personality traits (extroversion, agreeableness, conscientiousness, neuroticism, and openness to experience), difficulties in emotion regulation, depression, anxiety, and psychological well-being. Participants in Retreat 1 improved in RIT performance and AF over time whereas the controls did not. The control participants later also improved on both dimensions during their own retreat (Retreat 2). These improved levels of RIT performance and AF were sustained in follow-up assessments conducted approximately 5 months after the training. Longitudinal dynamic models with combined data from both retreats showed that improvement in RIT performance during training influenced the change in AF over time, which is consistent with a key claim in the Buddhist literature that enhanced capacity for self-regulation is an important precursor of changes in emotional well-being. PsycINFO Database Record (c) 2011 APA, all rights reserved.

Do lessons learned in a training intervention on web-based health care resources diffuse to nonexposed members in the primary care setting? A comparative study.

PubMed

Homa, Karen; Schifferdecker, Karen E; Reed, Virginia A

2008-01-01

The Internet offers a significant information resource for health professionals. A strategy to improve the use of these resources is for health care providers and staff to receive specific training. The aim of this study was to determine whether those who attended an Internet health care resource training intervention transferred knowledge and skills to others in the practice. Twenty-four primary care practices participated in the study in which 64 providers and staff attended a training intervention and 288 did not. A preintervention questionnaire that assessed knowledge, skill, and Internet usage was compared with a postintervention questionnaire. The main effect of interest in the linear model was the group by time interaction term, to determine whether knowledge and skill improved for both groups. There were 41 attendees and 222 nonattendees that completed both pre- and postintervention questionnaires. There were 9 variables that showed a possible diffusion pattern, in which both attendees and nonattendees improved between pre- and postintervention. Overall, the training intervention seemed to have impacted knowledge and skills of the respondents and also reported improvements in the clinical area of patient education, but frequency of use for most Web resources for medical decision making did not improve. An improvement strategy that depends on a training intervention for a few members in a practice may not necessarily transfer relative to all aspects of patient care.

Do Lessons Learned in a Training Intervention on Web-Based Health Care Resources Diffuse to Nonexposed Members in the Primary Care Setting? A Comparative Study

PubMed Central

Homa, Karen; Schifferdecker, Karen E.; Reed, Virginia A.

2009-01-01

Objective The Internet offers a significant information resource for health professionals. A strategy to improve the use of these resources is for health care providers and staff to receive specific training. The aim of this study was to determine whether those who attended an Internet health care resource training intervention transferred knowledge and skills to others in the practice. Methods Twenty-four primary care practices participated in the study in which 64 providers and staff attended a training intervention and 288 did not. A preintervention questionnaire that assessed knowledge, skill, and Internet usage was compared with a postintervention questionnaire. The main effect of interest in the linear model was the group by time interaction term, to determine whether knowledge and skill improved for both groups. Results There were 41 attendees and 222 nonattendees that completed both pre- and postintervention questionnaires. There were 9 variables that showed a possible diffusion pattern, in which both attendees and nonattendees improved between pre- and postintervention. Overall, the training intervention seemed to have impacted knowledge and skills of the respondents and also reported improvements in the clinical area of patient education, but frequency of use for most Web resources for medical decision making did not improve. Conclusion An improvement strategy that depends on a training intervention for a few members in a practice may not necessarily transfer relative to all aspects of patient care. PMID:19020403

Using Neural Networks to Improve the Performance of Radiative Transfer Modeling Used for Geometry Dependent LER Calculations

NASA Astrophysics Data System (ADS)

Fasnacht, Z.; Qin, W.; Haffner, D. P.; Loyola, D. G.; Joiner, J.; Krotkov, N. A.; Vasilkov, A. P.; Spurr, R. J. D.

2017-12-01

In order to estimate surface reflectance used in trace gas retrieval algorithms, radiative transfer models (RTM) such as the Vector Linearized Discrete Ordinate Radiative Transfer Model (VLIDORT) can be used to simulate the top of the atmosphere (TOA) radiances with advanced models of surface properties. With large volumes of satellite data, these model simulations can become computationally expensive. Look up table interpolation can improve the computational cost of the calculations, but the non-linear nature of the radiances requires a dense node structure if interpolation errors are to be minimized. In order to reduce our computational effort and improve the performance of look-up tables, neural networks can be trained to predict these radiances. We investigate the impact of using look-up table interpolation versus a neural network trained using the smart sampling technique, and show that neural networks can speed up calculations and reduce errors while using significantly less memory and RTM calls. In future work we will implement a neural network in operational processing to meet growing demands for reflectance modeling in support of high spatial resolution satellite missions.

[Clinical faculty in nursing care: weaving together the competences of nurse and teacher for a role change].

PubMed

Perrenoud, Béatrice; Marquis, Anne-Marie

2007-09-01

The nurse preceptor holds a specific role in the healthcare staff linked with both educational and nursing cultures. This article presents the analysis of the training program developed at the CHUV (Switzerland). The analysis indicates tra- how the training model centered on thefields of nursing and education, improves the development of a bi cultural identity, and the implementation of the preceptorship role. This training model effectively enables nurse preceptors to support students learning in a care perspective and allow them to cope with the potential conflicts between educational and nursing approaches. An evaluation of the training experience and some potential directions for the program are discussed.

A Mouse Model of Visual Perceptual Learning Reveals Alterations in Neuronal Coding and Dendritic Spine Density in the Visual Cortex.

PubMed

Wang, Yan; Wu, Wei; Zhang, Xian; Hu, Xu; Li, Yue; Lou, Shihao; Ma, Xiao; An, Xu; Liu, Hui; Peng, Jing; Ma, Danyi; Zhou, Yifeng; Yang, Yupeng

2016-01-01

Visual perceptual learning (VPL) can improve spatial vision in normally sighted and visually impaired individuals. Although previous studies of humans and large animals have explored the neural basis of VPL, elucidation of the underlying cellular and molecular mechanisms remains a challenge. Owing to the advantages of molecular genetic and optogenetic manipulations, the mouse is a promising model for providing a mechanistic understanding of VPL. Here, we thoroughly evaluated the effects and properties of VPL on spatial vision in C57BL/6J mice using a two-alternative, forced-choice visual water task. Briefly, the mice underwent prolonged training at near the individual threshold of contrast or spatial frequency (SF) for pattern discrimination or visual detection for 35 consecutive days. Following training, the contrast-threshold trained mice showed an 87% improvement in contrast sensitivity (CS) and a 55% gain in visual acuity (VA). Similarly, the SF-threshold trained mice exhibited comparable and long-lasting improvements in VA and significant gains in CS over a wide range of SFs. Furthermore, learning largely transferred across eyes and stimulus orientations. Interestingly, learning could transfer from a pattern discrimination task to a visual detection task, but not vice versa. We validated that this VPL fully restored VA in adult amblyopic mice and old mice. Taken together, these data indicate that mice, as a species, exhibit reliable VPL. Intrinsic signal optical imaging revealed that mice with perceptual training had higher cut-off SFs in primary visual cortex (V1) than those without perceptual training. Moreover, perceptual training induced an increase in the dendritic spine density in layer 2/3 pyramidal neurons of V1. These results indicated functional and structural alterations in V1 during VPL. Overall, our VPL mouse model will provide a platform for investigating the neurobiological basis of VPL.

Enhancing “usual practice” Treatment Foster Care: Findings from a randomized trial on improving youth outcomes

PubMed Central

Farmer, Elizabeth M.Z.; Burns, Barbara J.; Wagner, H. Ryan; Murray, Maureen; Southerland, Dannia G.

2009-01-01

Objectives This article reports the initial findings from a randomized trial to enhance Treatment Foster Care (TFC) in “usual care” agencies. The intervention, Together Facing the Challenge, was built upon a combination of practice-based elements from a prior descriptive study of TFC and selected elements from Chamberlain’s evidence-based model (MTFC) to fill conspicuous gaps in usual practice. The study was designed to examine whether additional training and consultation to staff and treatment parents improved outcomes for youth. Methods The study was conducted with 247 youth in TFC and their treatment parents from 14 TFC agencies in a southeastern state. Half of the agencies were randomized to the intervention condition and received study-provided training and consultation. Control agencies continued to provide training and treatment as usual. Data for the current analyses come from interviews with treatment parents at baseline, 6, and 12 months. Results Youth in the intervention group showed significant improvement (compared to the youth in the control group) on the three focal domains – symptoms, behaviors, and strengths. Effects were larger for behaviors and symptoms than for strengths. Conclusions This study employs a “hybrid” model to improve practice. It builds upon current practices in existing agencies and infuses additional training and consultation to overcome observed deficits. Such an approach has tremendous potential for moving beyond a singular focus on disseminating evidence-based interventions to a broader view of improving practice in a wide range of agencies. PMID:20513677

Cognitive Training and Transcranial Direct Current Stimulation for Mild Cognitive Impairment in Parkinson's Disease: A Randomized Controlled Trial

PubMed Central

Gasson, Natalie; Johnson, Andrew R.; Booth, Leon; Loftus, Andrea M.

2018-01-01

This study examined whether standard cognitive training, tailored cognitive training, transcranial direct current stimulation (tDCS), standard cognitive training + tDCS, or tailored cognitive training + tDCS improved cognitive function and functional outcomes in participants with PD and mild cognitive impairment (PD-MCI). Forty-two participants with PD-MCI were randomized to one of six groups: (1) standard cognitive training, (2) tailored cognitive training, (3) tDCS, (4) standard cognitive training + tDCS, (5) tailored cognitive training + tDCS, or (6) a control group. Interventions lasted 4 weeks, with cognitive and functional outcomes measured at baseline, post-intervention, and follow-up. The trial was registered with the Australian New Zealand Clinical Trials Registry (ANZCTR: 12614001039673). While controlling for moderator variables, Generalized Linear Mixed Models (GLMMs) showed that when compared to the control group, the intervention groups demonstrated variable statistically significant improvements across executive function, attention/working memory, memory, language, activities of daily living (ADL), and quality of life (QOL; Hedge's g range = 0.01 to 1.75). More outcomes improved for the groups that received standard or tailored cognitive training combined with tDCS. Participants with PD-MCI receiving cognitive training (standard or tailored) or tDCS demonstrated significant improvements on cognitive and functional outcomes, and combining these interventions provided greater therapeutic effects. PMID:29780572

A model of four hierarchical levels to train Chinese residents' teaching skills for "practice-based learning and improvement" competency.

PubMed

Yang, Ying-Ying; Yang, Ling-Yu; Hsu, Hui-Chi; Huang, Chia-Chang; Huang, Chin-Chou; Kirby, Ralph; Cheng, Hao Min; Chang, Ching-Chi; Chuang, Chiao-Lin; Liang, Jen-Feng; Lin, Chun-Chi; Lee, Wei-Shin; Ho, Shung-Tai; Lee, Fa-Yauh

2015-01-01

The current study focused on validating a protocol for training and auditing the resident's practice-based learning and improvement (PBLI) and quality improvement (QI) competencies for primary care. Twelve second-year (R2), 12 first-year (R1) and 12 postgraduate year-1 residents were enrolled into group A, B and C, respectively, as trainees. After three training protocols had been completed, a writing test, self-assessed questionnaire and mini-OSTE and end-of-rotation assessment were used in auditing the PBLI competency, performance and teaching ability of trainees. Baseline expert-assessed PBLI and QI knowledge application tool writing scores were low for the R1 and R2 residents. After three training protocols, PBLI and QI proficiencies, performance and teaching abilities were improved to similar levels cross the three training levels of residents based on the expert-assessed writing test-audited assessments and on the faculty and standardized clerk-assessed end-of-rotation-/mini-OSTE-audited assessments. The different four-level hierarchical protocols used to teach group A, B and C were equally beneficial and fitted their needs; namely the different levels of the trainees. Specifically, each level was able to augment their PBLI and QI proficiency. This educational intervention helps medical institutions to train residents as PBLI instructors.

Animal models in plastic and reconstructive surgery simulation-a review.

PubMed

Loh, Charles Yuen Yung; Wang, Aline Yen Ling; Tiong, Vincent Tze Yang; Athanassopoulos, Thanassi; Loh, Meiling; Lim, Philip; Kao, Huang-Kai

2018-01-01

The use of live and cadaveric animal models in surgical training is well established as a means of teaching and improving surgical skill in a controlled setting. We aim to review, evaluate, and summarize the models published in the literature that are applicable to Plastic Surgery training. A PubMed search for keywords relating to animal models in Plastic Surgery and the associated procedures was conducted. Animal models that had cross over between specialties such as microsurgery with Neurosurgery and pinnaplasty with ear, nose, and throat surgery were included as they were deemed to be relevant to our training curriculum. A level of evidence and recommendation assessment was then given to each surgical model. Our review found animal models applicable to plastic surgery training in four major categories namely-microsurgery training, flap raising, facial surgery, and hand surgery. Twenty-four separate articles described various methods of practicing microsurgical techniques on different types of animals. Fourteen different articles each described various methods of conducting flap-based procedures which consisted of either local or perforator flap dissection. Eight articles described different models for practicing hand surgery techniques. Finally, eight articles described animal models that were used for head and neck procedures. A comprehensive summary of animal models related to plastic surgery training has been compiled. Cadaveric animal models provide a readily available introduction to many procedures and ought to be used instead of live models when feasible. Copyright © 2017 Elsevier Inc. All rights reserved.

A successful program for training parent mentors to provide assistance with obtaining health insurance for uninsured children.

PubMed

Flores, Glenn; Walker, Candy; Lin, Hua; Lee, Michael; Fierro, Marco; Henry, Monica; Massey, Kenneth; Portillo, Alberto

2015-01-01

Seven million US children lack health insurance. Community health workers are effective in insuring uninsured children, and parent mentors (PMs) in improving asthmatic children's outcomes. It is unknown, however, whether a training program can result in PMs acquiring knowledge/skills to insure uninsured children. The study aim was to determine whether a PM training program results in improved knowledge/skills regarding insuring uninsured minority children. Minority parents in a primary-care clinic who already had Medicaid/Children's Health Insurance Program (CHIP)-covered children were selected as PMs, attending a 2-day training session addressing 9 topics. A 33-item pretraining test assessed knowledge/skills regarding Medicaid/CHIP, the application process, and medical homes. A 46-item posttest contained the same 33 pretest items (ordered differently) and 13 Likert-scale questions on training satisfaction. All 15 PMs were female and nonwhite, 60% were unemployed, and the mean annual income was $20,913. After training, overall test scores (0-100 scale) significantly increased, from a mean of 62 (range 39-82) to 88 (range 67-100) (P < .01), and the number of wrong answers decreased (mean reduction 8; P < .01). Significant improvements occurred in 6 of 9 topics, and 100% of PMs reported being very satisfied (86%) or satisfied (14%) with the training. Preliminary data indicate PMs are significantly more effective than traditional Medicaid/CHIP outreach/enrollment in insuring uninsured minority children. A PM training program resulted in significant improvements in knowledge and skills regarding outreach to and enrollment of uninsured, Medicaid/CHIP-eligible children, with high levels of satisfaction with the training. This PM training program might be a useful model for training Patient Protection and Affordable Care Act navigators. Copyright © 2015 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

Corticospinal excitability as a predictor of functional gains at the affected upper limb following robotic training in chronic stroke survivors.

PubMed

Milot, Marie-Hélène; Spencer, Steven J; Chan, Vicky; Allington, James P; Klein, Julius; Chou, Cathy; Pearson-Fuhrhop, Kristin; Bobrow, James E; Reinkensmeyer, David J; Cramer, Steven C

2014-01-01

Robotic training can help improve function of a paretic limb following a stroke, but individuals respond differently to the training. A predictor of functional gains might improve the ability to select those individuals more likely to benefit from robot-based therapy. Studies evaluating predictors of functional improvement after a robotic training are scarce. One study has found that white matter tract integrity predicts functional gains following a robotic training of the hand and wrist. Objective. To determine the predictive ability of behavioral and brain measures in order to improve selection of individuals for robotic training. Twenty subjects with chronic stroke participated in an 8-week course of robotic exoskeletal training for the arm. Before training, a clinical evaluation, functional magnetic resonance imaging (fMRI), diffusion tensor imaging, and transcranial magnetic stimulation (TMS) were each measured as predictors. Final functional gain was defined as change in the Box and Block Test (BBT). Measures significant in bivariate analysis were fed into a multivariate linear regression model. Training was associated with an average gain of 6 ± 5 blocks on the BBT (P < .0001). Bivariate analysis revealed that lower baseline motor-evoked potential (MEP) amplitude on TMS, and lower laterality M1 index on fMRI each significantly correlated with greater BBT change. In the multivariate linear regression analysis, baseline MEP magnitude was the only measure that remained significant. Subjects with lower baseline MEP magnitude benefited the most from robotic training of the affected arm. These subjects might have reserve remaining for the training to boost corticospinal excitability, translating into functional gains. © The Author(s) 2014.

Integration of Hands-On Team Training into Existing Curriculum Improves Both Technical and Nontechnical Skills in Laparoscopic Cholecystectomy.

PubMed

Caskey, Robert C; Owei, Lily; Rao, Raghavendra; Riddle, Elijah W; Brooks, Ari D; Dempsey, Daniel T; Morris, Jon B; Neylan, Christopher J; Williams, Noel N; Dumon, Kristoffel R

Nontechnical skills are an essential component of surgical education and a major competency assessed by the ACGME milestones project. However, the optimal way to integrate nontechnical skills training into existing curricula and then objectively evaluate the outcome is still unknown. The aim of this study was to determine the effect laparoscopic team-based task training would have on the nontechnical skills needed for laparoscopic surgery. 9 PGY-1 residents underwent an established training curriculum for teaching the knowledge and technical skills involved in laparoscopic cholecystectomy. Initial training involved a didactic session, expert-led practice on a porcine model in a simulated operating room and laparoscopic skills practice on a virtual reality trainer. Residents then performed a laparoscopic cholecystectomy on the same porcine model as a preintervention test. Three to four months following this, residents were subjected to specific nontechnical skills training involving 2 simple team-based laparoscopic tasks. They then practiced a further 4 to 6 hours on the virtual reality trainer. A repeat postintervention laparoscopic cholecystectomy was then performed 3 to 4 months after nontechnical skills training. Both the preintervention and postintervention laparoscopic cholecystectomies were audiovisually recorded and then evaluated by 2 independent surgeons in a blinded fashion. Technical skills were assessed using objective structured assessment of technical skills (OSATS) and a technique specific rating scale (TRS) that we developed for laparoscopic cholecystectomy. Nontechnical skills were assessed using nontechnical skills for surgeons (NOTSS). Residents also completed a survey at the beginning and end of the training. Tertiary care, university based teaching institution. A total of 9 general surgery residents at the intern level. The mean OSATS score improved from 13.7 ± 1.24 to 26.7 ± 0.31 (p < 0.001), the mean TRS score improved from 6 ± 0.46 to 13.1 ± 0.36 (p < 0.001) and the mean NOTSS score improved from 21.7 ± 1.83 to 36.3 ± 0.87 (p < 0.001) following the training. There was a strong correlation between OSATS and NOTSS scores (Pearson's R = 0.98) and TRS and NOTSS (R = 0.94). The inter-rater agreement was 0.79 for NOTSS, 0.9 for OSATS, and 0.82 for TRS. Following completion of the training, residents self-reported improvements in exchanging information (p < 0.01), coordinating activities (p < 0.01) and coping with pressure in the operating room (p < 0.001). Simple, team-based nontechnical skills training for laparoscopic cholecystectomy that was separate from technical skills training led to a sustained increase in residents' nontechnical skills 3 to 4 months after training. This was associated with a self-reported improvement in many nontechnical skills based on resident survey. Based on these results, we recommend that such designated nontechnical skills training is a valid alternative to other methods such as coaching and debriefing. We, therefore, plan to continue our efforts to develop team-based simulation tasks aimed at improving nontechnical skills for multiple surgical modalities. Copyright © 2017 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

A new beating-heart off-pump coronary artery bypass grafting training model.

PubMed

Bouma, Wobbe; Kuijpers, Michiel; Bijleveld, Aanke; De Maat, Gijs E; Koene, Bart M; Erasmus, Michiel E; Natour, Ehsan; Mariani, Massimo A

2015-01-01

Training models are essential in mastering the skills required for off-pump coronary artery bypass grafting (OPCAB). We describe a new, high-fidelity, effective and reproducible beating-heart OPCAB training model in human cadavers. Human cadavers were embalmed according to the 'Thiel method' which allows their long-term and repeated use. The training model was constructed by bilateral ligation of the pulmonary veins, cross-clamping of the aorta, positioning of an intra-aortic balloon pump (IABP) in the left ventricle (LV) through the apex (tightened with pledget-reinforced purse strings) and finally placing of a fluid line in the LV through the left atrial appendage (tightened with a pledget-reinforced purse string). The LV was filled with saline to the desired pressure through the fluid line and the IABP was switched on and set to a desired frequency [usually 60-80 beats per minute (bpm)]. A high-fidelity simulation has known limitations, but a more complex, realistic training environment with an actual beating (human) heart strengthens the entire training exercise and is of incremental value. All types of coronary artery anastomosis can be trained with this model. Training should be performed under the supervision of an experienced OPCAB surgeon and training progress is best evaluated with serial Objective Structured Assessment of Technical Skills (OSATS). A score of at least 48 points on the final OSATS ('good' on all components) is recommended before trainees can start their training on patients. The entire set-up provides a versatile training model to help develop and improve the skills required to safely perform beating heart OPCAB anastomoses. © The Author 2014. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

Educating teenagers about hearing health by training them to educate children.

PubMed

Welch, David; Reddy, Ravi; Hand, Jennifer; Devine, Irina May

2016-09-01

We investigated the change in hearing-health behaviour amongst teenagers trained to deliver the Dangerous Decibels programme to younger children. The Dangerous Decibels programme uses a two-stage process to train 8-12 year-old children to protect their hearing from noise: (1) a team of experts train 'Educators' who (2) give classroom training to children in schools. Training teenagers as Educators may add a second level of benefit if teenagers internalize the hearing-health messages that they present and thus protect their own hearing better. They were assessed before training, immediately after, and three months later (after all had presented the classroom training) using a questionnaire. In addition, a focus group was conducted with a subgroup of the Educators to assess their subjective experience. We trained 44 Educators aged 14-17 years. Results were generally positive: there were significant and sustained improvements in knowledge, self-reported behaviour, and perceived supports towards protecting hearing, and trends but not significant changes in attitudes or perceived barriers to hearing protection. Providing training to teenagers had benefits beyond the delivery of training to younger children, but improvements in the delivery model may increase the uptake and impact on the teenagers.

Evaluation of a Childhood Obesity Prevention Online Training Certificate Program for Community Family Educators.

PubMed

Eck, Kaitlyn; Alleman, Gayle Povis; Quick, Virginia; Martin-Biggers, Jennifer; Hongu, Nobuko; Byrd-Bredbenner, Carol

2016-12-01

Community family educators have the opportunity to incorporate childhood obesity prevention concepts in their programming with families of young children, but often lack formal health and nutrition education. The purpose of this feasibility study was to create an online training certificate program for community family educators and assess the program's effectiveness at improving participant's knowledge, attitudes, and intended and actual behaviors related to healthy lifestyles. Community family educators (n = 68) completed an online pretest, viewed 13 brief videos (8-15 min) focused on childhood obesity related topics and took mini-knowledge self-checks after each video followed by an online posttest. At posttest, paired t tests showed participants' childhood obesity prevention related knowledge (i.e., nutrition, physical activity, screen time and sleep) improved significantly (p < 0.001). Participants' attitudes toward parenting behaviors related to feeding practices, family meals, physical activity, screen time control and parent modeling significantly (p < 0.05) improved. Improvements also were seen in participants' intentions to promote obesity prevention behaviors (i.e., age appropriate portions sizes, adequate physically active, and parental role modeling). Furthermore, changes in personal health behaviors at posttest revealed participants had significantly (p < 0.05) greater dietary restraint, improvements in sleep quality, and reductions of use of electronic devices during meals and snacks. Overall, participants were very satisfied with the training program, felt comfortable with skills acquired, and enjoyed the program. Findings suggest this online training program is a feasible and effective method for improving community family educators' knowledge, attitudes, and intentions for obesity-prevention related parenting practices.

A randomized controlled trial of the effect of participatory ergonomic low back pain training on workplace improvement

PubMed Central

Kajiki, Shigeyuki; Izumi, Hiroyuki; Hayashida, Kenshi; Kusumoto, Akira; Nagata, Tomohisa; Mori, Koji

2017-01-01

Objectives: This study aimed to determine the effects of participatory workplace improvement (PWI) -based provision of ergonomic training and ergonomic action checklists (ACLs) to on-site managers on workplace improvement activities for low back pain (LBP). Methods: A randomized controlled trial (RCT) was conducted at a manufacturing company in Japan. Teams entered in the study were randomly assigned to a control and an intervention group. A total of three interventional training sessions on methods of ergonomics were provided to on-site managers in the intervention group, with 1-month intervals between sessions. Ergonomic ACLs were provided at the same time. After completion of the training sessions, each team then provided a report of improvements each month for the next 10 months. Two people in charge of safety and health chose two major objectives of the implemented activities from the five categories. The reported number of improvements was analyzed using a Poisson regression model. Results: In the intervention group, although the incident rate ratio (IRR) of PWIs in countermeasures for the LBP category was significantly elevated after the training sessions, the IRR of improvements decreased over time during the 10-month follow-up period. No significant difference was observed in the IRR of total PWIs in either the control or intervention group. Conclusions: PWI-based provision of ergonomic training sessions and ergonomics ACLs to on-site managers was shown to be effective for workplace improvement activities targeted at LBP. However, because the effects decrease over time, efforts should be made to maintain the effects through regular interventions. PMID:28320978

A randomized controlled trial of the effect of participatory ergonomic low back pain training on workplace improvement.

PubMed

Kajiki, Shigeyuki; Izumi, Hiroyuki; Hayashida, Kenshi; Kusumoto, Akira; Nagata, Tomohisa; Mori, Koji

2017-05-25

This study aimed to determine the effects of participatory workplace improvement (PWI) -based provision of ergonomic training and ergonomic action checklists (ACLs) to on-site managers on workplace improvement activities for low back pain (LBP). A randomized controlled trial (RCT) was conducted at a manufacturing company in Japan. Teams entered in the study were randomly assigned to a control and an intervention group. A total of three interventional training sessions on methods of ergonomics were provided to on-site managers in the intervention group, with 1-month intervals between sessions. Ergonomic ACLs were provided at the same time. After completion of the training sessions, each team then provided a report of improvements each month for the next 10 months. Two people in charge of safety and health chose two major objectives of the implemented activities from the five categories. The reported number of improvements was analyzed using a Poisson regression model. In the intervention group, although the incident rate ratio (IRR) of PWIs in countermeasures for the LBP category was significantly elevated after the training sessions, the IRR of improvements decreased over time during the 10-month follow-up period. No significant difference was observed in the IRR of total PWIs in either the control or intervention group. PWI-based provision of ergonomic training sessions and ergonomics ACLs to on-site managers was shown to be effective for workplace improvement activities targeted at LBP. However, because the effects decrease over time, efforts should be made to maintain the effects through regular interventions.

Comparison of self-efficacy and its improvement after artificial simulator or live animal model emergency procedure training.

PubMed

Hall, Andrew B; Riojas, Ramon; Sharon, Danny

2014-03-01

The objective of this study is to compare post-training self-efficacy between artificial simulators and live animal training for the performance of emergency medical procedures. Volunteer airmen of the 81st Medical Group, without prior medical procedure training, were randomly assigned to two experimental arms consisting of identical lectures and training of diagnostic peritoneal lavage, thoracostomy (chest tube), and cricothyroidotomy on either the TraumaMan (Simulab Corp., Seattle, Washington) artificial simulator or a live pig (Sus scrofa domestica) model. Volunteers were given a postlecture and postskills training assessment of self-efficacy. Twenty-seven volunteers that initially performed artificial simulator training subsequently underwent live animal training and provided assessments comparing both modalities. The results were first, postskills training self-efficacy scores were significantly higher than postlecture scores for either training mode and for all procedures (p < 0.0001). Second, post-training self-efficacy scores were not statistically different between live animal and artificial simulator training for diagnostic peritoneal lavage (p = 0.555), chest tube (p = 0.486), and cricothyroidotomy (p = 0.329). Finally, volunteers undergoing both training modalities indicated preference for live animal training (p < 0.0001). We conclude that artificial simulator and live animal training produce equivalent levels of self-efficacy after initial training, but there is a preference in using a live animal model to achieve those skills. Reprint & Copyright © 2014 Association of Military Surgeons of the U.S.

Simulation in shoulder surgery.

PubMed

Colaço, Henry B; Tennent, Duncan

2016-10-01

Simulation is a rapidly developing field in medical education. There is a growing need for trainee surgeons to acquire surgical skills in a cost-effective learning environment to improve patient safety and compensate for a reduction in training time and operative experience. Although simulation is not a replacement for traditional models of surgical training, and robust assessment metrics need to be validated before widespread use for accreditation, it is a useful adjunct that may ultimately lead to improving surgical outcomes for our patients.

Quality assessment of a new surgical simulator for neuroendoscopic training.

PubMed

Filho, Francisco Vaz Guimarães; Coelho, Giselle; Cavalheiro, Sergio; Lyra, Marcos; Zymberg, Samuel T

2011-04-01

Ideal surgical training models should be entirely reliable, atoxic, easy to handle, and, if possible, low cost. All available models have their advantages and disadvantages. The choice of one or another will depend on the type of surgery to be performed. The authors created an anatomical model called the S.I.M.O.N.T. (Sinus Model Oto-Rhino Neuro Trainer) Neurosurgical Endotrainer, which can provide reliable neuroendoscopic training. The aim in the present study was to assess both the quality of the model and the development of surgical skills by trainees. The S.I.M.O.N.T. is built of a synthetic thermoretractable, thermosensible rubber called Neoderma, which, combined with different polymers, produces more than 30 different formulas. Quality assessment of the model was based on qualitative and quantitative data obtained from training sessions with 9 experienced and 13 inexperienced neurosurgeons. The techniques used for evaluation were face validation, retest and interrater reliability, and construct validation. The experts considered the S.I.M.O.N.T. capable of reproducing surgical situations as if they were real and presenting great similarity with the human brain. Surgical results of serial training showed that the model could be considered precise. Finally, development and improvement in surgical skills by the trainees were observed and considered relevant to further training. It was also observed that the probability of any single error was dramatically decreased after each training session, with a mean reduction of 41.65% (range 38.7%-45.6%). Neuroendoscopic training has some specific requirements. A unique set of instruments is required, as is a model that can resemble real-life situations. The S.I.M.O.N.T. is a new alternative model specially designed for this purpose. Validation techniques followed by precision assessments attested to the model's feasibility.

A novel approach to rater training and certification in multinational trials.

PubMed

Jeglic, Elizabeth; Kobak, Kenneth A; Engelhardt, Nina; Williams, Janet B W; Lipsitz, Joshua D; Salvucci, Donna; Bryson, Heather; Bellew, Kevin

2007-07-01

Clinical trials are becoming increasingly international in scope. Global studies pose unique challenges in training and calibrating raters owing to language and cultural differences. Recent findings that poorly conducted interviews reduce study power, makes attention to raters' clinical skills critical. In this study, 109 raters from 14 countries went through a two-step certification process on the Hamilton Depression and Anxiety Rating Scales: (i) an online didactic tutorial on scoring conventions, and (ii) applied clinical training, consisting of small language-specific groups in which raters took turns interviewing patients while observed by an expert trainer, and observation and evaluation of individual interviews. Translators were used when native-language trainers were unavailable. Those who were unable to attend the startup meeting received the training individually via telephone. Results found a significant improvement in raters' knowledge of scoring conventions, with the mean number of correct answers on the 20-item test improving from 14.59 to 17.83, P<0.0001. In addition, raters' clinical skills improved significantly, with the mean score on the Rater Applied Performance Scale improving from their first to their second testing from 10.25 to 11.31, P=0.003. These results support the efficacy of this applied training model in improving raters' applied clinical skills in multinational trials.

Superior Effects of Eccentric to Concentric Knee Extensor Resistance Training on Physical Fitness, Insulin Sensitivity and Lipid Profiles of Elderly Men

PubMed Central

Chen, Trevor Chung-Ching; Tseng, Wei-Chin; Huang, Guan-Ling; Chen, Hsin-Lian; Tseng, Kuo-Wei; Nosaka, Kazunori

2017-01-01

It has been reported that eccentric training of knee extensors is effective for improving blood insulin sensitivity and lipid profiles to a greater extent than concentric training in young women. However, it is not known whether this is also the case for elderly individuals. Thus, the present study tested the hypothesis that eccentric training of the knee extensors would improve physical function and health parameters (e.g., blood lipid profiles) of older adults better than concentric training. Healthy elderly men (60–76 years) were assigned to either eccentric training or concentric training group (n = 13/group), and performed 30–60 eccentric or concentric contractions of knee extensors once a week. The intensity was progressively increased over 12 weeks from 10 to 100% of maximal concentric strength for eccentric training and from 50 to 100% for concentric training. Outcome measures were taken before and 4 days after the training period. The results showed that no sings of muscle damage were observed after any sessions. Functional physical fitness (e.g., 30-s chair stand) and maximal concentric contraction strength of the knee extensors increased greater (P ≤ 0.05) after eccentric training than concentric training. Homeostasis model assessment, oral glucose tolerance test and whole blood glycosylated hemoglobin showed improvement of insulin sensitivity only after eccentric training (P ≤ 0.05). Greater (P ≤ 0.05) decreases in fasting triacylglycerols, total, and low-density lipoprotein cholesterols were evident after eccentric training than concentric training, and high-density lipoprotein cholesterols increased only after eccentric training. These results support the hypothesis and suggest that it is better to focus on eccentric contractions in exercise medicine. PMID:28443029

[Training program in endourological surgery. Future perspectives.

PubMed

Soria, Federico; Villacampa, Felipe; Serrano, Alvaro; Moreno, Jesús; Rioja, Jorge; Sánchez, Francisco Miguel

2018-01-01

Current training in urological endoscopy lacks a specific training program. However, there is a clear need for a specific and uniform program, which will ensure the training, regardless of the unit where it is carried out. So, the goal is to first evaluate the current model and then bring improvements for update. The hospital training accreditation programme are only the adjustment of the official program of the urology specialty to the specific circumstances of each center, which causes variability in training of residents. After reviewing 19 training programs belonging to 12 Spanish regions. The current outlook shows that scarcely 10% of hospitals quantify the number of procedures/ year, although the Spanish program emphasizes that the achievement of the residents should be quantified. Urology residents, sense their training as inadequate and therefore their level of satisfaction is moderate. The three main problems detected by residents as an obstacle on their training are: the lack of supervision, tutors completing their own learning. Finally, the lack of quantification in surgical activities is described as a threat. This has no easy solution, since the learning curve of the most common techniques in endourology is not correctly established. Regarding aspects that can improve the current model, they highlight the need to design a specific program. The need to customize the training, the ineludible accreditation of tutors and obviously dignify the tutor's teaching activity. Another basic aspect is the inclusion of new technologies as training tools, e-learning. As well as the implementation of an adequate competency assessment plan and the possibility of relying on simulation systems. Finally, they highlight the need to attend monographic meetings and external clinic rotations to promote critical training.

Recognition of genetically modified product based on affinity propagation clustering and terahertz spectroscopy

NASA Astrophysics Data System (ADS)

Liu, Jianjun; Kan, Jianquan

2018-04-01

In this paper, based on the terahertz spectrum, a new identification method of genetically modified material by support vector machine (SVM) based on affinity propagation clustering is proposed. This algorithm mainly uses affinity propagation clustering algorithm to make cluster analysis and labeling on unlabeled training samples, and in the iterative process, the existing SVM training data are continuously updated, when establishing the identification model, it does not need to manually label the training samples, thus, the error caused by the human labeled samples is reduced, and the identification accuracy of the model is greatly improved.

MEDICAL LABORATORY ASSISTANT TEACHER EDUCATION INSTITUTE--PILOT PROGRAM. FINAL REPORT.

ERIC Educational Resources Information Center

COUCH, REX D.

AN INTERDISCIPLINARY GROUP COOPERATED IN PLANNING, CONDUCTING, AND EVALUATING A TEACHER EDUCATION INSTITUTE THAT WOULD OFFER THE OPPORTUNITY FOR TEACHER PARTICIPANTS TO IMPROVE THEIR TEACHING, PROVIDE AN EXPERIMENTAL APPROACH TO TEACHER TRAINING, AND SERVE AS A MODEL FOR OTHER TEACHER TRAINING INSTITUTES. BEHAVIORAL OBJECTIVES AND PARTICIPANT…

THE TECHNOLOGY OF MILITARY TRAINING.

ERIC Educational Resources Information Center

WALLIS, D.

THIS DOCUMENT IS PART OF THE PROCEEDINGS OF A CONFERENCE ON OPERATIONAL AND PERSONNEL RESEARCH IN THE MANAGEMENT OF MANPOWER SYSTEMS, HELD IN BRUSSELS IN 1965. A MODEL ILLUSTRATES THE DEVELOPMENT OF AN IMPROVED MILITARY INSTRUCTIONAL SYSTEM WHICH PROVIDES CONTINUOUS FEEDBACK AND CONTROL OF LEARNING. THE TRAINING COURSE INCLUDES--(1) A CLEAR…

Appling Andragogy Theory in Photoshop Training Programs

ERIC Educational Resources Information Center

Alajlan, Abdulrahman Saad

2015-01-01

Andragogy is a strategy for teaching adults that can be applied to Photoshop training. Photoshop workshops are frequented by adult learners, and thus andragogical models for instruction would be extremely helpful for prospective trainers looking to improve their classroom designs. Adult learners are much different than child learners, given the…

Pilot of a Learning Management System to Enhance Counselors' Relational Qualities through Mindfulness-Based Practices

ERIC Educational Resources Information Center

Ballinger, Julie Ann

2013-01-01

Mindfulness-based practices are associated with increased attentional qualities, improved self-focus styles, enhanced empathic understanding, and strengthened self-compassion, making these practices a viable addition to counselor training programs. However, current mindfulness training models are primarily designed for relief of psychological…

Effect of core strength and endurance training on performance in college students: randomized pilot study.

PubMed

Schilling, Jim F; Murphy, Jeff C; Bonney, John R; Thich, Jacob L

2013-07-01

Core training continues to be emphasized with the proposed intent of improving athletic performance. The purpose of this investigation was to discover if core isometric endurance exercises were superior to core isotonic strengthening exercises and if either influenced specific endurance, strength, and performance measures. Ten untrained students were randomly assigned to core isometric endurance (n = 5) and core isotonic strength training (n = 5). Each performed three exercises, two times per week for six weeks. A repeated measures ANOVA was used to compare the measurements for the dependent variables and significance by bonferroni post-hoc testing. The training protocols were compared using a 2 × 3 mixed model ANOVA. Improvement in trunk flexor and extensor endurance (p < 0.05) along with squat and bench press strength (p < 0.05) occurred with the strength group. Improvement in trunk flexor and right lateral endurance (p < 0.05) along with strength in the squat (p < 0.05) were found with the endurance group. Neither training protocol claimed superiority and both were ineffective in improving performance. Published by Elsevier Ltd.

Outcomes in knowledge, attitudes and confidence of nursing staff working in nursing and residential care homes following a dementia training programme.

PubMed

Scerri, Anthony; Scerri, Charles

2017-11-08

Dementia training programmes for staff working in long-term care settings have been found to be effective in improving staff outcomes. This study investigated the impact of a dementia training programme for all Maltese nursing staff working in public nursing/residential homes on their knowledge, attitudes and confidence. Additionally, we identified the predictors of these domains before and after the programme. A 14-hour training programme focusing on dementia management, care and policy was developed for all nursing staff working in public nursing and residential homes in Malta. A pretest-posttest design was used to evaluate the participants' knowledge of dementia, attitudes and confidence in working with residents with dementia using validated tools. Demographic variables were measured and compared with each staff domain. The majority of nursing staff attended the training programme with 261 fully completed questionnaires being collected pre-training and 214 post-training. The programme significantly improved nursing staff knowledge, attitudes and confidence. Stepwise regression analysis of each staff domain showed that the strongest predictor in all models at pre-training was the intensity of previous training programmes. Furthermore, staff who attended previous training continued to improve in their attitudes and confidence following programme completion. The study continues to shed further evidence on the impact of dementia training programs on staff outcomes. It also indicated that the intensity of previous participation in dementia training programmes was related to the participants' knowledge, attitudes and confidence and that continual exposure to training had a cumulative effect.

Increasing radiology capacity within the lung cancer pathway: centralised work-based support for trainee chest X-ray reporting radiographers.

PubMed

Woznitza, Nick; Steele, Rebecca; Piper, Keith; Burke, Stephen; Rowe, Susan; Bhowmik, Angshu; Maughn, Sue; Springett, Kate

2018-05-27

Diagnostic capacity and time to diagnosis are frequently identified as a barrier to improving cancer patient outcomes. Maximising the contribution of the medical imaging workforce, including reporting radiographers, is one way to improve service delivery. An efficient and effective centralised model of workplace training support was designed for a cohort of trainee chest X-ray (CXR) reporting radiographers. A comprehensive schedule of tutorials was planned and aligned with the curriculum of a post-graduate certificate in CXR reporting. Trainees were supported via a hub and spoke model (centralised training model), with the majority of education provided by a core group of experienced CXR reporting radiographers. Trainee and departmental feedback on the model was obtained using an online survey. Fourteen trainees were recruited from eight National Health Service Trusts across London. Significant efficiencies of scale were possible with centralised support (48 h) compared to traditional workplace support (348 h). Trainee and manager feedback overall was positive. Trainees and managers both reported good trainee support, translation of learning to practice and increased confidence. Logistics, including trainee travel and release, were identified as areas for improvement. Centralised workplace training support is an effective and efficient method to create sustainable diagnostic capacity and support improvements in the lung cancer pathway. © 2018 The Authors. Journal of Medical Radiation Sciences published by John Wiley & Sons Australia, Ltd on behalf of Australian Society of Medical Imaging and Radiation Therapy and New Zealand Institute of Medical Radiation Technology.

Measuring trainer fidelity in the transfer of suicide prevention training

PubMed Central

Cross, Wendi F.; Pisani, Anthony R.; Schmeelk-Cone, Karen; Xia, Yinglin; Tu, Xin; McMahon, Marcie; Munfakh, Jimmie Lou; Gould, Madelyn S.

2014-01-01

Background Finding effective and efficient models to train large numbers of suicide prevention interventionists, including ‘hotline’ crisis counselors, is a high priority. Train-the-trainer (TTT) models are widely used but understudied. Aims To assess the extent to which trainers following TTT delivered the Applied Suicide Intervention Skills Training (ASIST) program with fidelity, and to examine fidelity across two trainings and seven training segments. Methods We recorded and reliably rated trainer fidelity, defined as adherence to program content and competence of program delivery, for 34 newly trained ASIST trainers delivering the program to crisis center staff on two separate occasions. A total of 324 observations were coded. Trainer demographics were also collected. Results On average, trainers delivered two-thirds of the program. Previous training was associated with lower levels of trainer adherence to the program. 18% of trainers' observations were rated as solidly competent. Trainers did not improve fidelity from their first to second training. Significantly higher fidelity was found for lectures and lower fidelity was found for interactive training activities including asking about suicide and creating a safe plan. Conclusions We found wide variability in trainer fidelity to the ASIST program following TTT and few trainers had high levels of both adherence and competence. More research is needed to examine the cost-effectiveness of TTT models. PMID:24901061

The Effectiveness of Vowel Production Training with Real-Time Spectrographic Displays for Children with Profound Hearing Impairment.

NASA Astrophysics Data System (ADS)

Ertmer, David Joseph

1994-01-01

The effectiveness of vowel production training which incorporated direct instruction in combination with spectrographic models and feedback was assessed for two children who exhibited profound hearing impairment. A multiple-baseline design across behaviors, with replication across subjects was implemented to determine if vowel production accuracy improved following the introduction of treatment. Listener judgments of vowel correctness were obtained during the baseline, training, and follow-up phases of the study. Data were analyzed through visual inspection of changes in levels of accuracy, changes in trends of accuracy, and changes in variability of accuracy within and across phases. One subject showed significant improvement of all three trained vowel targets; the second subject for the first trained target only (Kolmogorov-Smirnov Two Sample Test). Performance trends during training sessions suggest that continued treatment would have resulted in further improvement for both subjects. Vowel duration, fundamental frequency, and the frequency locations of the first and second formants were measured before and after training. Acoustic analysis revealed highly individualized changes in the frequency locations of F1 and F2. Vowels which received the most training were maintained at higher levels than those which were introduced later in training, Some generalization of practiced vowel targets to untrained words was observed in both subjects. A bias towards judging productions as "correct" was observed for both subjects during self-evaluation tasks using spectrographic feedback.

Cooperative Program Improvement; An Experiment in ABE In-Service Training. Doolittle Family Education Center Experimental In-Service Training Project. Final Report.

ERIC Educational Resources Information Center

Griffith, William S.; And Others

This document, consisting of seven chapters and 12 appendixes, is a full final report of the Doolittle Family Education Center Experimental In-Service Training Project. Chapter II consists of the history and plan of the project including an explanation of the framework of the model that was used to conceptualize the project. Chapter III is a…

Accurate Descriptions of Hot Flow Behaviors Across β Transus of Ti-6Al-4V Alloy by Intelligence Algorithm GA-SVR

NASA Astrophysics Data System (ADS)

Wang, Li-yong; Li, Le; Zhang, Zhi-hua

2016-09-01

Hot compression tests of Ti-6Al-4V alloy in a wide temperature range of 1023-1323 K and strain rate range of 0.01-10 s-1 were conducted by a servo-hydraulic and computer-controlled Gleeble-3500 machine. In order to accurately and effectively characterize the highly nonlinear flow behaviors, support vector regression (SVR) which is a machine learning method was combined with genetic algorithm (GA) for characterizing the flow behaviors, namely, the GA-SVR. The prominent character of GA-SVR is that it with identical training parameters will keep training accuracy and prediction accuracy at a stable level in different attempts for a certain dataset. The learning abilities, generalization abilities, and modeling efficiencies of the mathematical regression model, ANN, and GA-SVR for Ti-6Al-4V alloy were detailedly compared. Comparison results show that the learning ability of the GA-SVR is stronger than the mathematical regression model. The generalization abilities and modeling efficiencies of these models were shown as follows in ascending order: the mathematical regression model < ANN < GA-SVR. The stress-strain data outside experimental conditions were predicted by the well-trained GA-SVR, which improved simulation accuracy of the load-stroke curve and can further improve the related research fields where stress-strain data play important roles, such as speculating work hardening and dynamic recovery, characterizing dynamic recrystallization evolution, and improving processing maps.

Quality assessment and improvement of post graduate family medicine training in the USA.

PubMed

Hoekzema, Grant S; Maxwell, Lisa; Gravel, Joseph W; Mills, Walter W; Geiger, William; Honeycutt, J David

2016-09-01

In 2013, the World Organisation of Family Doctors published training standards for post-graduate medical education (GME) in Family Medicine/General Practice (FP/GP). GME quality has not been well-defined, other than meeting accreditation standards. In 2009, the Association of Family Medicine Residency Directors (AFMRD) developed a tool that would aid in raising the quality of family medicine residency training in the USA. We describe the development of this quality improvement tool, which we called the residency performance index (RPI), and its first three years of use by US family medicine residency (FMR) programmes. The RPI uses metrics specific to family medicine training in the USA to help programmes identify strengths and areas for improvement in their educational activities. Our review of three years of experience with the RPI revealed difficulties with collecting data, and lack of information on graduates' scope of practice. It also showed the potential usefulness of the tool as a programme improvement mechanism. The RPI is a nationwide, standardised, programme quality improvement tool for family medicine residency programmes in the USA, which was successfully launched as part of AFMRD's strategic plan. Although some initial challenges need to be addressed, it has the promise to aid family medicine residencies in their internal improvement efforts. This model could be adapted in other post-graduate training settings in FM/GP around the world.

Virtual reality training for surgical trainees in laparoscopic surgery.

PubMed

Nagendran, Myura; Gurusamy, Kurinchi Selvan; Aggarwal, Rajesh; Loizidou, Marilena; Davidson, Brian R

2013-08-27

Standard surgical training has traditionally been one of apprenticeship, where the surgical trainee learns to perform surgery under the supervision of a trained surgeon. This is time-consuming, costly, and of variable effectiveness. Training using a virtual reality simulator is an option to supplement standard training. Virtual reality training improves the technical skills of surgical trainees such as decreased time for suturing and improved accuracy. The clinical impact of virtual reality training is not known. To assess the benefits (increased surgical proficiency and improved patient outcomes) and harms (potentially worse patient outcomes) of supplementary virtual reality training of surgical trainees with limited laparoscopic experience. We searched the Cochrane Central Register of Controlled Trials (CENTRAL) in The Cochrane Library, MEDLINE, EMBASE and Science Citation Index Expanded until July 2012. We included all randomised clinical trials comparing virtual reality training versus other forms of training including box-trainer training, no training, or standard laparoscopic training in surgical trainees with little laparoscopic experience. We also planned to include trials comparing different methods of virtual reality training. We included only trials that assessed the outcomes in people undergoing laparoscopic surgery. Two authors independently identified trials and collected data. We analysed the data with both the fixed-effect and the random-effects models using Review Manager 5 analysis. For each outcome we calculated the mean difference (MD) or standardised mean difference (SMD) with 95% confidence intervals based on intention-to-treat analysis. We included eight trials covering 109 surgical trainees with limited laparoscopic experience. Of the eight trials, six compared virtual reality versus no supplementary training. One trial compared virtual reality training versus box-trainer training and versus no supplementary training, and one trial compared virtual reality training versus box-trainer training. There were no trials that compared different forms of virtual reality training. All the trials were at high risk of bias. Operating time and operative performance were the only outcomes reported in the trials. The remaining outcomes such as mortality, morbidity, quality of life (the primary outcomes of this review) and hospital stay (a secondary outcome) were not reported. Virtual reality training versus no supplementary training: The operating time was significantly shorter in the virtual reality group than in the no supplementary training group (3 trials; 49 participants; MD -11.76 minutes; 95% CI -15.23 to -8.30). Two trials that could not be included in the meta-analysis also showed a reduction in operating time (statistically significant in one trial). The numerical values for operating time were not reported in these two trials. The operative performance was significantly better in the virtual reality group than the no supplementary training group using the fixed-effect model (2 trials; 33 participants; SMD 1.65; 95% CI 0.72 to 2.58). The results became non-significant when the random-effects model was used (2 trials; 33 participants; SMD 2.14; 95% CI -1.29 to 5.57). One trial could not be included in the meta-analysis as it did not report the numerical values. The authors stated that the operative performance of virtual reality group was significantly better than the control group. Virtual reality training versus box-trainer training: The only trial that reported operating time did not report the numerical values. In this trial, the operating time in the virtual reality group was significantly shorter than in the box-trainer group. Of the two trials that reported operative performance, only one trial reported the numerical values. The operative performance was significantly better in the virtual reality group than in the box-trainer group (1 trial; 19 participants; SMD 1.46; 95% CI 0.42 to 2.50). In the other trial that did not report the numerical values, the authors stated that the operative performance in the virtual reality group was significantly better than the box-trainer group. Virtual reality training appears to decrease the operating time and improve the operative performance of surgical trainees with limited laparoscopic experience when compared with no training or with box-trainer training. However, the impact of this decreased operating time and improvement in operative performance on patients and healthcare funders in terms of improved outcomes or decreased costs is not known. Further well-designed trials at low risk of bias and random errors are necessary. Such trials should assess the impact of virtual reality training on clinical outcomes.

Modelling the training effects of kinaesthetic acuity measurement in children.

PubMed

Sims, K; Morton, J

1998-07-01

In previous papers (Sims, Henderson, Hulme, & Morton, 1996a; Sims, Henderson, Morton, & Hulme, 1996b) we have found that the motor skills of clumsy children are capable of significant improvement following relatively brief interventions. Most remarkably, this included a 10-minute intervention while testing the kinaesthetic acuity of the children using a staircase method (Pest). In this paper, we show that Pest testing improves the kinaesthetic acuity of normal children as well. We analyse the available data on the development and improvement of motor skills and kinaesthetic acuity and derive a causal model for the underlying skills. We show that at least three independent cognitive/biological components are required to account for the data. These three components are affected differently by the various interventions that have been tried. We deduce that improvement on a general test of motor impairment can be found as a result of training in kinaesthetic acuity or through other, independent factors.

Innovative Model of Practice-Oriented Training of Employees of the Town-Forming Enterprise in the Mining Region (by the Example of JSC "SUEK-Kuzbass")

NASA Astrophysics Data System (ADS)

Kulay, Svetlana; Kayachev, Gennady

2017-11-01

The article proposes to improve the system of training of employees of joint-stock company SUEK-Kuzbass in the educational institutions of the Kemerovo region according to the requirements of the company using practice-oriented training technology. The aim of the work is to substantiate the effectiveness of implementing practice-oriented training, identify priority directions and ways of its development. The main objectives of the study are: to identify the main advantages for the company and students; determine the criteria for the success and practical value of applying practice-oriented training for the company; conduct a comparative analysis of the target and practice-oriented model of training for the company. The real needs of the employer through the dual form of training were taking into account. The expansion of positive experience in training engineering personnel in higher education in technology-based training with the involvement of specialists from other regions of the company and expanding training in mining was also included.

Exploring QSARs of the interaction of flavonoids with GABA (A) receptor using MLR, ANN and SVM techniques.

PubMed

Deeb, Omar; Shaik, Basheerulla; Agrawal, Vijay K

2014-10-01

Quantitative Structure-Activity Relationship (QSAR) models for binding affinity constants (log Ki) of 78 flavonoid ligands towards the benzodiazepine site of GABA (A) receptor complex were calculated using the machine learning methods: artificial neural network (ANN) and support vector machine (SVM) techniques. The models obtained were compared with those obtained using multiple linear regression (MLR) analysis. The descriptor selection and model building were performed with 10-fold cross-validation using the training data set. The SVM and MLR coefficient of determination values are 0.944 and 0.879, respectively, for the training set and are higher than those of ANN models. Though the SVM model shows improvement of training set fitting, the ANN model was superior to SVM and MLR in predicting the test set. Randomization test is employed to check the suitability of the models.

Prototyping of cerebral vasculature physical models

PubMed Central

Khan, Imad S.; Kelly, Patrick D.; Singer, Robert J.

2014-01-01

Background: Prototyping of cerebral vasculature models through stereolithographic methods have the ability to accurately depict the 3D structures of complicated aneurysms with high accuracy. We describe the method to manufacture such a model and review some of its uses in the context of treatment planning, research, and surgical training. Methods: We prospectively used the data from the rotational angiography of a 40-year-old female who presented with an unruptured right paraclinoid aneurysm. The 3D virtual model was then converted to a physical life-sized model. Results: The model constructed was shown to be a very accurate depiction of the aneurysm and its associated vasculature. It was found to be useful, among other things, for surgical training and as a patient education tool. Conclusion: With improving and more widespread printing options, these models have the potential to become an important part of research and training modalities. PMID:24678427

Progress toward improved leadership and management training in pathology.

PubMed

Weiss, Ronald L; Hassell, Lewis A; Parks, Eric R

2014-04-01

Competency gaps in leadership and laboratory management skills continue to exist between what training programs deliver and what recent graduates and future employers expect. A number of recent surveys substantiate this. Interest in delivering content in these areas is challenged by time constraints, the presence of knowledgeable faculty role models, and the necessary importance placed on diagnostic skills development, which overshadows any priority trainees have toward developing these skills. To describe the problem, the near-future horizon, the current solutions, and the recommendations for improving resident training in laboratory management. The demands of new health care delivery models and the value being placed on these skills by the Pathology Milestones and Next Accreditation System initiative of the Accreditation Council for Graduate Medical Education for training programs emphasizes their importance. This initiative includes 6 milestone competencies in laboratory management. Organizations like the American Society for Clinical Pathology, the American Pathology Foundation, the College of American Pathologists, and the Association of Pathology Chairs Program Directors Section recognize these competencies and are working to create new tools for training programs to deploy. It is our recommendation that (1) every training program develop a formal educational strategy for management training, (2) greater opportunity and visibility be afforded for peer-reviewed publications on management topics in mainstream pathology literature, and (3) pathology milestones-oriented tools be developed to assist program directors and their trainees in developing this necessary knowledge and skills.

Comparison of Individualized Covert Modeling, Self-Control Desensitization, and Study Skills Training for Alleviation of Test Anxiety.

ERIC Educational Resources Information Center

Harris, Gina; Johhson, Suzanne Bennett

1980-01-01

Individualized covert modeling and self-control desensitization substantially reduced self-reported test anxiety. However, the individualized covert modeling group was the only treatment group that showed significant improvement in academic performance. (Author)

The benefits of virtual reality simulator training for laparoscopic surgery.

PubMed

Hart, Roger; Karthigasu, Krishnan

2007-08-01

Virtual reality is a computer-generated system that provides a representation of an environment. This review will analyse the literature with regard to any benefit to be derived from training with virtual reality equipment and to describe the current equipment available. Virtual reality systems are not currently realistic of the live operating environment because they lack tactile sensation, and do not represent a complete operation. The literature suggests that virtual reality training is a valuable learning tool for gynaecologists in training, particularly those in the early stages of their careers. Furthermore, it may be of benefit for the ongoing audit of surgical skills and for the early identification of a surgeon's deficiencies before operative incidents occur. It is only a matter of time before realistic virtual reality models of most complete gynaecological operations are available, with improved haptics as a result of improved computer technology. It is inevitable that in the modern climate of litigation virtual reality training will become an essential part of clinical training, as evidence for its effectiveness as a training tool exists, and in many countries training by operating on live animals is not possible.

Music training and inhibitory control: a multidimensional model.

PubMed

Moreno, Sylvain; Farzan, Faranak

2015-03-01

Training programs aimed to improve cognitive skills have either yielded mixed results or remain to be validated. The limited benefits of such regimens are largely attributable to weak understanding of (1) how (and which) interventions provide the most cognitive improvements; and (2) how brain networks and neural mechanisms that underlie specific cognitive abilities can be modified selectively. Studies indicate that music training leads to robust and long-lasting benefits to behavior. Importantly, behavioral advantages conferred by music extend beyond perceptual abilities to even nonauditory functions, such as inhibitory control (IC) and its neural correlates. Alternative forms of arts engagement or brain training do not appear to yield such enhancements, which suggests that music uniquely taps into brain networks subserving a variety of auditory as well as domain-general mechanisms such as IC. To account for such widespread benefits of music training, we propose a framework of transfer effects characterized by three dimensions: level of processing, nature of the transfer, and involvement of executive functions. We suggest that transfer of skills is mediated through modulation of general cognitive processes, in particular IC. We believe that this model offers a viable framework to test the extent and limitations of music-related changes. © 2014 New York Academy of Sciences.

Hybrid simulated annealing and its application to optimization of hidden Markov models for visual speech recognition.

PubMed

Lee, Jong-Seok; Park, Cheol Hoon

2010-08-01

We propose a novel stochastic optimization algorithm, hybrid simulated annealing (SA), to train hidden Markov models (HMMs) for visual speech recognition. In our algorithm, SA is combined with a local optimization operator that substitutes a better solution for the current one to improve the convergence speed and the quality of solutions. We mathematically prove that the sequence of the objective values converges in probability to the global optimum in the algorithm. The algorithm is applied to train HMMs that are used as visual speech recognizers. While the popular training method of HMMs, the expectation-maximization algorithm, achieves only local optima in the parameter space, the proposed method can perform global optimization of the parameters of HMMs and thereby obtain solutions yielding improved recognition performance. The superiority of the proposed algorithm to the conventional ones is demonstrated via isolated word recognition experiments.

Error Detection-Based Model to Assess Educational Outcomes in Crisis Resource Management Training: A Pilot Study.

PubMed

Bouhabel, Sarah; Kay-Rivest, Emily; Nhan, Carol; Bank, Ilana; Nugus, Peter; Fisher, Rachel; Nguyen, Lily Hp

2017-06-01

Otolaryngology-head and neck surgery (OTL-HNS) residents face a variety of difficult, high-stress situations, which may occur early in their training. Since these events occur infrequently, simulation-based learning has become an important part of residents' training and is already well established in fields such as anesthesia and emergency medicine. In the domain of OTL-HNS, it is gradually gaining in popularity. Crisis Resource Management (CRM), a program adapted from the aviation industry, aims to improve outcomes of crisis situations by attempting to mitigate human errors. Some examples of CRM principles include cultivating situational awareness; promoting proper use of available resources; and improving rapid decision making, particularly in high-acuity, low-frequency clinical situations. Our pilot project sought to integrate CRM principles into an airway simulation course for OTL-HNS residents, but most important, it evaluated whether learning objectives were met, through use of a novel error identification model.

Randomized Clinical Trial of Cognitive Behavioral Social Skills Training for Schizophrenia: Improvement in Functioning and Experiential Negative Symptoms

PubMed Central

Granholm, Eric; Holden, Jason; Link, Peter C.; McQuaid, John R.

2014-01-01

Objective Identifying treatments to improve functioning and reduce negative symptoms in consumers with schizophrenia is of high public health significance. Method In this randomized clinical trial, participants with schizophrenia or schizoaffective disorder (N=149) were randomly assigned to cognitive behavioral social skills training (CBSST) or an active goal-focused supportive contact (GFSC) control condition. CBSST combined cognitive behavior therapy with social skills training and problem solving training to improve functioning and negative symptoms. GFSC was weekly supportive group therapy focused on setting and achieving functioning goals. Blind raters assessed functioning (primary outcome: Independent Living Skills Survey (ILSS)), CBSST skill knowledge, positive and negative symptoms, depression, and defeatist performance attitudes. Results In mixed-effects regression models in intent-to-treat analyses, CBSST skill knowledge, functioning, amotivation/asociality negative symptoms and defeatist performance attitudes improved significantly more in CBSST relative to GFSC. In both treatment groups, comparable improvements were also found for positive symptoms and a performance-based measure of social competence. Conclusions The results suggest CBSST is an effective treatment to improve functioning and experiential negative symptoms in consumers with schizophrenia, and both CBSST and supportive group therapy that is actively focused on setting and achieving functioning goals can improve social competence and reduce positive symptoms. PMID:24911420

Improved probabilistic inference as a general learning mechanism with action video games.

PubMed

Green, C Shawn; Pouget, Alexandre; Bavelier, Daphne

2010-09-14

Action video game play benefits performance in an array of sensory, perceptual, and attentional tasks that go well beyond the specifics of game play [1-9]. That a training regimen may induce improvements in so many different skills is notable because the majority of studies on training-induced learning report improvements on the trained task but limited transfer to other, even closely related, tasks ([10], but see also [11-13]). Here we ask whether improved probabilistic inference may explain such broad transfer. By using a visual perceptual decision making task [14, 15], the present study shows for the first time that action video game experience does indeed improve probabilistic inference. A neural model of this task [16] establishes how changing a single parameter, namely the strength of the connections between the neural layer providing the momentary evidence and the layer integrating the evidence over time, captures improvements in action-gamers behavior. These results were established in a visual, but also in a novel auditory, task, indicating generalization across modalities. Thus, improved probabilistic inference provides a general mechanism for why action video game playing enhances performance in a wide variety of tasks. In addition, this mechanism may serve as a signature of training regimens that are likely to produce transfer of learning. Copyright © 2010 Elsevier Ltd. All rights reserved.

Efficacy of Surgical Simulation Training in a Low-Income Country.

PubMed

Tansley, Gavin; Bailey, Jonathan G; Gu, Yuqi; Murray, Michelle; Livingston, Patricia; Georges, Ntakiyiruta; Hoogerboord, Marius

2016-11-01

Simulation training has evolved as an important component of postgraduate surgical education and has shown to be effective in teaching procedural skills. Despite potential benefits to low- and middle-income countries (LMIC), simulation training is predominately used in high-income settings. This study evaluates the effectiveness of simulation training in one LMIC (Rwanda). Twenty-six postgraduate surgical trainees at the University of Rwanda (Kigali, Rwanda) and Dalhousie University (Halifax, Canada) participated in the study. Participants attended one 3-hour simulation session using a high-fidelity, tissue-based model simulating the creation of an end ileostomy. Each participant was anonymously recorded completing the assigned task at three time points: prior to, immediately following, and 90 days following the simulation training. A single blinded expert reviewer assessed the performance using the Objective Structured Assessment of Technical Skill (OSATS) instrument. The mean OSATS score improvement for participants who completed all the assessments was 6.1 points [95 % Confidence Interval (CI) 2.2-9.9, p = 0.005]. Improvement was sustained over a 90-day period with a mean improvement of 4.1 points between the first and third attempts (95 % CI 0.3-7.9, p = 0.038). Simulation training was effective in both study sites, though most gains occurred with junior-level learners, with a mean improvement of 8.3 points (95 % CI 5.1-11.6, p < 0.001). Significant improvements were not identified for senior-level learners. This study supports the benefit for simulation in surgical training in LMICs. Skill improvements were limited to junior-level trainees. This work provides justification for investment in simulation-based curricula in Rwanda and potentially other LMICs.

Improving the quality of preclinical research echocardiography: Observations, training and guidelines for measurement.

PubMed

Donner, Daniel G; Kiriazis, Helen; Du, Xiao-Jun; Marwick, Thomas H; McMullen, Julie R

2018-04-20

Informal training in preclinical research may be a contributor to the poor reproducibility of preclinical cardiology research and low rates of translation into clinical research and practice. Mouse echocardiography is a widely used technique to assess cardiac structure and function in drug intervention studies using disease models. The inter-observer variability (IOV) of clinical echocardiographic measurements has been shown to improve with formalized training, but preclinical echocardiography lacks similarly critical standardization of training. The aims of this investigation were to assess the IOV of echocardiographic measurements from studies in mice, and address any technical impediments to reproducibility by implementing standardized guidelines through formalized training. In this prospective, single-site, observational cohort study, 13 scientists performing preclinical echocardiographic image analysis were assessed for measurement of short-axis M-mode-derived dimensions and calculated left ventricular mass (LVMass). Ten M-mode images of mouse hearts acquired and analyzed by an expert researcher with a spectrum of LVMass were selected for assessment, and validated by autopsy weight. Following the initial observation, a structured formal training program was introduced, and accuracy and reproducibility were re-evaluated. Mean absolute percentage error (MAPE) for Expert-calculated LVMass was 6{plus minus}4% compared to autopsy LVMass, and 25{plus minus}21% for participants before training. Standardized formal training improved participant MAPE by approximately 30% relative to expert-calculated LVMass (p<0.001). Participants initially categorized with high-range error (25-45%) improved to low-moderate error ranges (<15-25%). This report reveals an example of technical skill training insufficiency likely endemic to preclinical research and provides validated guidelines for echocardiographic measurement for adaptation to formalized in-training programs.

Eccentric Training for Tendon Healing After Acute Lesion: A Rat Model.

PubMed

Kaux, Jean-François; Libertiaux, Vincent; Leprince, Pierre; Fillet, Marianne; Denoel, Vincent; Wyss, Clémence; Lecut, Christelle; Gothot, André; Le Goff, Caroline; Croisier, Jean-Louis; Crielaard, Jean-Michel; Drion, Pierre

2017-05-01

The tendon is a dynamic entity that remodels permanently. Platelet-rich plasma (PRP) injection has been shown to have a beneficial effect on tendon healing after lesion in rats. Furthermore, eccentric exercise seems to improve the mechanical quality of the tendon. A combination of PRP injection and eccentric training might be more effective than either treatment alone. Controlled laboratory study. Adult male rats were anesthetized, an incision was performed in the middle of their left patellar tendon and an injection of physiological fluid (PF) or homologous PRP was randomly made at the lesion level. The rats were then divided into 2 groups: the eccentric group, undergoing eccentric training 3 times a week, and the untrained group, without any training. Thus, 4 groups were compared. After 5 weeks, the tendons were removed and their ultimate tensile strength and energy were measured. Tendons were frozen for proteomic analyses when all biomechanical tests were completed. Statistical analysis was performed with linear mixed effect models. No significant difference was found between the treatments using PF injection or PRP injection alone. However, the value of the ultimate tensile force at rupture was increased by 4.5 N (108% of control, P = .006) when eccentric training was performed. An intragroup analysis revealed that eccentric training significantly improved the ultimate force values for the PRP group. Proteomic analysis revealed that eccentric training led to an increase in abundance of several cytoskeletal proteins in the PF group, while a decrease in abundance of enzymes of the glycolytic pathway occurred in the PRP-treated groups, indicating that this treatment might redirect the exercise-driven metabolic plasticity of the tendon. Eccentric training altered the metabolic plasticity of tendon and led to an improvement of injured tendon resistance regardless of the treatment injected (PF or PRP). This study demonstrates the necessity of eccentric rehabilitation and training in cases of tendon lesion regardless of the treatment carried out.

In vivo porcine training model for cranial neurosurgery.

PubMed

Regelsberger, Jan; Eicker, Sven; Siasios, Ioannis; Hänggi, Daniel; Kirsch, Matthias; Horn, Peter; Winkler, Peter; Signoretti, Stefano; Fountas, Kostas; Dufour, Henry; Barcia, Juan A; Sakowitz, Oliver; Westermaier, Thomas; Sabel, Michael; Heese, Oliver

2015-01-01

Supplemental education is desirable for neurosurgical training, and the use of human cadaver specimen and virtual reality models is routine. An in vivo porcine training model for cranial neurosurgery was introduced in 2005, and our recent experience with this unique model is outlined here. For the first time, porcine anatomy is illustrated with particular respect to neurosurgical procedures. The pros and cons of this model are described. The aim of the course was to set up a laboratory scenery imitating an almost realistic operating room in which anatomy of the brain and neurosurgical techniques in a mentored environment free from time constraints could be trained. Learning objectives of the course were to learn about the microsurgical techniques in cranial neurosurgery and the management of complications. Participants were asked to evaluate the quality and utility of the programme via standardized questionnaires by a grading scale from A (best) to E (worst). In total, 154 residents have been trained on the porcine model to date. None of the participants regarded his own residency programme as structured. The bleeding and complication management (97%), the realistic laboratory set-up (89%) and the working environment (94%) were favoured by the vast majority of trainees and confirmed our previous findings. After finishing the course, the participants graded that their skills in bone drilling, dissecting the brain and preserving cerebral vessels under microscopic magnification had improved to level A and B. In vivo hands-on courses, fully equipped with microsurgical instruments, offer an outstanding training opportunity in which bleeding management on a pulsating, vital brain represents a unique training approach. Our results have shown that education programmes still lack practical training facilities in which in vivo models may act as a complementary approach in surgical training.

Improving well-being at work: A randomized controlled intervention based on selection, optimization, and compensation.

PubMed

Müller, Andreas; Heiden, Barbara; Herbig, Britta; Poppe, Franziska; Angerer, Peter

2016-04-01

This study aimed to develop, implement, and evaluate an occupational health intervention that is based on the theoretical model of selection, optimization, and compensation (SOC). We conducted a stratified randomized controlled intervention with 70 nurses of a community hospital in Germany (94% women; mean age 43.7 years). Altogether, the training consisted of 6 sessions (16.5 hours) over a period of 9 months. The training took place in groups of 6-8 employees. Participants were familiarized with the SOC model and developed and implemented a personal project based on SOC to cope effectively with 1 important job demand or to activate a job resource. Consistent with our hypotheses, we observed a meaningful trend that the proposed SOC training enhanced mental well-being, particularly in employees with a strong commitment to the intervention. While highly committed training participants reported higher levels of job control at follow-up, the effects were not statistical significant. Additional analyses of moderation effects showed that the training is particularly effective to enhance mental well-being when job control is low. Contrary to our assumptions, perceived work ability was not improved by the training. Our study provides first indications that SOC training might be a promising approach to occupational health and stress prevention. Moreover, it identifies critical success factors of occupational interventions based on SOC. However, additional studies are needed to corroborate the effectiveness of SOC trainings in the occupational contexts. (c) 2016 APA, all rights reserved).

A Comparison of Mindfulness-Based Group Training and Skills Group Training in Adults With ADHD.

PubMed

Edel, Marc-Andreas; Hölter, Tanja; Wassink, Kristina; Juckel, Georg

2017-04-01

To compare a novel "third wave" mindfulness-based training program with an established skills training derived from dialectical behavior therapy, to reduce ADHD symptoms and improve mindfulness and self-efficacy. Ninety-one adults with ADHD (combined and inattentive type, mainly medicated) were non-randomly assigned to and treated within a mindfulness-based training group (MBTG, n = 39) or a skills training group (STG, n = 52), each performed in 13 weekly 2-hr sessions. General linear models with repeated measures revealed that both programs resulted in a similar reduction of ADHD symptoms, and improvement of mindfulness and self-efficacy. However, the effect sizes were in the small-to-medium range. A decrease in ADHD symptoms ≥30% was observed in 30.8% of the MBTG participants and 11.5% of the STG participants. The comparatively weak results may be due to limitations such as the absence of randomization, the lack of a control group without intervention, and the lack of matching groups for borderline, depression, and anxiety status. Moreover, audio instructions for home exercises and more stringent monitoring of participants' progress and eventual absence from sessions might have improved the outcome.

Intensive Auditory Cognitive Training Improves Verbal Memory in Adolescents and Young Adults at Clinical High Risk for Psychosis.

PubMed

Loewy, Rachel; Fisher, Melissa; Schlosser, Danielle A; Biagianti, Bruno; Stuart, Barbara; Mathalon, Daniel H; Vinogradov, Sophia

2016-07-01

Individuals at clinical high risk (CHR) for psychosis demonstrate cognitive impairments that predict later psychotic transition and real-world functioning. Cognitive training has shown benefits in schizophrenia, but has not yet been adequately tested in the CHR population. In this double-blind randomized controlled trial, CHR individuals (N = 83) were given laptop computers and trained at home on 40 hours of auditory processing-based exercises designed to target verbal learning and memory operations, or on computer games (CG). Participants were assessed with neurocognitive tests based on the Measurement and Treatment Research to Improve Cognition in Schizophrenia initiative (MATRICS) battery and rated on symptoms and functioning. Groups were compared before and after training using a mixed-effects model with restricted maximum likelihood estimation, given the high study attrition rate (42%). Participants in the targeted cognitive training group showed a significant improvement in Verbal Memory compared to CG participants (effect size = 0.61). Positive and Total symptoms improved in both groups over time. CHR individuals showed patterns of training-induced cognitive improvement in verbal memory consistent with prior observations in schizophrenia. This is a particularly vulnerable domain in individuals at-risk for psychosis that predicts later functioning and psychotic transition. Ongoing follow-up of this cohort will assess the durability of training effects in CHR individuals, as well as the potential impact on symptoms and functioning over time. Clinical Trials Number: NCT00655239. URL: https://clinicaltrials.gov/ct2/show/NCT00655239?term=vinogradov&rank=5. Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center 2016.

Role of virtual reality simulation in endoscopy training

PubMed Central

Harpham-Lockyer, Louis; Laskaratos, Faidon-Marios; Berlingieri, Pasquale; Epstein, Owen

2015-01-01

Recent advancements in virtual reality graphics and models have allowed virtual reality simulators to be incorporated into a variety of endoscopic training programmes. Use of virtual reality simulators in training programmes is thought to improve skill acquisition amongst trainees which is reflected in improved patient comfort and safety. Several studies have already been carried out to ascertain the impact that usage of virtual reality simulators may have upon trainee learning curves and how this may translate to patient comfort. This article reviews the available literature in this area of medical education which is particularly relevant to all parties involved in endoscopy training and curriculum development. Assessment of the available evidence for an optimal exposure time with virtual reality simulators and the long-term benefits of their use are also discussed. PMID:26675895

Role of virtual reality simulation in endoscopy training.

PubMed

Harpham-Lockyer, Louis; Laskaratos, Faidon-Marios; Berlingieri, Pasquale; Epstein, Owen

2015-12-10

Recent advancements in virtual reality graphics and models have allowed virtual reality simulators to be incorporated into a variety of endoscopic training programmes. Use of virtual reality simulators in training programmes is thought to improve skill acquisition amongst trainees which is reflected in improved patient comfort and safety. Several studies have already been carried out to ascertain the impact that usage of virtual reality simulators may have upon trainee learning curves and how this may translate to patient comfort. This article reviews the available literature in this area of medical education which is particularly relevant to all parties involved in endoscopy training and curriculum development. Assessment of the available evidence for an optimal exposure time with virtual reality simulators and the long-term benefits of their use are also discussed.

Many Molecular Properties from One Kernel in Chemical Space

DOE Office of Scientific and Technical Information (OSTI.GOV)

Ramakrishnan, Raghunathan; von Lilienfeld, O. Anatole

We introduce property-independent kernels for machine learning modeling of arbitrarily many molecular properties. The kernels encode molecular structures for training sets of varying size, as well as similarity measures sufficiently diffuse in chemical space to sample over all training molecules. Corresponding molecular reference properties provided, they enable the instantaneous generation of ML models which can systematically be improved through the addition of more data. This idea is exemplified for single kernel based modeling of internal energy, enthalpy, free energy, heat capacity, polarizability, electronic spread, zero-point vibrational energy, energies of frontier orbitals, HOMOLUMO gap, and the highest fundamental vibrational wavenumber. Modelsmore » of these properties are trained and tested using 112 kilo organic molecules of similar size. Resulting models are discussed as well as the kernels’ use for generating and using other property models.« less

Slow walking model for children with multiple disabilities via an application of humanoid robot

NASA Astrophysics Data System (ADS)

Wang, ZeFeng; Peyrodie, Laurent; Cao, Hua; Agnani, Olivier; Watelain, Eric; Wang, HaoPing

2016-02-01

Walk training research with children having multiple disabilities is presented. Orthosis aid in walking for children with multiple disabilities such as Cerebral Palsy continues to be a clinical and technological challenge. In order to reduce pain and improve treatment strategies, an intermediate structure - humanoid robot NAO - is proposed as an assay platform to study walking training models, to be transferred to future special exoskeletons for children. A suitable and stable walking model is proposed for walk training. It would be simulated and tested on NAO. This comparative study of zero moment point (ZMP) supports polygons and energy consumption validates the model as more stable than the conventional NAO. Accordingly direction variation of the center of mass and the slopes of linear regression knee/ankle angles, the Slow Walk model faithfully emulates the gait pattern of children.

The effect of rhythmic musical training on healthy older adults' gait and cognitive function.

PubMed

Maclean, Linda M; Brown, Laura J E; Astell, Arlene J

2014-08-01

Older adults' gait is disturbed when a demanding secondary cognitive task is added. Gait training has been shown to improve older adults' walking performance, but it is not clear how training affects their cognitive performance. This study examined the impact on gait, in terms of cost or benefit to cognitive performance, of training healthy older adults to walk to a rhythmic musical beat. In a mixed model design, 45 healthy older adults aged more than 65 years (M = 71.7 years) were randomly assigned to 3 groups. One group received a rhythmic musical training and their dual-task (DT) walking and cognitive performances were compared with a group who had music playing in the background but no training, and a third group who heard no music and received no training. Outcomes in single-task (ST) and DT conditions were step-time variability and velocity for gait and correct cognitive responses for the cognitive task. The Musical Training group's step-time variability improved in both the ST (p < .05) and the DT (p < .05) after training, without adversely affecting their cognitive performance. No change was seen in the control groups. Rhythmic musical training can improve gait steadiness in healthy older adults with no negative impact on concurrent cognitive functioning. This could potentially enhance "postural reserve" and reduce fall risk. © The Author 2013. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Interprofessional education increases knowledge, promotes team building, and changes practice in the care of Parkinson's disease.

PubMed

Cohen, Elaine V; Hagestuen, Ruth; González-Ramos, Gladys; Cohen, Hillel W; Bassich, Celia; Book, Elaine; Bradley, Kathy P; Carter, Julie H; Di Minno, Mariann; Gardner, Joan; Giroux, Monique; González, Manny J; Holten, Sandra; Joseph, Ricky; Kornegay, Denise D; Simpson, Patricia A; Tomaino, Concetta M; Vandendolder, Richard P; Walde-Douglas, Maria; Wichmann, Rosemary; Morgan, John C

2016-01-01

Examine outcomes for the National Parkinson Foundation (NPF) Allied Team Training for Parkinson (ATTP), an interprofessional education (IPE) program in Parkinson's disease (PD) and team-based care for medicine, nursing, occupational, physical and music therapies, physician assistant, social work and speech-language pathology disciplines. Healthcare professionals need education in evidence-based PD practices and working effectively in teams. Few evidence-based models of IPE in PD exist. Knowledge about PD, team-based care, the role of other disciplines and attitudes towards healthcare teams were measured before and after a protocol-driven training program. Knowledge, attitudes and practice changes were again measured at 6-month post-training. Trainee results were compared to results of controls. Twenty-six NPF-ATTP trainings were held across the U.S. (2003-2013). Compared to control participants (n = 100), trainees (n = 1468) showed statistically significant posttest improvement in all major outcomes, including self-perceived (p < 0.001) and objective knowledge (p < 0.001), Understanding Role of Other Disciplines (p < 0.001), Attitudes Toward Health Care Teams Scale (p < 0.001), and the Attitudes Toward Value of Teams (p < 0.001) subscale. Despite some decline, significant improvements were largely sustained at six-month post-training. Qualitative analyses confirmed post-training practice changes. The NPF-ATTP model IPE program showed sustained positive gains in knowledge of PD, team strategies and role of other disciplines, team attitudes, and important practice improvements. Further research should examine longer-term outcomes, objectively measure practice changes and mediators, and determine impact on patient outcomes. Copyright © 2015 Elsevier Ltd. All rights reserved.

Sustaining Fidelity Following the Nationwide PMTO™ Implementation in Norway

PubMed Central

Forgatch, Marion S.; DeGarmo, David S.

2011-01-01

This report describes three studies from the nationwide Norwegian implementation of Parent Management Training – Oregon Model (PMTO™), an empirically supported treatment for families of children with behavior problems (Forgatch and Patterson 2010). Separate stages of the implementation were evaluated using a fidelity measure based on direct observation of intervention sessions. Study 1 assessed growth in fidelity observed early, mid, and late in the training of a group of practitioners. We hypothesized increased fidelity and decreased variability in practice. Study 2 evaluated method fidelity over the course of three generations of practitioners trained in PMTO. Generation 1 (G1) was trained by the PMTO developer/purveyors; Generation 2 (G2) was trained by selected G1 Norwegian trainers; and Generation 3 (G3) was trained by G1 and G2 trainers. We hypothesized decrease in fidelity with each generation. Study 3 tested the predictive validity of fidelity in a cross-cultural replication, hypothesizing that higher fidelity scores would correlate with improved parenting practices observed in parent-child interactions before and after treatment. In Study 1, trainees' performance improved and became more homogeneous as predicted. In Study 2, a small decline in fidelity followed the transfer from the purveyor trainers to Norwegian trainers in G2, but G3 scores were equivalent to those attained by G1. Thus, the hypothesis was not fully supported. Finally, the FIMP validity model replicated; PMTO fidelity significantly contributed to improvements in parenting practices from pre- to post-treatment. The data indicate that PMTO was transferred successfully to Norwegian implementation with sustained fidelity and cross-cultural generalization. PMID:21671090

Effects of Training on Knowledge, Attitude and Practices of Malaria Prevention and Control among Community Role Model Care Givers in South Western Nigeria.

PubMed

Olalekan, Adebimpe W; Adebukola, Adebimpe M

2015-10-01

Malaria is endemic in Nigeria, with significant records of mortality and morbidity. Adequate community involvement is central to a successful implementation of malaria control programs. This study assessed the effects of a training programme on knowledge of malaria prevention and control among community role model care givers. A descriptive cross sectional study of a pre-and post-test design method was conducted among 400 eligible community members in Osun State. Training was given in the form of organized lectures, health education and practical demonstration sessions. Scores of pre-test and post-test conducted after four months interval were compared. Multistage sampling method was adopted in selecting study participants, while data was analyzed using the SPSS software version 17.0. Mean age was 43.8 (±1.4) years. Average knowledge score of cause, transmission, risk factors and consequences, awareness of common symptoms and preventive practices improved during post-training test when compared with pr-training test. The overall descriptive mean knowledge score in pre-test and post-test were 2.1 and 3.5 respectively out of an average maximum score of 5.0, giving an increment of 66.7%. Role model care givers with formal education were twice and three times more likely to know about disease 'transmission' (OR 1.9, 95%CI 0.11-0.19, p=0.002) and 'consequences' (OR 2.9, 95%CI 0.25-0.65, p=0.040) respectively compared to those without formal education. Training on malaria improved the knowledge of malaria prevention and control among role model community care givers towards a successful implementation of malaria control programmes.

Cultural consultation as a model for training multidisciplinary mental healthcare professionals in cultural competence skills: preliminary results.

PubMed

Owiti, J A; Ajaz, A; Ascoli, M; de Jongh, B; Palinski, A; Bhui, K S

2014-01-01

Lack of cultural competence in care contributes to poor experiences and outcomes from care for migrants and racial and ethnic minorities. As a result, health and social care organizations currently promote cultural competence of their workforce as a means of addressing persistent poor experiences and outcomes. At present, there are unsystematic and diverse ways of promoting cultural competence, and their impact on clinician skills and patient outcomes is unknown. We developed and implemented an innovative model, cultural consultation service (CCS), to promote cultural competence of clinicians and directly improve on patient experiences and outcomes from care. CCS model is an adaptation of the McGill model, which uses ethnographic methodology and medical anthropological knowledge. The method and approach not only contributes both to a broader conceptual and dynamic understanding of culture, but also to learning of cultural competence skills by healthcare professionals. The CCS model demonstrates that multidisciplinary workforce can acquire cultural competence skills better through the clinical encounter, as this promotes integration of learning into day-to-day practice. Results indicate that clinicians developed a broader and patient-centred understanding of culture, and gained skills in narrative-based assessment method, management of complexity of care, competing assumptions and expectations, and clinical cultural formulation. Cultural competence is defined as a set of skills, attitudes and practices that enable the healthcare professionals to deliver high-quality interventions to patients from diverse cultural backgrounds. Improving on the cultural competence skills of the workforce has been promoted as a way of reducing ethnic and racial inequalities in service outcomes. Currently, diverse models for training in cultural competence exist, mostly with no evidence of effect. We established an innovative narrative-based cultural consultation service in an inner-city area to work with community mental health services to improve on patients' outcomes and clinicians' cultural competence skills. We targeted 94 clinicians in four mental health service teams in the community. After initial training sessions, we used a cultural consultation model to facilitate 'in vivo' learning. During cultural consultation, we used an ethnographic interview method to assess patients in the presence of referring clinicians. Clinicians' self-reported measure of cultural competence using the Tool for Assessing Cultural Competence Training (n = 28, at follow-up) and evaluation forms (n = 16) filled at the end of each cultural consultation showed improvement in cultural competence skills. We conclude that cultural consultation model is an innovative way of training clinicians in cultural competence skills through a dynamic interactive process of learning within real clinical encounters. © 2013 John Wiley & Sons Ltd.

Improving Patient Safety through Simulation Training in Anesthesiology: Where Are We?

PubMed Central

2016-01-01

There have been colossal technological advances in the use of simulation in anesthesiology in the past 2 decades. Over the years, the use of simulation has gone from low fidelity to high fidelity models that mimic human responses in a startlingly realistic manner, extremely life-like mannequin that breathes, generates E.K.G, and has pulses, heart sounds, and an airway that can be programmed for different degrees of obstruction. Simulation in anesthesiology is no longer a research fascination but an integral part of resident education and one of ACGME requirements for resident graduation. Simulation training has been objectively shown to increase the skill-set of anesthesiologists. Anesthesiology is leading the movement in patient safety. It is rational to assume a relationship between simulation training and patient safety. Nevertheless there has not been a demonstrable improvement in patient outcomes with simulation training. Larger prospective studies that evaluate the improvement in patient outcomes are needed to justify the integration of simulation training in resident education but ample number of studies in the past 5 years do show a definite benefit of using simulation in anesthesiology training. This paper gives a brief overview of the history and evolution of use of simulation in anesthesiology and highlights some of the more recent studies that have advanced simulation-based training. PMID:26949389

Maximizing lipocalin prediction through balanced and diversified training set and decision fusion.

PubMed

Nath, Abhigyan; Subbiah, Karthikeyan

2015-12-01

Lipocalins are short in sequence length and perform several important biological functions. These proteins are having less than 20% sequence similarity among paralogs. Experimentally identifying them is an expensive and time consuming process. The computational methods based on the sequence similarity for allocating putative members to this family are also far elusive due to the low sequence similarity existing among the members of this family. Consequently, the machine learning methods become a viable alternative for their prediction by using the underlying sequence/structurally derived features as the input. Ideally, any machine learning based prediction method must be trained with all possible variations in the input feature vector (all the sub-class input patterns) to achieve perfect learning. A near perfect learning can be achieved by training the model with diverse types of input instances belonging to the different regions of the entire input space. Furthermore, the prediction performance can be improved through balancing the training set as the imbalanced data sets will tend to produce the prediction bias towards majority class and its sub-classes. This paper is aimed to achieve (i) the high generalization ability without any classification bias through the diversified and balanced training sets as well as (ii) enhanced the prediction accuracy by combining the results of individual classifiers with an appropriate fusion scheme. Instead of creating the training set randomly, we have first used the unsupervised Kmeans clustering algorithm to create diversified clusters of input patterns and created the diversified and balanced training set by selecting an equal number of patterns from each of these clusters. Finally, probability based classifier fusion scheme was applied on boosted random forest algorithm (which produced greater sensitivity) and K nearest neighbour algorithm (which produced greater specificity) to achieve the enhanced predictive performance than that of individual base classifiers. The performance of the learned models trained on Kmeans preprocessed training set is far better than the randomly generated training sets. The proposed method achieved a sensitivity of 90.6%, specificity of 91.4% and accuracy of 91.0% on the first test set and sensitivity of 92.9%, specificity of 96.2% and accuracy of 94.7% on the second blind test set. These results have established that diversifying training set improves the performance of predictive models through superior generalization ability and balancing the training set improves prediction accuracy. For smaller data sets, unsupervised Kmeans based sampling can be an effective technique to increase generalization than that of the usual random splitting method. Copyright © 2015 Elsevier Ltd. All rights reserved.

Beneficial effects of exercise training in heart failure are lost in male diabetic rats.

PubMed

Boudia, Dalila; Domergue, Valérie; Mateo, Philippe; Fazal, Loubina; Prud'homme, Mathilde; Prigent, Héloïse; Delcayre, Claude; Cohen-Solal, Alain; Garnier, Anne; Ventura-Clapier, Renée; Samuel, Jane-Lise

2017-12-01

Exercise training has been demonstrated to have beneficial effects in patients with heart failure (HF) or diabetes. However, it is unknown whether diabetic patients with HF will benefit from exercise training. Male Wistar rats were fed either a standard (Sham, n = 53) or high-fat, high-sucrose diet ( n = 66) for 6 mo. After 2 mo of diet, the rats were already diabetic. Rats were then randomly subjected to either myocardial infarction by coronary artery ligation (MI) or sham operation. Two months later, heart failure was documented by echocardiography and animals were randomly subjected to exercise training with treadmill for an additional 8 wk or remained sedentary. At the end, rats were euthanized and tissues were assayed by RT-PCR, immunoblotting, spectrophotometry, and immunohistology. MI induced a similar decrease in ejection fraction in diabetic and lean animals but a higher premature mortality in the diabetic group. Exercise for 8 wk resulted in a higher working power developed by MI animals with diabetes and improved glycaemia but not ejection fraction or pathological phenotype. In contrast, exercise improved the ejection fraction and increased adaptive hypertrophy after MI in the lean group. Trained diabetic rats with MI were nevertheless able to develop cardiomyocyte hypertrophy but without angiogenic responses. Exercise improved stress markers and cardiac energy metabolism in lean but not diabetic-MI rats. Hence, following HF, the benefits of exercise training on cardiac function are blunted in diabetic animals. In conclusion, exercise training only improved the myocardial profile of infarcted lean rats fed the standard diet. NEW & NOTEWORTHY Exercise training is beneficial in patients with heart failure (HF) or diabetes. However, less is known of the possible benefit of exercise training for HF patients with diabetes. Using a rat model where both diabetes and MI had been induced, we showed that 2 mo after MI, 8 wk of exercise training failed to improve cardiac function and metabolism in diabetic animals in contrast to lean animals.

Improvement of short-term numerical wind predictions

NASA Astrophysics Data System (ADS)

Bedard, Joel

Geophysic Model Output Statistics (GMOS) are developed to optimize the use of NWP for complex sites. GMOS differs from other MOS that are widely used by meteorological centers in the following aspects: it takes into account the surrounding geophysical parameters such as surface roughness, terrain height, etc., along with wind direction; it can be directly applied without any training, although training will further improve the results. The GMOS was applied to improve the Environment Canada GEM-LAM 2.5km forecasts at North Cape (PEI, Canada): It improves the predictions RMSE by 25-30% for all time horizons and almost all meteorological conditions; the topographic signature of the forecast error due to insufficient grid refinement is eliminated and the NWP combined with GMOS outperform the persistence from a 2h horizon, instead of 4h without GMOS. Finally, GMOS was applied at another site (Bouctouche, NB, Canada): similar improvements were observed, thus showing its general applicability. Keywords: wind energy, wind power forecast, numerical weather prediction, complex sites, model output statistics

Beyond communication: the development of a training program for hospital and hospice staff in the detection and management of psychological distress--preliminary results.

PubMed

Jenkins, Kate; Alberry, Beccy; Daniel, Jane; Dixie, Laura; North, Vivien; Patterson, Lawrence; Pestell, Sarah; North, Nigel

2010-03-01

In the United Kingdom, a Four-Tier Model of Psychological Support has been recommended for all patients with cancer and their families. This model suggests that staff at Tier 2, such as nurses, doctors, and allied health professionals, should be proficient in screening for psychological distress and intervening with techniques such as psycho-education and problem solving. Research has suggested that although communication skills training is essential for staff working in cancer services, it does not necessarily improve the detection of specific psychological disorder or staff confidence in intervening with highly distressed patients. The objective was therefore to design a training program that addressed this deficit and was easily accessible to hospital staff. A training package was developed to train staff in the recommended skills. A literature review of teaching modalities and the effectiveness of different formats was conducted. A four-session program was developed, to be administered by staff at Tiers 3 and 4 of the model, such as clinical psychologists and counsellors. Over 3 years, 255 sets of data were collected from staff who attended the course. Precourse, postcourse, and 6-month follow-up data were collected through the use of confidence questionnaires, developed from the literature. The data show a significant improvement in staff confidence across all domains measured, including confidence in the detection and management of psychological distress (p =.0001). Although the results have limitations and the data are subjective, we can conclude that this course significantly improves staff confidence in dealing with psychological distress and that this increased confidence is maintained over a 6-month follow-up period.

The School of Posture as a postural training method for Paraíba Telecommunications Operators.

PubMed

Cardia, M C; Soares Màsculo, F

2001-01-01

This work proposes to show the experience of posture training accomplished in the Paraíba State Telecommunication Company, using the knowledge of the Back School. The sample was composed of 12 operators, employees of the company, representing 31% of this population. The model applied in TELPA (Paraíba Telecommunication Company, Brazil) was based on the models of Sherbrooke, Canada, and of the School of Posture of Paraìba Federal University. Fifty-eight point four percent of participants showed a reduction of column pain, 25% improved the quality of the rest and the received training was considered enough for the learning of correct postures at work in 75% of the cases. The whole population approved of the training, and 83.3% of the cases considered that this training influenced their lives very positively.

Developing a higher specialist training programme in renal medicine in the era of competence-based training.

PubMed

Kamesh, Lavanya; Clapham, Mike; Foggensteiner, Lukas

2012-08-01

Renal specialty medical training in the UK was reformed in August 2007, with an emphasis placed on competency-based training and the publication of a new curriculum and assessment blueprint. This model of training places additional time demands on both trainees and trainers, with implications for job planning and service delivery. We evaluated the resource requirements and impact on service delivery of implementing a high-quality training programme in renal medicine. Each trainee maintained a portfolio containing details of workplace-based assessments. The change in educational environment led to improved trainee satisfaction. The mean total consultant time involved in implementing the training programme was 0.7 programmed activities (PAs) per trainee per week in the first year, which decreased to 0.5 PAs per trainee per week in the second year. This pilot study indicates that it is possible to integrate successful and high-quality specialty training in a busy clinical environment. The model outlined could form a template for postgraduate specialist training delivery in a variety of medical specialties.

SWARM : a scientific workflow for supporting Bayesian approaches to improve metabolic models.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Shi, X.; Stevens, R.; Mathematics and Computer Science

2008-01-01

With the exponential growth of complete genome sequences, the analysis of these sequences is becoming a powerful approach to build genome-scale metabolic models. These models can be used to study individual molecular components and their relationships, and eventually study cells as systems. However, constructing genome-scale metabolic models manually is time-consuming and labor-intensive. This property of manual model-building process causes the fact that much fewer genome-scale metabolic models are available comparing to hundreds of genome sequences available. To tackle this problem, we design SWARM, a scientific workflow that can be utilized to improve genome-scale metabolic models in high-throughput fashion. SWARM dealsmore » with a range of issues including the integration of data across distributed resources, data format conversions, data update, and data provenance. Putting altogether, SWARM streamlines the whole modeling process that includes extracting data from various resources, deriving training datasets to train a set of predictors and applying Bayesian techniques to assemble the predictors, inferring on the ensemble of predictors to insert missing data, and eventually improving draft metabolic networks automatically. By the enhancement of metabolic model construction, SWARM enables scientists to generate many genome-scale metabolic models within a short period of time and with less effort.« less

Playing Action Video Games Improves Visuomotor Control.

PubMed

Li, Li; Chen, Rongrong; Chen, Jing

2016-08-01

Can playing action video games improve visuomotor control? If so, can these games be used in training people to perform daily visuomotor-control tasks, such as driving? We found that action gamers have better lane-keeping and visuomotor-control skills than do non-action gamers. We then trained non-action gamers with action or nonaction video games. After they played a driving or first-person-shooter video game for 5 or 10 hr, their visuomotor control improved significantly. In contrast, non-action gamers showed no such improvement after they played a nonaction video game. Our model-driven analysis revealed that although different action video games have different effects on the sensorimotor system underlying visuomotor control, action gaming in general improves the responsiveness of the sensorimotor system to input error signals. The findings support a causal link between action gaming (for as little as 5 hr) and enhancement in visuomotor control, and suggest that action video games can be beneficial training tools for driving. © The Author(s) 2016.

Preclinical endoscopic training using a part-task simulator: learning curve assessment and determination of threshold score for advancement to clinical endoscopy.

PubMed

Jirapinyo, Pichamol; Abidi, Wasif M; Aihara, Hiroyuki; Zaki, Theodore; Tsay, Cynthia; Imaeda, Avlin B; Thompson, Christopher C

2017-10-01

Preclinical simulator training has the potential to decrease endoscopic procedure time and patient discomfort. This study aims to characterize the learning curve of endoscopic novices in a part-task simulator and propose a threshold score for advancement to initial clinical cases. Twenty novices with no prior endoscopic experience underwent repeated endoscopic simulator sessions using the part-task simulator. Simulator scores were collected; their inverse was averaged and fit to an exponential curve. The incremental improvement after each session was calculated. Plateau was defined as the session after which incremental improvement in simulator score model was less than 5%. Additionally, all participants filled out questionnaires regarding simulator experience after sessions 1, 5, 10, 15, and 20. A visual analog scale and NASA task load index were used to assess levels of comfort and demand. Twenty novices underwent 400 simulator sessions. Mean simulator scores at sessions 1, 5, 10, 15, and 20 were 78.5 ± 5.95, 176.5 ± 17.7, 275.55 ± 23.56, 347 ± 26.49, and 441.11 ± 38.14. The best fit exponential model was [time/score] = 26.1 × [session #] -0.615 ; r 2  = 0.99. This corresponded to an incremental improvement in score of 35% after the first session, 22% after the second, 16% after the third and so on. Incremental improvement dropped below 5% after the 12th session corresponding to the predicted score of 265. Simulator training was related to higher comfort maneuvering an endoscope and increased readiness for supervised clinical endoscopy, both plateauing between sessions 10 and 15. Mental demand, physical demand, and frustration levels decreased with increased simulator training. Preclinical training using an endoscopic part-task simulator appears to increase comfort level and decrease mental and physical demand associated with endoscopy. Based on a rigorous model, we recommend that novices complete a minimum of 12 training sessions and obtain a simulator score of at least 265 to be best prepared for clinical endoscopy.

Efficient use of historical data for genomic selection: a case study of rust resistance in wheat

USDA-ARS?s Scientific Manuscript database

Genomic selection (GS) is a new methodology that can improve wheat breeding efficiency. To implement GS, a training population (TP) with both phenotypic and genotypic data is required to train a statistical model used to predict genotyped selection candidates (SCs). Several factors impact prediction...

"Getting Practical" and the National Network of Science Learning Centres

ERIC Educational Resources Information Center

Chapman, Georgina; Langley, Mark; Skilling, Gus; Walker, John

2011-01-01

The national network of Science Learning Centres is a co-ordinating partner in the Getting Practical--Improving Practical Work in Science programme. The principle of training provision for the "Getting Practical" programme is a cascade model. Regional trainers employed by the national network of Science Learning Centres trained the cohort of local…

Examining Technology and Teaching Efficacy of Preservice Teacher Candidates: A Deliberate Course Design Model

ERIC Educational Resources Information Center

Willis, Jana M.

2015-01-01

Training programs that improve technology self-efficacy of teacher candidates will better prepare candidates to overcome technology challenges with greater levels of confidence. The purpose of this study was to examine self-efficacy levels of preservice teacher candidates who participated in scaffolded technology training designed to establish and…

Toward a Current, Comprehensive, Integrative, and Flexible Model of Motivation for Instructional Design

ERIC Educational Resources Information Center

Hardre, Patricia L.; Miller, Raymond B.

2006-01-01

Workplace motivation historically has been an HR function, with ID as a training function. This division produces a split between motivation and training, leaving them isolated from one another. Intervention design needs to include motivation throughout its phases, to maximize motivating opportunities for performance improvement. The current…

An Academic Degree in Russia: Reality and Perspectives

ERIC Educational Resources Information Center

Laptev, V. V.; Pisareva, S. A.; Tryapitsyna, A. P.

2015-01-01

The article discusses the history of the formation of the system of awarding degrees in Russia. It analyzes the reasons for the devaluation of academic degrees in contemporary Russia, and it reveals the ways to improve researcher training in graduate school. Possible models for integrating the Russian system of researcher training into an open…

Group Work during International Disaster Outreach Projects: A Model to Advance Cultural Competence

ERIC Educational Resources Information Center

West-Olatunji, Cirecie; Henesy, Rachel; Varney, Melanie

2015-01-01

Given the rise in disasters worldwide, counselors will increasingly be called upon to respond. Current accreditation standards require that programs train students to become skillful in disaster/crisis interventions. Group processing to enhance self-awareness and improve conceptualization skills is an essential element of such training. This…

Fresh frozen cadaver workshops for advanced vascular surgical training.

PubMed

Jansen, Shirley; Cowie, Margaret; Linehan, John; Hamdorf, Jeffery M

2014-11-01

Reduction in working hours, streamlined training schemes and increasing use of endovascular techniques has meant a reduction in operative experience for newer vascular surgical trainees, especially those exposures which are not routinely performed such as thoracoabdominal, thoracotomy and retroperitoneal aortic, for example. This paper describes an Advanced Anatomy of Exposure course which was designed and convened at the Clinical Training & Evaluation Centre in Western Australia and uses fresh frozen cadavers. Feedback was obtained from the participants who attended over three courses by questionnaire. Feedback was strongly positive for the course meeting both its learning outcomes and personal learning objectives, and in addition, making a significant contribution to specialty skills. Most participants thought the fresh frozen cadaveric model significantly improved the learning objectives for training. The fresh frozen cadaver is an excellent teaching model highly representative of the living open surgical scenario where advanced trainees and newly qualified consultants can improve their operative confidence and consequently patient safety in vascular surgery. An efficient fresh frozen cadaver teaching programme can benefit many health professionals simultaneously maximizing the use of donated human tissue. © 2013 Royal Australasian College of Surgeons.

Laparoscopic surgical box model training for surgical trainees with limited prior laparoscopic experience.

PubMed

Gurusamy, Kurinchi Selvan; Nagendran, Myura; Toon, Clare D; Davidson, Brian R

2014-03-01

Surgical training has traditionally been one of apprenticeship, where the surgical trainee learns to perform surgery under the supervision of a trained surgeon. This is time consuming, costly, and of variable effectiveness. Training using a box model physical simulator is an option to supplement standard training. However, the value of this modality on trainees with limited prior laparoscopic experience is unknown. To compare the benefits and harms of box model training for surgical trainees with limited prior laparoscopic experience versus standard surgical training or supplementary animal model training. We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, and Science Citation Index Expanded to May 2013. We planned to include all randomised clinical trials comparing box model trainers versus other forms of training including standard laparoscopic training and supplementary animal model training in surgical trainees with limited prior laparoscopic experience. We also planned to include trials comparing different methods of box model training. Two authors independently identified trials and collected data. We analysed the data with both the fixed-effect and the random-effects models using Review Manager 5. For each outcome, we calculated the risk ratio (RR), mean difference (MD), or standardised mean difference (SMD) with 95% confidence intervals (CI) based on intention-to-treat analysis whenever possible. We identified eight trials that met the inclusion criteria. One trial including 17 surgical trainees did not contribute to the meta-analysis. We included seven trials (249 surgical trainees belonging to various postgraduate years ranging from year one to four) in which the participants were randomised to supplementary box model training (122 trainees) versus standard training (127 trainees). Only one trial (50 trainees) was at low risk of bias. The box trainers used in all the seven trials were video trainers. Six trials were conducted in USA and one trial in Canada. The surgeries in which the final assessments were made included laparoscopic total extraperitoneal hernia repairs, laparoscopic cholecystectomy, laparoscopic tubal ligation, laparoscopic partial salpingectomy, and laparoscopic bilateral mid-segment salpingectomy. The final assessments were made on a single operative procedure.There were no deaths in three trials (0/82 (0%) supplementary box model training versus 0/86 (0%) standard training; RR not estimable; very low quality evidence). The other trials did not report mortality. The estimated effect on serious adverse events was compatible with benefit and harm (three trials; 168 patients; 0/82 (0%) supplementary box model training versus 1/86 (1.1%) standard training; RR 0.36; 95% CI 0.02 to 8.43; very low quality evidence). None of the trials reported patient quality of life. The operating time was significantly shorter in the supplementary box model training group versus the standard training group (1 trial; 50 patients; MD -6.50 minutes; 95% CI -10.85 to -2.15). The proportion of patients who were discharged as day-surgery was significantly higher in the supplementary box model training group versus the standard training group (1 trial; 50 patients; 24/24 (100%) supplementary box model training versus 15/26 (57.7%) standard training; RR 1.71; 95% CI 1.23 to 2.37). None of the trials reported trainee satisfaction. The operating performance was significantly better in the supplementary box model training group versus the standard training group (seven trials; 249 trainees; SMD 0.84; 95% CI 0.57 to 1.10).None of the trials compared box model training versus animal model training or versus different methods of box model training. There is insufficient evidence to determine whether laparoscopic box model training reduces mortality or morbidity. There is very low quality evidence that it improves technical skills compared with standard surgical training in trainees with limited previous laparoscopic experience. It may also decrease operating time and increase the proportion of patients who were discharged as day-surgery in the first total extraperitoneal hernia repair after box model training. However, the duration of the benefit of box model training is unknown. Further well-designed trials of low risk of bias and random errors are necessary. Such trials should assess the long-term impact of box model training on clinical outcomes and compare box training with other forms of training.

Effectiveness of a multi-level implementation strategy for ASD interventions: study protocol for two linked cluster randomized trials.

PubMed

Brookman-Frazee, Lauren; Stahmer, Aubyn C

2018-05-09

The Centers for Disease Control (2018) estimates that 1 in 59 children has autism spectrum disorder, and the annual cost of ASD in the U.S. is estimated to be $236 billion. Evidence-based interventions have been developed and demonstrate effectiveness in improving child outcomes. However, research on generalizable methods to scale up these practices in the multiple service systems caring for these children has been limited and is critical to meet this growing public health need. This project includes two, coordinated studies testing the effectiveness of the Translating Evidence-based Interventions (EBI) for ASD: Multi-Level Implementation Strategy (TEAMS) model. TEAMS focuses on improving implementation leadership, organizational climate, and provider attitudes and motivation in order to improve two key implementation outcomes-provider training completion and intervention fidelity and subsequent child outcomes. The TEAMS Leadership Institute applies implementation leadership strategies and TEAMS Individualized Provider Strategies for training applies motivational interviewing strategies to facilitate provider and organizational behavior change. A cluster randomized implementation/effectiveness Hybrid, type 3, trial with a dismantling design will be used to understand the effectiveness of TEAMS and the mechanisms of change across settings and participants. Study #1 will test the TEAMS model with AIM HI (An Individualized Mental Health Intervention for ASD) in publicly funded mental health services. Study #2 will test TEAMS with CPRT (Classroom Pivotal Response Teaching) in education settings. Thirty-seven mental health programs and 37 school districts will be randomized, stratified by county and study, to one of four groups (Standard Provider Training Only, Standard Provider Training + Leader Training, Enhanced Provider Training, Enhanced Provider Training + Leader Training) to test the effectiveness of combining standard, EBI-specific training with the two TEAMS modules individually and together on multiple implementation outcomes. Implementation outcomes including provider training completion, fidelity (coded by observers blind to group assignment) and child behavior change will be examined for 295 mental health providers, 295 teachers, and 590 children. This implementation intervention has the potential to increase quality of care for ASD in publicly funded settings by improving effectiveness of intervention implementation. The process and modules will be generalizable to multiple service systems, providers, and interventions, providing broad impact in community services. This study is registered with Clinicaltrials.gov ( NCT03380078 ). Registered 20 December 2017, retrospectively registered.

Computer-based, personalized cognitive training versus classical computer games: a randomized double-blind prospective trial of cognitive stimulation.

PubMed

Peretz, Chava; Korczyn, Amos D; Shatil, Evelyn; Aharonson, Vered; Birnboim, Smadar; Giladi, Nir

2011-01-01

Many studies have suggested that cognitive training can result in cognitive gains in healthy older adults. We investigated whether personalized computerized cognitive training provides greater benefits than those obtained by playing conventional computer games. This was a randomized double-blind interventional study. Self-referred healthy older adults (n = 155, 68 ± 7 years old) were assigned to either a personalized, computerized cognitive training or to a computer games group. Cognitive performance was assessed at baseline and after 3 months by a neuropsychological assessment battery. Differences in cognitive performance scores between and within groups were evaluated using mixed effects models in 2 approaches: adherence only (AO; n = 121) and intention to treat (ITT; n = 155). Both groups improved in cognitive performance. The improvement in the personalized cognitive training group was significant (p < 0.03, AO and ITT approaches) in all 8 cognitive domains. However, in the computer games group it was significant (p < 0.05) in only 4 (AO) or 6 domains (ITT). In the AO analysis, personalized cognitive training was significantly more effective than playing games in improving visuospatial working memory (p = 0.0001), visuospatial learning (p = 0.0012) and focused attention (p = 0.0019). Personalized, computerized cognitive training appears to be more effective than computer games in improving cognitive performance in healthy older adults. Further studies are needed to evaluate the ecological validity of these findings. Copyright © 2011 S. Karger AG, Basel.

Multiparous Ewe as a Model for Teaching Vaginal Hysterectomy Techniques.

PubMed

Kerbage, Yohan; Cosson, Michel; Hubert, Thomas; Giraudet, Géraldine

2017-12-01

Despite being linked to improving patient outcomes and limiting costs, the use of vaginal hysterectomy is on the wane. Although a combination of reasons might explain this trend, one cause is a lack of practical training. An appropriate teaching model must therefore be devised. Currently, only low-fidelity simulators exist. Ewes provide an appropriate model for pelvic anatomy and are well-suited for testing vaginal mesh properties. This article sets out a vaginal hysterectomy procedure for use as an education and training model. A multiparous ewe was the model. Surgery was performed under general anesthesia. The ewe was in a lithotomy position resembling that assumed by women on the operating table. Two vaginal hysterectomies were performed on two ewes, following every step precisely as if the model were human. Each surgical step of vaginal hysterectomy performed on the ewe and on a woman were compared side by side. We identified that all surgical steps were particularly similar. The main limitations of this model are costs ($500/procedure), logistic problems (housing large animals), and public opposition to animal training models. The ewe appears to be an appropriate model for teaching and training of vaginal hysterectomy.

Dissemination of evidence-based practice: can we train therapists from a distance?

PubMed

Vismara, Laurie A; Young, Gregory S; Stahmer, Aubyn C; Griffith, Elizabeth McMahon; Rogers, Sally J

2009-12-01

Although knowledge about the efficacy of behavioral interventions for children with ASD is increasing, studies of effectiveness and transportability to community settings are needed. The current study conducted an effectiveness trial to compare distance learning vs. live instruction for training community-based therapists to implement the Early Start Denver Model. Findings revealed: (a) distance learning and live instruction were equally effective for teaching therapists to both implement the model and to train parents; (b) didactic workshops and team supervision were required to improve therapists' skill use; (c) significant child gains occurred over time and across teaching modalities; and (d) parents implemented the model more skillfully after coaching. Implications are discussed in relation to the economic and clinical utility of distance learning.

Cognitive skills training in digital era: A paradigm shift in surgical education using the TaTME model.

PubMed

Knol, Joep; Keller, Deborah S

2018-04-30

Surgical competence is a complex, multifactorial process, requiring ample time and training. Optimal training is based on acquiring knowledge and psychomotor and cognitive skills. Practicing surgical skills is one of the most crucial tasks for both the novice surgeon learning new procedures and surgeons already in practice learning new techniques. Focus is placed on teaching traditional technical skills, but the importance of cognitive skills cannot be underestimated. Cognitive skills allow recognizing environmental cues to improve technical performance including situational awareness, mental readiness, risk assessment, anticipating problems, decision-making, adaptation, and flexibility, and may also accelerate the trainee's understanding of a procedure, formalize the steps being practiced, and reduce the overall training time to become technically proficient. The introduction and implementation of the transanal total mesorectal excision (TaTME) into practice may be the best demonstration of this new model of teaching and training, including pre-training, course attendance, and post-course guidance on technical and cognitive skills. To date, the TaTME framework has been the ideal model for structured training to ensure safe implementation. Further development of metrics to grade successful learning and assessment of long term outcomes with the new pathway will confirm the success of this training model. Copyright © 2018 Royal College of Surgeons of Edinburgh (Scottish charity number SC005317) and Royal College of Surgeons in Ireland. All rights reserved.

Aerobic Exercise Training Modalities and Prediabetes Risk Reduction.

PubMed

Rowan, Chip P; Riddell, Michael C; Gledhill, Norman; Jamnik, Veronica K

2017-03-01

Prediabetes is linked to several modifiable risk factors, in particular, physical activity participation. The optimal prescription for physical activity remains uncertain. This pilot study aimed to investigate the effectiveness of continuous moderate intensity (CON) versus high-intensity interval training (HIIT) in persons with prediabetes. Outcome measures included glycated hemoglobin (A1C), body composition, musculoskeletal and aerobic fitness. Participants (n = 35) were recruited and screened using a questionnaire plus capillary blood point-of-care A1C analysis. After baseline screening/exclusions, 21 participants were randomly assigned to either HIIT or CON training three times per week for 12 wk. All participants also undertook resistance training two times per week. A1C, an oral glucose tolerance test, select measures of physical and physiological fitness were assessed at baseline and follow-up. There were no significant differences in improvements in select metabolic indicators to training between CON and HIT groups. Pooled participant data showed a mean reduction in A1C of 0.5% (95% confidence interval [CI] = 0.3%-0.7%), whereas β-cell function (%β) improved by 28.9% (95% CI = 16.5%-39.2%) and insulin sensitivity (%S) decreased by 34.8 (95% CI = 57.8%-11.8), as assessed by the Homeostatic Model Assessment. Significant reductions in waist circumference of 4.5 cm (P < 0.001) and a 20% (P < 0.001) improvement in aerobic fitness were also observed in both training groups. The completion of a 12-wk exercise program involving both resistance training and either HIIT or CON training results in improved glycemic control, visceral adiposity, and aerobic fitness in persons with prediabetes.

Laparoscopic skill improvement after virtual reality simulator training in medical students as assessed by augmented reality simulator.

PubMed

Nomura, Tsutomu; Mamada, Yasuhiro; Nakamura, Yoshiharu; Matsutani, Takeshi; Hagiwara, Nobutoshi; Fujita, Isturo; Mizuguchi, Yoshiaki; Fujikura, Terumichi; Miyashita, Masao; Uchida, Eiji

2015-11-01

Definitive assessment of laparoscopic skill improvement after virtual reality simulator training is best obtained during an actual operation. However, this is impossible in medical students. Therefore, we developed an alternative assessment technique using an augmented reality simulator. Nineteen medical students completed a 6-week training program using a virtual reality simulator (LapSim). The pretest and post-test were performed using an object-positioning module and cholecystectomy on an augmented reality simulator(ProMIS). The mean performance measures between pre- and post-training on the LapSim were compared with a paired t-test. In the object-positioning module, the execution time of the task (P < 0.001), left and right instrument path length (P = 0.001), and left and right instrument economy of movement (P < 0.001) were significantly shorter after than before the LapSim training. With respect to improvement in laparoscopic cholecystectomy using a gallbladder model, the execution time to identify, clip, and cut the cystic duct and cystic artery as well as the execution time to dissect the gallbladder away from the liver bed were both significantly shorter after than before the LapSim training (P = 0.01). Our training curriculum using a virtual reality simulator improved the operative skills of medical students as objectively evaluated by assessment using an augmented reality simulator instead of an actual operation. We hope that these findings help to establish an effective training program for medical students. © 2015 Japan Society for Endoscopic Surgery, Asia Endosurgery Task Force and Wiley Publishing Asia Pty Ltd.

A randomised controlled trial of adjunctive yoga and adjunctive physical exercise training for cognitive dysfunction in schizophrenia.

PubMed

Bhatia, Triptish; Mazumdar, Sati; Wood, Joel; He, Fanyin; Gur, Raquel E; Gur, Ruben C; Nimgaonkar, Vishwajit L; Deshpande, Smita N

2017-04-01

Yoga and physical exercise have been used as adjunctive intervention for cognitive dysfunction in schizophrenia (SZ), but controlled comparisons are lacking. Aims A single-blind randomised controlled trial was designed to evaluate whether yoga training or physical exercise training enhance cognitive functions in SZ, based on a prior pilot study. Consenting, clinically stable, adult outpatients with SZ (n=286) completed baseline assessments and were randomised to treatment as usual (TAU), supervised yoga training with TAU (YT) or supervised physical exercise training with TAU (PE). Based on the pilot study, the primary outcome measure was speed index for the cognitive domain of 'attention' in the Penn computerised neurocognitive battery. Using mixed models and contrasts, cognitive functions at baseline, 21 days (end of training), 3 and 6 months post-training were evaluated with intention-to-treat paradigm. Speed index of attention domain in the YT group showed greater improvement than PE at 6 months follow-up (p<0.036, effect size 0.51). In the PE group, 'accuracy index of attention domain showed greater improvement than TAU alone at 6-month follow-up (p<0.025, effect size 0.61). For several other cognitive domains, significant improvements were observed with YT or PE compared with TAU alone (p<0.05, effect sizes 0.30-1.97). Both YT and PE improved attention and additional cognitive domains well past the training period, supporting our prior reported beneficial effect of YT on speed index of attention domain. As adjuncts, YT or PE can benefit individuals with SZ.

Evaluation of a low-cost, 3D-printed model for bronchoscopy training.

PubMed

Parotto, Matteo; Jiansen, Joshua Qua; AboTaiban, Ahmed; Ioukhova, Svetlana; Agzamov, Alisher; Cooper, Richard; O'Leary, Gerald; Meineri, Massimiliano

2017-01-01

Flexible bronchoscopy is a fundamental procedure in anaesthesia and critical care medicine. Although learning this procedure is a complex task, the use of simulation-based training provides significant advantages, such as enhanced patient safety. Access to bronchoscopy simulators may be limited in low-resource settings. We have developed a low-cost 3D-printed bronchoscopy training model. A parametric airway model was obtained from an online medical model repository and fabricated using a low-cost 3D printer. The participating physicians had no prior bronchoscopy experience. Participants received a 30-minute lecture on flexible bronchoscopy and were administered a 15-item pre-test questionnaire on bronchoscopy. Afterwards, participants were instructed to perform a series of predetermined bronchoscopy tasks on the 3D printed simulator on 4 consecutive occasions. The time needed to perform the tasks and the quality of task performance (identification of bronchial anatomy, technique, dexterity, lack of trauma) were recorded. Upon completion of the simulator tests, participants were administered the 15-item questionnaire (post-test) once again. Participant satisfaction data on the perceived usefulness and accuracy of the 3D model were collected. A statistical analysis was performed using the t-test. Data are reported as mean values (± standard deviation). The time needed to complete all tasks was 152.9 ± 71.5 sec on the 1st attempt vs. 98.7 ± 40.3 sec on the 4th attempt (P = 0.03). Likewise, the quality of performance score improved from 8.3 ± 6.7 to 18.2 ± 2.5 (P < 0.0001). The average number of correct answers in the questionnaire was 6.8 ± 1.9 pre-test and 13.3 ± 3.1 post-test (P < 0.0001). Participants reported a high level of satisfaction with the perceived usefulness and accuracy of the model. We developed a 3D-printed model for bronchoscopy training. This model improved trainee performance and may represent a valid, low-cost bronchoscopy training tool.

Relationships between training load, injury, and fitness in sub-elite collision sport athletes.

PubMed

Gabbett, Tim J; Domrow, Nathan

2007-11-01

The purpose of this study was to develop statistical models that estimate the influence of training load on training injury and physical fitness in collision sport athletes. The incidence of training injuries was studied in 183 rugby league players over two competitive seasons. Participants were assessed for height, body mass, skinfold thickness, vertical jump, 10-m, 20-m and 40-m sprint time, agility, and estimated maximal aerobic power in the off-season, pre-season, mid-season, and end-season. Training load and injury data were summarised into pre-season, early-competition, and late-competition training phases. Individual training load, fitness, and injury data were modelled using a logistic regression model with a binomial distribution and logit link function, while team training load and injury data were modelled using a linear regression model. While physical fitness improved with training, there was no association (P=0.16-0.99) between training load and changes in physical fitness during any of the training phases. However, increases in training load during the early-competition training phase decreased (P= 0.04) agility performance. A relationship (P= 0.01-0.04) was observed between the log of training load and odds of injury during each training phase, resulting in a 1.50 - 2.85 increase in the odds of injury for each arbitrary unit increase in training load. Furthermore, during the pre-season training phase there was a relationship (P= 0.01) between training load and injury incidence within the training load range of 155 and 590 arbitrary units. During the early and late-competition training phases, increases in training load of 175-620 arbitrary units and 145-410 arbitrary units, respectively, resulted in no further increase in injury incidence. These findings demonstrate that increases in training load, particularly during the pre-season training phase, increase the odds of injury in collision sport athletes. However, while increases in training load from 175 to 620 arbitrary units during the early-competition training phase result in no further increase in injury incidence, marked reductions in agility performances can occur. These findings suggest that reductions in training load during the early-competition training phase can reduce the odds of injury without compromising agility performances in collision sport athletes.

Transfer of training in the development of intracorporeal suturing skill in medical student novices: a prospective randomized trial.

PubMed

Muresan, Claude; Lee, Tommy H; Seagull, Jacob; Park, Adrian E

2010-10-01

To help optimize the use of limited resources in trainee education, we developed a prospective randomized trial to determine the most effective means of teaching laparoscopic suturing to novices. Forty-one medical students received rudimentary instruction in intracorporeal suturing, then were pretested on a pig enterotomy model. They then were posttested after completion of 1 of 4 training arms: laparoscopic suturing, laparoscopic drills, open suturing, and virtual reality (VR) drills. Tests were scored for speed, accuracy, knot quality, and mental workload (National Aeronautics and Space Administration [NASA] Task Load Index). Paired t tests were used. Task time was improved in all groups except the VR group. Knot quality improved only in the open or laparoscopic suturing groups. Mental workload improved only for those practicing on a physical laparoscopic trainer. For novice trainees, the efficacy of VR training is questionable. In contrast, the other training methods had benefits in terms of time, quality, and perceived workload. Copyright © 2010 Elsevier Inc. All rights reserved.

Surrogate Modeling of High-Fidelity Fracture Simulations for Real-Time Residual Strength Predictions

NASA Technical Reports Server (NTRS)

Spear, Ashley D.; Priest, Amanda R.; Veilleux, Michael G.; Ingraffea, Anthony R.; Hochhalter, Jacob D.

2011-01-01

A surrogate model methodology is described for predicting in real time the residual strength of flight structures with discrete-source damage. Starting with design of experiment, an artificial neural network is developed that takes as input discrete-source damage parameters and outputs a prediction of the structural residual strength. Target residual strength values used to train the artificial neural network are derived from 3D finite element-based fracture simulations. A residual strength test of a metallic, integrally-stiffened panel is simulated to show that crack growth and residual strength are determined more accurately in discrete-source damage cases by using an elastic-plastic fracture framework rather than a linear-elastic fracture mechanics-based method. Improving accuracy of the residual strength training data would, in turn, improve accuracy of the surrogate model. When combined, the surrogate model methodology and high-fidelity fracture simulation framework provide useful tools for adaptive flight technology.

Surrogate Modeling of High-Fidelity Fracture Simulations for Real-Time Residual Strength Predictions

NASA Technical Reports Server (NTRS)

Spear, Ashley D.; Priest, Amanda R.; Veilleux, Michael G.; Ingraffea, Anthony R.; Hochhalter, Jacob D.

2011-01-01

A surrogate model methodology is described for predicting, during flight, the residual strength of aircraft structures that sustain discrete-source damage. Starting with design of experiment, an artificial neural network is developed that takes as input discrete-source damage parameters and outputs a prediction of the structural residual strength. Target residual strength values used to train the artificial neural network are derived from 3D finite element-based fracture simulations. Two ductile fracture simulations are presented to show that crack growth and residual strength are determined more accurately in discrete-source damage cases by using an elastic-plastic fracture framework rather than a linear-elastic fracture mechanics-based method. Improving accuracy of the residual strength training data does, in turn, improve accuracy of the surrogate model. When combined, the surrogate model methodology and high fidelity fracture simulation framework provide useful tools for adaptive flight technology.

Strengthening health workforce capacity through work-based training

PubMed Central

2013-01-01

Background Although much attention has been given to increasing the number of health workers, less focus has been directed at developing models of training that address real-life workplace needs. Makerere University School of Public Health (MakSPH) with funding support from the Centers for Disease Control and Prevention (CDC) developed an eight-month modular, in-service work-based training program aimed at strengthening the capacity for monitoring and evaluation (M&E) and continuous quality improvement (CQI) in health service delivery. Methods This capacity building program, initiated in 2008, is offered to in-service health professionals working in Uganda. The purpose of the training is to strengthen the capacity to provide quality health services through hands-on training that allows for skills building with minimum work disruptions while encouraging greater involvement of other institutional staff to enhance continuity and sustainability. The hands-on training uses practical gaps and challenges at the workplace through a highly participatory process. Trainees work with other staff to design and implement ‘projects’ meant to address work-related priority problems, working closely with mentors. Trainees’ knowledge and skills are enhanced through short courses offered at specific intervals throughout the course. Results Overall, 143 trainees were admitted between 2008 and 2011. Of these, 120 (84%) from 66 institutions completed the training successfully. Of the trainees, 37% were Social Scientists, 34% were Medical/Nursing/Clinical Officers, 5.8% were Statisticians, while 23% belonged to other professions. Majority of the trainees (80%) were employed by Non-Government Organizations while 20% worked with the public health sector. Trainees implemented 66 projects which addressed issues such as improving access to health care services; reducing waiting time for patients; strengthening M&E systems; and improving data collection and reporting. The projects implemented aimed to improve trainees’ skills and competencies in M&E and CQI and the design of the projects was such that they could share these skills with other staff, with minimal interruptions of their work. Conclusions The modular, work-based training model strengthens the capacity of the health workforce through hands-on, real-life experiences in the work-setting and improves institutional capacity, thereby providing a practical example of health systems strengthening through health workforce capacity building. PMID:23347473

Toward high-throughput phenotyping: unbiased automated feature extraction and selection from knowledge sources.

PubMed

Yu, Sheng; Liao, Katherine P; Shaw, Stanley Y; Gainer, Vivian S; Churchill, Susanne E; Szolovits, Peter; Murphy, Shawn N; Kohane, Isaac S; Cai, Tianxi

2015-09-01

Analysis of narrative (text) data from electronic health records (EHRs) can improve population-scale phenotyping for clinical and genetic research. Currently, selection of text features for phenotyping algorithms is slow and laborious, requiring extensive and iterative involvement by domain experts. This paper introduces a method to develop phenotyping algorithms in an unbiased manner by automatically extracting and selecting informative features, which can be comparable to expert-curated ones in classification accuracy. Comprehensive medical concepts were collected from publicly available knowledge sources in an automated, unbiased fashion. Natural language processing (NLP) revealed the occurrence patterns of these concepts in EHR narrative notes, which enabled selection of informative features for phenotype classification. When combined with additional codified features, a penalized logistic regression model was trained to classify the target phenotype. The authors applied our method to develop algorithms to identify patients with rheumatoid arthritis and coronary artery disease cases among those with rheumatoid arthritis from a large multi-institutional EHR. The area under the receiver operating characteristic curves (AUC) for classifying RA and CAD using models trained with automated features were 0.951 and 0.929, respectively, compared to the AUCs of 0.938 and 0.929 by models trained with expert-curated features. Models trained with NLP text features selected through an unbiased, automated procedure achieved comparable or slightly higher accuracy than those trained with expert-curated features. The majority of the selected model features were interpretable. The proposed automated feature extraction method, generating highly accurate phenotyping algorithms with improved efficiency, is a significant step toward high-throughput phenotyping. © The Author 2015. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Advancements in automated tissue segmentation pipeline for contrast-enhanced CT scans of adult and pediatric patients

NASA Astrophysics Data System (ADS)

Somasundaram, Elanchezhian; Kaufman, Robert; Brady, Samuel

2017-03-01

The development of a random forests machine learning technique is presented for fully-automated neck, chest, abdomen, and pelvis tissue segmentation of CT images using Trainable WEKA (Waikato Environment for Knowledge Analysis) Segmentation (TWS) plugin of FIJI (ImageJ, NIH). The use of a single classifier model to segment six tissue classes (lung, fat, muscle, solid organ, blood/contrast agent, bone) in the CT images is studied. An automated unbiased scheme to sample pixels from the training images and generate a balanced training dataset over the seven classes is also developed. Two independent training datasets are generated from a pool of 4 adult (>55 kg) and 3 pediatric patients (<=55 kg) with 7 manually contoured slices for each patient. Classifier training investigated 28 image filters comprising a total of 272 features. Highly correlated and insignificant features are eliminated using Correlated Feature Subset (CFS) selection with Best First Search (BFS) algorithms in WEKA. The 2 training models (from the 2 training datasets) had 74 and 71 input training features, respectively. The study also investigated the effect of varying the number of trees (25, 50, 100, and 200) in the random forest algorithm. The performance of the 2 classifier models are evaluated on inter-patient intra-slice, intrapatient inter-slice and inter-patient inter-slice test datasets. The Dice similarity coefficients (DSC) and confusion matrices are used to understand the performance of the classifiers across the tissue segments. The effect of number of features in the training input on the performance of the classifiers for tissue classes with less than optimal DSC values is also studied. The average DSC values for the two training models on the inter-patient intra-slice test data are: 0.98, 0.89, 0.87, 0.79, 0.68, and 0.84, for lung, fat, muscle, solid organ, blood/contrast agent, and bone, respectively. The study demonstrated that a robust segmentation accuracy for lung, muscle and fat tissue classes. For solid-organ, blood/contrast and bone, the performance of the segmentation pipeline improved significantly by using the advanced capabilities of WEKA. However, further improvements are needed to reduce the noise in the segmentation.

Transformational leadership can improve workforce competencies.

PubMed

Thompson, Juliana

2012-03-01

Staffing problems can arise because of poor delegation skills or a failure by leaders to respond appropriately to economic factors and patient demographics. Training dilemmas, meanwhile, can arise because of managers' confusion about what constitutes 'training' and what constitutes 'education', and where responsibility of provision lies, with the consequence that they neglect these activities. This article uses Kouzes and Posner's (2009) transformational leadership model to show how managers can respond. Leaders who challenge budgets, consider new ways of working and engage effectively with the workforce can improve productivity and care, while those who invest in appropriate learning will have a highly trained workforce. The author explains how integration of leadership roles and management functions can lead to innovative problem solving.

Advancing Quality Improvement in Public Health Departments Through a Statewide Training Program.

PubMed

Davis, Mary V; Cornett, Amanda; Mahanna, Elizabeth; See, Claire; Randolph, Greg

2016-01-01

To examine the effectiveness of an ongoing statewide public health quality improvement training program (PH QI 101) among 4 cohorts of training participants. We conducted a mixed-method evaluation of the PH QI 101 training program that included measures of participants' satisfaction, learning, behavior change, and participants' translation and spread to their organizations what was learned. Data analysis included descriptive quantitative statistics and qualitative reviews. The Mann-Whitney U test was used to examine changes in participants' confidence to conduct a QI project from pre- to posttraining and 6 months posttraining. Two hundred two staff members from 37 North Carolina local health departments. An 8-month experiential learning process in which participants learn to use QI methods by applying them to a specific project. More than 90% of participants reported satisfaction with the program. Median scores on perceived self-confidence to conduct a QI project significantly increased for all training waves. At least 85% of participants reported spreading QI tools to coworkers posttraining. Two-thirds of participants in 3 waves reported that the QI project conducted during the training was at the sustaining results stage. Most participants in 3 of the training waves reported initiating new QI projects at their health department following training. Facilitators to implementation included interest and support from managers and leaders. Lack of interest and competing priorities among other staff were key barriers to implementation. This program successfully trained 4 waves of public health professionals in QI tools and methods. Leader training and involvement was a key addition to the adapted model. This statewide approach may serve as a model to other states as they seek to achieve national accreditation standards.

Naloxone and the Inner City Youth Experience (NICYE): a community-based participatory research study examining young people's perceptions of the BC take home naloxone program.

PubMed

Mitchell, Keren; Durante, S Elise; Pellatt, Katrina; Richardson, Chris G; Mathias, Steve; Buxton, Jane A

2017-06-07

Take home naloxone (THN) programs reduce mortality by training bystanders to respond to opioid overdoses. Clinical observation by the health care team at the Inner City Youth (ICY) program indicated that young adults appeared to enthusiastically participate in the THN program and developed improved relationships with staff after THN training. However, we found a dearth of literature exploring the experiences of young adults with THN programs. This study set out to address this gap and identify suggestions from the young adults for program improvement. The primary research question was "How do street-involved young people experience the THN Program in Vancouver, BC?" The study was undertaken at the ICY Program. Two peer researchers with lived experience of THN were recruited from ICY and were involved in all phases of the study. The peer researchers and a graduate student facilitated two focus groups and five individual interviews with ICY program participants using a semi-structured interview guide. Audio recordings were transcribed verbatim. The cut-up-and-put-in-folders approach was used to identify emerging themes. The themes that emerged were perceptions of risk, altruism, strengthening relationship with staff, access to training, empowerment, and confidence in ability to respond, and suggestions for youth-friendly training. These themes were then situated within the framework of the health belief model to provide additional context. Participants viewed themselves as vulnerable to overdose and spoke of the importance of expanding access to THN training. Following training, participants reported an increase in internal locus of control, an improved sense of safety among the community of people who use drugs, improved self-esteem, and strengthened relationships with ICY staff. Overall, participants found THN training engaging, which appeared to enhance participation in other ICY programming. Young people perceived THN training as a positive experience that improved relationships with staff. Participant recommendations for quality improvement were implemented within the provincial program.

Effect of Face-to-face Education, Problem-based Learning, and Goldstein Systematic Training Model on Quality of Life and Fatigue among Caregivers of Patients with Diabetes.

PubMed

Masoudi, Reza; Soleimani, Mohammad Ali; Yaghoobzadeh, Ameneh; Baraz, Shahram; Hakim, Ashrafalsadat; Chan, Yiong H

2017-01-01

Education is a fundamental component for patients with diabetes to achieve good glycemic control. In addition, selecting the appropriate method of education is one of the most effective factors in the quality of life. The present study aimed to evaluate the effect of face-to-face education, problem-based learning, and Goldstein systematic training model on the quality of life (QOL) and fatigue among caregivers of patients with diabetes. This randomized clinical trial was conducted in Hajar Hospital (Shahrekord, Iran) in 2012. The study subjects consisted of 105 family caregivers of patients with diabetes. The participants were randomly assigned to three intervention groups (35 caregivers in each group). For each group, 5-h training sessions were held separately. QOL and fatigue were evaluated immediately before and after the intervention, and after 1, 2, 3, and 4 months of intervention. There was a significant increase in QOL for all the three groups. Both the problem-based learning and the Goldstein method showed desirable QOL improvement over time. The desired educational intervention for fatigue reduction during the 4-month post-intervention period was the Goldstein method. A significant reduction was observed in fatigue in all three groups after the intervention ( P < 0.001). The results of the present study illustrated that the problem-based learning and Goldstein systematic training model improve the QOL of caregivers of patients with diabetes. In addition, the Goldstein systematic training model had the greatest effect on the reduction of fatigue within 4 months of the intervention.

Shoulder arthroscopy simulator training improves shoulder arthroscopy performance in a cadaveric model.

PubMed

Henn, R Frank; Shah, Neel; Warner, Jon J P; Gomoll, Andreas H

2013-06-01

The purpose of this study was to quantify the benefits of shoulder arthroscopy simulator training with a cadaveric model of shoulder arthroscopy. Seventeen first-year medical students with no prior experience in shoulder arthroscopy were enrolled and completed this study. Each subject completed a baseline proctored arthroscopy on a cadaveric shoulder, which included controlling the camera and completing a standard series of tasks using the probe. The subjects were randomized, and 9 of the subjects received training on a virtual reality simulator for shoulder arthroscopy. All subjects then repeated the same cadaveric arthroscopy. The arthroscopic videos were analyzed in a blinded fashion for time to task completion and subjective assessment of technical performance. The 2 groups were compared by use of Student t tests, and change over time within groups was analyzed with paired t tests. There were no observed differences between the 2 groups on the baseline evaluation. The simulator group improved significantly from baseline with respect to time to completion and subjective performance (P < .05). Time to completion was significantly faster in the simulator group compared with controls at the final evaluation (P < .05). No difference was observed between the groups on the subjective scores at the final evaluation (P = .98). Shoulder arthroscopy simulator training resulted in significant benefits in clinical shoulder arthroscopy time to task completion in this cadaveric model. This study provides important additional evidence of the benefit of simulators in orthopaedic surgical training. There may be a role for simulator training in shoulder arthroscopy education. Copyright © 2013 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

Shoulder Arthroscopy Simulator Training Improves Shoulder Arthroscopy Performance in a Cadaver Model

PubMed Central

Henn, R. Frank; Shah, Neel; Warner, Jon J.P.; Gomoll, Andreas H.

2013-01-01

Purpose The purpose of this study was to quantify the benefits of shoulder arthroscopy simulator training with a cadaver model of shoulder arthroscopy. Methods Seventeen first year medical students with no prior experience in shoulder arthroscopy were enrolled and completed this study. Each subject completed a baseline proctored arthroscopy on a cadaveric shoulder, which included controlling the camera and completing a standard series of tasks using the probe. The subjects were randomized, and nine of the subjects received training on a virtual reality simulator for shoulder arthroscopy. All subjects then repeated the same cadaveric arthroscopy. The arthroscopic videos were analyzed in a blinded fashion for time to task completion and subjective assessment of technical performance. The two groups were compared with students t-tests, and change over time within groups was analyzed with paired t-tests. Results There were no observed differences between the two groups on the baseline evaluation. The simulator group improved significantly from baseline with respect to time to completion and subjective performance (p<0.05). Time to completion was significantly faster in the simulator group compared to controls at final evaluation (p<0.05). No difference was observed between the groups on the subjective scores at final evaluation (p=0.98). Conclusions Shoulder arthroscopy simulator training resulted in significant benefits in clinical shoulder arthroscopy time to task completion in this cadaver model. This study provides important additional evidence of the benefit of simulators in orthopaedic surgical training. Clinical Relevance There may be a role for simulator training in shoulder arthroscopy education. PMID:23591380

Advanced ultrasound training for fourth-year medical students: a novel training program at The Ohio State University College of Medicine.

PubMed

Bahner, David P; Royall, Nelson A

2013-02-01

Ultrasound training and education in medical schools is rare, and the foci of current ultrasound curricula are limited. There is a significant need for advanced ultrasound training models in medical school curricula to reduce educational burdens for physician residency programs and improve overall physician competency.The authors describe and evaluate the advanced ultrasound training program developed at The Ohio State University College of Medicine (OSU COM). The OSU COM program is a longitudinal advanced ultrasound curriculum for fourth-year medical students pursuing specialties that require frequent use of focused ultrasound. One hundred fifty student participants have completed the yearlong program to date. Participants engage in didactic lectures, journal club sessions, hands-on training, teaching and patient-modeling activities, and complete a final project. Experienced Ohio State University Medical Center faculty are recruited from specialties that frequently use ultrasound (e.g., emergency medicine, internal medicine, obstetrics-gynecology). A multimodal instructional assessment approach ensures that ultrasound training yields experience with cognitive, behavioral, and constructive learning components. The authors discuss the benefits of the program as well as its challenges and future directions.The advanced ultrasound training program at OSU COM demonstrates a novel approach to providing ultrasound training for medical students, offering a feasible model for meeting training guidelines without increasing the educational requirements for residency programs.

Audiovisual Rehabilitation in Hemianopia: A Model-Based Theoretical Investigation

PubMed Central

Magosso, Elisa; Cuppini, Cristiano; Bertini, Caterina

2017-01-01

Hemianopic patients exhibit visual detection improvement in the blind field when audiovisual stimuli are given in spatiotemporally coincidence. Beyond this “online” multisensory improvement, there is evidence of long-lasting, “offline” effects induced by audiovisual training: patients show improved visual detection and orientation after they were trained to detect and saccade toward visual targets given in spatiotemporal proximity with auditory stimuli. These effects are ascribed to the Superior Colliculus (SC), which is spared in these patients and plays a pivotal role in audiovisual integration and oculomotor behavior. Recently, we developed a neural network model of audiovisual cortico-collicular loops, including interconnected areas representing the retina, striate and extrastriate visual cortices, auditory cortex, and SC. The network simulated unilateral V1 lesion with possible spared tissue and reproduced “online” effects. Here, we extend the previous network to shed light on circuits, plastic mechanisms, and synaptic reorganization that can mediate the training effects and functionally implement visual rehabilitation. The network is enriched by the oculomotor SC-brainstem route, and Hebbian mechanisms of synaptic plasticity, and is used to test different training paradigms (audiovisual/visual stimulation in eye-movements/fixed-eyes condition) on simulated patients. Results predict different training effects and associate them to synaptic changes in specific circuits. Thanks to the SC multisensory enhancement, the audiovisual training is able to effectively strengthen the retina-SC route, which in turn can foster reinforcement of the SC-brainstem route (this occurs only in eye-movements condition) and reinforcement of the SC-extrastriate route (this occurs in presence of survived V1 tissue, regardless of eye condition). The retina-SC-brainstem circuit may mediate compensatory effects: the model assumes that reinforcement of this circuit can translate visual stimuli into short-latency saccades, possibly moving the stimuli into visual detection regions. The retina-SC-extrastriate circuit is related to restitutive effects: visual stimuli can directly elicit visual detection with no need for eye movements. Model predictions and assumptions are critically discussed in view of existing behavioral and neurophysiological data, forecasting that other oculomotor compensatory mechanisms, beyond short-latency saccades, are likely involved, and stimulating future experimental and theoretical investigations. PMID:29326578

Audiovisual Rehabilitation in Hemianopia: A Model-Based Theoretical Investigation.

PubMed

Magosso, Elisa; Cuppini, Cristiano; Bertini, Caterina

2017-01-01

Hemianopic patients exhibit visual detection improvement in the blind field when audiovisual stimuli are given in spatiotemporally coincidence. Beyond this "online" multisensory improvement, there is evidence of long-lasting, "offline" effects induced by audiovisual training: patients show improved visual detection and orientation after they were trained to detect and saccade toward visual targets given in spatiotemporal proximity with auditory stimuli. These effects are ascribed to the Superior Colliculus (SC), which is spared in these patients and plays a pivotal role in audiovisual integration and oculomotor behavior. Recently, we developed a neural network model of audiovisual cortico-collicular loops, including interconnected areas representing the retina, striate and extrastriate visual cortices, auditory cortex, and SC. The network simulated unilateral V1 lesion with possible spared tissue and reproduced "online" effects. Here, we extend the previous network to shed light on circuits, plastic mechanisms, and synaptic reorganization that can mediate the training effects and functionally implement visual rehabilitation. The network is enriched by the oculomotor SC-brainstem route, and Hebbian mechanisms of synaptic plasticity, and is used to test different training paradigms (audiovisual/visual stimulation in eye-movements/fixed-eyes condition) on simulated patients. Results predict different training effects and associate them to synaptic changes in specific circuits. Thanks to the SC multisensory enhancement, the audiovisual training is able to effectively strengthen the retina-SC route, which in turn can foster reinforcement of the SC-brainstem route (this occurs only in eye-movements condition) and reinforcement of the SC-extrastriate route (this occurs in presence of survived V1 tissue, regardless of eye condition). The retina-SC-brainstem circuit may mediate compensatory effects: the model assumes that reinforcement of this circuit can translate visual stimuli into short-latency saccades, possibly moving the stimuli into visual detection regions. The retina-SC-extrastriate circuit is related to restitutive effects: visual stimuli can directly elicit visual detection with no need for eye movements. Model predictions and assumptions are critically discussed in view of existing behavioral and neurophysiological data, forecasting that other oculomotor compensatory mechanisms, beyond short-latency saccades, are likely involved, and stimulating future experimental and theoretical investigations.

Assessing Continuous Operator Workload With a Hybrid Scaffolded Neuroergonomic Modeling Approach.

PubMed

Borghetti, Brett J; Giametta, Joseph J; Rusnock, Christina F

2017-02-01

We aimed to predict operator workload from neurological data using statistical learning methods to fit neurological-to-state-assessment models. Adaptive systems require real-time mental workload assessment to perform dynamic task allocations or operator augmentation as workload issues arise. Neuroergonomic measures have great potential for informing adaptive systems, and we combine these measures with models of task demand as well as information about critical events and performance to clarify the inherent ambiguity of interpretation. We use machine learning algorithms on electroencephalogram (EEG) input to infer operator workload based upon Improved Performance Research Integration Tool workload model estimates. Cross-participant models predict workload of other participants, statistically distinguishing between 62% of the workload changes. Machine learning models trained from Monte Carlo resampled workload profiles can be used in place of deterministic workload profiles for cross-participant modeling without incurring a significant decrease in machine learning model performance, suggesting that stochastic models can be used when limited training data are available. We employed a novel temporary scaffold of simulation-generated workload profile truth data during the model-fitting process. A continuous workload profile serves as the target to train our statistical machine learning models. Once trained, the workload profile scaffolding is removed and the trained model is used directly on neurophysiological data in future operator state assessments. These modeling techniques demonstrate how to use neuroergonomic methods to develop operator state assessments, which can be employed in adaptive systems.

High Intensity Aerobic Exercise Training Improves Deficits of Cardiovascular Autonomic Function in a Rat Model of Type 1 Diabetes Mellitus with Moderate Hyperglycemia

PubMed Central

Grisé, Kenneth N.; Olver, T. Dylan; McDonald, Matthew W.; Dey, Adwitia; Jiang, Mao; Lacefield, James C.; Shoemaker, J. Kevin; Noble, Earl G.; Melling, C. W. James

2016-01-01

Indices of cardiovascular autonomic neuropathy (CAN) in experimental models of Type 1 diabetes mellitus (T1DM) are often contrary to clinical data. Here, we investigated whether a relatable insulin-treated model of T1DM would induce deficits in cardiovascular (CV) autonomic function more reflective of clinical results and if exercise training could prevent those deficits. Sixty-four rats were divided into four groups: sedentary control (C), sedentary T1DM (D), control exercise (CX), or T1DM exercise (DX). Diabetes was induced via multiple low-dose injections of streptozotocin and blood glucose was maintained at moderate hyperglycemia (9–17 mM) through insulin supplementation. Exercise training consisted of daily treadmill running for 10 weeks. Compared to C, D had blunted baroreflex sensitivity, increased vascular sympathetic tone, increased serum neuropeptide Y (NPY), and decreased intrinsic heart rate. In contrast, DX differed from D in all measures of CAN (except NPY), including heart rate variability. These findings demonstrate that this T1DM model elicits deficits and exercise-mediated improvements to CV autonomic function which are reflective of clinical T1DM. PMID:26885531

Predicting space telerobotic operator training performance from human spatial ability assessment

NASA Astrophysics Data System (ADS)

Liu, Andrew M.; Oman, Charles M.; Galvan, Raquel; Natapoff, Alan

2013-11-01

Our goal was to determine whether existing tests of spatial ability can predict an astronaut's qualification test performance after robotic training. Because training astronauts to be qualified robotics operators is so long and expensive, NASA is interested in tools that can predict robotics performance before training begins. Currently, the Astronaut Office does not have a validated tool to predict robotics ability as part of its astronaut selection or training process. Commonly used tests of human spatial ability may provide such a tool to predict robotics ability. We tested the spatial ability of 50 active astronauts who had completed at least one robotics training course, then used logistic regression models to analyze the correlation between spatial ability test scores and the astronauts' performance in their evaluation test at the end of the training course. The fit of the logistic function to our data is statistically significant for several spatial tests. However, the prediction performance of the logistic model depends on the criterion threshold assumed. To clarify the critical selection issues, we show how the probability of correct classification vs. misclassification varies as a function of the mental rotation test criterion level. Since the costs of misclassification are low, the logistic models of spatial ability and robotic performance are reliable enough only to be used to customize regular and remedial training. We suggest several changes in tracking performance throughout robotics training that could improve the range and reliability of predictive models.

Warrior Model for Human Performance and Injury Prevention: Eagle Tactical Athlete Program (ETAP) Part II.

PubMed

Sell, Timothy C; Abt, John P; Crawford, Kim; Lovalekar, Mita; Nagai, Takashi; Deluzio, Jennifer B; Smalley, Brain W; McGrail, Mark A; Rowe, Russell S; Cardin, Sylvain; Lephart, Scott M

2010-01-01

Physical training for United States military personnel requires a combination of injury prevention and performance optimization to counter unintentional musculoskeletal injuries and maximize warrior capabilities. Determining the most effective activities and tasks to meet these goals requires a systematic, research-based approach that is population specific based on the tasks and demands of the Warrior. The authors have modified the traditional approach to injury prevention to implement a comprehensive injury prevention and performance optimization research program with the 101st Airborne Division (Air Assault) at Fort Campbell, KY. This is second of two companion papers and presents the last three steps of the research model and includes Design and Validation of the Interventions, Program Integration and Implementation, and Monitor and Determine the Effectiveness of the Program. An 8-week trial was performed to validate the Eagle Tactical Athlete Program (ETAP) to improve modifiable suboptimal characteristics identified in Part I. The experimental group participated in ETAP under the direction of a ETAP Strength and Conditioning Specialist while the control group performed the current physical training at Fort Campbell under the direction of a Physical Training Leader and as governed by FM 21-20 for the 8-week study period. Soldiers performing ETAP demonstrated improvements in several tests for strength, flexibility, performance, physiology, and the APFT compared to current physical training performed at Fort Campbell. ETAP was proven valid to improve certain suboptimal characteristics within the 8-week trial as compared to the current training performed at Fort Campbell. ETAP has long-term implications and with expected greater improvements when implemented into a Division pre-deployment cycle of 10-12 months which will result in further systemic adaptations for each variable.

Planning and assessing a cross-training initiative with multi-skilled employees.

PubMed

Wermers, M A; Dagnillo, R; Glenn, R; Macfarlane, R; St Clair, V; Scott, D

1996-06-01

An improvement initiative begun by nurses at Parkview Episcopal Medical Center (Pueblo, Colo) to develop patient-focused care delivered by multiskilled workers followed a quality improvement methodology. Implementation of the new care delivery system on a model unit--2 South--provided the opportunity to plan, analyze data, and make changes as appropriate. Parkview's indoctrination of the teachings of W. Edwards Deming has helped leaders and staff realize the integral role of training in improvement activities. In his 14 points, Deming emphasizes the importance of employee education and of the employee having a clear understanding of his or her job. The time and money put into up-front education should help ensure the long-term success of this initiative. DEFINING THE CAREPARTNER: Three new multi-skilled positions were developed on 2 South--a Personal CarePartner, a Business CarePartner, and a Clinical CarePartner. By cross-training each of these roles to perform duties formerly done by centralized departments, 2 South was able to cut costs and time while ensuring quality care. TRAINING THE CAREPARTNER: An internally developed training program provided the new CarePartners with up-front education to prepare them to deliver patient-centered care. 2 South has experienced drops in patient falls and medication errors--areas that are often negatively affected when multi-skilled programs are instituted. Patient and physician surveys have shown increased satisfaction with care provided on the unit. The increased efficiency of the model unit has produced these outcomes while cutting costs substantially. The interdisciplinary team coordinating the improvement project learned many lessons in the process, including the importance of communication, education, and a sense of humor.

Robotic virtual reality simulation plus standard robotic orientation versus standard robotic orientation alone: a randomized controlled trial.

PubMed

Vaccaro, Christine M; Crisp, Catrina C; Fellner, Angela N; Jackson, Christopher; Kleeman, Steven D; Pavelka, James

2013-01-01

The objective of this study was to compare the effect of virtual reality simulation training plus robotic orientation versus robotic orientation alone on performance of surgical tasks using an inanimate model. Surgical resident physicians were enrolled in this assessor-blinded randomized controlled trial. Residents were randomized to receive either (1) robotic virtual reality simulation training plus standard robotic orientation or (2) standard robotic orientation alone. Performance of surgical tasks was assessed at baseline and after the intervention. Nine of 33 modules from the da Vinci Skills Simulator were chosen. Experts in robotic surgery evaluated each resident's videotaped performance of the inanimate model using the Global Rating Scale (GRS) and Objective Structured Assessment of Technical Skills-modified for robotic-assisted surgery (rOSATS). Nine resident physicians were enrolled in the simulation group and 9 in the control group. As a whole, participants improved their total time, time to incision, and suture time from baseline to repeat testing on the inanimate model (P = 0.001, 0.003, <0.001, respectively). Both groups improved their GRS and rOSATS scores significantly (both P < 0.001); however, the GRS overall pass rate was higher in the simulation group compared with the control group (89% vs 44%, P = 0.066). Standard robotic orientation and/or robotic virtual reality simulation improve surgical skills on an inanimate model, although this may be a function of the initial "practice" on the inanimate model and repeat testing of a known task. However, robotic virtual reality simulation training increases GRS pass rates consistent with improved robotic technical skills learned in a virtual reality environment.

Effect of multimedia information sequencing on educational outcome in orthodontic training.

PubMed

Aly, Medhat; Willems, Guy; Van Den Noortgate, Wim; Elen, Jan

2012-08-01

The aim of this research was to compare the effectiveness of hierarchical sequencing (HS) versus elaboration sequencing (ES) models in improving educational outcome of clinical knowledge when using instructional multimedia programs in postgraduate orthodontic training. Twenty-four postgraduate and 24 undergraduate dental students participated in this study. The postgraduates were following an orthodontic speciality training programme. The undergraduates were fourth- and fifth-year dental students. Twelve instructional multimedia modules were developed, six logically sequenced (LS) discussing six different orthodontic topics. Another six modules on identical topics were sequenced according to one macro-sequencing (MS) model. The implemented MS model was either HS or ES. The only difference between LS and MS modules was the adopted sequencing model. All participants were assigned into consistent pairs of students and were randomly divided into a test and a control group. In each pair, one student studied the LS module (control group) while the other studied the MS version (test group). Pre- and post-evaluation tests of each pair of participants were performed to measure knowledge, understanding and application of each participant with regard to the discussed topic. A multilevel analysis was conducted to assess the estimated effect of the different sequencing models. The level of significance was set at 0.05. At baseline, no significant differences (P > 0.05) were found in pre-test scores between groups. The HS model showed a significant effect on the scores achieved (P = 0.05). The test group showed a significantly higher estimated probability of correct answers to the questions (P = 0.003) when applying the HS model. The HS model may improve educational outcome when using instructional multimedia programs in postgraduate orthodontic training.

The Clinical Learning Dyad Model: An Innovation in Midwifery Education.

PubMed

Cohen, Susanna R; Thomas, Celeste R; Gerard, Claudia

2015-01-01

There is a national shortage of women's health and primary care providers in the United States, including certified nurse-midwives and certified midwives. This shortage is directly related to how many students can be trained within the existing system. The current model of midwifery clinical training is based on apprenticeship, with one-on-one interaction between a student and preceptor. Thus, the number of newly trained midwifery providers is limited by the number of available and willing preceptors. The clinical learning dyad model (CLDM), which pairs 2 beginning midwifery students with one preceptor in a busy practice, addresses this problem. In addition, this model brings in a senior midwife student as a near-peer mentor when the students are first oriented into outpatient clinical practice. The model began as a pilot project to improve the quality of training and increase available student spots in clinical education. This article discusses the origins of the model, the specifics of its design, and the results of a midterm and one-year postintervention survey. Students and preceptors involved in this model identified several advantages to the program, including increased student accountability, enhanced socialization into the profession, improved learning, and reduced teaching burden on preceptors. An additional benefit of the CLDM is that students form a learning community and collaborate with preceptors to care for women in busy clinical settings. Challenges of the model will also be discussed. Further research is needed to evaluate the effectiveness of the CLDM. This article is part of a special series of articles that address midwifery innovations in clinical practice, education, interprofessional collaboration, health policy, and global health. © 2015 by the American College of Nurse-Midwives.

The effect of experience, simulator-training and biometric feedback on manual ventilation technique.

PubMed

Lewis, Rebecca; Sherfield, Cerrie A; Fellows, Christopher R; Burrow, Rachel; Young, Iain; Dugdale, Alex

2017-05-01

To determine the frequency of provision and main providers (veterinary surgeons, nurses or trainees) of manual ventilation in UK veterinary practices. Furthermore, to determine the variation in peak inspiratory (inflation) pressure (PIP), applied to a lung model during manual ventilation, by three different groups of operators (inexperienced, experienced and specialist), before and after training. Questionnaire survey, lung model simulator development and prospective testing. Postal questionnaires were sent to 100 randomly selected veterinary practices. The lung model simulator was manually ventilated in a staged process over 3 weeks, with and without real-time biometric feedback (PIP display), by three groups of volunteer operators: inexperienced, experienced and specialist. The questionnaires determined that veterinary nurses were responsible for providing the majority of manual ventilation in veterinary practices, mainly drawing on theoretical knowledge rather than any specific training. Thoracic surgery and apnoea were the main reasons for provision of manual ventilation. Specialists performed well when manually ventilating the lung model, regardless of feedback training. Both inexperienced and experienced operators showed significant improvement in technique when using the feedback training tool: variation in PIP decreased significantly until operators provided manual ventilation at PIPs within the defined optimum range. Preferences for different forms of feedback (graphical, numerical or scale display), revealed that the operators' choice was not always the method which gave least variation in PIP. This study highlighted a need for training in manual ventilation at an early stage in veterinary and veterinary nursing careers and demonstrated how feedback is important in the process of experiential learning. A manometer device which can provide immediate feedback during training, or indeed in a real clinical setting, should improve patient safety. Copyright © 2017 Association of Veterinary Anaesthetists and American College of Veterinary Anesthesia and Analgesia. Published by Elsevier Ltd. All rights reserved.

Assessment of Evidence-based Management Training Program: Application of a Logic Model.

PubMed

Guo, Ruiling; Farnsworth, Tracy J; Hermanson, Patrick M

2016-06-01

The purposes of this study were to apply a logic model to plan and implement an evidence-based management (EBMgt) educational training program for healthcare administrators and to examine whether a logic model is a useful tool for evaluating the outcomes of the educational program. The logic model was used as a conceptual framework to guide the investigators in developing an EBMgt educational training program and evaluating the outcomes of the program. The major components of the logic model were constructed as inputs, outputs, and outcomes/impacts. The investigators delineated the logic model based on the results of the needs assessment survey. Two 3-hour training workshops were delivered to 30 participants. To assess the outcomes of the EBMgt educational program, pre- and post-tests and self-reflection surveys were conducted. The data were collected and analyzed descriptively and inferentially, using the IBM Statistical Package for the Social Sciences (SPSS) 22.0. A paired sample t-test was performed to compare the differences in participants' EBMgt knowledge and skills prior to and after the training. The assessment results showed that there was a statistically significant difference in participants' EBMgt knowledge and information searching skills before and after the training (p< 0.001). Participants' confidence in using the EBMgt approach for decision-making was significantly increased after the training workshops (p< 0.001). Eighty-three percent of participants indicated that the knowledge and skills they gained through the training program could be used for future management decision-making in their healthcare organizations. The overall evaluation results of the program were positive. It is suggested that the logic model is a useful tool for program planning, implementation, and evaluation, and it also improves the outcomes of the educational program.

Predicting the threshold of pulse-train electrical stimuli using a stochastic auditory nerve model: the effects of stimulus noise.

PubMed

Xu, Yifang; Collins, Leslie M

2004-04-01

The incorporation of low levels of noise into an electrical stimulus has been shown to improve auditory thresholds in some human subjects (Zeng et al., 2000). In this paper, thresholds for noise-modulated pulse-train stimuli are predicted utilizing a stochastic neural-behavioral model of ensemble fiber responses to bi-phasic stimuli. The neural refractory effect is described using a Markov model for a noise-free pulse-train stimulus and a closed-form solution for the steady-state neural response is provided. For noise-modulated pulse-train stimuli, a recursive method using the conditional probability is utilized to track the neural responses to each successive pulse. A neural spike count rule has been presented for both threshold and intensity discrimination under the assumption that auditory perception occurs via integration over a relatively long time period (Bruce et al., 1999). An alternative approach originates from the hypothesis of the multilook model (Viemeister and Wakefield, 1991), which argues that auditory perception is based on several shorter time integrations and may suggest an NofM model for prediction of pulse-train threshold. This motivates analyzing the neural response to each individual pulse within a pulse train, which is considered to be the brief look. A logarithmic rule is hypothesized for pulse-train threshold. Predictions from the multilook model are shown to match trends in psychophysical data for noise-free stimuli that are not always matched by the long-time integration rule. Theoretical predictions indicate that threshold decreases as noise variance increases. Theoretical models of the neural response to pulse-train stimuli not only reduce calculational overhead but also facilitate utilization of signal detection theory and are easily extended to multichannel psychophysical tasks.

Hand-assisted laparoscopic sigmoid colectomy skills acquisition: augmented reality simulator versus human cadaver training models.

PubMed

Leblanc, Fabien; Senagore, Anthony J; Ellis, Clyde N; Champagne, Bradley J; Augestad, Knut M; Neary, Paul C; Delaney, Conor P

2010-01-01

The aim of this study was to compare a simulator with the human cadaver model for hand-assisted laparoscopic colorectal skills acquisition training. An observational prospective comparative study was conducted to compare the laparoscopic surgery training models. The study took place during the laparoscopic colectomy training course performed at the annual scientific meeting of the American Society of Colon and Rectal Surgeons. Thirty four practicing surgeons performed hand-assisted laparoscopic sigmoid colectomy on human cadavers (n = 7) and on an augmented reality simulator (n = 27). Prior laparoscopic colorectal experience was assessed. Trainers and trainees completed independently objective structured assessment forms. Training models were compared by trainees' technical skills scores, events scores, and satisfaction. Prior laparoscopic experience was similar in both surgeon groups. Generic and specific skills scores were similar on both training models. Generic events scores were significantly better on the cadaver model. The 2 most frequent generic events occurring on the simulator were poor hand-eye coordination and inefficient use of retraction. Specific events were scored better on the simulator and reached the significance limit (p = 0.051) for trainers. The specific events occurring on the cadaver were intestinal perforation and left ureter identification difficulties. Overall satisfaction was better for the cadaver than for the simulator model (p = 0.009). With regard to skills scores, the augmented reality simulator had adequate qualities for the hand-assisted laparoscopic colectomy training. Nevertheless, events scores highlighted weaknesses of the anatomical replication on the simulator. Although improvements likely will be required to incorporate the simulator more routinely into the colorectal training, it may be useful in its current form for more junior trainees or those early on their learning curve. Copyright 2010 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Mid-Level Healthcare Personnel Training: An Evaluation of the Revised, Nationally-Standardized, Pre-Service Curriculum for Clinical Officers in Mozambique

PubMed Central

Feldacker, Caryl; Chicumbe, Sergio; Dgedge, Martinho; Augusto, Gerito; Cesar, Freide; Robertson, Molly; Mbofana, Francisco; O'Malley, Gabrielle

2014-01-01

Introduction Mozambique suffers from a critical shortage of healthcare workers. Mid-level healthcare workers, (Tecnicos de Medicina Geral (TMG)), in Mozambique require less money and time to train than physicians. From 2009–2010, the Mozambique Ministry of Health (MoH) and the International Training and Education Center for Health (I-TECH), University of Washington, Seattle, revised the TMG curriculum. To evaluate the effect of the curriculum revision, we used mixed methods to determine: 1) if TMGs meet the MoH's basic standards of clinical competency; and 2) do scores on measurements of clinical knowledge, physical exam, and clinical case scenarios differ by curriculum? Methods T-tests of differences in means examined differences in continuous score variables between curriculum groups. Univariate and multivariate linear regression models assess curriculum-related and demographic factors associated with assessment scores on each of the three evaluation methods at the p<0.05 level. Qualitative interviews and focus groups inform interpretation. Results We found no significant differences in sex, marital status and age between the 112 and 189 TMGs in initial and revised curriculum, respectively. Mean scores at graduation of initial curriculum TMGs were 56.7%, 63.5%, and 49.1% on the clinical cases, knowledge test, and physical exam, respectively. Scores did not differ significantly from TMGs in the revised curriculum. Results from linear regression models find that training institute was the most significant predictor of TMG scores on both the clinical cases and physical exam. Conclusion TMGs trained in either curriculum may be inadequately prepared to provide quality care. Curriculum changes are a necessary, but insufficient, part of improving TMG knowledge and skills overall. A more comprehensive, multi-level approach to improving TMG training that includes post-graduation mentoring, strengthening the pre-service internship training, and greater resources for training institute faculty may result in improvements in TMG capacity and patient care over time. PMID:25068590

Mid-level healthcare personnel training: an evaluation of the revised, nationally-standardized, pre-service curriculum for clinical officers in Mozambique.

PubMed

Feldacker, Caryl; Chicumbe, Sergio; Dgedge, Martinho; Augusto, Gerito; Cesar, Freide; Robertson, Molly; Mbofana, Francisco; O'Malley, Gabrielle

2014-01-01

Mozambique suffers from a critical shortage of healthcare workers. Mid-level healthcare workers, (Tecnicos de Medicina Geral (TMG)), in Mozambique require less money and time to train than physicians. From 2009-2010, the Mozambique Ministry of Health (MoH) and the International Training and Education Center for Health (I-TECH), University of Washington, Seattle, revised the TMG curriculum. To evaluate the effect of the curriculum revision, we used mixed methods to determine: 1) if TMGs meet the MoH's basic standards of clinical competency; and 2) do scores on measurements of clinical knowledge, physical exam, and clinical case scenarios differ by curriculum? T-tests of differences in means examined differences in continuous score variables between curriculum groups. Univariate and multivariate linear regression models assess curriculum-related and demographic factors associated with assessment scores on each of the three evaluation methods at the p<0.05 level. Qualitative interviews and focus groups inform interpretation. We found no significant differences in sex, marital status and age between the 112 and 189 TMGs in initial and revised curriculum, respectively. Mean scores at graduation of initial curriculum TMGs were 56.7%, 63.5%, and 49.1% on the clinical cases, knowledge test, and physical exam, respectively. Scores did not differ significantly from TMGs in the revised curriculum. Results from linear regression models find that training institute was the most significant predictor of TMG scores on both the clinical cases and physical exam. TMGs trained in either curriculum may be inadequately prepared to provide quality care. Curriculum changes are a necessary, but insufficient, part of improving TMG knowledge and skills overall. A more comprehensive, multi-level approach to improving TMG training that includes post-graduation mentoring, strengthening the pre-service internship training, and greater resources for training institute faculty may result in improvements in TMG capacity and patient care over time.

Robust visual tracking via multiple discriminative models with object proposals

NASA Astrophysics Data System (ADS)

Zhang, Yuanqiang; Bi, Duyan; Zha, Yufei; Li, Huanyu; Ku, Tao; Wu, Min; Ding, Wenshan; Fan, Zunlin

2018-04-01

Model drift is an important reason for tracking failure. In this paper, multiple discriminative models with object proposals are used to improve the model discrimination for relieving this problem. Firstly, the target location and scale changing are captured by lots of high-quality object proposals, which are represented by deep convolutional features for target semantics. And then, through sharing a feature map obtained by a pre-trained network, ROI pooling is exploited to wrap the various sizes of object proposals into vectors of the same length, which are used to learn a discriminative model conveniently. Lastly, these historical snapshot vectors are trained by different lifetime models. Based on entropy decision mechanism, the bad model owing to model drift can be corrected by selecting the best discriminative model. This would improve the robustness of the tracker significantly. We extensively evaluate our tracker on two popular benchmarks, the OTB 2013 benchmark and UAV20L benchmark. On both benchmarks, our tracker achieves the best performance on precision and success rate compared with the state-of-the-art trackers.

Implementation and evaluation of a dilation and evacuation simulation training curriculum.

PubMed

York, Sloane L; McGaghie, William C; Kiley, Jessica; Hammond, Cassing

2016-06-01

To evaluate obstetrics and gynecology resident physicians' performance following a simulation curriculum on dilation and evacuation (D&E) procedures. This study included two phases: simulation curriculum development and resident physician performance evaluation following training on a D&E simulator. Trainees participated in two evaluations. Simulation training evaluated participants performing six cases on a D&E simulator, measuring procedural time and a 26-step checklist of D&E steps. The operative training portion evaluated residents' performance after training on the simulator using mastery learning techniques. Intra-operative evaluation was based on a 21-step checklist score, Objective Structured Assessment of Technical Skills (OSATS), and percentage of cases completed. Twenty-two residents participated in simulation training, demonstrating improved performance from cases one and two to cases five and six, as measured by checklist score and procedural time (p<.001 and p=.001, respectively). Of 10 participants in the operative training, all performed at least three D&Es, while seven performed at least six cases. While checklist scores did not change significantly from the first to sixth case (mean for first case: 18.3; for sixth case: 19.6; p=.593), OSATS ratings improved from case one (19.7) to case three (23.5; p=.001) and to case six (26.8; p=.005). Trainees completed approximately 71.6% of their first case (range: 21.4-100%). By case six, the six participants performed 81.2% of the case (range: 14.3-100%). D&E simulation using a newly-developed uterine model and simulation curriculum improves resident technical skills. Simulation training with mastery learning techniques transferred to high level of performance in OR using checklist. The OSATS measured skills and showed improvement in performance with subsequent cases. Implementation of a D&E simulation curriculum offers potential for improved surgical training and abortion provision. Copyright © 2016 Elsevier Inc. All rights reserved.

A Novel Training Program for Police Officers that Improves Interactions with Mentally Ill Individuals and is Cost-Effective

PubMed Central

Krameddine, Yasmeen I.; DeMarco, David; Hassel, Robert; Silverstone, Peter H.

2013-01-01

Police and law enforcement providers frequently come into contact with individuals who have psychiatric disorders, sometimes with tragic results. Repeated studies suggest that greater understanding of psychiatric conditions by police officers would be beneficial. Here we present a novel approach to training police officers to improve their interactions with those who might have a mental illness. This approach involved developing a carefully scripted role-play training, which involved police officers (n = 663) interacting with highly trained actors during six realistic scenarios. The primary goal of the training was to improve empathy, communication skills, and the ability of officers to de-escalate potentially difficult situations. Uniquely, feedback was given to officers after each scenario by several individuals including experienced police officers, a mental health professional, and by the actors involved (with insights such as “this is how you made me feel”). Results showed that there were no changes in attitudes of the police toward the mentally ill comparing data at baseline and at 6 months after the training in those who completed both ratings (n = 170). In contrast, there were significant improvements in directly measured behaviors (n = 142) as well as in indirect measurements of behavior throughout the police force. Thus, compared to previous years, there was a significant increase in the recognition of mental health issues as a reason for a call (40%), improved efficiency in dealing with mental health issues, and a decrease in weapon or physical interactions with mentally ill individuals. The training cost was $120 per officer but led to significant cost savings (more than $80,000) in the following 6 months. In conclusion, this novel 1-day training course significantly changed behavior of police officers in meaningful ways and also led to cost savings. We propose that this training model could be adopted by other police agencies. PMID:23515226

[Interpersonal competence in orthopedics and traumatology : Why technical and procedural skills alone are not sufficient].

PubMed

Seemann, R; Münzberg, M; Stange, R; Rüsseler, M; Egerth, M; Bouillon, B; Hoffmann, R; Mutschler, M

2016-10-01

Patient safety has increasingly gained significance as criterion which clinics and doctors will be measured against in terms of ethics and finances. The "human factor" moved into focus regarding the question of how to reduce treatment errors in clinical daily routine. Nevertheless, systematic mediation of interpersonal competences only plays a minor role in the catalogue of requirements for medical specialization and professional training. This is the case not only in orthopedics and traumatology, but in other medical fields as well. At the insistence of DGOU and in cooperation with Lufthansa Flight Training, a training model was initiated, comparable to training models used in aviation. In aviation, apart from the training of procedural and technical abilities, regular soft skills training has become standard in the training of all Lufthansa staff. Several studies confirm that by improving communication, interaction, and teamwork skills not only a reduction of intolerable incidents is observed, but also a positive economic effect. Interpersonal competences should be firmly anchored in orthopedics and traumatology and thus be implemented as third post in specialist training.

How a Training Program Is Transforming the Role of Traditional Birth Attendants from Cultural Practitioners to Unique Health-care Providers: A Community Case Study in Rural Guatemala.

PubMed

Hernandez, Sasha; Oliveira, Jessica Bastos; Shirazian, Taraneh

2017-01-01

In low- and middle-income countries (LMICs), where the rates of maternal mortality continue to be inappropriately high, there has been recognition of the importance of training traditional birth attendants (TBAs) to help improve outcomes during pregnancy and childbirth. In Guatemala, there is no national comprehensive training program in place despite the fact that the majority of women rely on TBAs during pregnancy and childbirth. This community case study presents a unique education program led by TBAs for TBAs in rural Guatemala. Discussion of this training program focuses on programming implementation, curriculum development, sustainable methodology, and how an educational partnership with the current national health-care system can increase access to health care for women in LMICs. Recent modifications to this training model are also discussed including how a change in the clinical curriculum is further integrating TBAs into the national health infrastructure. The training program has demonstrated that Guatemalan TBAs are able to improve their basic obstetrical knowledge, are capable of identifying and referring early complications of pregnancy and labor, and can deliver basic prenatal care that would otherwise not be provided. This training model is helping transform the role of the TBA from a sole cultural practitioner to a validated health-care provider within the health-care infrastructure of Guatemala and has the potential to do the same in other LMICs.

Effect of respiratory muscle training on GLUT-4 in the sheep diaphragm.

PubMed

Bhandari, A; Xia, Y; Cortright, R; Dohm, G L; Bazzy, A R

2000-08-01

Endurance exercise training is associated with enhanced glucose uptake and hence improvement in carbohydrate metabolism. Glucose transport (GLUT) membrane proteins are regulated by a variety of physiological stimuli, including exercise. In limb muscle, both acute exercise and endurance training enhance the expression of the skeletal muscle transporter, GLUT-4. The purpose of this study is to determine whether chronic loading enhances GLUT-4 expression in the diaphragm. The effect of chronic inspiratory flow resistive (IFR) loading on diaphragm GLUT-4 was studied in a model of respiratory muscle endurance training in sheep. IFR loads (resistance 50-100 cm H2O x L(-1) x s(-1)) were maintained for 3 h x d(-1), 5-6 d x wk(-1) for 3 wk. Loading was adjusted so that PaO2 was >60 Torr and PaCO2 <45 Torr in room air. Six untrained sheep were used as controls. GLUT-4 protein and mRNA were analyzed by Western and Northern analysis respectively. GLUT-4 protein levels were two-fold greater in trained animals when compared with controls (P < 0.01). GLUT-4 mRNA levels in the trained muscles was not significantly different from controls. We conclude that in the sheep diaphragm, chronic IFR loading increases GLUT-4 protein levels. This increase may be one of the mechanisms contributing to the improved respiratory muscle endurance previously demonstrated in this animal model of respiratory muscle training.

Physiologically Based Pharmacokinetic Modeling in Lead Optimization. 1. Evaluation and Adaptation of GastroPlus To Predict Bioavailability of Medchem Series.

PubMed

Daga, Pankaj R; Bolger, Michael B; Haworth, Ian S; Clark, Robert D; Martin, Eric J

2018-03-05

When medicinal chemists need to improve bioavailability (%F) within a chemical series during lead optimization, they synthesize new series members with systematically modified properties mainly by following experience and general rules of thumb. More quantitative models that predict %F of proposed compounds from chemical structure alone have proven elusive. Global empirical %F quantitative structure-property (QSPR) models perform poorly, and projects have too little data to train local %F QSPR models. Mechanistic oral absorption and physiologically based pharmacokinetic (PBPK) models simulate the dissolution, absorption, systemic distribution, and clearance of a drug in preclinical species and humans. Attempts to build global PBPK models based purely on calculated inputs have not achieved the <2-fold average error needed to guide lead optimization. In this work, local GastroPlus PBPK models are instead customized for individual medchem series. The key innovation was building a local QSPR for a numerically fitted effective intrinsic clearance (CL loc ). All inputs are subsequently computed from structure alone, so the models can be applied in advance of synthesis. Training CL loc on the first 15-18 rat %F measurements gave adequate predictions, with clear improvements up to about 30 measurements, and incremental improvements beyond that.

Does rational selection of training and test sets improve the outcome of QSAR modeling?

PubMed

Martin, Todd M; Harten, Paul; Young, Douglas M; Muratov, Eugene N; Golbraikh, Alexander; Zhu, Hao; Tropsha, Alexander

2012-10-22

Prior to using a quantitative structure activity relationship (QSAR) model for external predictions, its predictive power should be established and validated. In the absence of a true external data set, the best way to validate the predictive ability of a model is to perform its statistical external validation. In statistical external validation, the overall data set is divided into training and test sets. Commonly, this splitting is performed using random division. Rational splitting methods can divide data sets into training and test sets in an intelligent fashion. The purpose of this study was to determine whether rational division methods lead to more predictive models compared to random division. A special data splitting procedure was used to facilitate the comparison between random and rational division methods. For each toxicity end point, the overall data set was divided into a modeling set (80% of the overall set) and an external evaluation set (20% of the overall set) using random division. The modeling set was then subdivided into a training set (80% of the modeling set) and a test set (20% of the modeling set) using rational division methods and by using random division. The Kennard-Stone, minimal test set dissimilarity, and sphere exclusion algorithms were used as the rational division methods. The hierarchical clustering, random forest, and k-nearest neighbor (kNN) methods were used to develop QSAR models based on the training sets. For kNN QSAR, multiple training and test sets were generated, and multiple QSAR models were built. The results of this study indicate that models based on rational division methods generate better statistical results for the test sets than models based on random division, but the predictive power of both types of models are comparable.

Six weeks of a polarized training-intensity distribution leads to greater physiological and performance adaptations than a threshold model in trained cyclists.

PubMed

Neal, Craig M; Hunter, Angus M; Brennan, Lorraine; O'Sullivan, Aifric; Hamilton, D Lee; De Vito, Giuseppe; Galloway, Stuart D R

2013-02-15

This study was undertaken to investigate physiological adaptation with two endurance-training periods differing in intensity distribution. In a randomized crossover fashion, separated by 4 wk of detraining, 12 male cyclists completed two 6-wk training periods: 1) a polarized model [6.4 (±1.4 SD) h/wk; 80%, 0%, and 20% of training time in low-, moderate-, and high-intensity zones, respectively]; and 2) a threshold model [7.5 (±2.0 SD) h/wk; 57%, 43%, and 0% training-intensity distribution]. Before and after each training period, following 2 days of diet and exercise control, fasted skeletal muscle biopsies were obtained for mitochondrial enzyme activity and monocarboxylate transporter (MCT) 1 and 4 expression, and morning first-void urine samples were collected for NMR spectroscopy-based metabolomics analysis. Endurance performance (40-km time trial), incremental exercise, peak power output (PPO), and high-intensity exercise capacity (95% maximal work rate to exhaustion) were also assessed. Endurance performance, PPOs, lactate threshold (LT), MCT4, and high-intensity exercise capacity all increased over both training periods. Improvements were greater following polarized rather than threshold for PPO [mean (±SE) change of 8 (±2)% vs. 3 (±1)%, P < 0.05], LT [9 (±3)% vs. 2 (±4)%, P < 0.05], and high-intensity exercise capacity [85 (±14)% vs. 37 (±14)%, P < 0.05]. No changes in mitochondrial enzyme activities or MCT1 were observed following training. A significant multilevel, partial least squares-discriminant analysis model was obtained for the threshold model but not the polarized model in the metabolomics analysis. A polarized training distribution results in greater systemic adaptation over 6 wk in already well-trained cyclists. Markers of muscle metabolic adaptation are largely unchanged, but metabolomics markers suggest different cellular metabolic stress that requires further investigation.

Engagement with the auditory processing system during targeted auditory cognitive training mediates changes in cognitive outcomes in individuals with schizophrenia

PubMed Central

Biagianti, Bruno; Fisher, Melissa; Neilands, Torsten B.; Loewy, Rachel; Vinogradov, Sophia

2016-01-01

BACKGROUND Individuals with schizophrenia who engage in targeted cognitive training (TCT) of the auditory system show generalized cognitive improvements. The high degree of variability in cognitive gains maybe due to individual differences in the level of engagement of the underlying neural system target. METHODS 131 individuals with schizophrenia underwent 40 hours of TCT. We identified target engagement of auditory system processing efficiency by modeling subject-specific trajectories of auditory processing speed (APS) over time. Lowess analysis, mixed models repeated measures analysis, and latent growth curve modeling were used to examine whether APS trajectories were moderated by age and illness duration, and mediated improvements in cognitive outcome measures. RESULTS We observed signifcant improvements in APS from baseline to 20 hours of training (initial change), followed by a flat APS trajectory (plateau) at subsequent time-points. Participants showed inter-individual variability in the steepness of the initial APS change and in the APS plateau achieved and sustained between 20–40 hours. We found that participants who achieved the fastest APS plateau, showed the greatest transfer effects to untrained cognitive domains. CONCLUSIONS There is a significant association between an individual's ability to generate and sustain auditory processing efficiency and their degree of cognitive improvement after TCT, independent of baseline neurocognition. APS plateau may therefore represent a behavioral measure of target engagement mediating treatment response. Future studies should examine the optimal plateau of auditory processing efficiency required to induce significant cognitive improvements, in the context of inter-individual differences in neural plasticity and sensory system efficiency that characterize schizophrenia. PMID:27617637

Effects of task repetition but no transfer of inhibitory control training in healthy adults.

PubMed

Talanow, Tobias; Ettinger, Ulrich

2018-06-01

Executive functions (EFs) comprise the updating, shifting and inhibition dimensions. According to the Unity and Diversity Model, the inhibition dimension is fully accounted for by a general EFs factor. This suggests that training of inhibition should transfer, in part, to updating and shifting. Therefore, we tested the effectiveness of a three-week inhibition training (high-conflict Stroop task) and explored near transfer effects to an untrained inhibition task (antisaccade task) and far transfer effects to untrained tasks demanding task-set shifting (number-letter-task), working memory updating (n-back task) and planning abilities (Stockings of Cambridge task). We employed a randomized pretest/treatment/posttest study design in n = 102 healthy young adults, assigned to an intensive Stroop training (n = 38), an active control condition (n = 34) or no training intervention (n = 30). In the Stroop training group, Stroop performance improved with practice, while performance in the active control group remained unchanged. The Stroop training group showed improvements in overall Stroop task performance from pretest to posttest, but we observed neither near nor far transfer effects. Additionally, specifically stronger gains on incongruent Stroop trials compared to congruent trials were observed in the Stroop training group when color bar trials were excluded from the pretest-posttest-analysis. Generally, there were substantial improvements from pretest to posttest independent of training condition in all transfer tasks. In sum, our data do not support the existence of transfer effects from inhibition training in healthy young adults. Copyright © 2018 Elsevier B.V. All rights reserved.

A Learning Evaluation for an Immersive Virtual Laboratory for Technical Training Applied into a Welding Workshop

ERIC Educational Resources Information Center

Torres, Francisco; Neira Tovar, Leticia A.; del Rio, Marta Sylvia

2017-01-01

This study aims to explore the results of welding virtual training performance, designed using a learning model based on cognitive and usability techniques, applying an immersive concept focused on person attention. Moreover, it also intended to demonstrate that exits a moderating effect of performance improvement when the user experience is taken…

Older Adults' Perceived Changes in Physical Self-Worth Associated with Resistance Training

ERIC Educational Resources Information Center

Dionigi, Rylee A.; Cannon, Jack

2009-01-01

Using Sonstroem, Harlow, and Josephs' (1994) expanded version of the Exercise and Self-Esteem Model (EXSEM; Sonstroem & Morgan, 1989), we explored how 9 older adults (6 women and 3 men, aged 65-72 years) involved in a resistance training program experienced and perceived changes in physical self-worth (i.e., improved strength, functional…

Cityworks: A Strategic Planning Model for Workforce Education and Training. Progress Report, January-June 1996.

ERIC Educational Resources Information Center

City Coll. of San Francisco, CA.

"CityWorks" is a strategic plan for improving workforce education and training at California's City College of San Francisco (CCSF). In January 1996, a Project Group was formed to determine a timeline and tasks to be accomplished by the project through June 1996, establishing goals related to project dissemination, forming external…

Using Virtual Interactive Training Agents (ViTA) with Adults with Autism and Other Developmental Disabilities

ERIC Educational Resources Information Center

Burke, Shanna L.; Bresnahan, Tammy; Li, Tan; Epnere, Katrina; Rizzo, Albert; Partin, Mary; Ahlness, Robert M.; Trimmer, Matthew

2018-01-01

Conversational virtual human (VH) agents are increasingly used to support role-play experiential learning. This project examined whether a Virtual Interactive Training Agent (ViTA) system would improve job interviewing skills in individuals with autism and developmental disabilities (N = 32). A linear mixed model was employed to evaluate adjusted…

Short Term Intervention Model for Enhancing Divergent Thinking among School Aged Children

ERIC Educational Resources Information Center

Doron, Eyal

2016-01-01

Creative ability can be developed and improved through intervention and training. This study presents a unique and innovative intervention program for enhancing creative thinking among children, focusing on divergent thinking skills. The program was designed as a short-term (10 weeks) training and conducted with 150 school students ranging in age…

Improving Fifth Grade Students' Mathematics Self-Efficacy Calibration and Performance through Self-Regulation Training

ERIC Educational Resources Information Center

Ramdass, Darshanand H.

2009-01-01

This primary goal of this study was to investigate the effects of strategy training and self-reflection, two subprocesses of Zimmerman's cyclical model of self-regulation, on fifth grade students' mathematics performance, self-efficacy, self-evaluation, and calibration measures of self-efficacy bias, self-efficacy accuracy, self-evaluation bias,…

A Model to Improve Teacher Performance in Implementing Individual Instructional Programs for Exceptional Children in a Mainstream Education. Midi Report.

ERIC Educational Resources Information Center

Vidaurri, Otilia V.

Described is a teacher development center, an inservice program designed to develop competencies for individualizing instruction in 73 regular and special educators attending 2-week training sessions. It is explained that training focused on 12 content modules (including teacher communication and guidance, classroom management, and organization of…

Development of the KOSMS management simulation training system and its application

NASA Astrophysics Data System (ADS)

Takatsu, Yoshiki

The use of games which simulate actual corporate management has recently become more common and is now utilized in various ways for in-house corporate training courses. KOSMS (Kobe Steel Management Simulation System), a training system designed to help improve the management skills of senior management staff, is a unique management simulation training system in which the participants, using personal computers, must make decisions concerning a variety of management activities, in simulated competition with other corporations. This report outlines the KOSMS system, and describes the basic structure and detailed contents of the management simulation models, and actual application of the KOSMS management simulation training.

New paradigm in training of undergraduate clinical skills: the NEPTUNE-CS project at the Split University School of Medicine.

PubMed

Simunovic, Vladimir J; Hozo, Izet; Rakic, Mladen; Jukic, Marko; Tomic, Snjezana; Kokic, Slaven; Ljutic, Dragan; Druzijanic, Nikica; Grkovic, Ivica; Simunovic, Filip; Marasovic, Dujomir

2010-10-01

Clinical skills' training is arguably the weakest point in medical schools' curriculum. This study briefly describes how we at the Split University School of Medicine cope with this problem. We consider that, over the last decades, a considerable advancement in teaching methodologies, tools, and assessment of students has been made. However, there are many unresolved issues, most notably: (i) the institutional value system, impeding the motivation of the teaching staff; (ii) lack of a strong mentoring system; (iii) organization, timing, and placement of training in the curriculum; (iv) lack of publications pertinent to training; and (v) unwillingness of patients to participate in student training. To improve the existing training models we suggest increased institutional awareness of obstacles, as well as willingness to develop mechanisms for increasing the motivation of faculty. It is necessary to introduce changes in the structure and timing of training and to complement it with a catalog, practicum, and portfolio of clinical skills. At Split University School of Medicine, we developed a new paradigm aimed to improve the teaching of clinical skills called "Neptune-CSS," which stands for New Paradigm in Training of Undergraduate Clinical Skills in Split.

Approximated mutual information training for speech recognition using myoelectric signals.

PubMed

Guo, Hua J; Chan, A D C

2006-01-01

A new training algorithm called the approximated maximum mutual information (AMMI) is proposed to improve the accuracy of myoelectric speech recognition using hidden Markov models (HMMs). Previous studies have demonstrated that automatic speech recognition can be performed using myoelectric signals from articulatory muscles of the face. Classification of facial myoelectric signals can be performed using HMMs that are trained using the maximum likelihood (ML) algorithm; however, this algorithm maximizes the likelihood of the observations in the training sequence, which is not directly associated with optimal classification accuracy. The AMMI training algorithm attempts to maximize the mutual information, thereby training the HMMs to optimize their parameters for discrimination. Our results show that AMMI training consistently reduces the error rates compared to these by the ML training, increasing the accuracy by approximately 3% on average.

Evaluation of a mental health training intervention for multidisciplinary teams in primary care in Brazil: a pre- and posttest study.

PubMed

Goncalves, Daniel A; Fortes, Sandra; Campos, Monica; Ballester, Dinarte; Portugal, Flávia Batista; Tófoli, Luis Fernando; Gask, Linda; Mari, Jair; Bower, Peter

2013-01-01

The aim of this research was to investigate whether a training intervention to enhance collaboration between mental health and primary care professionals improved the detection and management of mental health problems in primary health care in four large cities in Brazil. The training intervention was a multifaceted program over 96 h focused on development of a shared care model. A quasiexperimental study design was undertaken with assessment of performance by nurse and general practitioners (GPs) pre- and postintervention. Rates of recognition of mental health disorders (compared with the General Health Questionnaire) were the primary outcome, while self-reports of patient-centered care, psychosocial interventions and referral were the secondary outcomes. Six to 8 months postintervention, no changes were observed in terms of rate of recognition across the entire sample. Nurses significantly increased their recognition rates (from 23% to 39%, P=.05), while GPs demonstrated a significant decrease (from 42% to 30%, P=.04). There were significant increases in reports of patient-centered care, but no changes in other secondary outcomes. Training professionals in a shared care model was not associated with consistent improvements in the recognition or management of mental health problems. Although instabilities in the local context may have contributed to the lack of effects, wider changes in the system of care may be required to augment training and encourage reliable changes in behavior, and more specific educating models are necessary. Copyright © 2013 Elsevier Inc. All rights reserved.

Second-order sliding mode controller with model reference adaptation for automatic train operation

NASA Astrophysics Data System (ADS)

Ganesan, M.; Ezhilarasi, D.; Benni, Jijo

2017-11-01

In this paper, a new approach to model reference based adaptive second-order sliding mode control together with adaptive state feedback is presented to control the longitudinal dynamic motion of a high speed train for automatic train operation with the objective of minimal jerk travel by the passengers. The nonlinear dynamic model for the longitudinal motion of the train comprises of a locomotive and coach subsystems is constructed using multiple point-mass model by considering the forces acting on the vehicle. An adaptation scheme using Lyapunov criterion is derived to tune the controller gains by considering a linear, stable reference model that ensures the stability of the system in closed loop. The effectiveness of the controller tracking performance is tested under uncertain passenger load, coupler-draft gear parameters, propulsion resistance coefficients variations and environmental disturbances due to side wind and wet rail conditions. The results demonstrate improved tracking performance of the proposed control scheme with a least jerk under maximum parameter uncertainties when compared to constant gain second-order sliding mode control.

Modification Of Learning Rate With Lvq Model Improvement In Learning Backpropagation

NASA Astrophysics Data System (ADS)

Tata Hardinata, Jaya; Zarlis, Muhammad; Budhiarti Nababan, Erna; Hartama, Dedy; Sembiring, Rahmat W.

2017-12-01

One type of artificial neural network is a backpropagation, This algorithm trained with the network architecture used during the training as well as providing the correct output to insert a similar but not the same with the architecture in use at training.The selection of appropriate parameters also affects the outcome, value of learning rate is one of the parameters which influence the process of training, Learning rate affects the speed of learning process on the network architecture.If the learning rate is set too large, then the algorithm will become unstable and otherwise the algorithm will converge in a very long period of time.So this study was made to determine the value of learning rate on the backpropagation algorithm. LVQ models of learning rate is one of the models used in the determination of the value of the learning rate of the algorithm LVQ.By modifying this LVQ model to be applied to the backpropagation algorithm. From the experimental results known to modify the learning rate LVQ models were applied to the backpropagation algorithm learning process becomes faster (epoch less).

Design and analysis of a magnetorheological damper for train suspension

NASA Astrophysics Data System (ADS)

Lau, Yiu-Kee; Liao, Wei-Hsin

2004-07-01

The development of high-speed railway vehicles has been a great interest of many countries because high-speed trains have been proven as an efficient and economical transportation means while minimizing air pollution. However, the high speed of the train would cause significant car body vibrations. Thus effective vibration control of the car body is needed to improve the ride comfort and safety of the railway vehicle. Various kinds of railway vehicle suspensions such as passive, active, and semi-active systems could be used to cushion passengers from vibrations. Among them, semi-active suspensions are believed to achieve high performance while maintaining system stable and fail-safe. In this paper, it is aimed to design a magnetorheological (MR) fluid damper, which is suitable for semi-active train suspension system in order to improve the ride quality. A double-ended MR damper is designed, fabricated, and tested. Then a model for the double-ended MR damper is integrated in the secondary suspension of a full-scale railway vehicle model. A semi-active on-off control strategy based on the absolute velocity measurement of the car body is adopted. The controlled performances are compared with other types of suspension systems. The results show the feasibility and effectiveness of the semi-active train suspension system with the developed MR dampers.

Impact of a standardized training program on midwives’ ability to assess fetal heart anatomy by ultrasound

PubMed Central

2014-01-01

Background Studies of prenatal detection of congenital heart disease (CHD) in the UK, Italy, and Norway indicate that it should be possible to improve the prenatal detection rate of CHD in Sweden. These studies have shown that training programs, visualization of the outflow tracts and color-Doppler all can help to speed up and improve the detection rate and accuracy. We aimed to introduce a more accurate standardized fetal cardiac ultrasound screening protocol in Sweden. Methods A novel pedagogical model for training midwives in standardized cardiac imaging was developed, a model using a think-aloud analysis during a pre- and post-course test and a subsequent group reflection. The self-estimated difficulties and knowledge gaps of two experienced and two beginner midwives were identified. A two-day course with mixed lectures, demonstrations and hands-on sessions was followed by a feedback session three months later consisting of an interview and check-up. The long-term effects were tested two years later. Results At the post-course test the self-assessed uncertainty was lower than at the pre-course test. The qualitative evaluation showed that the color Doppler images were difficult to interpret, but the training seems to have improved their ability to use the new technique. The ability to perform the method remained at the new level at follow-up both three months and two years later. Conclusions Our results indicate that by implementing new imaging modalities and providing hands-on training, uncertainty can be reduced and examination time decreased, but they also show that continuous on-site training with clinical and technical back-up is important. PMID:24889837

Research methodology workshops evaluation using the Kirkpatrick's model: translating theory into practice.

PubMed

Abdulghani, Hamza Mohammad; Shaik, Shaffi Ahamed; Khamis, Nehal; Al-Drees, Abdulmajeed Abdulrahman; Irshad, Mohammad; Khalil, Mahmoud Salah; Alhaqwi, Ali Ibrahim; Isnani, Arthur

2014-04-01

Qualitative and quantitative evaluation of academic programs can enhance the development, effectiveness, and dissemination of comparative quality reports as well as quality improvement efforts. To evaluate the five research methodology workshops through assessing participants' satisfaction, knowledge and skills gain and impact on practices by the Kirkpatrick's evaluation model. The four level Kirkpatrick's model was applied for the evaluation. Training feedback questionnaires, pre and post tests, learner development plan reports and behavioral surveys were used to evaluate the effectiveness of the workshop programs. Of the 116 participants, 28 (24.1%) liked with appreciation, 62 (53.4%) liked with suggestions and 26 (22.4%) disliked the programs. Pre and post MCQs tests mean scores showed significant improvement of relevant basic knowledge and cognitive skills by 17.67% (p ≤ 0.005). Pre-and-post tests scores on workshops sub-topics also significantly improved for the manuscripts (p ≤ 0.031) and proposal writing (p ≤ 0.834). As for the impact, 56.9% of participants started research, and 6.9% published their studies. The results from participants' performance revealed an overall positive feedback and 79% of participant reported transfer of training skills at their workplace. The course outcomes achievement and suggestions given for improvements offer insight into the program which were encouraging and very useful. Encouraging "research culture" and work-based learning are probably the most powerful determinants for research promotion. These findings therefore encourage faculty development unit to continue its training and development in the research methodology aspects.

Comparison of different modelling approaches of drive train temperature for the purposes of wind turbine failure detection

NASA Astrophysics Data System (ADS)

Tautz-Weinert, J.; Watson, S. J.

2016-09-01

Effective condition monitoring techniques for wind turbines are needed to improve maintenance processes and reduce operational costs. Normal behaviour modelling of temperatures with information from other sensors can help to detect wear processes in drive trains. In a case study, modelling of bearing and generator temperatures is investigated with operational data from the SCADA systems of more than 100 turbines. The focus is here on automated training and testing on a farm level to enable an on-line system, which will detect failures without human interpretation. Modelling based on linear combinations, artificial neural networks, adaptive neuro-fuzzy inference systems, support vector machines and Gaussian process regression is compared. The selection of suitable modelling inputs is discussed with cross-correlation analyses and a sensitivity study, which reveals that the investigated modelling techniques react in different ways to an increased number of inputs. The case study highlights advantages of modelling with linear combinations and artificial neural networks in a feedforward configuration.

Working memory training in older adults: Bayesian evidence supporting the absence of transfer.

PubMed

Guye, Sabrina; von Bastian, Claudia C

2017-12-01

The question of whether working memory training leads to generalized improvements in untrained cognitive abilities is a longstanding and heatedly debated one. Previous research provides mostly ambiguous evidence regarding the presence or absence of transfer effects in older adults. Thus, to draw decisive conclusions regarding the effectiveness of working memory training interventions, methodologically sound studies with larger sample sizes are needed. In this study, we investigated whether or not a computer-based working memory training intervention induced near and far transfer in a large sample of 142 healthy older adults (65 to 80 years). Therefore, we randomly assigned participants to either the experimental group, which completed 25 sessions of adaptive, process-based working memory training, or to the active, adaptive visual search control group. Bayesian linear mixed-effects models were used to estimate performance improvements on the level of abilities, using multiple indicator tasks for near (working memory) and far transfer (fluid intelligence, shifting, and inhibition). Our data provided consistent evidence supporting the absence of near transfer to untrained working memory tasks and the absence of far transfer effects to all of the assessed abilities. Our results suggest that working memory training is not an effective way to improve general cognitive functioning in old age. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

An integrated decision model for the application of airborne sensors for improved response to accidental and terrorist chemical vapor releases

NASA Astrophysics Data System (ADS)

Kapitan, Loginn

This research created a new model which provides an integrated approach to planning the effective selection and employment of airborne sensor systems in response to accidental or intentional chemical vapor releases. The approach taken was to use systems engineering and decision analysis methods to construct a model architecture which produced a modular structure for integrating both new and existing components into a logical procedure to assess the application of airborne sensor systems to address chemical vapor hazards. The resulting integrated process model includes an internal aggregation model which allowed differentiation among alternative airborne sensor systems. Both models were developed and validated by experts and demonstrated using appropriate hazardous chemical release scenarios. The resultant prototype integrated process model or system fills a current gap in capability allowing improved planning, training and exercise for HAZMAT teams and first responders when considering the selection and employment of airborne sensor systems. Through the research process, insights into the current response structure and how current airborne capability may be most effectively used were generated. Furthermore, the resultant prototype system is tailorable for local, state, and federal application, and can potentially be modified to help evaluate investments in new airborne sensor technology and systems. Better planning, training and preparedness exercising holds the prospect for the effective application of airborne assets for improved response to large scale chemical release incidents. Improved response will result in fewer casualties and lives lost, reduced economic impact, and increased protection of critical infrastructure when faced with accidental and intentional terrorist release of hazardous industrial chemicals. With the prospect of more airborne sensor systems becoming available, this prototype system integrates existing and new tools into an effective process for the selection and employment of airborne sensors to better plan, train and exercise ahead of potential chemical release events.

Quality of life and sleep quality are similarly improved after aquatic or dry-land aerobic training in patients with type 2 diabetes: A randomized clinical trial.

PubMed

S Delevatti, Rodrigo; Schuch, Felipe Barreto; Kanitz, Ana Carolina; Alberton, Cristine L; Marson, Elisa Corrêa; Lisboa, Salime Chedid; Pinho, Carolina Dertzbocher Feil; Bregagnol, Luciana Peruchena; Becker, Maríndia Teixeira; Kruel, Luiz Fernando M

2018-05-01

To compare the effects of two aerobic training models in water and on dry-land on quality of life, depressive symptoms and sleep quality in patients with type 2 diabetes. Randomized clinical trial. Thirty-five patients with type 2 diabetes were randomly assigned to aquatic aerobic training group (n=17) or dry-land aerobic training group (n=18). Exercise training length was of 12 weeks, performed in three weekly sessions (45min/session), with intensity progressing from 85% to 100% of heart rate of anaerobic threshold during interventions. All outcomes were evaluated at baseline and 12 weeks later. In per protocol analysis, physical and psychological domains of quality of life improved in both groups (p<0.05) without between-group differences. Overall quality of life and sleep quality improved in both groups (p<0.05), without between-group differences in per protocol and intention to treat analysis. No changes on depressive symptoms were observed in both groups at follow-up. Aerobic training in an aquatic environment provides similar effects to aerobic training in a dry-land environment on quality of life, depressive symptoms and sleep quality in patients with type 2 diabetes. Clinical trial reg. no. NCT01956357, clinicaltrials.gov. Copyright © 2017 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

Visual Working Memory Capacity Can Be Increased by Training on Distractor Filtering Efficiency.

PubMed

Li, Cui-Hong; He, Xu; Wang, Yu-Juan; Hu, Zhe; Guo, Chun-Yan

2017-01-01

It is generally considered that working memory (WM) capacity is limited and that WM capacity affects cognitive processes. Distractor filtering efficiency has been suggested to be an important factor in determining the visual working memory (VWM) capacity of individuals. In the present study, we investigated whether training in visual filtering efficiency (FE) could improve VWM capacity, as measured by performance on the change detection task (CDT) and changes of contralateral delay activity (CDA) (contralateral delay activity) of different conditions, and evaluated the transfer effect of visual FE training on verbal WM and fluid intelligence, as indexed by performance on the verbal WM span task and Raven's Standard Progressive Matrices (RSPM) test, respectively. Participants were divided into high- and low-capacity groups based on their performance in a CDT designed to test VWM capacity, and then the low-capacity individuals received 20 days of FE training. The training significantly improved the group's performance in the CDT, and their CDA models of different conditions became more similar with high capacity group, and the effect generalized to improve verbal WM span. These gains were maintained at a 3-month follow-up test. Participants' RSPM scores were not changed by the training. These findings support the notion that WM capacity is determined, at least in part, by distractor FE and can be enhanced through training.

Gastric precancerous diseases classification using CNN with a concise model.

PubMed

Zhang, Xu; Hu, Weiling; Chen, Fei; Liu, Jiquan; Yang, Yuanhang; Wang, Liangjing; Duan, Huilong; Si, Jianmin

2017-01-01

Gastric precancerous diseases (GPD) may deteriorate into early gastric cancer if misdiagnosed, so it is important to help doctors recognize GPD accurately and quickly. In this paper, we realize the classification of 3-class GPD, namely, polyp, erosion, and ulcer using convolutional neural networks (CNN) with a concise model called the Gastric Precancerous Disease Network (GPDNet). GPDNet introduces fire modules from SqueezeNet to reduce the model size and parameters about 10 times while improving speed for quick classification. To maintain classification accuracy with fewer parameters, we propose an innovative method called iterative reinforced learning (IRL). After training GPDNet from scratch, we apply IRL to fine-tune the parameters whose values are close to 0, and then we take the modified model as a pretrained model for the next training. The result shows that IRL can improve the accuracy about 9% after 6 iterations. The final classification accuracy of our GPDNet was 88.90%, which is promising for clinical GPD recognition.

Microsurgery Workout: A Novel Simulation Training Curriculum Based on Nonliving Models.

PubMed

Rodriguez, Jose R; Yañez, Ricardo; Cifuentes, Ignacio; Varas, Julian; Dagnino, Bruno

2016-10-01

Currently, there are no valid training programs based solely on nonliving models. The authors aimed to develop and validate a microsurgery training program based on nonliving models and assess the transfer of skills to a live rat model. Postgraduate year-3 general surgery residents were assessed in a 17-session program, performing arterial and venous end-to-end anastomosis on ex vivo chicken models. Procedures were recorded and rated by two blinded experts using validated global and specific scales (objective structured assessment of technical skills) and a validated checklist. Operating times and patency rates were assessed. Hand-motion analysis was used to measure economy of movements. After training, residents performed an arterial and venous end-to-end anastomosis on live rats. Results were compared to six experienced surgeons in the same models. Values of p < 0.05 were considered statistically significant. Learning curves were achieved. Ten residents improved their median global and specific objective structured assessment of technical skills scores for artery [10 (range, 8 to 10) versus 28 (range, 27 to 29), p < 0.05; and 8 (range, 7 to 9) versus 28 (range, 27 to 28), p < 0.05] and vein [8 (range, 8 to 11) versus 28 (range, 27 to 28), p < 0.05; and 8 (range, 7 to 9) versus 28 (range, 27 to 29), p < 0.05]. Checklist scores also improved for both procedures (p < 0.05). Trainees were slower and less efficient than experienced surgeons (p < 0.05). In the living rat, patency rates at 30 minutes were 100 percent and 50 percent for artery and vein, respectively. Significant acquisition of microsurgical skills was achieved by trainees to a level similar to that of experienced surgeons. Acquired skills were transferred to a more complex live model.

Naturalistic Decision Making for Power System Operators

DOE Office of Scientific and Technical Information (OSTI.GOV)

Greitzer, Frank L.; Podmore, Robin; Robinson, Marck

2010-02-01

Motivation – Investigations of large-scale outages in the North American interconnected electric system often attribute the causes to three T’s: Trees, Training and Tools. To document and understand the mental processes used by expert operators when making critical decisions, a naturalistic decision making (NDM) model was developed. Transcripts of conversations were analyzed to reveal and assess NDM-based performance criteria. Findings/Design – An item analysis indicated that the operators’ Situation Awareness Levels, mental models, and mental simulations can be mapped at different points in the training scenario. This may identify improved training methods or analytical/ visualization tools. Originality/Value – This studymore » applies for the first time, the concepts of Recognition Primed Decision Making, Situation Awareness Levels and Cognitive Task Analysis to training of electric power system operators. Take away message – The NDM approach provides a viable framework for systematic training management to accelerate learning in simulator-based training scenarios for power system operators and teams.« less

Mechanical simulators for training for laparoscopic surgery in urology.

PubMed

Rassweiler, Jens; Klein, Jan; Teber, Dogu; Schulze, Michael; Frede, Thomas

2007-03-01

The introduction of laparoscopic surgery into urology has led to new training concepts differing significantly from previous concepts of training for open surgery. This paper focuses on the type and importance of mechanical simulators in laparoscopic training. On the basis of our own studies and experience with the development of various concepts of laparoscopic training, including different modules (i.e., Pelvi-trainer, animal models, clinical mentoring) since 1991, we reviewed the current literature concerning all types of simulators. We focused on training for laparoscopic ablative and reconstructive surgery using mechanical simulators. The principle of a mechanical simulator (i.e., a box with the possibility of trocar insertion) has not changed during the last decade. However, the types of Pelvi-trainers and the models used inside have been improved significantly. According to the task of the simulator, various sophisticated models have been developed, including standardized phantoms, animal organs, and even perfused segments of porcine organs. For laparoscopic suturing, various step-by-step training concepts have been presented. These can be used for determination of the ability of a physician with an interest in laparoscopic surgery, but also to classify the training status of a laparosopic surgeon. Training in laparoscopic surgery has become an important topic, not only in learning a procedure, but also in maintaining skills and preparing for the management of complications. For these purposes, mechanical simulators will definitely play an important role in the future.

Effectiveness of Gross Model-Based Emotion Regulation Strategies Training on Anger Reduction in Drug-Dependent Individuals and its Sustainability in Follow-up.

PubMed

Massah, Omid; Sohrabi, Faramarz; A'azami, Yousef; Doostian, Younes; Farhoudian, Ali; Daneshmand, Reza

2016-03-01

Emotion plays an important role in adapting to life changes and stressful events. Difficulty regulating emotions is one of the problems drug abusers often face, and teaching these individuals to express and manage their emotions can be effective on improving their difficult circumstances. The present study aimed to determine the effectiveness of the Gross model-based emotion regulation strategies training on anger reduction in drug-dependent individuals. The present study had a quasi-experimental design wherein pretest-posttest evaluations were applied using a control group. The population under study included addicts attending Marivan's methadone maintenance therapy centers in 2012 - 2013. Convenience sampling was used to select 30 substance-dependent individuals undergoing maintenance treatment who were then randomly assigned to the experiment and control groups. The experiment group received its training in eight two-hour sessions. Data were analyzed using analysis of co-variance and paired t-test. There was significant reduction in anger symptoms of drug-dependent individuals after gross model based emotion regulation training (ERT) (P < 0.001). Moreover, the effectiveness of the training on anger was persistent in the follow-up period. Symptoms of anger in drug-dependent individuals of this study were reduced by gross model-based emotion regulation strategies training. Based on the results of this study, we may conclude that the gross model based emotion regulation strategies training can be applied alongside other therapies to treat drug abusers undergoing rehabilitation.

Using a Theory-guided Learning Collaborative Model to Improve Implementation of EBPs in a State Children’s Mental Health System: A Pilot Study

PubMed Central

Nadeem, Erum; Weiss, Dara; Olin, S. Serene; Hoagwood, Kimberly E.; Horwitz, Sarah M.

2016-01-01

Learning collaboratives (LCs) are used widely to promote implementation of evidence-based practices (EBPs). However, there has been limited research on the effectiveness of LCs and models vary widely in their structure, focus and components. The goal of the present study was to develop and field test a theory-based LC model to augment a state-led, evidence-based training program for clinicians providing mental health services to children. Analysis of implementation outcomes contrasted LC sites to matched comparison sites that participated in the clinical training program alone. Results suggested that clinicians from sites participating in the LC were more highly engaged in the state-led clinical training program and were more likely to complete program requirements. PMID:27167744

Using a Theory-Guided Learning Collaborative Model to Improve Implementation of EBPs in a State Children's Mental Health System: A Pilot Study.

PubMed

Nadeem, Erum; Weiss, Dara; Olin, S Serene; Hoagwood, Kimberly E; Horwitz, Sarah M

2016-11-01

Learning collaboratives (LCs) are used widely to promote implementation of evidence-based practices. However, there has been limited research on the effectiveness of LCs and models vary widely in their structure, focus and components. The goal of the present study was to develop and field test a theory-based LC model to augment a state-led, evidence-based training program for clinicians providing mental health services to children. Analysis of implementation outcomes contrasted LC sites to matched comparison sites that participated in the clinical training program alone. Results suggested that clinicians from sites participating in the LC were more highly engaged in the state-led clinical training program and were more likely to complete program requirements.

Mean-field thalamocortical modeling of longitudinal EEG acquired during intensive meditation training.

PubMed

Saggar, Manish; Zanesco, Anthony P; King, Brandon G; Bridwell, David A; MacLean, Katherine A; Aichele, Stephen R; Jacobs, Tonya L; Wallace, B Alan; Saron, Clifford D; Miikkulainen, Risto

2015-07-01

Meditation training has been shown to enhance attention and improve emotion regulation. However, the brain processes associated with such training are poorly understood and a computational modeling framework is lacking. Modeling approaches that can realistically simulate neurophysiological data while conforming to basic anatomical and physiological constraints can provide a unique opportunity to generate concrete and testable hypotheses about the mechanisms supporting complex cognitive tasks such as meditation. Here we applied the mean-field computational modeling approach using the scalp-recorded electroencephalogram (EEG) collected at three assessment points from meditating participants during two separate 3-month-long shamatha meditation retreats. We modeled cortical, corticothalamic, and intrathalamic interactions to generate a simulation of EEG signals recorded across the scalp. We also present two novel extensions to the mean-field approach that allow for: (a) non-parametric analysis of changes in model parameter values across all channels and assessments; and (b) examination of variation in modeled thalamic reticular nucleus (TRN) connectivity over the retreat period. After successfully fitting whole-brain EEG data across three assessment points within each retreat, two model parameters were found to replicably change across both meditation retreats. First, after training, we observed an increased temporal delay between modeled cortical and thalamic cells. This increase provides a putative neural mechanism for a previously observed reduction in individual alpha frequency in these same participants. Second, we found decreased inhibitory connection strength between the TRN and secondary relay nuclei (SRN) of the modeled thalamus after training. This reduction in inhibitory strength was found to be associated with increased dynamical stability of the model. Altogether, this paper presents the first computational approach, taking core aspects of physiology and anatomy into account, to formally model brain processes associated with intensive meditation training. The observed changes in model parameters inform theoretical accounts of attention training through meditation, and may motivate future study on the use of meditation in a variety of clinical populations. Copyright © 2015 Elsevier Inc. All rights reserved.

Does Rational Selection of Training and Test Sets Improve the Outcome of QSAR Modeling?

EPA Science Inventory

Prior to using a quantitative structure activity relationship (QSAR) model for external predictions, its predictive power should be established and validated. In the absence of a true external dataset, the best way to validate the predictive ability of a model is to perform its s...

Integration of leadership training into a problem/case-based learning program for first- and second-year medical students.

PubMed

Ginzburg, Samara B; Deutsch, Susan; Bellissimo, Jaclyn; Elkowitz, David E; Stern, Joel Nh; Lucito, Robert

2018-01-01

The evolution of health care systems in response to societal and financial pressures has changed care delivery models, which presents new challenges for physicians. Leadership training is increasingly being recognized as an essential component of medical education training to prepare physicians to meet these needs. Unfortunately, most medical schools do not include leadership training. It has been suggested that a longitudinal and integrated approach to leadership training should be sought. We hypothesized that integration of leadership training into our hybrid problem-based learning (PBL)/case-based learning (CBL) program, Patient-Centered Explorations in Active Reasoning, Learning and Synthesis (PEARLS), would be an effective way for medical students to develop leadership skills without the addition of curricular time. We designed a unique leadership program in PEARLS in which 98 medical students participated during each of their six courses throughout the first 2 years of school. A program director and trained faculty facilitators educated students and coached them on leadership development throughout this time. Students were assessed by their facilitator at the end of every course on development of leadership skills related to teamwork, meaningful self-assessment, process improvement, and thinking outside the box. Students consistently improved their performance from the first to the final course in all four leadership parameters evaluated. The skills that demonstrated the greatest change were those pertaining to thinking outside the box and process improvement. Incorporation of a longitudinal and integrated approach to leadership training into an existing PBL/CBL program is an effective way for medical students to improve their leadership skills without the addition of curricular time. These results offer a new, time-efficient option for leadership development in schools with existing PBL/CBL programs.

Comparison of Different Forms of Exercise Training in Patients With Cardiac Disease: Where Does High-Intensity Interval Training Fit?

PubMed

Gayda, Mathieu; Ribeiro, Paula A B; Juneau, Martin; Nigam, Anil

2016-04-01

In this review, we discuss the most recent forms of exercise training available to patients with cardiac disease and their comparison or their combination (or both) during short- and long-term (phase II and III) cardiac rehabilitation programs. Exercise training modalities to be discussed include inspiratory muscle training (IMT), resistance training (RT), continuous aerobic exercise training (CAET), and high-intensity interval training (HIIT). Particular emphasis is placed on HIIT compared or combined (or both) with other forms such as CAET or RT. For example, IMT combined with CAET was shown to be superior to CAET alone for improving functional capacity, ventilatory function, and quality of life in patients with chronic heart failure. Similarly, RT combined with CAET was shown to optimize benefits with respect to functional capacity, muscle function, and quality of life. Furthermore, in recent years, HIIT has emerged as an alternative or complementary (or both) exercise modality to CAET, providing equivalent if not superior benefits to conventional continuous aerobic training with respect to aerobic fitness, cardiovascular function, quality of life, efficiency, safety, tolerance, and exercise adherence in both short- and long-term training studies. Finally, short-interval HIIT was shown to be useful in the initiation and improvement phases of cardiac rehabilitation, whereas moderate- or longer-interval (or both) HIIT protocols appear to be more appropriate for the improvement and maintenance phases because of their high physiological stimulus. We now propose progressive models of exercise training (phases II-III) for patients with cardiac disease, including a more appropriate application of HIIT based on the scientific literature in the context of a multimodal cardiac rehabilitation program. Copyright © 2016 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.

Introducing a Fresh Cadaver Model for Ultrasound-guided Central Venous Access Training in Undergraduate Medical Education

PubMed Central

Miller, Ryan; Ho, Hang; Ng, Vivienne; Tran, Melissa; Rappaport, Douglas; Rappaport, William J.A.; Dandorf, Stewart J.; Dunleavy, James; Viscusi, Rebecca; Amini, Richard

2016-01-01

Introduction Over the past decade, medical students have witnessed a decline in the opportunities to perform technical skills during their clinical years. Ultrasound-guided central venous access (USG-CVA) is a critical procedure commonly performed by emergency medicine, anesthesia, and general surgery residents, often during their first month of residency. However, the acquisition of skills required to safely perform this procedure is often deficient upon graduation from medical school. To ameliorate this lack of technical proficiency, ultrasound simulation models have been introduced into undergraduate medical education to train venous access skills. Criticisms of simulation models are the innate lack of realistic tactile qualities, as well as the lack of anatomical variances when compared to living patients. The purpose of our investigation was to design and evaluate a life-like and reproducible training model for USG-CVA using a fresh cadaver. Methods This was a cross-sectional study at an urban academic medical center. An 18-point procedural knowledge tool and an 18-point procedural skill evaluation tool were administered during a cadaver lab at the beginning and end of the surgical clerkship. During the fresh cadaver lab, procedure naïve third-year medical students were trained on how to perform ultrasound-guided central venous access of the femoral and internal jugular vessels. Preparation of the fresh cadaver model involved placement of a thin-walled latex tubing in the anatomic location of the femoral and internal jugular vein respectively. Results Fifty-six third-year medical students participated in this study during their surgical clerkship. The fresh cadaver model provided high quality and lifelike ultrasound images despite numerous cannulation attempts. Technical skill scores improved from an average score of 3 to 12 (p<0.001) and procedural knowledge scores improved from an average score of 4 to 8 (p<0.001). Conclusion The use of this novel cadaver model prevented extravasation of fluid, maintained ultrasound-imaging quality, and proved to be an effective educational model allowing third-year medical students to improve and maintain their technical skills. PMID:27330672

Introducing a Fresh Cadaver Model for Ultrasound-guided Central Venous Access Training in Undergraduate Medical Education.

PubMed

Miller, Ryan; Ho, Hang; Ng, Vivienne; Tran, Melissa; Rappaport, Douglas; Rappaport, William J A; Dandorf, Stewart J; Dunleavy, James; Viscusi, Rebecca; Amini, Richard

2016-05-01

Over the past decade, medical students have witnessed a decline in the opportunities to perform technical skills during their clinical years. Ultrasound-guided central venous access (USG-CVA) is a critical procedure commonly performed by emergency medicine, anesthesia, and general surgery residents, often during their first month of residency. However, the acquisition of skills required to safely perform this procedure is often deficient upon graduation from medical school. To ameliorate this lack of technical proficiency, ultrasound simulation models have been introduced into undergraduate medical education to train venous access skills. Criticisms of simulation models are the innate lack of realistic tactile qualities, as well as the lack of anatomical variances when compared to living patients. The purpose of our investigation was to design and evaluate a life-like and reproducible training model for USG-CVA using a fresh cadaver. This was a cross-sectional study at an urban academic medical center. An 18-point procedural knowledge tool and an 18-point procedural skill evaluation tool were administered during a cadaver lab at the beginning and end of the surgical clerkship. During the fresh cadaver lab, procedure naïve third-year medical students were trained on how to perform ultrasound-guided central venous access of the femoral and internal jugular vessels. Preparation of the fresh cadaver model involved placement of a thin-walled latex tubing in the anatomic location of the femoral and internal jugular vein respectively. Fifty-six third-year medical students participated in this study during their surgical clerkship. The fresh cadaver model provided high quality and lifelike ultrasound images despite numerous cannulation attempts. Technical skill scores improved from an average score of 3 to 12 (p<0.001) and procedural knowledge scores improved from an average score of 4 to 8 (p<0.001). The use of this novel cadaver model prevented extravasation of fluid, maintained ultrasound-imaging quality, and proved to be an effective educational model allowing third-year medical students to improve and maintain their technical skills.

Does Self-Control Training Improve Self-Control? A Meta-Analysis.

PubMed

Friese, Malte; Frankenbach, Julius; Job, Veronika; Loschelder, David D

2017-11-01

Self-control is positively associated with a host of beneficial outcomes. Therefore, psychological interventions that reliably improve self-control are of great societal value. A prominent idea suggests that training self-control by repeatedly overriding dominant responses should lead to broad improvements in self-control over time. Here, we conducted a random-effects meta-analysis based on robust variance estimation of the published and unpublished literature on self-control training effects. Results based on 33 studies and 158 effect sizes revealed a small-to-medium effect of g = 0.30, confidence interval (CI 95 ) [0.17, 0.42]. Moderator analyses found that training effects tended to be larger for (a) self-control stamina rather than strength, (b) studies with inactive compared to active control groups, (c) males than females, and (d) when proponents of the strength model of self-control were (co)authors of a study. Bias-correction techniques suggested the presence of small-study effects and/or publication bias and arrived at smaller effect size estimates (range: g corrected = .13 to .24). The mechanisms underlying the effect are poorly understood. There is not enough evidence to conclude that the repeated control of dominant responses is the critical element driving training effects.

Regular rehearsal helps in consolidation of long term memory.

PubMed

Parle, Milind; Singh, Nirmal; Vasudevan, Mani

2006-01-01

Memory, one of the most complex functions of the brain comprises of multiple components such as perception, registration, consolidation, storage, retrieval and decay. The present study was undertaken to evaluate the impact of different training sessions on the retention capacity of rats. The capacity of retention of learnt task was measured using exteroceptive behavioral models such as Hexagonal swimming pool apparatus, Hebb-Williams maze and Elevated plus-maze. A total of 150 rats divided into fifteen groups were employed in the present study. The animals were subjected to different training sessions during first three days. The ability to retain the learned task was tested after single, sub-acute, acute, sub-chronic and chronic exposure to above exteroceptive memory models in separate groups of animals. The memory score of all animals was recorded after 72 h, 192 h and 432 h of their last training trial. Rats of single exposure group did not show any effect on memory. Sub-acute training group animals showed improved memory up to 72 h only, where as in acute and sub-chronic training groups this memory improvement was extended up to 192 h. The rats, which were subjected to chronic exposures showed a significant improvement in retention capacity that lasted up to a period of eighteen days. These observations suggest that repeated rehearsals at regular intervals are probably necessary for consolidation of long-term memory. It was observed that sub-acute, acute and sub-chronic exposures, improved the retrieval ability of rats but this memory improving effect was short lived. Thus, rehearsal or training plays a crucial role in enhancing one's capacity of retaining the learnt information. Key PointsThe present study underlines the importance of regular rehearsals in enhancing one's capacity of retaining the learnt information. " Sub-acute, acute & sub-chronic rehearsals result in storing of information for a limited period of time.Quick decay of information or forgetting is a natural continuously active process designed to wipe out unnecessary and useless information.The capacities of grasping, understanding and memory are all crucial for career growth.Single exposure to a new environment is not sufficient enough to form a permanent memory trace in brain.

Characterization of Used Nuclear Fuel with Multivariate Analysis for Process Monitoring

DOE Office of Scientific and Technical Information (OSTI.GOV)

Dayman, Kenneth J.; Coble, Jamie B.; Orton, Christopher R.

2014-01-01

The Multi-Isotope Process (MIP) Monitor combines gamma spectroscopy and multivariate analysis to detect anomalies in various process streams in a nuclear fuel reprocessing system. Measured spectra are compared to models of nominal behavior at each measurement location to detect unexpected changes in system behavior. In order to improve the accuracy and specificity of process monitoring, fuel characterization may be used to more accurately train subsequent models in a full analysis scheme. This paper presents initial development of a reactor-type classifier that is used to select a reactor-specific partial least squares model to predict fuel burnup. Nuclide activities for prototypic usedmore » fuel samples were generated in ORIGEN-ARP and used to investigate techniques to characterize used nuclear fuel in terms of reactor type (pressurized or boiling water reactor) and burnup. A variety of reactor type classification algorithms, including k-nearest neighbors, linear and quadratic discriminant analyses, and support vector machines, were evaluated to differentiate used fuel from pressurized and boiling water reactors. Then, reactor type-specific partial least squares models were developed to predict the burnup of the fuel. Using these reactor type-specific models instead of a model trained for all light water reactors improved the accuracy of burnup predictions. The developed classification and prediction models were combined and applied to a large dataset that included eight fuel assembly designs, two of which were not used in training the models, and spanned the range of the initial 235U enrichment, cooling time, and burnup values expected of future commercial used fuel for reprocessing. Error rates were consistent across the range of considered enrichment, cooling time, and burnup values. Average absolute relative errors in burnup predictions for validation data both within and outside the training space were 0.0574% and 0.0597%, respectively. The errors seen in this work are artificially low, because the models were trained, optimized, and tested on simulated, noise-free data. However, these results indicate that the developed models may generalize well to new data and that the proposed approach constitutes a viable first step in developing a fuel characterization algorithm based on gamma spectra.« less

Training community mental health staff in Guangzhou, China: evaluation of the effect of a new training model.

PubMed

Li, Jie; Li, Juan; Thornicroft, Graham; Yang, Hui; Chen, Wen; Huang, Yuanguang

2015-10-26

Increasing numbers of people with mental disorders receive services at primary care in China. The aims of this study are to evaluate impact of a new training course and supervision for community mental health staff to enhance their levels of mental health knowledge and to reduce their stigmatization toward people with mental illness. A total of 77 community mental health staff from eight regions in Guangzhou in China were recruited for the study.4 regions were randomly allocated to the new training model group, and 4 to the old training model group. Levels of mental health knowledge were measured by purpose-made assessment schedule and by the Mental Health Knowledge Schedule (MAKS). Stigma was evaluated by the Mental Illness: Clinicians' Attitudes Scale (MICA) and the Reported and Intended Behavior Scale (RIBS). Evaluation questionnaires were given at the beginning of course, at the end, and at 6 month and at 12 month follow-up. After the training period, the 6-month, and the 12-month, knowledge scores of the intervention group were higher than the control group. At 6-month and 12-month follow-up, means scores of MAKS of the intervention group increased more than the control group (both p < 0.05) when age, sex, marriage status, title and time were controlled for. At 6-month follow-up, means scores of MICA of the intervention group decreased more than that of the control group (p < 0.01). At after-training, at 6-months, and at 12-months, mean scores of RIBS of the intervention group increased more than the control (p < 0.01, p < 0.001, p < 0.001) when age, sex, marriage status, title and time were controlled for. Compared with the traditional training course and supervision, the new course improved community mental health staff knowledge of mental disorders, improving their attitudes toward people with mental disorder, and increasing their willingness to have contact with people with mental disorder.

Swim Training Improves HOMA-IR in Type 2 Diabetes Induced by High Fat Diet and Low Dose of Streptozotocin in Male Rats.

PubMed

Ghiasi, Rafigheh; Ghadiri Soufi, Farhad; Somi, Mohammad Hossein; Mohaddes, Gisou; Mirzaie Bavil, Fariba; Naderi, Roya; Alipour, Mohammad Reza

2015-09-01

Insulin resistance plays a key role in the onset and development of type 2 diabetes mellitus (T2DM) and its complications. In this study, we evaluated the effect of swim training on insulin resistance in diabetic rats. Forty male Wistar rats were randomly divided into four groups (n=10): sedentary control (Con), sedentary diabetic (Dia), swim trained control (Exe) and swim trained diabetic (Dia+Exe) rats. Diabetes was induced by high fat diet (HFD) and a low dose of streptozotocin (35 mg/kg, i.p). In trained groups, one week after the induction of diabetes, animals were subjected to swimming (60 min/5 days a week) for 10 weeks. At the end of training, fasting blood sugar (FBS), oral glucose tolerance test (OGTT), fasting/basal insulin, glycosylated hemoglobin (HbA1c) levels, insulin resistance index, homeostasis model assessment method (HOMA-IR), triglycerides (TG,) total cholesterol (TCh), and high density lipoprotein (HDL) levels in blood were measured. Swimming significantly improved OGTT (P<0.01) and HOMA-IR (P<0.01). Swim training also significantly decreased FBS (p<0.01), fasting/basal insulin (P<0.01), HbA1C (p<0.01), TG (P<0.05), and TCh (P<0.05) levels. It also significantly increased HDL (p<0.05) level. Our findings indicate that swim training improved glycemic control and insulin sensitivity in type 2 diabetes caused by high fat diet in male rats.

A cascade model of mentorship for frontline health workers in rural health facilities in Eastern Uganda: processes, achievements and lessons.

PubMed

Ajeani, Judith; Mangwi Ayiasi, Richard; Tetui, Moses; Ekirapa-Kiracho, Elizabeth; Namazzi, Gertrude; Muhumuza Kananura, Ronald; Namusoke Kiwanuka, Suzanne; Beyeza-Kashesya, Jolly

2017-08-01

There is increasing demand for trainers to shift from traditional didactic training to innovative approaches that are more results-oriented. Mentorship is one such approach that could bridge the clinical knowledge gap among health workers. This paper describes the experiences of an attempt to improve health-worker performance in maternal and newborn health in three rural districts through a mentoring process using the cascade model. The paper further highlights achievements and lessons learnt during implementation of the cascade model. The cascade model started with initial training of health workers from three districts of Pallisa, Kibuku and Kamuli from where potential local mentors were selected for further training and mentorship by central mentors. These local mentors then went on to conduct mentorship visits supported by the external mentors. The mentorship process concentrated on partograph use, newborn resuscitation, prevention and management of Post-Partum Haemorrhage (PPH), including active management of third stage of labour, preeclampsia management and management of the sick newborn. Data for this paper was obtained from key informant interviews with district-level managers and local mentors. Mentorship improved several aspects of health-care delivery, ranging from improved competencies and responsiveness to emergencies and health-worker professionalism. In addition, due to better district leadership for Maternal and Newborn Health (MNH), there were improved supplies/medicine availability, team work and innovative local problem-solving approaches. Health workers were ultimately empowered to perform better. The study demonstrated that it is possible to improve the competencies of frontline health workers through performance enhancement for MNH services using locally built capacity in clinical mentorship for Emergency Obstetric and Newborn Care (EmONC). The cascade mentoring process needed strong external mentorship support at the start to ensure improved capacity among local mentors to provide mentorship among local district staff.

On your time: online training for the public health workforce.

PubMed

Kenefick, Hope Worden; Ravid, Sharon; MacVarish, Kathleen; Tsoi, Jennifer; Weill, Kenny; Faye, Elizabeth; Fidler, Anne

2014-03-01

The need for competency-based training for the public health workforce is well documented. However, human and financial resource limitations within public health agencies often make it difficult for public health practitioners to attend classroom-based training programs. The Internet is an increasingly popular way of extending training beyond the workforce. Although research describes attributes of effective online learning modules, much of the available training delivered via the Internet does not incorporate such attributes. The authors describe the On Your Time training series, an effective distance education program and training model for public health practitioners, which includes a standardized process for development, review, evaluation, and continuous quality improvement. On Your Time is a series of awareness-level (i.e., addressing what practitioners should know), competency-based training modules that address topics related to regulatory responsibilities of public health practitioners (e.g., assuring compliance with codes and regulations governing housing, retail food safety, private water supplies, hazardous and solid waste, on-site wastewater systems, etc.), public health surveillance, case investigation, disease prevention, health promotion, and emergency preparedness. The replicable model incorporates what is known about best practices for online training and maximizes available resources in the interests of sustainability.

Robotic kidney autotransplantation in a porcine model: a procedure-specific training platform for the simulation of robotic intracorporeal vascular anastomosis.

PubMed

Tiong, Ho Yee; Goh, Benjamin Yen Seow; Chiong, Edmund; Tan, Lincoln Guan Lim; Vathsala, Anatharaman

2018-03-31

Robotic-assisted kidney transplantation (RKT) with the Da Vinci (Intuitive, USA) platform has been recently developed to improve outcomes by decreasing surgical site complications and morbidity, especially in obese patients. This potential paradigm shift in the surgical technique of kidney transplantation is performed in only a few centers. For wider adoption of this high stake complex operation, we aimed to develop a procedure-specific simulation platform in a porcine model for the training of robotic intracorporeal vascular anastomosis and evaluating vascular anastomoses patency. This paper describes the requirements and steps developed for the above training purpose. Over a series of four animal ethics' approved experiments, the technique of robotic-assisted laparoscopic autotransplantation of the kidney was developed in Amsterdam live pigs (60-70 kg). The surgery was based around the vascular anastomosis technique described by Menon et al. This non-survival porcine training model is targeted at transplant surgeons with robotic surgery experience. Under general anesthesia, each pig was placed in lateral decubitus position with the placement of one robotic camera port, two robotic 8 mm ports and one assistant port. Robotic docking over the pig posteriorly was performed. The training platform involved the following procedural steps. First, ipsilateral iliac vessel dissection was performed. Second, robotic-assisted laparoscopic donor nephrectomy was performed with in situ perfusion of the kidney with cold Hartmann's solution prior to complete division of the hilar vessels, ureter and kidney mobilization. Thirdly, the kidney was either kept in situ for orthotopic autotransplantation or mobilized to the pelvis and orientated for the vascular anastomosis, which was performed end to end or end to side after vessel loop clamping of the iliac vessels, respectively, using 6/0 Gore-Tex sutures. Following autotransplantation and release of vessel loops, perfusion of the graft was assessed using intraoperative indocyanine green imaging and monitoring urine output after unclamping. This training platform demonstrates adequate face and content validity. With practice, arterial anastomotic time could be improved, showing its construct validity. This porcine training model can be useful in providing training for robotic intracorporeal vascular anastomosis and may facilitate confident translation into a transplant human recipient.

Interactive training model of TRIZ for mechanical engineers in China

NASA Astrophysics Data System (ADS)

Tan, Runhua; Zhang, Huangao

2014-03-01

Innovation is a process of taking an original idea and converting it into a business value, in which the engineers face some inventive problems which can be solved hardly by experience. TRIZ, as a new theory for companies in China, provides both conceptual and procedural knowledge for finding and solving inventive problems. Because the government plays a leading role in the diffusion of TRIZ, too many companies from different industries are waiting to be trained, but the quantity of the trainers mastering TRIZ is incompatible with that requirement. In this context, to improve the training effect, an interactive training model of TRIZ for the mechanical engineers in China is developed and the implementation in the form of training classes is carried out. The training process is divided into 6 phases as follows: selecting engineers, training stage-1, finding problems, training stage-2, finding solutions and summing up. The government, TRIZ institutions and companies to join the programs interact during the process. The government initiates and monitors a project in form of a training class of TRIZ and selects companies to join the programs. Each selected companies choose a few engineers to join the class and supervises the training result. The TRIZ institutions design the training courses and carry out training curriculum. With the beginning of the class, an effective communication channel is established by means of interview, discussion face to face, E-mail, QQ and so on. After two years training practices, the results show that innovative abilities of the engineers to join and pass the final examinations increased distinctly, and most of companies joined the training class have taken congnizance of the power of TRIZ for product innovation. This research proposes an interactive training model of TRIZ for mechanical engineers in China to expedite the knowledge diffusion of TRIZ.

The impact of training and working conditions on junior doctors’ intention to leave clinical practice

PubMed Central

2014-01-01

Background The shortage of physicians is an evolving problem throughout the world. In this study we aimed to identify to what extent junior doctors’ training and working conditions determine their intention to leave clinical practice after residency training. Methods A prospective cohort study was conducted in 557 junior doctors undergoing residency training in German hospitals. Self-reported specialty training conditions, working conditions and intention to leave clinical practice were measured over three time points. Scales covering training conditions were assessed by structured residency training, professional support, and dealing with lack of knowledge; working conditions were evaluated by work overload, job autonomy and social support, based on the Demand–Control–Support model. Multivariate ordinal logistic regression analyses with random intercept for longitudinal data were applied to determine the odds ratio of having a higher level of intention to leave clinical practice. Results In the models that considered training and working conditions separately to predict intention to leave clinical practice we found significant baseline effects and change effects. After modelling training and working conditions simultaneously, we found evidence that the change effect of job autonomy (OR 0.77, p = .005) was associated with intention to leave clinical practice, whereas for the training conditions, only the baseline effects of structured residency training (OR 0.74, p = .017) and dealing with lack of knowledge (OR 0.74, p = .026) predicted intention to leave clinical practice. Conclusions Junior doctors undergoing specialty training experience high workload in hospital practice and intense requirements in terms of specialty training. Our study indicates that simultaneously improving working conditions over time and establishing a high standard of specialty training conditions may prevent junior doctors from considering leaving clinical practice after residency training. PMID:24942360

Tailored cognitive-behavioural therapy and exercise training improves the physical fitness of patients with fibromyalgia.

PubMed

van Koulil, S; van Lankveld, W; Kraaimaat, F W; van Helmond, T; Vedder, A; van Hoorn, H; Donders, A R T; Wirken, L; Cats, H; van Riel, P L C M; Evers, A W M

2011-12-01

Patients with fibromyalgia have diminished levels of physical fitness, which may lead to functional disability and exacerbating complaints. Multidisciplinary treatment comprising cognitive-behavioural therapy (CBT) and exercise training has been shown to be effective in improving physical fitness. However, due to the high drop-out rates and large variability in patients' functioning, it was proposed that a tailored treatment approach might yield more promising treatment outcomes. High-risk fibromyalgia patients were randomly assigned to a waiting list control group (WLC) or a treatment condition (TC), with the treatment consisting of 16 twice-weekly sessions of CBT and exercise training tailored to the patient's cognitive-behavioural pattern. Physical fitness was assessed with two physical tests before and 3 months after treatment and at corresponding intervals in the WLC. Treatment effects were evaluated using linear mixed models. The level of physical fitness had improved significantly in the TC compared with the WLC. Attrition rates were low, effect sizes large and reliable change indices indicated a clinically relevant improvement among the TC. A tailored multidisciplinary treatment approach for fibromyalgia consisting of CBT and exercise training is well tolerated, yields clinically relevant changes, and appears a promising approach to improve patients' physical fitness. ClinicalTrials.gov ID NCT00268606.

Effectiveness of community health workers for promoting use of safety eyewear by Latino farm workers.

PubMed

Forst, Linda; Lacey, Steven; Chen, Hua Yun; Jimenez, Rocio; Bauer, Susan; Skinner, Sara; Alvarado, Ramona; Nickels, Leslie; Zanoni, Joseph; Petrea, Robert; Conroy, Lorraine

2004-12-01

To evaluate The Community Health Worker "promotor de salud" (CHW) model is evaluated as a tool for reducing eye injuries in Latino farm workers. In 2001, 786 workers on 34 farms were divided into three intervention blocks: (A) CHWs provided protective eyewear and training to farm workers; (B) CHWs provided eyewear but no training to farm workers; (C) eyewear was distributed to farm workers with no CHW present and no training. Pre- and post-intervention questionnaires demonstrated greater self-reported use of eyewear in all blocks after the intervention (P < 0.0001), with Block A showing the greatest change compared to B (P < 0.0001) and C (P = 0.03); this was supported by field observations. Block A showed the greatest improvement in knowledge on questions related to training content. CHWs were an effective tool to train farm workers in eye health and safety, improving the use of personal protective equipment and knowledge.

Can Mindfulness Training Improve Medication Adherence? Integrative Review of the Current Evidence and Proposed Conceptual Model.

PubMed

Salmoirago-Blotcher, Elena; Carey, Michael P

Medication adherence is a complex, multi-determined behavior that is often influenced by system- (e.g., cost), drug- (e.g., regimen complexity), and patient-related (e.g., depression) factors. System-level approaches (e.g., making medications more affordable) are critically important but do not address patient-level factors that can undermine adherence. In this paper, we identify patient-level determinants of non-adherence and discuss whether mindfulness-training approaches that target these determinants can help to improve adherence to medical treatment. We highlight two chronic medical conditions (viz., heart failure and HIV) where poor adherence is a significant concern, and examine the evidence regarding the use of mindfulness interventions to improve medication adherence in these two conditions. We also discuss the theoretical underpinnings of mindfulness training with respect to medication adherence, and conclude by suggesting directions for future research. Copyright © 2018 Elsevier Inc. All rights reserved.

[Added value of family practitioners' supervision of junior doctors in a walk-in clinic].

PubMed

Perdrix, J; Gubser, R; Gilgien, W; Bischoff, T

2011-05-18

The pending workforce crisis in family medicine has triggered various initiatives. This article describes the PMU-FLON walk-in clinic, a project of the Institute of General Medicine University of Lausanne. The working conditions in this clinic are close to that of a family practice. Doctors in training are supervised by family doctors who work part-time in the clinic. The objective is to improve training in the various fields of family medicine, from technical skills (improving optimal use of diagnostic tools), to integrating patients' requests in a more global patient-centered approach. This new educational model allows doctors in training to benefit from the specific approaches of different trainers. It will contribute to promoting quality family medicine in the future.

Model for Team Training Using the Advanced Trauma Operative Management Course: Pilot Study Analysis.

PubMed

Perkins, R Serene; Lehner, Kathryn A; Armstrong, Randy; Gardiner, Stuart K; Karmy-Jones, Riyad C; Izenberg, Seth D; Long, William B; Wackym, P Ashley

2015-01-01

Education and training of surgeons has traditionally focused on the development of individual knowledge, technical skills, and decision making. Team training with the surgeon's operating room staff has not been prioritized in existing educational paradigms, particularly in trauma surgery. We aimed to determine whether a pilot curriculum for surgical technicians and nurses, based on the American College of Surgeons' Advanced Trauma Operative Management (ATOM) course, would improve staff knowledge if conducted in a team-training environment. Between December 2012 and December 2014, 22 surgical technicians and nurses participated in a curriculum complementary to the ATOM course, consisting of 8 individual 8-hour training sessions designed by and conducted at our institution. Didactic and practical sessions included educational content, hands-on instruction, and alternating role play during 5 system-specific injury scenarios in a simulated operating room environment. A pre- and postcourse examination was administered to participants to assess for improvements in team members' didactic knowledge. Course participants displayed a significant improvement in didactic knowledge after working in a team setting with trauma surgeons during the ATOM course, with a 9-point improvement on the postcourse examination (83%-92%, p = 0.0008). Most participants (90.5%) completing postcourse surveys reported being "highly satisfied" with course content and quality after working in our simulated team-training setting. Team training is critical to improving the knowledge base of surgical technicians and nurses in the trauma operative setting. Improved communication, efficiency, appropriate equipment use, and staff awareness are the desired outcomes when shifting the paradigm from individual to surgical team training so that improved patient outcomes, decreased risk, and cost savings can be achieved. Determine whether a pilot curriculum for surgical technicians and nurses, based on the American College of Surgeons' ATOM course, improves staff knowledge if conducted in a team-training environment. Surgical technicians and nurses participated in a curriculum complementary to the ATOM course. In all, 8 individual 8-hour training sessions were conducted at our institution and contained both didactic and practical content, as well as alternating role play during 5 system-specific injury scenarios. A pre- and postcourse examination was administered to assess for improvements in didactic knowledge. The course was conducted in a simulated team-training setting at the Legacy Institute for Surgical Education and Innovation (Portland, OR), an American College of Surgeons Accredited Educational Institute. In all, 22 surgical technicians and operating room nurses participated in 8 separate ATOM(s) courses and had at least 1 year of surgical scrubbing experience in general surgery with little or no exposure to Level I trauma surgical care. Of these participants, 16 completed the postcourse examination. Participants displayed a significant improvement in didactic knowledge (83%-92%, p = 0.0008) after the ATOM(s) course. Of the 14 participants who completed postcourse surveys, 90.5% were "highly satisfied" with the course content and quality. Team training is critical to improving the knowledge base of surgical technicians and nurses in the trauma operative setting and may contribute to improved patient outcomes, decreased risk, and hospital cost savings. Copyright © 2015 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Ventures in Community Improvement (VICI): Findings from a Four-Site Replication Initiative, 1984-1987.

ERIC Educational Resources Information Center

Levin, Laurie; And Others

Ventures in Community Improvement (VICI) is a program that provides intensive training in construction skills to disadvantaged youth and at the same time allows them to produce tangible improvements in housing and public facilities in their own low-income communities. The model was tested twice previously, once in an eight-state demonstration that…

A House Staff Training Program to Improve the Clinical Instruction of Medical Students.

ERIC Educational Resources Information Center

Meleca, C. Benjamin; Schimpfhauser, Frank T.

A demonstrated model for effective instructional skill improvement in the medical clinical sciences is described. A two-year project was funded by the National Fund for Medical Education to design and implement a program to assist house staff in the improvement of clinical instruction. A total of 148 medical residents were surveyed about their…

Benefits to the Simulation Training Community of a New ANSI Standard for the Exchange of Aero Simulation Models

NASA Technical Reports Server (NTRS)

Hildreth, Bruce L.; Jackson, E. Bruce

2009-01-01

The American Institute of Aeronautics Astronautics (AIAA) Modeling and Simulation Technical Committee is in final preparation of a new standard for the exchange of flight dynamics models. The standard will become an ANSI standard and is under consideration for submission to ISO for acceptance by the international community. The standard has some a spects that should provide benefits to the simulation training community. Use of the new standard by the training simulation community will reduce development, maintenance and technical refresh investment on each device. Furthermore, it will significantly lower the cost of performing model updates to improve fidelity or expand the envelope of the training device. Higher flight fidelity should result in better transfer of training, a direct benefit to the pilots under instruction. Costs of adopting the standard are minimal and should be paid back within the cost of the first use for that training device. The standard achie ves these advantages by making it easier to update the aerodynamic model. It provides a standard format for the model in a custom eXtensible Markup Language (XML) grammar, the Dynamic Aerospace Vehicle Exchange Markup Language (DAVE-ML). It employs an existing XML grammar, MathML, to describe the aerodynamic model in an input data file, eliminating the requirement for actual software compilation. The major components of the aero model become simply an input data file, and updates are simply new XML input files. It includes naming and axis system conventions to further simplify the exchange of information.

Apprenticeship-based training in neurogastroenterology and motility.

PubMed

Vasant, Dipesh H; Sharma, Amol; Bhagatwala, Jigar; Viswanathan, Lavanya; Rao, Satish S C

2018-03-01

Although neurogastroenterology and motility (NGM) disorders affect 50% of patients seen in clinics, many gastroenterologists receive limited NGM training. One-month apprenticeship-based NGM training has been provided at ten centers in the USA for a decade, however, outcomes of this training are unclear. Our goal was to describe the effectiveness of this program from a trainees perspective. Areas covered: We describe the training model, learning experiences, and outcomes of one-month apprenticeship-based training in NGM at a center of excellence, using a detailed individual observer account and data from 12 consecutive trainees that completed the program. During a one-month training period, 302 procedures including; breath tests (BT) n = 132, anorectal manometry (ARM) n = 29 and esophageal manometry (EM) n = 28, were performed. Post-training, all trainees (n = 12) knew indications for motility tests, and the majority achieved independence in basic interpretation of BT, EM and ARM. Additionally, in a multiple-choice NGM written-test paper, trainees achieved significant improvements in test scores post-training (P = 0.003). Expert commentary: One-month training at a high-volume center can facilitate rapid learning of NGM and the indications, basic interpretation and utility of motility tests. Trainees demonstrate significant independence, and this training model provides an ideal platform for those interested in sub-specialty NGM.

Improving the Accuracy and Training Speed of Motor Imagery Brain-Computer Interfaces Using Wavelet-Based Combined Feature Vectors and Gaussian Mixture Model-Supervectors.

PubMed

Lee, David; Park, Sang-Hoon; Lee, Sang-Goog

2017-10-07

In this paper, we propose a set of wavelet-based combined feature vectors and a Gaussian mixture model (GMM)-supervector to enhance training speed and classification accuracy in motor imagery brain-computer interfaces. The proposed method is configured as follows: first, wavelet transforms are applied to extract the feature vectors for identification of motor imagery electroencephalography (EEG) and principal component analyses are used to reduce the dimensionality of the feature vectors and linearly combine them. Subsequently, the GMM universal background model is trained by the expectation-maximization (EM) algorithm to purify the training data and reduce its size. Finally, a purified and reduced GMM-supervector is used to train the support vector machine classifier. The performance of the proposed method was evaluated for three different motor imagery datasets in terms of accuracy, kappa, mutual information, and computation time, and compared with the state-of-the-art algorithms. The results from the study indicate that the proposed method achieves high accuracy with a small amount of training data compared with the state-of-the-art algorithms in motor imagery EEG classification.

A technology training protocol for meeting QSEN goals: Focusing on meaningful learning.

PubMed

Luo, Shuhong; Kalman, Melanie

2018-01-01

The purpose of this paper is to describe and discuss how we designed and developed a 12-step technology training protocol. The protocol is meant to improve meaningful learning in technology education so that nursing students are able to meet the informatics requirements of Quality and Safety Education in Nursing competencies. When designing and developing the training protocol, we used a simplified experiential learning model that addressed the core features of meaningful learning: to connect new knowledge with students' prior knowledge and real-world workflow. Before training, we identified students' prior knowledge and workflow tasks. During training, students learned by doing, reflected on their prior computer skills and workflow, designed individualized procedures for integration into their workflow, and practiced the self-designed procedures in real-world settings. The trainer was a facilitator who provided a meaningful learning environment, asked the right questions to guide reflective conversation, and offered scaffoldings at critical moments. This training protocol could significantly improve nurses' competencies in using technologies and increase their desire to adopt new technologies. © 2017 Wiley Periodicals, Inc.

Establishing a Research and Evaluation Capability for the Joint Medical Education and Training Campus.

PubMed

Kirby, Sheila Nataraj; Marsh, Julie A; Thie, Harry J

2011-01-01

In calling for the transformation of military medical education and training, the 2005 Base Realignment and Closure Commission recommended relocating basic and specialty enlisted medical training to a single site to take advantage of economies of scale and the opportunity for joint training. As a result, a joint medical education and training campus (METC) has been established at Fort Sam Houston, Texas. Two of METC's primary long-term goals are to become a high-performing learning organization and to seek accreditation as a community college. Such goals require a clear model of organizational improvement with well-defined metrics for measuring its performance and using research and evaluation to assess and improve that performance. Lessons learned from a review of practices at institutions with similar missions-such as community colleges, corporate universities, the UK's Defence Medical Education and Training Agency, and other federal agencies, such as the Veterans Health Administration-establish a clear need for an office of institutional research to help METC attain its organizational goals. They also provide useful recommendations regarding the METC office's structure, scope, and governance.

Establishing a Research and Evaluation Capability for the Joint Medical Education and Training Campus

PubMed Central

Kirby, Sheila Nataraj; Marsh, Julie A.; Thie, Harry J.

2011-01-01

Abstract In calling for the transformation of military medical education and training, the 2005 Base Realignment and Closure Commission recommended relocating basic and specialty enlisted medical training to a single site to take advantage of economies of scale and the opportunity for joint training. As a result, a joint medical education and training campus (METC) has been established at Fort Sam Houston, Texas. Two of METC's primary long-term goals are to become a high-performing learning organization and to seek accreditation as a community college. Such goals require a clear model of organizational improvement with well-defined metrics for measuring its performance and using research and evaluation to assess and improve that performance. Lessons learned from a review of practices at institutions with similar missions—such as community colleges, corporate universities, the UK's Defence Medical Education and Training Agency, and other federal agencies, such as the Veterans Health Administration—establish a clear need for an office of institutional research to help METC attain its organizational goals. They also provide useful recommendations regarding the METC office's structure, scope, and governance. PMID:28083182

Embryo transfer simulation improves pregnancy rates and decreases time to proficiency in Reproductive Endocrinology and Infertility fellow embryo transfers.

PubMed

Heitmann, Ryan J; Hill, Micah J; Csokmay, John M; Pilgrim, Justin; DeCherney, Alan H; Deering, Shad

2017-05-01

To design and evaluate an ET simulator to train Reproductive Endocrinology and Infertility (REI) fellows' techniques of ET. Simulation model development and retrospective cohort analysis. Not applicable. Patients undergoing IVF. Simulation model evaluation and implementation of ET simulation training. Pregnancy rates. The REI fellow and faculty evaluation responses (n = 19/21 [90%]) of the model demonstrated realistic characteristics, with evaluators concluding the model was suitable for training in almost all evaluated areas. A total of 12 REI fellows who performed ET were analyzed: 6 before ET trainer and 6 after ET trainer. Pregnancy rates were 31% in the initial 10 ETs per fellow before simulator vs. 46% after simulator. One of six pre-ET trainer fellows (17%) had pregnancy rates ≥40% in their first 10 ETs; whereas four of six post-ET trainer fellows had pregnancy rates ≥40% in their first 10 ETs. The average number of ETs to obtain >40% pregnancy efficiency was 27 ETs before trainer vs. 15 ETs after trainer. Pregnancy rates were similar in the two groups after 20 ETs, and collective terminal pregnancy rates were >50% after 40 ETs. Embryo transfer simulation improved REI fellow pregnancy rates in their first 10 transfers and led to a more rapid ET proficiency. These data suggest potential value in adopting ET simulation, even in programs with a robust history of live ET in fellowship training. Published by Elsevier Inc.

Effect of training on word-recognition performance in noise for young normal-hearing and older hearing-impaired listeners.

PubMed

Burk, Matthew H; Humes, Larry E; Amos, Nathan E; Strauser, Lauren E

2006-06-01

The objective of this study was to evaluate the effectiveness of a training program for hearing-impaired listeners to improve their speech-recognition performance within a background noise when listening to amplified speech. Both noise-masked young normal-hearing listeners, used to model the performance of elderly hearing-impaired listeners, and a group of elderly hearing-impaired listeners participated in the study. Of particular interest was whether training on an isolated word list presented by a standardized talker can generalize to everyday speech communication across novel talkers. Word-recognition performance was measured for both young normal-hearing (n = 16) and older hearing-impaired (n = 7) adults. Listeners were trained on a set of 75 monosyllabic words spoken by a single female talker over a 9- to 14-day period. Performance for the familiar (trained) talker was measured before and after training in both open-set and closed-set response conditions. Performance on the trained words of the familiar talker were then compared with those same words spoken by three novel talkers and to performance on a second set of untrained words presented by both the familiar and unfamiliar talkers. The hearing-impaired listeners returned 6 mo after their initial training to examine retention of the trained words as well as their ability to transfer any knowledge gained from word training to sentences containing both trained and untrained words. Both young normal-hearing and older hearing-impaired listeners performed significantly better on the word list in which they were trained versus a second untrained list presented by the same talker. Improvements on the untrained words were small but significant, indicating some generalization to novel words. The large increase in performance on the trained words, however, was maintained across novel talkers, pointing to the listener's greater focus on lexical memorization of the words rather than a focus on talker-specific acoustic characteristics. On return in 6 mo, listeners performed significantly better on the trained words relative to their initial baseline performance. Although the listeners performed significantly better on trained versus untrained words in isolation, once the trained words were embedded in sentences, no improvement in recognition over untrained words within the same sentences was shown. Older hearing-impaired listeners were able to significantly improve their word-recognition abilities through training with one talker and to the same degree as young normal-hearing listeners. The improved performance was maintained across talkers and across time. This might imply that training a listener using a standardized list and talker may still provide benefit when these same words are presented by novel talkers outside the clinic. However, training on isolated words was not sufficient to transfer to fluent speech for the specific sentence materials used within this study. Further investigation is needed regarding approaches to improve a hearing aid user's speech understanding in everyday communication situations.

Three-dimensional textural features of conventional MRI improve diagnostic classification of childhood brain tumours.

PubMed

Fetit, Ahmed E; Novak, Jan; Peet, Andrew C; Arvanitits, Theodoros N

2015-09-01

The aim of this study was to assess the efficacy of three-dimensional texture analysis (3D TA) of conventional MR images for the classification of childhood brain tumours in a quantitative manner. The dataset comprised pre-contrast T1 - and T2-weighted MRI series obtained from 48 children diagnosed with brain tumours (medulloblastoma, pilocytic astrocytoma and ependymoma). 3D and 2D TA were carried out on the images using first-, second- and higher order statistical methods. Six supervised classification algorithms were trained with the most influential 3D and 2D textural features, and their performances in the classification of tumour types, using the two feature sets, were compared. Model validation was carried out using the leave-one-out cross-validation (LOOCV) approach, as well as stratified 10-fold cross-validation, in order to provide additional reassurance. McNemar's test was used to test the statistical significance of any improvements demonstrated by 3D-trained classifiers. Supervised learning models trained with 3D textural features showed improved classification performances to those trained with conventional 2D features. For instance, a neural network classifier showed 12% improvement in area under the receiver operator characteristics curve (AUC) and 19% in overall classification accuracy. These improvements were statistically significant for four of the tested classifiers, as per McNemar's tests. This study shows that 3D textural features extracted from conventional T1 - and T2-weighted images can improve the diagnostic classification of childhood brain tumours. Long-term benefits of accurate, yet non-invasive, diagnostic aids include a reduction in surgical procedures, improvement in surgical and therapy planning, and support of discussions with patients' families. It remains necessary, however, to extend the analysis to a multicentre cohort in order to assess the scalability of the techniques used. Copyright © 2015 John Wiley & Sons, Ltd.

First of all: Do not harm! Use of simulation for the training of regional anaesthesia techniques: Which skills can be trained without the patient as substitute for a mannequin.

PubMed

Sujatta, Susanne

2015-03-01

Character of clinical skills training is always influenced by technical improvement and cultural changes. Over the last years, two trends have changed the way of traditional apprenticeship-style training in regional anaesthesia: firstly, the development in ultrasound-guided regional anaesthesia, and secondly, the reduced acceptance of using patients as mannequins for invasive techniques. Against this background, simulation techniques are explored, ranging from simple low-fidelity part-task training models to train skills in needle application, to highly sophisticated virtual reality models – the full range is covered. This review tries to discuss all available options with benefits and neglects. The task in clinical practice will be in choosing the right level of sophistication for the desired approach and trainee level. However, the transfer of simulated skills to clinical practice has not been evaluated. It has to be proven whether simulation-trained skills could, as a last consequence, reduce the risk to patients. Copyright © 2015 Elsevier Ltd. All rights reserved.

Support and Strategies for Change Among Small Patient-Centered Medical Home Practices

PubMed Central

Scholle, Sarah Hudson; Asche, Stephen E.; Morton, Suzanne; Solberg, Leif I.; Tirodkar, Manasi A.; Jaén, Carlos Roberto

2013-01-01

PURPOSE We aimed to determine the motivations and barriers facing small practices that seek to adopt the patient-centered medical home (PCMH) model, as well as the type of help and strategies they use. METHODS We surveyed lead physicians at practices with fewer than 5 physicians, stratified by state and level of National Committee for Quality Assurance PCMH recognition, using a Web-based survey with telephone, fax, and mail follow-up. The response rate was 59%, yielding a total sample of 249 practices from 23 states. RESULTS Improving quality and patient experience were the strongest motivations for PCMH implementation; time and resources were the biggest barriers. Most practices participated in demonstration projects or received financial rewards for PCMH, and most received training or other kinds of help. Practices found training and help related to completing the PCMH application to be the most useful. Training for patients was both less common and less valued. The most commonly used strategies for practice transformation were staff training, systematizing processes of care, and quality measurement/goal setting. The least commonly endorsed strategy was involving patients in quality improvement. Practices with a higher level of PCMH recognition were more likely to have electronic health records, to report barriers, and to use measurement-based quality improvement strategies. CONCLUSIONS To spread the adoption of the PCMH model among small practices, financial support, practical training, and other help are likely to continue to be important. Few practices involved patients in their implementation, so it would be helpful to test the impact of greater patient involvement in the PCMH. PMID:23690387

Effect of Increased Intensity of Physiotherapy on Patient Outcomes After Stroke: An Economic Literature Review and Cost-Effectiveness Analysis

PubMed Central

Chan, B

2015-01-01

Background Functional improvements have been seen in stroke patients who have received an increased intensity of physiotherapy. This requires additional costs in the form of increased physiotherapist time. Objectives The objective of this economic analysis is to determine the cost-effectiveness of increasing the intensity of physiotherapy (duration and/or frequency) during inpatient rehabilitation after stroke, from the perspective of the Ontario Ministry of Health and Long-term Care. Data Sources The inputs for our economic evaluation were extracted from articles published in peer-reviewed journals and from reports from government sources or the Canadian Stroke Network. Where published data were not available, we sought expert opinion and used inputs based on the experts' estimates. Review Methods The primary outcome we considered was cost per quality-adjusted life-year (QALY). We also evaluated functional strength training because of its similarities to physiotherapy. We used a 2-state Markov model to evaluate the cost-effectiveness of functional strength training and increased physiotherapy intensity for stroke inpatient rehabilitation. The model had a lifetime timeframe with a 5% annual discount rate. We then used sensitivity analyses to evaluate uncertainty in the model inputs. Results We found that functional strength training and higher-intensity physiotherapy resulted in lower costs and improved outcomes over a lifetime. However, our sensitivity analyses revealed high levels of uncertainty in the model inputs, and therefore in the results. Limitations There is a high level of uncertainty in this analysis due to the uncertainty in model inputs, with some of the major inputs based on expert panel consensus or expert opinion. In addition, the utility outcomes were based on a clinical study conducted in the United Kingdom (i.e., 1 study only, and not in an Ontario or Canadian setting). Conclusions Functional strength training and higher-intensity physiotherapy may result in lower costs and improved health outcomes. However, these results should be interpreted with caution. PMID:26366241

Role of spared pathways in locomotor recovery after body-weight-supported treadmill training in contused rats.

PubMed

Singh, Anita; Balasubramanian, Sriram; Murray, Marion; Lemay, Michel; Houle, John

2011-12-01

Body-weight-supported treadmill training (BWSTT)-related locomotor recovery has been shown in spinalized animals. Only a few animal studies have demonstrated locomotor recovery after BWSTT in an incomplete spinal cord injury (SCI) model, such as contusion injury. The contribution of spared descending pathways after BWSTT to behavioral recovery is unclear. Our goal was to evaluate locomotor recovery in contused rats after BWSTT, and to study the role of spared pathways in spinal plasticity after BWSTT. Forty-eight rats received a contusion, a transection, or a contusion followed at 9 weeks by a second transection injury. Half of the animals in the three injury groups were given BWSTT for up to 8 weeks. Kinematics and the Basso-Beattie-Bresnahan (BBB) test assessed behavioral improvements. Changes in Hoffmann-reflex (H-reflex) rate depression property, soleus muscle mass, and sprouting of primary afferent fibers were also evaluated. BWSTT-contused animals showed accelerated locomotor recovery, improved H-reflex properties, reduced muscle atrophy, and decreased sprouting of small caliber afferent fibers. BBB scores were not improved by BWSTT. Untrained contused rats that received a transection exhibited a decrease in kinematic parameters immediately after the transection; in contrast, trained contused rats did not show an immediate decrease in kinematic parameters after transection. This suggests that BWSTT with spared descending pathways leads to neuroplasticity at the lumbar spinal level that is capable of maintaining locomotor activity. Discontinuing training after the transection in the trained contused rats abolished the improved kinematics within 2 weeks and led to a reversal of the improved H-reflex response, increased muscle atrophy, and an increase in primary afferent fiber sprouting. Thus continued training may be required for maintenance of the recovery. Transected animals had no effect of BWSTT, indicating that in the absence of spared pathways this training paradigm did not improve function.

Development of Evaluation Indicators for Hospice and Palliative Care Professionals Training Programs in Korea.

PubMed

Kang, Jina; Park, Kyoung-Ok

2017-01-01

The importance of training for Hospice and Palliative Care (HPC) professionals has been increasing with the systemization of HPC in Korea. Hence, the need and importance of training quality for HPC professionals are growing. This study evaluated the construct validity and reliability of the Evaluation Indicators for standard Hospice and Palliative Care Training (EIHPCT) program. As a framework to develop evaluation indicators, an invented theoretical model combining Stufflebeam's CIPP (Context-Input-Process-Product) evaluation model with PRECEDE-PROCEED model was used. To verify the construct validity of the EIHPCT program, a structured survey was performed with 169 professionals who were the HPC training program administrators, trainers, and trainees. To examine the validity of the areas of the EIHPCT program, exploratory factor analysis and confirmatory factor analysis were conducted. First, in the exploratory factor analysis, the indicators with factor loadings above 0.4 were chosen as desirable items, and some cross-loaded items that loaded at 0.4 or higher on two or more factors were adjusted as the higher factor. Second, the model fit of the modified EIHPCT program was quite good in the confirmatory factor analysis (Goodness-of-Fit Index > 0.70, Comparative Fit Index > 0.80, Normed Fit Index > 0.80, Root Mean square of Residuals < 0.05). The modified model of the EIHPCT comprised 4 areas, 13 subdomains, and 61 indicators. The evaluation indicators of the modified model will be valuable references for improving the HPC professional training program.

Cross-education of strength and skill: an old idea with applications in the aging nervous system.

PubMed

Barss, Trevor S; Pearcey, Gregory E P; Zehr, E Paul

2016-03-01

Edward Wheeler Scripture's 1894 work out of the Yale Psychological Laboratory has been influential in identifying the nervous system's contribution to the bilateral improvements that are seen with unilateral strength and skill training. Scripture coined the term "cross-education" to describe this improvement in the untrained contralateral limb. While physiological changes accompany aging that may negatively affect the performance of physical tasks, far too much credit has been given to the natural aging process rather than the effects of inactivity. Emerging evidence indicates strength or skill training interventions induce significant neuroplasticity in an aging population. The model of unilateral training provides a unique approach in which to elicit such plasticity. This brief review highlights the innate ability of the nervous system to adapt to unilateral strength and skill training interventions, regardless of age, and provides a novel perspective on the robust plastic ability of the aging nervous system.

Clinical Psychology Training: Accreditation and Beyond.

PubMed

Levenson, Robert W

2017-05-08

Beginning with efforts in the late 1940s to ensure that clinical psychologists were adequately trained to meet the mental health needs of the veterans of World War II, the accreditation of clinical psychologists has largely been the province of the Commission on Accreditation of the American Psychological Association. However, in 2008 the Psychological Clinical Science Accreditation System began accrediting doctoral programs that adhere to the clinical science training model. This review discusses the goals of accreditation and the history of the accreditation of graduate programs in clinical psychology, and provides an overview of the evaluation procedures used by these two systems. Accreditation is viewed against the backdrop of the slow rate of progress in reducing the burden of mental illness and the changes in clinical psychology training that might help improve this situation. The review concludes with a set of five recommendations for improving accreditation.

Satellite image analysis using neural networks

NASA Technical Reports Server (NTRS)

Sheldon, Roger A.

1990-01-01

The tremendous backlog of unanalyzed satellite data necessitates the development of improved methods for data cataloging and analysis. Ford Aerospace has developed an image analysis system, SIANN (Satellite Image Analysis using Neural Networks) that integrates the technologies necessary to satisfy NASA's science data analysis requirements for the next generation of satellites. SIANN will enable scientists to train a neural network to recognize image data containing scenes of interest and then rapidly search data archives for all such images. The approach combines conventional image processing technology with recent advances in neural networks to provide improved classification capabilities. SIANN allows users to proceed through a four step process of image classification: filtering and enhancement, creation of neural network training data via application of feature extraction algorithms, configuring and training a neural network model, and classification of images by application of the trained neural network. A prototype experimentation testbed was completed and applied to climatological data.

The use of behavior modeling training in a mobile app parent training program to improve functional communication of young children with autism spectrum disorder.

PubMed

Law, Gloria C; Neihart, Maureen; Dutt, Anuradha

2018-05-01

Communication intervention in early life can significantly impact long-term outcomes for young children with autism. Parents can be vital resources in the midst of the current manpower shortage. Map4speech is a new mobile application developed for parents of children with autism spectrum disorder. It is specially designed to provide high-quality, interactive learning, coupled with frequent feedback and live coaching to train parents in a naturalistic language intervention. A multiple-baseline single-case experimental design was conducted across three parent-child dyads. Results indicate that procedural integrity of parents' intervention techniques was above 85% during post-training intervention, and their respective children showed increases in spontaneous word/gesture use. The results show that mobile applications with feedback can be a promising means for improving efficiency and effectiveness in disseminating evidence-based practices for autism intervention.

Retrieval of ice thickness from polarimetric SAR data

NASA Technical Reports Server (NTRS)

Kwok, R.; Yueh, S. H.; Nghiem, S. V.; Huynh, D. D.

1993-01-01

We describe a potential procedure for retrieving ice thickness from multi-frequency polarimetric SAR data for thin ice. This procedure includes first masking out the thicker ice types with a simple classifier and then deriving the thickness of the remaining pixels using a model-inversion technique. The technique used to derive ice thickness from polarimetric observations is provided by a numerical estimator or neural network. A three-layer perceptron implemented with the backpropagation algorithm is used in this investigation with several improved aspects for a faster convergence rate and a better accuracy of the neural network. These improvements include weight initialization, normalization of the output range, the selection of offset constant, and a heuristic learning algorithm. The performance of the neural network is demonstrated by using training data generated by a theoretical scattering model for sea ice matched to the database of interest. The training data are comprised of the polarimetric backscattering coefficients of thin ice and the corresponding input ice parameters to the scattering model. The retrieved ice thickness from the theoretical backscattering coefficients is compare with the input ice thickness to the scattering model to illustrate the accuracy of the inversion method. Results indicate that the network convergence rate and accuracy are higher when multi-frequency training sets are presented. In addition, the dominant backscattering coefficients in retrieving ice thickness are found by comparing the behavior of the network trained backscattering data at various incidence angels. After the neural network is trained with the theoretical backscattering data at various incidence anges, the interconnection weights between nodes are saved and applied to the experimental data to be investigated. In this paper, we illustrate the effectiveness of this technique using polarimetric SAR data collected by the JPL DC-8 radar over a sea ice scene.

Treatment of Female Sexual Dysfunction Through Symbolic Modeling

ERIC Educational Resources Information Center

Nemetz, Georgia H.; And Others

1978-01-01

Clients (N=16) were randomly assigned to two groups receiving either individual or group treatment. Treatment consisted of relaxation training followed by viewing 45 videotaped vignettes depicting graduated sexual behaviors. Improvement remained stable through a one-year follow-up. Control clients showed no improvement and trends toward…

Transformed by Literacy

ERIC Educational Resources Information Center

Szachowicz, Susan

2010-01-01

When low test scores demanded a hard look at the curriculum, literacy became a focus for improvement at Brockton (MA) High School. Schoolwide training for teachers and a rolling implementation model ensured consistency and reinforcement of the skills. Results came in improved scores and national recognitions, including selection as a National…

Stochastic Spectral Descent for Discrete Graphical Models

DOE PAGES

Carlson, David; Hsieh, Ya-Ping; Collins, Edo; ...

2015-12-14

Interest in deep probabilistic graphical models has in-creased in recent years, due to their state-of-the-art performance on many machine learning applications. Such models are typically trained with the stochastic gradient method, which can take a significant number of iterations to converge. Since the computational cost of gradient estimation is prohibitive even for modestly sized models, training becomes slow and practically usable models are kept small. In this paper we propose a new, largely tuning-free algorithm to address this problem. Our approach derives novel majorization bounds based on the Schatten- norm. Intriguingly, the minimizers of these bounds can be interpreted asmore » gradient methods in a non-Euclidean space. We thus propose using a stochastic gradient method in non-Euclidean space. We both provide simple conditions under which our algorithm is guaranteed to converge, and demonstrate empirically that our algorithm leads to dramatically faster training and improved predictive ability compared to stochastic gradient descent for both directed and undirected graphical models.« less

Infrared small target detection based on Danger Theory

NASA Astrophysics Data System (ADS)

Lan, Jinhui; Yang, Xiao

2009-11-01

To solve the problem that traditional method can't detect the small objects whose local SNR is less than 2 in IR images, a Danger Theory-based model to detect infrared small target is presented in this paper. First, on the analog with immunology, the definition is given, in this paper, to such terms as dangerous signal, antigens, APC, antibodies. Besides, matching rule between antigen and antibody is improved. Prior to training the detection model and detecting the targets, the IR images are processed utilizing adaptive smooth filter to decrease the stochastic noise. Then at the training process, deleting rule, generating rule, crossover rule and the mutation rule are established after a large number of experiments in order to realize immediate convergence and obtain good antibodies. The Danger Theory-based model is built after the training process, and this model can detect the target whose local SNR is only 1.5.

Rank estimation and the multivariate analysis of in vivo fast-scan cyclic voltammetric data

PubMed Central

Keithley, Richard B.; Carelli, Regina M.; Wightman, R. Mark

2010-01-01

Principal component regression has been used in the past to separate current contributions from different neuromodulators measured with in vivo fast-scan cyclic voltammetry. Traditionally, a percent cumulative variance approach has been used to determine the rank of the training set voltammetric matrix during model development, however this approach suffers from several disadvantages including the use of arbitrary percentages and the requirement of extreme precision of training sets. Here we propose that Malinowski’s F-test, a method based on a statistical analysis of the variance contained within the training set, can be used to improve factor selection for the analysis of in vivo fast-scan cyclic voltammetric data. These two methods of rank estimation were compared at all steps in the calibration protocol including the number of principal components retained, overall noise levels, model validation as determined using a residual analysis procedure, and predicted concentration information. By analyzing 119 training sets from two different laboratories amassed over several years, we were able to gain insight into the heterogeneity of in vivo fast-scan cyclic voltammetric data and study how differences in factor selection propagate throughout the entire principal component regression analysis procedure. Visualizing cyclic voltammetric representations of the data contained in the retained and discarded principal components showed that using Malinowski’s F-test for rank estimation of in vivo training sets allowed for noise to be more accurately removed. Malinowski’s F-test also improved the robustness of our criterion for judging multivariate model validity, even though signal-to-noise ratios of the data varied. In addition, pH change was the majority noise carrier of in vivo training sets while dopamine prediction was more sensitive to noise. PMID:20527815

Preventive practicum training in healthcare organizations. The Meharry model.

PubMed

Levine, R S; St Onge, J; Moriarty, C J; Bailey, S; Logan, T; Zhu, K; Nelson, B K; Hodder, R A; Marino, W

1999-07-01

Practicum training for preventive medicine residents often occurs in agencies whose community is geographically defined and whose governance is closely linked to public election. We were unsure about the financial ability of such departments to support training and are concerned that over-reliance on traditional health departments might not be best for either medically indigent populations or preventive medicine. We, therefore, sought to apply a public health model--based on a strategic partnership between nursing and preventive medicine--to a large health care organization. The result was formation of a mini-health department, suitable for fully accredited preventive medicine practicum training, within the Alvin C. York Veterans Affairs Medical Center, Murfreesboro, TN. This Center serves a defined population of 21,594 patients and about 1600 employees. The theoretical framework for the new department was based on demonstration of a close fit between the competencies expected of preventive medicine physicians by the American College of Preventive Medicine (ACPM) and activities required by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO). Because of JCAHO requirements, many healthcare organizations already pay for preventive medicine services. By placing preventive medicine training faculty into existing budget slots at our institution, systemwide personnel costs for prevention decreased by about $36,000 per year, even as personnel funding for preventive medicine physicians increased from about $24,000 to $376,000 per year. Moreover, there was dramatic, sustained improvement in 17 indicators of preventive care quality as determined by an external peer review organization. In addition to providing a new venue for training, this model may also improve the quality and reach of preventive services, decreased fixed costs for service delivery, and yield new employment opportunities for preventive medicine physicians.

Training Regular Education Personnel To Be Special Education Consultants to Other Regular Education Personnel in Rural Settings.

ERIC Educational Resources Information Center

McIntosh, Dean K.; Raymond, Gail I.

The Program for Exceptional Children of the University of South Carolina developed a project to address the need for an improved service delivery model for handicapped students in rural South Carolina. The project trained regular elementary teachers at the master's degree level to function as consultants to other regular classroom teachers with…

Evaluating educational interventions for information literacy.

PubMed

Stevenson, Paul

2012-03-01

This article considers how information literacy training initiatives delivered by health library services are evaluated. It presents three validated assessment and evaluation models, and using examples from practice, discusses how these can be used to establish the impact of information literacy training and to improve current evaluation practices. HS. © 2012 The authors. Health Information and Libraries Journal © 2012 Health Libraries Group.

Relative Effects of a Comprehensive versus Reduced Training for Head Start Teachers Who Serve Spanish-Speaking English Learners

ERIC Educational Resources Information Center

Solari, Emily J.; Zucker, Tricia A.; Landry, Susan H.; Williams, Jeffrey M.

2016-01-01

With increased demand for improved early childhood education services, it is important to better understand the essential professional development resources that have the greatest impact on both teacher and child outcomes. This study compared the effectiveness of two teacher-training models in bilingual Migrant and Seasonal Head Start and Head…

Overcoming Hurdles Implementing Multi-skilling Policies

DTIC Science & Technology

2015-03-26

skilled workforce? Chapter II will communicate important concepts found in the literature on skill proficiency topics. These topics include skill...training methods that might improve learning and retention during the acquisition phase. 10 The active interlock modeling (AIM) protocol is a dyadic ...retention, as found in 43 Chapter 2. These techniques include dyadic training methods, overlearning, feedback, peer support, and managerial support

Challenge and Urgency in Defining Doctoral Education in Marriage and Family Therapy: Valuing Complementary Models

ERIC Educational Resources Information Center

Wampler, Karen S.

2010-01-01

In this overview, I comment on the strong theme of the need to define and improve the quality of doctoral education in marriage and family therapy that pervades the three essays. Deficits in research training are the central concern, although the essayists take different perspectives on the nature of the research training needed. The different…

Studying the Effectiveness of Physical Education in the Secondary School (by the Example of Kazakhstan)

ERIC Educational Resources Information Center

Botagariyev, ?ulegen A.; Kubiyeva, Svetlana S.; Baizakova, Venera E.; Mambetov, Nurolla; Tulegenov, Yerkin K.; Aralbayev, Alpysbay S.; Kairgozhin, Dulat U.

2016-01-01

The purpose of this study was to determine the effectiveness of the existing model of teaching physical training in secondary schools and the analysis of a game like method introduced to improve physical fitness of students. The authors substantiated the use of a game like method during physical training classes, which implementation should create…

Welfare to Work: Does Vocational Education and Training Make a Difference? Occasional Paper

ERIC Educational Resources Information Center

Karmel, Tom; Mark, Kevin; Nguyen, Nhi

2009-01-01

The purpose of this paper looks at the fundamental issue of whether VET does improve the employment prospects of the groups in question. It exploits data from the Student Outcome Survey to construct samples that proxy three welfare groups and models the post-training employment outcomes. Appendices include: (1) Characteristics of the proxy groups;…

Applying Multimedia Learning Theories to the Redesign of Residence Life Online Training Modules

ERIC Educational Resources Information Center

Kaliher, Licinia Barrueco

2010-01-01

The purpose of this Executive Position Paper (EPP) is to develop a model for improving the online training modules utilized by a mid-Atlantic Residence Life department. The complexity of the Residence Life staff positions, coupled with demands from other university departments and the need to provide as much information as possible, resulted in an…

Optimizing Preseason Training Loads in Australian Football.

PubMed

Carey, David L; Crow, Justin; Ong, Kok-Leong; Blanch, Peter; Morris, Meg E; Dascombe, Ben J; Crossley, Kay M

2018-02-01

To investigate whether preseason training plans for Australian football can be computer generated using current training-load guidelines to optimize injury-risk reduction and performance improvement. A constrained optimization problem was defined for daily total and sprint distance, using the preseason schedule of an elite Australian football team as a template. Maximizing total training volume and maximizing Banister-model-projected performance were both considered optimization objectives. Cumulative workload and acute:chronic workload-ratio constraints were placed on training programs to reflect current guidelines on relative and absolute training loads for injury-risk reduction. Optimization software was then used to generate preseason training plans. The optimization framework was able to generate training plans that satisfied relative and absolute workload constraints. Increasing the off-season chronic training loads enabled the optimization algorithm to prescribe higher amounts of "safe" training and attain higher projected performance levels. Simulations showed that using a Banister-model objective led to plans that included a taper in training load prior to competition to minimize fatigue and maximize projected performance. In contrast, when the objective was to maximize total training volume, more frequent training was prescribed to accumulate as much load as possible. Feasible training plans that maximize projected performance and satisfy injury-risk constraints can be automatically generated by an optimization problem for Australian football. The optimization methods allow for individualized training-plan design and the ability to adapt to changing training objectives and different training-load metrics.

Visual-auditory integration during speech imitation in autism.

PubMed

Williams, Justin H G; Massaro, Dominic W; Peel, Natalie J; Bosseler, Alexis; Suddendorf, Thomas

2004-01-01

Children with autistic spectrum disorder (ASD) may have poor audio-visual integration, possibly reflecting dysfunctional 'mirror neuron' systems which have been hypothesised to be at the core of the condition. In the present study, a computer program, utilizing speech synthesizer software and a 'virtual' head (Baldi), delivered speech stimuli for identification in auditory, visual or bimodal conditions. Children with ASD were poorer than controls at recognizing stimuli in the unimodal conditions, but once performance on this measure was controlled for, no group difference was found in the bimodal condition. A group of participants with ASD were also trained to develop their speech-reading ability. Training improved visual accuracy and this also improved the children's ability to utilize visual information in their processing of speech. Overall results were compared to predictions from mathematical models based on integration and non-integration, and were most consistent with the integration model. We conclude that, whilst they are less accurate in recognizing stimuli in the unimodal condition, children with ASD show normal integration of visual and auditory speech stimuli. Given that training in recognition of visual speech was effective, children with ASD may benefit from multi-modal approaches in imitative therapy and language training.

The Evolution of Medical Training Simulation in the U.S. Military.

PubMed

Linde, Amber S; Kunkler, Kevin

2016-01-01

The United States has been at war since 2003. During that time, training using Medical Simulation technology has been developed and integrated into military medical training for combat medics, nurses and surgeons. Efforts stemming from the Joint Programmatic Committee-1 (JPC-1) Medical Simulation and Training Portfolio has allowed for the improvement and advancement in military medical training by focusing on research in simulation training technology in order to achieve this. Based upon lessons learned capability gaps have been identified concerning the necessity to validate and enhance combat medial training simulators. These capability gaps include 1) Open Source/Open Architecture; 2) Modularity and Interoperability; and 3) Material and Virtual Reality (VR) Models. Using the capability gaps, JPC-1 has identified important research endeavors that need to be explored.

Microsurgery Training for the Twenty-First Century

PubMed Central

Myers, Simon Richard; Froschauer, Stefan; Akelina, Yelena; Tos, Pierluigi; Kim, Jeong Tae

2013-01-01

Current educational interventions and training courses in microsurgery are often predicated on theories of skill acquisition and development that follow a 'practice makes perfect' model. Given the changing landscape of surgical training and advances in educational theories related to skill development, research is needed to assess current training tools in microsurgery education and devise alternative methods that would enhance training. Simulation is an increasingly important tool for educators because, whilst facilitating improved technical proficiency, it provides a way to reduce risks to both trainees and patients. The International Microsurgery Simulation Society has been founded in 2012 in order to consolidate the global effort in promoting excellence in microsurgical training. The society's aim to achieve standarisation of microsurgical training worldwide could be realised through the development of evidence based educational interventions and sharing best practices. PMID:23898422

Using Functional Electrical Stimulation Mediated by Iterative Learning Control and Robotics to Improve Arm Movement for People With Multiple Sclerosis.

PubMed

Sampson, Patrica; Freeman, Chris; Coote, Susan; Demain, Sara; Feys, Peter; Meadmore, Katie; Hughes, Ann-Marie

2016-02-01

Few interventions address multiple sclerosis (MS) arm dysfunction but robotics and functional electrical stimulation (FES) appear promising. This paper investigates the feasibility of combining FES with passive robotic support during virtual reality (VR) training tasks to improve upper limb function in people with multiple sclerosis (pwMS). The system assists patients in following a specified trajectory path, employing an advanced model-based paradigm termed iterative learning control (ILC) to adjust the FES to improve accuracy and maximise voluntary effort. Reaching tasks were repeated six times with ILC learning the optimum control action from previous attempts. A convenience sample of five pwMS was recruited from local MS societies, and the intervention comprised 18 one-hour training sessions over 10 weeks. The accuracy of tracking performance without FES and the amount of FES delivered during training were analyzed using regression analysis. Clinical functioning of the arm was documented before and after treatment with standard tests. Statistically significant results following training included: improved accuracy of tracking performance both when assisted and unassisted by FES; reduction in maximum amount of FES needed to assist tracking; and less impairment in the proximal arm that was trained. The system was well tolerated by all participants with no increase in muscle fatigue reported. This study confirms the feasibility of FES combined with passive robot assistance as a potentially effective intervention to improve arm movement and control in pwMS and provides the basis for a follow-up study.

MAP as a model for practice-based learning and improvement in child psychiatry training.

PubMed

Kataoka, Sheryl H; Podell, Jennifer L; Zima, Bonnie T; Best, Karin; Sidhu, Shawn; Jura, Martha Bates

2014-01-01

Not only is there a growing literature demonstrating the positive outcomes that result from implementing evidence based treatments (EBTs) but also studies that suggest a lack of delivery of these EBTs in "usual care" practices. One way to address this deficit is to improve the quality of psychotherapy teaching for clinicians-in-training. The Accreditation Council for Graduate Medical Education (ACGME) requires all training programs to assess residents in a number of competencies including Practice-Based Learning and Improvements (PBLI). This article describes the piloting of Managing and Adapting Practice (MAP) for child psychiatry fellows, to teach them both EBT and PBLI skills. Eight child psychiatry trainees received 5 full days of MAP training and are delivering MAP in a year-long outpatient teaching clinic. In this setting, MAP is applied to the complex, multiply diagnosed psychiatric patients that present to this clinic. This article describes how MAP tools and resources assist in teaching trainees each of the eight required competency components of PBLI, including identifying deficits in expertise, setting learning goals, performing learning activities, conducting quality improvement methods in practice, incorporating formative feedback, using scientific studies to inform practice, using technology for learning, and participating in patient education. A case example illustrates the use of MAP in teaching PBLI. MAP provides a unique way to teach important quality improvement and practice-based learning skills to trainees while training them in important psychotherapy competence.

Training Attention Improves Decision Making in Individuals with Elevated Self-Reported Depressive Symptoms

PubMed Central

Cooper, Jessica A.; Gorlick, Marissa A.; Denny, Taylor; Worthy, Darrell A.; Beevers, Christopher G.; Maddox, W. Todd

2013-01-01

Depression is often characterized by attentional biases toward negative items and away from positive items, which likely affects reward and punishment processing. Recent work reported that training attention away from negative stimuli reduced this bias and reduced depressive symptoms. However, the effect of attention training on subsequent learning has yet to be explored. In the current study, participants were required to learn to maximize reward during decision-making. Undergraduates with elevated self-reported depressive symptoms received attention training toward positive stimuli prior to performing the decision-making task (n=20; active training). The active training group was compared to two groups: undergraduates with elevated self-reported depressive symptoms who received placebo training (n=22; placebo training) and control subjects with low levels of depressive symptoms (n=33; non-depressive control). The placebo-training depressive group performed worse and switched between options more than non-depressive controls on the reward maximization task. However, depressives that received active training performed as well as non-depressive controls. Computational modeling indicated that the placebo-trained group learned more from negative than from positive prediction errors, leading to more frequent switching. The non-depressive control and active training depressive groups showed similar learning from positive and negative prediction errors, leading to less frequent switching and better performance. Our results indicate that individuals with elevated depressive symptoms are impaired at reward maximization, but that the deficit can be improved with attention training toward positive stimuli. PMID:24197612

Training attention improves decision making in individuals with elevated self-reported depressive symptoms.

PubMed

Cooper, Jessica A; Gorlick, Marissa A; Denny, Taylor; Worthy, Darrell A; Beevers, Christopher G; Maddox, W Todd

2014-06-01

Depression is often characterized by attentional biases toward negative items and away from positive items, which likely affects reward and punishment processing. Recent work has reported that training attention away from negative stimuli reduced this bias and reduced depressive symptoms. However, the effect of attention training on subsequent learning has yet to be explored. In the present study, participants were required to learn to maximize reward during decision making. Undergraduates with elevated self-reported depressive symptoms received attention training toward positive stimuli prior to performing the decision-making task (n = 20; active training). The active-training group was compared to two other groups: undergraduates with elevated self-reported depressive symptoms who received placebo training (n = 22; placebo training) and a control group with low levels of depressive symptoms (n = 33; nondepressive control). The placebo-training depressive group performed worse and switched between options more than did the nondepressive controls on the reward maximization task. However, depressives that received active training performed as well as the nondepressive controls. Computational modeling indicated that the placebo-trained group learned more from negative than from positive prediction errors, leading to more frequent switching. The nondepressive control and active-training depressive groups showed similar learning from positive and negative prediction errors, leading to less-frequent switching and better performance. Our results indicate that individuals with elevated depressive symptoms are impaired at reward maximization, but that the deficit can be improved with attention training toward positive stimuli.

"I'll stop procrastinating now!" Fostering specific processes of self-regulated learning to reduce academic procrastination.

PubMed

Grunschel, Carola; Patrzek, Justine; Klingsieck, Katrin B; Fries, Stefan

2018-01-01

Academic procrastination is considered to be a result of self-regulation failure having detrimental effects on students' well-being and academic performance. In the present study, we developed and evaluated a group training that aimed to reduce academic procrastination. We based the training on a cyclical process model of self-regulated learning, thus, focusing on improving deficient processes of self-regulated learning among academic procrastinators (e.g., time management, dealing with distractions). The training comprised five sessions and took place once a week for 90 min in groups of no more than 10 students. Overall, 106 students completed the training. We evaluated the training using a comprehensive control group design with repeated measures (three points of measurement); the control group was trained after the intervention group's training. The results showed that our training was successful. The trained intervention group significantly reduced academic procrastination and improved specific processes of self-regulated learning (e.g., time management, concentration), whereas the untrained control group showed no change regarding these variables. After the control group had also been trained, the control group also showed the expected favorable changes. The students rated the training overall as good and found it recommendable for procrastinating friends. Hence, fostering self-regulatory processes in our intervention was a successful attempt to support students in reducing academic procrastination. The evaluation of the training encourages us to adapt the training for different groups of procrastinators.

Predicting concrete corrosion of sewers using artificial neural network.

PubMed

Jiang, Guangming; Keller, Jurg; Bond, Philip L; Yuan, Zhiguo

2016-04-01

Corrosion is often a major failure mechanism for concrete sewers and under such circumstances the sewer service life is largely determined by the progression of microbially induced concrete corrosion. The modelling of sewer processes has become possible due to the improved understanding of in-sewer transformation. Recent systematic studies about the correlation between the corrosion processes and sewer environment factors should be utilized to improve the prediction capability of service life by sewer models. This paper presents an artificial neural network (ANN)-based approach for modelling the concrete corrosion processes in sewers. The approach included predicting the time for the corrosion to initiate and then predicting the corrosion rate after the initiation period. The ANN model was trained and validated with long-term (4.5 years) corrosion data obtained in laboratory corrosion chambers, and further verified with field measurements in real sewers across Australia. The trained model estimated the corrosion initiation time and corrosion rates very close to those measured in Australian sewers. The ANN model performed better than a multiple regression model also developed on the same dataset. Additionally, the ANN model can serve as a prediction framework for sewer service life, which can be progressively improved and expanded by including corrosion rates measured in different sewer conditions. Furthermore, the proposed methodology holds promise to facilitate the construction of analytical models associated with corrosion processes of concrete sewers. Copyright © 2016 Elsevier Ltd. All rights reserved.

[From the Residency Training in the United States to See the Challenges and Directions of China Residency Standardized Training].

PubMed

Cui, Yong; Wang, Tianyou

2016-06-20

Resident standardization training has been started and spreaded out gradually in China. Resident standardization training is crucial to ensure the clinician homogenization, improve medical service quality and level of medical treatment and health care, so it received much attention from all sides. Residency training in American has a history of nearly a century. Systematic model of residency training in the United States had been established for nearly 50 years, and it is a typical representative and successful example of the western medical education. The purpose of this paper is to discuss the institutional arrangements and development direction of the resident standardization training in China, based on comparison of the two residency training system between the two countries on target, schedule, management institution, evaluation and remuneration.

Development and Two-Year Follow-Up Evaluation of a Training Workshop for the Large Preventive Positive Psychology Happy Family Kitchen Project in Hong Kong

PubMed Central

Lai, Agnes Y.; Mui, Moses W.; Wan, Alice; Stewart, Sunita M.; Yew, Carol; Lam, Tai-hing; Chan, Sophia S.

2016-01-01

Evidence-based practice and capacity-building approaches are essential for large-scale health promotion interventions. However, there are few models in the literature to guide and evaluate training of social service workers in community settings. This paper presents the development and evaluation of the “train-the-trainer” workshop (TTT) for the first large scale, community-based, family intervention projects, entitled “Happy Family Kitchen Project” (HFK) under the FAMILY project, a Hong Kong Jockey Club Initiative for a Harmonious Society. The workshop aimed to enhance social workers’ competence and performance in applying positive psychology constructs in their family interventions under HFK to improve family well-being of the community they served. The two-day TTT was developed and implemented by a multidisciplinary team in partnership with community agencies to 50 social workers (64% women). It focused on the enhancement of knowledge, attitude, and practice of five specific positive psychology themes, which were the basis for the subsequent development of the 23 family interventions for 1419 participants. Acceptability and applicability were enhanced by completing a needs assessment prior to the training. The TTT was evaluated by trainees’ reactions to the training content and design, changes in learners (trainees) and benefits to the service organizations. Focus group interviews to evaluate the workshop at three months after the training, and questionnaire survey at pre-training, immediately after, six months, one year and two years after training were conducted. There were statistically significant increases with large to moderate effect size in perceived knowledge, self-efficacy and practice after training, which sustained to 2-year follow-up. Furthermore, there were statistically significant improvements in family communication and well-being of the participants in the HFK interventions they implemented after training. This paper offers a practical example of development, implementation and model-based evaluation of training programs, which may be helpful to others seeking to develop such programs in diverse communities. PMID:26808541

Development and Two-Year Follow-Up Evaluation of a Training Workshop for the Large Preventive Positive Psychology Happy Family Kitchen Project in Hong Kong.

PubMed

Lai, Agnes Y; Mui, Moses W; Wan, Alice; Stewart, Sunita M; Yew, Carol; Lam, Tai-Hing; Chan, Sophia S

2016-01-01

Evidence-based practice and capacity-building approaches are essential for large-scale health promotion interventions. However, there are few models in the literature to guide and evaluate training of social service workers in community settings. This paper presents the development and evaluation of the "train-the-trainer" workshop (TTT) for the first large scale, community-based, family intervention projects, entitled "Happy Family Kitchen Project" (HFK) under the FAMILY project, a Hong Kong Jockey Club Initiative for a Harmonious Society. The workshop aimed to enhance social workers' competence and performance in applying positive psychology constructs in their family interventions under HFK to improve family well-being of the community they served. The two-day TTT was developed and implemented by a multidisciplinary team in partnership with community agencies to 50 social workers (64% women). It focused on the enhancement of knowledge, attitude, and practice of five specific positive psychology themes, which were the basis for the subsequent development of the 23 family interventions for 1419 participants. Acceptability and applicability were enhanced by completing a needs assessment prior to the training. The TTT was evaluated by trainees' reactions to the training content and design, changes in learners (trainees) and benefits to the service organizations. Focus group interviews to evaluate the workshop at three months after the training, and questionnaire survey at pre-training, immediately after, six months, one year and two years after training were conducted. There were statistically significant increases with large to moderate effect size in perceived knowledge, self-efficacy and practice after training, which sustained to 2-year follow-up. Furthermore, there were statistically significant improvements in family communication and well-being of the participants in the HFK interventions they implemented after training. This paper offers a practical example of development, implementation and model-based evaluation of training programs, which may be helpful to others seeking to develop such programs in diverse communities.

A multifaceted intervention model can give a lasting improvement of older peoples' nutritional status.

PubMed

Lorefält, B; Wilhelmsson, S

2012-04-01

The purpose of this study was with a multifaceted intervention model improve the nutritional status of elderly people living in residential homes to increase their energy intake and to maintain improvements over time. Three different municipal residential homes in the south-east of Sweden. The study population consisted of 67 elderly people. A within-subjects design was used which means that the participants were their own controls. A multifaceted intervention model was chosen, which included education on both theoretical and practical issues, training and support for staff, and individualized snacks to the residents. Nutritional status was measured by Mini Nutritional Assessment (MNA), the consumption of food was recorded by the staff using a food record method for 3 consecutive days. The length of night-time fasting has been calculated from the food records. Nutritional status improved after 3 months of intervention and was maintained after 9 months. Weight increased during the whole study period. Night-time fasting decreased but not to the recommended level. This study shows that it is possible by a multifaceted intervention model to increase energy intake including expanding snacks and thereby improve and maintain nutritional status over a longer period in the elderly living in residential homes. This result was possible to achieve because staff received education and training in nutritional issues and by provision of support during a period when new routines were introduced.

Implementing a trustworthy cost-accounting model.

PubMed

Spence, Jay; Seargeant, Dan

2015-03-01

Hospitals and health systems can develop an effective cost-accounting model and maximize the effectiveness of their cost-accounting teams by focusing on six key areas: Implementing an enhanced data model. Reconciling data efficiently. Accommodating multiple cost-modeling techniques. Improving transparency of cost allocations. Securing department manager participation. Providing essential education and training to staff members and stakeholders.

Prediction of pKa Values for Neutral and Basic Drugs based on Hybrid Artificial Intelligence Methods.

PubMed

Li, Mengshan; Zhang, Huaijing; Chen, Bingsheng; Wu, Yan; Guan, Lixin

2018-03-05

The pKa value of drugs is an important parameter in drug design and pharmacology. In this paper, an improved particle swarm optimization (PSO) algorithm was proposed based on the population entropy diversity. In the improved algorithm, when the population entropy was higher than the set maximum threshold, the convergence strategy was adopted; when the population entropy was lower than the set minimum threshold the divergence strategy was adopted; when the population entropy was between the maximum and minimum threshold, the self-adaptive adjustment strategy was maintained. The improved PSO algorithm was applied in the training of radial basis function artificial neural network (RBF ANN) model and the selection of molecular descriptors. A quantitative structure-activity relationship model based on RBF ANN trained by the improved PSO algorithm was proposed to predict the pKa values of 74 kinds of neutral and basic drugs and then validated by another database containing 20 molecules. The validation results showed that the model had a good prediction performance. The absolute average relative error, root mean square error, and squared correlation coefficient were 0.3105, 0.0411, and 0.9685, respectively. The model can be used as a reference for exploring other quantitative structure-activity relationships.

Quiet eye training in a visuomotor control task.

PubMed

Causer, Joe; Holmes, Paul S; Williams, Andrew Mark

2011-06-01

Several researchers have reported the importance of maintaining a longer final fixation on the target (termed the quiet eye period, QE) before performing an aiming task. We present an innovative, perceptual training intervention intended to improve the efficiency of gaze behavior (i.e., QE) in shotgun shooting. A sample of 20 international-level skeet shooters were assigned equally to one of two ability-matched groups based on their pretest shooting scores. A perceptual training group participated in a four-step preshot routine alongside three video feedback sessions involving their own gaze behaviors and those of an expert model in an effort to positively influence QE behaviors. A control group received video feedback of performance but without the addition of feedback on QE behaviors. Participants completed pretests and posttests along with an 8-wk training intervention. Subjects of the perceptual training group significantly increased their mean QE duration (397 vs 423 ms), used an earlier onset of QE (257 vs 244 ms), and recorded higher shooting accuracy scores (62 vs 70%) from pretest to posttest. Participants in the perceptual training group significantly reduced gun barrel displacement and absolute peak velocity on the posttest compared with the pretest, although neither variable was overtly trained. A transfer test based on performance during competition indicated that perceptual training significantly improved shooting accuracy from before to after the intervention. No pretest to posttest differences were observed for the control group on the measures reported. The results demonstrate the effectiveness of QE training in improving shooting accuracy and developing a more efficient visuomotor control strategy.The findings have implications for future research on training visuomotor behaviors, attention, and gaze orientation during the performance of aiming tasks.

Degraded neural and behavioral processing of speech sounds in a rat model of Rett syndrome

PubMed Central

Engineer, Crystal T.; Rahebi, Kimiya C.; Borland, Michael S.; Buell, Elizabeth P.; Centanni, Tracy M.; Fink, Melyssa K.; Im, Kwok W.; Wilson, Linda G.; Kilgard, Michael P.

2015-01-01

Individuals with Rett syndrome have greatly impaired speech and language abilities. Auditory brainstem responses to sounds are normal, but cortical responses are highly abnormal. In this study, we used the novel rat Mecp2 knockout model of Rett syndrome to document the neural and behavioral processing of speech sounds. We hypothesized that both speech discrimination ability and the neural response to speech sounds would be impaired in Mecp2 rats. We expected that extensive speech training would improve speech discrimination ability and the cortical response to speech sounds. Our results reveal that speech responses across all four auditory cortex fields of Mecp2 rats were hyperexcitable, responded slower, and were less able to follow rapidly presented sounds. While Mecp2 rats could accurately perform consonant and vowel discrimination tasks in quiet, they were significantly impaired at speech sound discrimination in background noise. Extensive speech training improved discrimination ability. Training shifted cortical responses in both Mecp2 and control rats to favor the onset of speech sounds. While training increased the response to low frequency sounds in control rats, the opposite occurred in Mecp2 rats. Although neural coding and plasticity are abnormal in the rat model of Rett syndrome, extensive therapy appears to be effective. These findings may help to explain some aspects of communication deficits in Rett syndrome and suggest that extensive rehabilitation therapy might prove beneficial. PMID:26321676

Teaching refusal skills to sexually active adolescents.

PubMed

Warzak, W J; Page, T J

1990-06-01

Refusal skills training was extended to sexually active handicapped female adolescents who lacked an effective refusal strategy. Role-plays for assessment and training were developed using the who, what, when and where of situations which resulted in unwanted intercourse. Refusal skills were trained following the format of rationale, modeling, rehearsal, feedback, and reinforcement. Baseline rates of most target behaviors were quite low. High frequencies of target behaviors were observed as each behavior became the focus of training. Generalization across staff and time was also observed. The skillfulness and effectiveness of the subjects' refusal skills were judged to be improved as a function of training. One-year follow-up showed decreased sexual activity for each girl.

Impact of laparoscopic surgery training laboratory on surgeon's performance

PubMed Central

Torricelli, Fabio C M; Barbosa, Joao Arthur B A; Marchini, Giovanni S

2016-01-01

Minimally invasive surgery has been replacing the open standard technique in several procedures. Similar or even better postoperative outcomes have been described in laparoscopic or robot-assisted procedures when compared to open surgery. Moreover, minimally invasive surgery has been providing less postoperative pain, shorter hospitalization, and thus a faster return to daily activities. However, the learning curve required to obtain laparoscopic expertise has been a barrier in laparoscopic spreading. Laparoscopic surgery training laboratory has been developed to aid surgeons to overcome the challenging learning curve. It may include tutorials, inanimate model skills training (box models and virtual reality simulators), animal laboratory, and operating room observation. Several different laparoscopic courses are available with specific characteristics and goals. Herein, we aim to describe the activities performed in a dry and animal-model training laboratory and to evaluate the impact of different kinds of laparoscopic surgery training courses on surgeon’s performance. Several tasks are performed in dry and animal laboratory to reproduce a real surgery. A short period of training can improve laparoscopic surgical skills, although most of times it is not enough to confer laparoscopic expertise for participants. Nevertheless, this short period of training is able to increase the laparoscopic practice of surgeons in their communities. Full laparoscopic training in medical residence or fellowship programs is the best way of stimulating laparoscopic dissemination. PMID:27933135

Convolutional networks for vehicle track segmentation

NASA Astrophysics Data System (ADS)

Quach, Tu-Thach

2017-10-01

Existing methods to detect vehicle tracks in coherent change detection images, a product of combining two synthetic aperture radar images taken at different times of the same scene, rely on simple and fast models to label track pixels. These models, however, are unable to capture natural track features, such as continuity and parallelism. More powerful but computationally expensive models can be used in offline settings. We present an approach that uses dilated convolutional networks consisting of a series of 3×3 convolutions to segment vehicle tracks. The design of our networks considers the fact that remote sensing applications tend to operate in low power and have limited training data. As a result, we aim for small and efficient networks that can be trained end-to-end to learn natural track features entirely from limited training data. We demonstrate that our six-layer network, trained on just 90 images, is computationally efficient and improves the F-score on a standard dataset to 0.992, up from 0.959 obtained by the current state-of-the-art method.

Training feed-forward neural networks with gain constraints

PubMed

Hartman

2000-04-01

Inaccurate input-output gains (partial derivatives of outputs with respect to inputs) are common in neural network models when input variables are correlated or when data are incomplete or inaccurate. Accurate gains are essential for optimization, control, and other purposes. We develop and explore a method for training feedforward neural networks subject to inequality or equality-bound constraints on the gains of the learned mapping. Gain constraints are implemented as penalty terms added to the objective function, and training is done using gradient descent. Adaptive and robust procedures are devised for balancing the relative strengths of the various terms in the objective function, which is essential when the constraints are inconsistent with the data. The approach has the virtue that the model domain of validity can be extended via extrapolation training, which can dramatically improve generalization. The algorithm is demonstrated here on artificial and real-world problems with very good results and has been advantageously applied to dozens of models currently in commercial use.

How to Begin a Quality Improvement Project.

PubMed

Silver, Samuel A; Harel, Ziv; McQuillan, Rory; Weizman, Adam V; Thomas, Alison; Chertow, Glenn M; Nesrallah, Gihad; Bell, Chaim M; Chan, Christopher T

2016-05-06

Quality improvement involves a combined effort among health care staff and stakeholders to diagnose and treat problems in the health care system. However, health care professionals often lack training in quality improvement methods, which makes it challenging to participate in improvement efforts. This article familiarizes health care professionals with how to begin a quality improvement project. The initial steps involve forming an improvement team that possesses expertise in the quality of care problem, leadership, and change management. Stakeholder mapping and analysis are useful tools at this stage, and these are reviewed to help identify individuals who might have a vested interest in the project. Physician engagement is a particularly important component of project success, and the knowledge that patients/caregivers can offer as members of a quality improvement team should not be overlooked. After a team is formed, an improvement framework helps to organize the scientific process of system change. Common quality improvement frameworks include Six Sigma, Lean, and the Model for Improvement. These models are contrasted, with a focus on the Model for Improvement, because it is widely used and applicable to a variety of quality of care problems without advanced training. It involves three steps: setting aims to focus improvement, choosing a balanced set of measures to determine if improvement occurs, and testing new ideas to change the current process. These new ideas are evaluated using Plan-Do-Study-Act cycles, where knowledge is gained by testing changes and reflecting on their effect. To show the real world utility of the quality improvement methods discussed, they are applied to a hypothetical quality improvement initiative that aims to promote home dialysis (home hemodialysis and peritoneal dialysis). This provides an example that kidney health care professionals can use to begin their own quality improvement projects. Copyright © 2016 by the American Society of Nephrology.

How to Begin a Quality Improvement Project

PubMed Central

Harel, Ziv; McQuillan, Rory; Weizman, Adam V.; Thomas, Alison; Chertow, Glenn M.; Nesrallah, Gihad; Bell, Chaim M.; Chan, Christopher T.

2016-01-01

Quality improvement involves a combined effort among health care staff and stakeholders to diagnose and treat problems in the health care system. However, health care professionals often lack training in quality improvement methods, which makes it challenging to participate in improvement efforts. This article familiarizes health care professionals with how to begin a quality improvement project. The initial steps involve forming an improvement team that possesses expertise in the quality of care problem, leadership, and change management. Stakeholder mapping and analysis are useful tools at this stage, and these are reviewed to help identify individuals who might have a vested interest in the project. Physician engagement is a particularly important component of project success, and the knowledge that patients/caregivers can offer as members of a quality improvement team should not be overlooked. After a team is formed, an improvement framework helps to organize the scientific process of system change. Common quality improvement frameworks include Six Sigma, Lean, and the Model for Improvement. These models are contrasted, with a focus on the Model for Improvement, because it is widely used and applicable to a variety of quality of care problems without advanced training. It involves three steps: setting aims to focus improvement, choosing a balanced set of measures to determine if improvement occurs, and testing new ideas to change the current process. These new ideas are evaluated using Plan-Do-Study-Act cycles, where knowledge is gained by testing changes and reflecting on their effect. To show the real world utility of the quality improvement methods discussed, they are applied to a hypothetical quality improvement initiative that aims to promote home dialysis (home hemodialysis and peritoneal dialysis). This provides an example that kidney health care professionals can use to begin their own quality improvement projects. PMID:27016497

Engineering teacher training models and experiences

NASA Astrophysics Data System (ADS)

González-Tirados, R. M.

2009-04-01

Institutions and Organisations that take training seriously and devote time, effort and resources, etc, to their own teams are more likely to succeed, since both initial teacher training and continuous improvement, studies, hours of group discussion, works on innovation and educational research, talks and permanent meetings, etc, will all serve to enhance teaching and its quality. Teachers will be able to introduce new components from previously taught classes into their university teaching which will contribute to improving their work and developing a suitable academic environment to include shared objectives, teachers and students. Moreover, this training will serve to enhance pedagogic innovation, new teaching-learning methodologies and contribute to getting teaching staff involved in respect of the guidelines set out by the EHEA. Bearing in mind that training and motivation can be key factors in any teacher's "performance", their productivity and the quality of their teaching, Teacher Training for a specific post inside the University Organisation is standard practice of so-called Human Resources management and an integral part of a teacher's work; it is a way of professionalising the teaching of the different branches of Engineering. At Madrid Polytechnic University, in the Institute of Educational Sciences (ICE), since it was founded in 1972, we have been working hard with university teaching staff. But it was not until 1992 after carrying out various studies on training needs that we planned and programmed different training actions, offering a wide range of possibilities. Thus, we designed and taught an "Initial Teacher Training Course", as it was first called in 1992, a programme basically aimed to train young Engineering teachers just setting out on their teaching career. In 2006, the name was changed to "Advanced University Teacher Training Course". Subsequently, with the appearance of the Bologna Declaration and the creation of the European Higher Education Area, we renewed the programme, content and methodology, teaching the course under the name of "Initial Teacher Training Course within the framework of the European Higher Education Area". Continuous Training means learning throughout one's life as an Engineering teacher. They are actions designed to update and improve teaching staff, and are systematically offered on the current issues of: Teaching Strategies, training for research, training for personal development, classroom innovations, etc. They are activities aimed at conceptual change, changing the way of teaching and bringing teaching staff up-to-date. At the same time, the Institution is at the disposal of all teaching staff as a meeting point to discuss issues in common, attend conferences, department meetings, etc. In this Congress we present a justification of both training models and their design together with some results obtained on: training needs, participation, how it is developing and to what extent students are profiting from it.

Moderate Aerobic Training Improves Cardiorespiratory Parameters in Elastase-Induced Emphysema

PubMed Central

Henriques, Isabela; Lopes-Pacheco, Miquéias; Padilha, Gisele A.; Marques, Patrícia S.; Magalhães, Raquel F.; Antunes, Mariana A.; Morales, Marcelo M.; Rocha, Nazareth N.; Silva, Pedro L.; Xisto, Débora G.; Rocco, Patricia R. M.

2016-01-01

Aim: We investigated the therapeutic effects of aerobic training on lung mechanics, inflammation, morphometry and biological markers associated with inflammation, and endothelial cell damage, as well as cardiac function in a model of elastase-induced emphysema. Methods: Eighty-four BALB/c mice were randomly allocated to receive saline (control, C) or 0.1 IU porcine pancreatic elastase (emphysema, ELA) intratracheally once weekly for 4 weeks. After the end of administration period, once cardiorespiratory impairment associated with emphysema was confirmed, each group was further randomized into sedentary (S) and trained (T) subgroups. Trained mice ran on a motorized treadmill, at moderate intensity, 30 min/day, 3 times/week for 4 weeks. Results: Four weeks after the first instillation, ELA animals, compared to C, showed: (1) reduced static lung elastance (Est,L) and levels of vascular endothelial growth factor (VEGF) in lung tissue, (2) increased elastic and collagen fiber content, dynamic elastance (E, in vitro), alveolar hyperinflation, and levels of interleukin-1β and tumor necrosis factor (TNF)-α, and (3) increased right ventricular diastolic area (RVA). Four weeks after aerobic training, ELA-T group, compared to ELA-S, was associated with reduced lung hyperinflation, elastic and collagen fiber content, TNF-α levels, and RVA, as well as increased Est,L, E, and levels of VEGF. Conclusion: Four weeks of regular and moderate intensity aerobic training modulated lung inflammation and remodeling, thus improving pulmonary function, and reduced RVA and pulmonary arterial hypertension in this animal model of elastase-induced emphysema. PMID:27536247

Laparoscopic Skills Are Improved With LapMentor™ Training

PubMed Central

Andreatta, Pamela B.; Woodrum, Derek T.; Birkmeyer, John D.; Yellamanchilli, Rajani K.; Doherty, Gerard M.; Gauger, Paul G.; Minter, Rebecca M.

2006-01-01

Objective: To determine if prior training on the LapMentor™ laparoscopic simulator leads to improved performance of basic laparoscopic skills in the animate operating room environment. Summary Background Data: Numerous influences have led to the development of computer-aided laparoscopic simulators: a need for greater efficiency in training, the unique and complex nature of laparoscopic surgery, and the increasing demand that surgeons demonstrate competence before proceeding to the operating room. The LapMentor™ simulator is expensive, however, and its use must be validated and justified prior to implementation into surgical training programs. Methods: Nineteen surgical interns were randomized to training on the LapMentor™ laparoscopic simulator (n = 10) or to a control group (no simulator training, n = 9). Subjects randomized to the LapMentor™ trained to expert criterion levels 2 consecutive times on 6 designated basic skills modules. All subjects then completed a series of laparoscopic exercises in a live porcine model, and performance was assessed independently by 2 blinded reviewers. Time, accuracy rates, and global assessments of performance were recorded with an interrater reliability between reviewers of 0.99. Results: LapMentor™ trained interns completed the 30° camera navigation exercise in significantly less time than control interns (166 ± 52 vs. 220 ± 39 seconds, P < 0.05); they also achieved higher accuracy rates in identifying the required objects with the laparoscope (96% ± 8% vs. 82% ± 15%, P < 0.05). Similarly, on the two-handed object transfer exercise, task completion time for LapMentor™ trained versus control interns was 130 ± 23 versus 184 ± 43 seconds (P < 0.01) with an accuracy rate of 98% ± 5% versus 80% ± 13% (P < 0.001). Additionally, LapMentor™ trained interns outperformed control subjects with regard to camera navigation skills, efficiency of motion, optimal instrument handling, perceptual ability, and performance of safe electrocautery. Conclusions: This study demonstrates that prior training on the LapMentor™ laparoscopic simulator leads to improved resident performance of basic skills in the animate operating room environment. This work marks the first prospective, randomized evaluation of the LapMentor™ simulator, and provides evidence that LapMentor™ training may lead to improved operating room performance. PMID:16772789

Using peer-assisted learning and role-playing to teach generic skills to dental students: the health care simulation model.

PubMed

El Tantawi, Maha M A; Abdelaziz, Hytham; AbdelRaheem, Amira S; Mahrous, Ahmed A

2014-01-01

Increasing importance is attached to teaching generic skills to undergraduate students in various disciplines. This article describes an extracurricular, student-led activity for teaching generic skills using the Model United Nations over three months. The activity used the Health Care Simulation Model (HCSM) with peer learning and role-playing to accomplish its objectives. An interview was used to select from undergraduate and postgraduate dental students at Alexandria University, Alexandria, Egypt, to develop a group of staff to act as peer teachers after receiving training (n=77). These peer teachers provided training for 123 undergraduate dental students to serve as delegates who acted as trainees or peer learners. At the end of the training sessions, a conference was held in which the students played the roles of delegates representing officials responsible for health care systems in ten countries. The students reported improvement in generic skills, enjoyed several aspects of the experience, and disliked other aspects of the model to a lesser extent. In multivariate analysis, perceived usefulness of the HCSM was significantly greater for staff than delegates and increased as self-reported improvement in knowledge of health care systems increased. This study suggests that innovative, student-centered educational methods can be effective for teaching generic skills and factual information.