Improving the United States airline industry's capacity to provide safe and dignified services to travelers with disabilities: focus group findings.

PubMed

McCarthy, Michael J

2011-01-01

As a component of a training development project for intercity air travel providers, we investigated the capacity of the airline industry to meet the needs of travelers with disabilities by exploring: (1) the level of sensitivity among personnel to travelers' needs, (2) training currently provided, (3) areas in which additional training might be beneficial, and (4) organisational/systems-level commitment to dignified assistance to all travelers. Forty-four airline/vendor employees participated in nine focus groups in four US cities. Groups were audio recorded and transcribed. A grounded-theory approach was used to develop a coding system which was then applied to transcripts to identify themes. Factors influencing capacity grouped broadly into four areas: characteristics of the job/system, characteristics of current training, characteristics of providers themselves, and characteristics of travelers. At an interpersonal level, providers were empathetic and desired to provide dignified services. They lacked training and adequate equipment in some cases, however, and organisational commitment varied between companies. Traveler characteristics were also shown to impact service delivery. Results are promising but additional regulatory and organisational policies are needed to ensure quality services. Providers and consumers of intercity air travel services may benefit from the findings and recommendations of this study.

The Effect of Additional Virtual Reality Training on Balance in Children with Cerebral Palsy after Lower Limb Surgery: A Feasibility Study.

PubMed

Meyns, Pieter; Pans, Liene; Plasmans, Kaat; Heyrman, Lieve; Desloovere, Kaat; Molenaers, Guy

2017-02-01

Impaired balance is disabling for children with cerebral palsy (CPc), especially for CPc who recently underwent lower limb surgery. Positive results of using virtual reality (VR) in balance rehabilitation have been published in several outpatient populations. We investigated the feasibility of applying additional VR training focused on sitting balance in CP inpatients of a rehabilitation center after lower limb surgery. Additionally, we investigated the rate of enjoyment of VR training compared with conventional physiotherapy. Eleven spastic CPc (4/7 males/females) following rehabilitation after lower limb orthopedic surgery were included (5-18 years). The control group received conventional physiotherapy. The intervention group received additional VR training. Balance was measured using the Trunk Control Measurement Scale every 3 weeks of the rehabilitation period. Enjoyment was analyzed using a 10-point Visual Analog Scale. Providing additional VR training was feasible in terms of recruitment, treatment adherence, and assessment adherence. Both groups improved sitting balance after therapy. The current games were not perceived as more enjoyable than conventional physiotherapy. Including additional VR training to conventional physiotherapy is feasible and might be promising to train sitting balance in CPc after lower limb surgery. Future research should take equal patient allocation and training duration between groups into consideration.

Competency-Based Education for the Molecular Genetic Pathology Fellow

PubMed Central

Talbert, Michael L.; Dunn, S. Terence; Hunt, Jennifer; Hillyard, David R.; Mirza, Imran; Nowak, Jan A.; Van Deerlin, Vivianna; Vnencak-Jones, Cindy L.

2009-01-01

The following report represents guidelines for competency-based fellowship training in Molecular Genetic Pathology (MGP) developed by the Association for Molecular Pathology Training and Education Committee and Directors of MGP Programs in the United States. The goals of the effort were to describe each of the Accreditation Council for Graduate Medical Education competencies as they apply to MGP fellowship training, provide a summary of goals and objectives, and recommend assessment tools. These guidelines are particularly pertinent to MGP training, which is a relatively new specialty that operates within a rapidly changing scientific and technological arena. It is hoped that this document will provide additional material for directors of existing MGP programs to consider for improvement of program objectives and enhancement of evaluation tools already in place. In addition, the guidelines should provide a valuable framework for the development of new MGP programs. PMID:19797613

Interactive internet-based clinical education: an efficient and cost-savings approach to point-of-care test training.

PubMed

Knapp, Herschel; Chan, Kee; Anaya, Henry D; Goetz, Matthew B

2011-06-01

We successfully created and implemented an effective HIV rapid testing training and certification curriculum using traditional in-person training at multiple sites within the U.S. Department of Veterans Affairs (VA) Healthcare System. Considering the multitude of geographically remote facilities in the nationwide VA system, coupled with the expansion of HIV diagnostics, we developed an alternate training method that is affordable, efficient, and effective. Using materials initially developed for in-person HIV rapid test in-services, we used a distance learning model to offer this training via live audiovisual online technology to educate clinicians at a remote outpatient primary care VA facility. Participants' evaluation metrics showed that this form of remote education is equivalent to in-person training; additionally, HIV testing rates increased considerably in the months following this intervention. Although there is a one-time setup cost associated with this remote training protocol, there is potential cost savings associated with the point-of-care nurse manager's time productivity by using the Internet in-service learning module for teaching HIV rapid testing. If additional in-service training modules are developed into Internet-based format, there is the potential for additional cost savings. Our cost analysis demonstrates that the remote in-service method provides a more affordable and efficient alternative compared with in-person training. The online in-service provided training that was equivalent to in-person sessions based on first-hand supervisor observation, participant satisfaction surveys, and follow-up results. This method saves time and money, requires fewer personnel, and affords access to expert trainers regardless of geographic location. Further, it is generalizable to training beyond HIV rapid testing. Based on these consistent implementation successes, we plan to expand use of online training to include remote VA satellite facilities spanning several states for a variety of diagnostic devices. Ultimately, Internet-based training has the potential to provide "big city" quality of care to patients at remote (rural) clinics.

Training Cyber Warriors: What Can Be Learned from Defense Language Training?

DTIC Science & Technology

2015-01-01

other agencies. In addition, the National Cryp- tologic School , Foreign Service Institute, and CIA University, among others, each train students for...They provide a variety of services, including group instruction , distance learning , and one-on-one tutoring. Pipeline-Building Programs The Language...commonly monolingual English speakers,1 (2) the U.S. education system provides limited opportunities for students to learn other languages in

Islam and family planning: changing perceptions of health care providers and medical faculty in Pakistan

PubMed Central

Mir, Ali Mohammad; Shaikh, Gul Rashida

2013-01-01

ABSTRACT A USAID-sponsored family planning project called “FALAH” (Family Advancement for Life and Health), implemented in 20 districts of Pakistan, aimed to lower unmet need for family planning by improving access to services. To enhance the quality of care offered by the public health system, the FALAH project trained 10,534 facility-based health care providers, managers, and medical college faculty members to offer client-centered family planning services, which included a module to explain the Islamic viewpoint on family planning developed through an iterative process involving religious scholars and public health experts. At the end of the FALAH project, we conducted a situation analysis of health facilities including interviews with providers to measure family planning knowledge of trained and untrained providers; interviewed faculty to obtain their feedback about the training module; and measured changes in women's contraceptive use through baseline and endline surveys. Trained providers had a better understanding of family planning concepts than untrained providers. In addition, discussions with trained providers indicated that the training module on Islam and family planning helped them to become advocates for family planning. Faculty indicated that the module enhanced their confidence about the topic of family planning and Islam, making it easier to introduce and discuss the issue with their students. Over the 3.5-year project period, which included several components in addition to the training activity, we found an overall increase of 9 percentage points in contraceptive prevalence in the project implementation districts—from 29% to 38%. The Islam and family planning module has now been included in the teaching program of major public-sector medical universities and the Regional Training Institutes of the Population Welfare Department. Other countries with sizeable Muslim populations and low contraceptive prevalence could benefit from this module. PMID:25276535

Water Resources Division training catalog

USGS Publications Warehouse

Hotchkiss, W.R.; Foxhoven, L.A.

1984-01-01

The National Training Center provides technical and management sessions nesessary for the conductance of the U.S. Geological Survey 's training programs. This catalog describes the facilities and staff at the Lakewood Training Center and describes Water Resources Division training courses available through the center. In addition, the catalog describes the procedures for gaining admission, formulas for calculating fees, and discussion of course evaluations. (USGS)

Tomography and generative training with quantum Boltzmann machines

NASA Astrophysics Data System (ADS)

Kieferová, Mária; Wiebe, Nathan

2017-12-01

The promise of quantum neural nets, which utilize quantum effects to model complex data sets, has made their development an aspirational goal for quantum machine learning and quantum computing in general. Here we provide methods of training quantum Boltzmann machines. Our work generalizes existing methods and provides additional approaches for training quantum neural networks that compare favorably to existing methods. We further demonstrate that quantum Boltzmann machines enable a form of partial quantum state tomography that further provides a generative model for the input quantum state. Classical Boltzmann machines are incapable of this. This verifies the long-conjectured connection between tomography and quantum machine learning. Finally, we prove that classical computers cannot simulate our training process in general unless BQP=BPP , provide lower bounds on the complexity of the training procedures and numerically investigate training for small nonstoquastic Hamiltonians.

32 CFR 634.10 - Remedial driver training programs.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 32 National Defense 4 2010-07-01 2010-07-01 true Remedial driver training programs. 634.10 Section 634.10 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY (CONTINUED) LAW... individual driving history or incidents requiring additional training. The curriculum should provide...

32 CFR 634.10 - Remedial driver training programs.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 32 National Defense 4 2012-07-01 2011-07-01 true Remedial driver training programs. 634.10 Section 634.10 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY (CONTINUED) LAW... individual driving history or incidents requiring additional training. The curriculum should provide...

32 CFR 634.10 - Remedial driver training programs.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 32 National Defense 4 2011-07-01 2011-07-01 false Remedial driver training programs. 634.10 Section 634.10 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY (CONTINUED) LAW... individual driving history or incidents requiring additional training. The curriculum should provide...

32 CFR 634.10 - Remedial driver training programs.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 32 National Defense 4 2013-07-01 2013-07-01 false Remedial driver training programs. 634.10 Section 634.10 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY (CONTINUED) LAW... individual driving history or incidents requiring additional training. The curriculum should provide...

32 CFR 634.10 - Remedial driver training programs.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 32 National Defense 4 2014-07-01 2013-07-01 true Remedial driver training programs. 634.10 Section 634.10 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY (CONTINUED) LAW... individual driving history or incidents requiring additional training. The curriculum should provide...

Trains across the USA

ERIC Educational Resources Information Center

McIntosh, Phyllis

2013-01-01

This feature article explores the topic of trains from their early history to recent trends in railroading. A glossary provides related vocabulary, a sidebar called "Romance of the Rails" adds colorful detail about train songs and railroad lore. An additional section, "Classroom Activities," by John Silver, presents three…

Increasing Meaningful Assistive Technology Use in the Classrooms

ERIC Educational Resources Information Center

Connor, Cynthia; Beard, Lawrence A.

2015-01-01

Although personal technology is consistently used by students and teachers, meaningful use of technology for instruction may not be feasible without providing teachers specific training and support. One university is providing workshops, feedback through coursework, and hands-on training to teacher candidates and local area teachers. In addition,…

IMMUNISATION TRAINING NEEDS IN MALAWI.

PubMed

Tsega, A Y; Hausi, H T; Steinglass, R; Chirwa, G Z

2014-09-01

The Malawi Ministry of Health (MOH) and its immunisation partners conducted a training needs assessment in May 2013 to assess the current status of immunisation training programmemes in health training institutions, to identify unmet training needs, and to recommend possible solutions for training of health workers on a regular basis. A cross-sectional, descriptive study. Health training institutions in Malawi, a developing country that does not regularly update its curricula to include new vaccines and management tools, nor train healthcare workers on a regular basis. Researchers interviewed Malawi's central immunisation manager, three zonal immunisation officers, six district officers, 12 health facility immunisation coordinators, and eight principals of training institutions. All health training institutions in Malawi include immunisation in their preservice training curricula. However, the curriculum is not regularly updated; thus, the graduates are not well equipped to provide quality services. In addition, the duration of the training curriculum is inadequate, and in-service training sessions for managers and service providers are conducted only on an ad hoc basis. All levels of Malawi's health system have not met sufficient training needs for providing immunisations, and the health training institutions teach their students with outdated materials. It is recommended that the training institutions update their training curricula regularly and the service providers are trained on a regular basis.

Realistic training for effective crew performance

NASA Technical Reports Server (NTRS)

Foushee, H. C.

1985-01-01

Evaluation of incident and accident statistics reveals that most problems occur not because of a lack of proficiency in pilot training, but because of the inability to coordinate skills into effective courses of action. Line-Oriented Flight Training (LOFT) and Cockpit Resource Management (CRM) programs provide training which will develop both individual crew member skills, as well as those associated with effective group function. A study conducted by NASA at the request of the U.S. Congress supports the argument for training that enhances crew performance in addition to providing individual technical skills, and is described in detail.

Survey to child/adolescent psychiatry and developmental/behavioral pediatric training directors to expand psychiatric-mental health training to nurse practitioners.

PubMed

Schwartz, Richard H; O'Laughlen, Mary C; Kim, Joshua

2017-06-01

There is an ongoing shortage of child mental health professionals. Nurse practitioners (NPs) who completed behavioral and mental health training have proven that they can diagnose and manage many pediatric problems. To ask the training directors of both child/adolescent psychiatry (CAP) and developmental/behavioral pediatric (DBP) programs about their receptivity and willingness to give additional training for NPs who provide care to children with behavioral and mental health issues and examine the main obstacles to the development of such programs. A survey was sent to 151 CAP and DBP training directors in the United States. The return rate was 67% (N = 101). Only 12% expressed objection to the concept of additional NP training in CAP or DBP, but only 53% of training directors currently reported having sufficient faculty to do so. Some training directors reported already having advanced behavioral and mental health training programs for NPs (31%) and most (82%) would consider expanding, if funded. There is support for advanced training for NPs, but funding is needed to make this a reality. Expansion of such programs might rapidly improve accessibility and reduce waiting time of mental health providers for children and adolescents. ©2017 American Association of Nurse Practitioners.

Inspiratory and expiratory respiratory muscle training as an adjunct to concurrent strength and endurance training provides no additional 2000 m performance benefits to rowers.

PubMed

Bell, Gordon J; Game, Alex; Jones, Richard; Webster, Travis; Forbes, Scott C; Syrotuik, Dan

2013-01-01

The purpose of this study was to examine respiratory muscle training (RMT) combined with 9 weeks of resistance and endurance training on rowing performance and cardiopulmonary responses. Twenty-seven rowers (mean ± SD: age = 27 ± 9 years; height = 176.9 ± 10.8 cm; and body mass = 76.1 ± 12.6 kg) were randomly assigned to an inspiratory only (n = 13) or expiratory only (n = 14) training group. Both RMT programs were 3 sets of 10 reps, 6 d/wk in addition to an identical 3 d/wk resistance and 3 d/wk endurance training program. Both groups showed similar improvements in 2000 m rowing performance, cardiorespiratory fitness, strength, and maximum inspiratory (PImax) and expiratory (PEmax) pressures (p < .05). It was concluded that there were no additional benefits of 9 weeks of inspiratory or expiratory RMT on simulated 2000 m rowing performance or cardiopulmonary responses when combined with resistance and endurance training in rowers.

Project Job: Vocational Training Program for Mentally Retarded Adults.

ERIC Educational Resources Information Center

Career Development for Exceptional Individuals, 1983

1983-01-01

A vocational training program for trainable mentally retarded youth and adults provided instruction on functional skills, travel training, and independent living skills in addition to supervised performance in part time jobs in the community. The program expanded into small business subsidiaries for boat cleaning and detailing and marine serving.…

Evaluator Training: Content and Topic Valuation in University Evaluation Courses

ERIC Educational Resources Information Center

Davies, Randall; MacKay, Kathryn

2014-01-01

Quality training opportunities for evaluators will always be important to the evaluation profession. While studies have documented the number of university programs providing evaluation training, additional information is needed concerning what content is being taught in current evaluation courses. This article summarizes the findings of a survey…

MENTOR 2

DTIC Science & Technology

2017-09-30

training sessions; internet service was either not available or was restricted. We overcame this problem by using Creo, a high-end software for...based on participants, and customize the training program. Similarly, we have also identified and catalogued a number of training aids in the form...align with AST2 interests in providing services , particularly associated with digital manufacturing and workforce training . Additionally, a number of

Guidelines for Line-Oriented Flight Training, Volume 1

NASA Technical Reports Server (NTRS)

Lauber, J. K.; Foushee, H. C.

1981-01-01

Line-Oriented Flight Training (LOFT) is a developing training technology which synthesizes high-fidelity aircraft simulation and high-fidelity line-operations simulation to provide realistic, dynamic pilot training in a simulated line environment. LOFT is an augmentation of existing pilot training which concentrates upon command, leadership, and resource management skills. This report, based on an NASA/Industry workshop held in January, 1981, is designed to serve as a handbook for LOFT users. In addition to providing background information, guidelines are presented for designing LOFT scenarios, conducting real-time LOFT operations, pilot debriefing, and instructor qualification and training. The final chapter addressed other uses of LOFT and line-operations (or full-mission) simulation.

Effects of the addition of functional electrical stimulation to ground level gait training with body weight support after chronic stroke.

PubMed

Prado-Medeiros, Christiane L; Sousa, Catarina O; Souza, Andréa S; Soares, Márcio R; Barela, Ana M F; Salvini, Tania F

2011-01-01

The addition of functional electrical stimulation (FES) to treadmill gait training with partial body weight support (BWS) has been proposed as a strategy to facilitate gait training in people with hemiparesis. However, there is a lack of studies that evaluate the effectiveness of FES addition on ground level gait training with BWS, which is the most common locomotion surface. To investigate the additional effects of commum peroneal nerve FES combined with gait training and BWS on ground level, on spatial-temporal gait parameters, segmental angles, and motor function. Twelve people with chronic hemiparesis participated in the study. An A1-B-A2 design was applied. A1 and A2 corresponded to ground level gait training using BWS, and B corresponded to the same training with the addition of FES. The assessments were performed using the Modified Ashworth Scale (MAS), Functional Ambulation Category (FAC), Rivermead Motor Assessment (RMA), and filming. The kinematics analyzed variables were mean walking speed of locomotion; step length; stride length, speed and duration; initial and final double support duration; single-limb support duration; swing period; range of motion (ROM), maximum and minimum angles of foot, leg, thigh, and trunk segments. There were not changes between phases for the functional assessment of RMA, for the spatial-temporal gait variables and segmental angles, no changes were observed after the addition of FES. The use of FES on ground level gait training with BWS did not provide additional benefits for all assessed parameters.

Cost-Sharing of General and Specific Training with Depreciation of Human Capital.

ERIC Educational Resources Information Center

Pichler, Eva

1993-01-01

Investigates why employers (particularly those valuing technical progress as important for performance) share general training costs and returns. Workers stay with a firm paying a wage below their opportunity wage if it continually provides additional training so that the prospect of future wages outweighs the short-run gain from quitting and…

Mental Health Liaison Aboard Ship.

DTIC Science & Technology

1984-02-01

participate in inservice training programs. Other calls demonstrated that commands were anticipating potential difficulties and planning accordingly. An...and coordinating efforts. Providing MDR’s with additional training in diagnostics or the assessment A of suicide potential can increase their

Building Capacity for Complementary and Integrative Medicine Through a Large, Cross-Agency, Acupuncture Training Program: Lessons Learned from a Military Health System and Veterans Health Administration Joint Initiative Project.

PubMed

Niemtzow, Richard; Baxter, John; Gallagher, Rollin M; Pock, Arnyce; Calabria, Kathryn; Drake, David; Galloway, Kevin; Walter, Joan; Petri, Richard; Piazza, Thomas; Burns, Stephen; Hofmann, Lew; Biery, John; Buckenmaier, Chester

2018-03-26

Complementary and integrative medicine (CIM) use in the USA continues to expand, including within the Military Health System (MHS) and Veterans Health Administration (VHA). To mitigate the opioid crisis and provide additional non-pharmacological pain management options, a large cross-agency collaborative project sought to develop and implement a systems-wide curriculum, entitled Acupuncture Training Across Clinical Settings (ATACS). ATACS curriculum content and structure were created and refined over the course of the project in response to consultations with Subject Matter Experts and provider feedback. Course content was developed to be applicable to the MHS and VHA environments and training was open to many types of providers. Training included a 4-hr didactic and "hands on" clinical training program focused on a single auricular acupuncture protocol, Battlefield Acupuncture. Trainee learning and skills proficiency were evaluated by trainer-observation and written examination. Immediately following training, providers completed an evaluation survey on their ATACS experience. One month later, they were asked to complete another survey regarding their auricular acupuncture use and barriers to use. The present evaluation describes the ATACS curriculum, faculty and trainee characteristics, as well as trainee and program developer perspectives. Over the course of a 19-mo period, 2,712 providers completed the in-person, 4-hr didactic and hands-on clinical training session. Due to the increasing requests for training, additional ATACS faculty were trained. Overall, 113 providers were approved to be training faculty. Responses from the trainee surveys indicated high satisfaction with the ATACS training program and illuminated several challenges to using auricular acupuncture with patients. The most common reported barrier to using auricular acupuncture was the lack of obtaining privileges to administer auricular acupuncture within clinical practice. The ATACS program provided a foundational template to increase CIM across the MHS and VHA. The lessons learned in the program's implementation will aid future CIM training programs and improve program evaluations. Future work is needed to determine the most efficient means of improving CIM credentialing and privileging procedures, standardizing and adopting uniform CIM EHR codes and documentation, and examining the effectiveness of CIM techniques in real-world settings.

Day Care Center Curriculum Guide.

ERIC Educational Resources Information Center

Antill, Francis, Ed.; And Others

Content, materials, and teaching suggestions are provided for trainable retarded children in the following areas: self care skills; motor skills and coordination; communication; socialization; vocational training; safety; health; and intellectual stimulation. Eleven supplements give additional information on toilet training, a perceptual survey…

Training Requirements and Curriculum Content for Primary Care Providers Delivering Preventive Oral Health Services to Children Enrolled in Medicaid.

PubMed

Sams, Lattice D; Rozier, R Gary; Quinonez, Rocio B

2016-07-01

Despite the emphasis on delivery of preventive oral health services in non-dental settings, limited information exists about state Medicaid policies and strategies to educate practicing physicians in the delivery of these services. This study aims to determine: (1) training requirements and policies for reimbursement of oral health services, (2) teaching delivery methods used to train physicians, and (3) curricula content available to providers among states that reimburse non-dental providers for oral health services. Using Web-based Internet searches as the primary data source, and a supplemental e-mail survey of all states offering in-person training, we assessed training requirements, methods of delivery for training, and curriculum content for states with Medicaid reimbursement to primary care providers delivering preventive oral health services. RESULTS of descriptive analyses are presented for information collected and updated in 2014. Forty-two states provide training sessions or resources to providers, 34 requiring provider training before reimbursement for oral health services. Web-based training is the most common CME delivery method. Only small differences in curricular content were reported by the 11 states that use in-person didactic sessions as the delivery method. Although we found that most states require training and curricular content is similar, training was most often delivered using Web-based courses without any additional delivery methods. Research is needed to evaluate the impact of a mixture of training methods and other quality improvement methods on increased adoption and implementation of preventive oral health services in medical practices.

A Comparison of Computer-based and Instructor-led Training for Long-term Care Staff.

ERIC Educational Resources Information Center

Harrington, Susan S.; Walker, Bonnie L.

2002-01-01

Fire safety training was provided to long-term care staff by computer (n=47) or a print-based, instructor-led program (n=47). Compared to 47 controls, both treatment groups significantly increased knowledge. The computer-trained staff were enthusiastic about the learning method and expressed greater interest in additional safety topics. (SK)

Training Health Service Technicians as Teacher Assistants in an Inpatient Residential Emotional/Behavior Disorder Classroom Setting

ERIC Educational Resources Information Center

Banks, Walter E.

2012-01-01

Schools have identified that the use of Teacher Assistants often provides needed additional support in the school setting. In a Health Care Facility that provides inpatient psychiatric services, children ages 5-14 are required to engage in school activities. Currently there are no Teacher Assistants trained in the facility. This study focuses on…

78 FR 67799 - Qualification, Service, and Use of Crewmembers and Aircraft Dispatchers

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-12

...This final rule revises the training requirements for pilots in air carrier operations. The regulations enhance air carrier pilot training programs by emphasizing the development of pilots' manual handling skills and adding safety-critical tasks such as recovery from stall and upset. The final rule also requires enhanced runway safety training and pilot monitoring training to be incorporated into existing requirements for scenario-based flight training and requires air carriers to implement remedial training programs for pilots. The FAA expects these changes to contribute to a reduction in aviation accidents. Additionally, the final rule revises recordkeeping requirements for communications between the flightcrew and dispatch; ensures that personnel identified as flight attendants have completed flight attendant training and qualification requirements; provides civil enforcement authority for making fraudulent statements; and, provides a number of conforming and technical changes to existing air carrier crewmember training and qualification requirements. The final rule also includes provisions that provide opportunities for air carriers to modify training program requirements for flightcrew members when the air carrier operates multiple aircraft types with similar design and flight handling characteristics.

Recommendations from the Investigational New Drug/Investigational Device Exemption Task Force of the clInical and Translational Science Award Consortium: developing and implementing a sponsor-investigators training program.

PubMed

Holbein, M E Blair; Berglund, Jelena Petrovic; O'Reilly, Erin K; Hartman, Karen; Speicher, Lisa A; Adamo, Joan E; O'Riordan, Gerri; Brown, Jennifer Swanton; Schuff, Kathryn G

2014-06-01

The objective of this study was to provide recommendations for provision of training for sponsor and investigators at Academic Health Centers. A subgroup of the Investigational New Drug/Investigational Device Exemption (IND/IDE) Task Force of the Clinical and Translational Science Award (CTSA) program Regulatory Knowledge Key Function Committee was assembled to specifically address how clinical investigators who hold an IND/IDE and thus assume the role of sponsor-investigators are adequately trained to meet the additional regulatory requirements of this role. The participants who developed the recommendations were representatives of institutions with IND/IDE support programs. Through an informal survey, the task force determined that a variety and mix of models are used to provide support for IND/IDE holders within CTSA institutions. In addition, a CTSA consortium-wide resources survey was used. The participants worked from the models and survey results to develop consensus recommendations to address institutional support, training content, and implementation. The CTSA IND/IDE Task Force recommendations are as follows: (1) Institutions should assess the scope of Food and Drug Administration-regulated research, perform a needs analysis, and provide resources to implement a suitable training program; (2) The model of training program should be tailored to each institution; (3) The training should specifically address the unique role of sponsor-investigators, and the effectiveness of training should be evaluated regularly by methods that fit the model adopted by the institution; and (4) Institutional leadership should mandate sponsor-investigator training and effectively communicate the necessity and availability of training.

Entrustable professional activity (EPA) reshapes the practice of specialist training.

PubMed

Niemi-Murola, Leila

In addition to medical expertise, competence-based medical training comprises communication and collaboration skills, professionalism, and leadership skills. Continuous feedback is essential for learning and development, and feedback only from the medical specialist examination taken in the end of training does not ensure thorough specialist training. Entrustable professional activity (EPA) is a unit of professional practice, defined as tasks or responsibilities typical of the specialty. EPA translates competence-based training into manageable and meaningful entities and provides tools for the evaluation of medical competence.

Challenges in managing postpartum hemorrhage in resource-poor countries.

PubMed

Karoshi, Mahantesh; Keith, Louis

2009-06-01

Managing postpartum hemorrhage depends in part on having a prepared mind, a complement of trained coworkers, and full access to modern therapies. The last 2 components are rare in resource-poor areas and their absence may be accentuated by climatic instability and lack of basic transportation. Greater use of the active management of third stage of labor and administration of misoprostol by nontrained birth attendants will provide beneficial reductions in hemorrhage rates in resource-poor areas. Additional improvements depend on increasing public awareness, facilitating existing nongovernmental organizations in their community-related, upgrading training of traditional birth attendants, and providing cell phone communication to workers in remote areas, in addition to providing better access to blood.

Training Space Surgeons for Missions to the Moon and Mars

NASA Technical Reports Server (NTRS)

Pool, S. L.; McSwain, N.

2004-01-01

Over a period of 4 years, several working groups reviewed the provisions for medical care in low earth orbit and for future flights such as to the Moon and Mars. More than 60 medical experts representing a wide variety of clinical backgrounds participated in the working groups. They concluded that NASA medical training for long-duration missions, while critical to success, is currently aimed at short-term skill retention. They noted that several studies have shown that skills and knowledge deteriorate rapidly in the absence of adequate sustainment training. American Heart Association studies have shown that typically less than twenty-five percent of learned skills remain after 6 to 8 months. In addition to identifying the current training deficiencies, the working groups identified additional skill and knowledge sets required for missions to the Moon and Mars and curricula were developed to address inadequacies. Space medicine care providers may be categorized into 4 types based on health care responsibilities and level of education required. The first 2 types are currently recognized positions within the flight crew: crew medical officers and astronaut-physician. The crew medical officer (CMO), a non-medically trained astronaut crewmember, is given limited emergency medical technician-like training to provide medical care on orbit. Many of hidher duties are carried out under the direction of a ground-based flight surgeon in mission control. Second is the astronaut- physician whose primary focus is on mission specialist duties and training, and who has very limited ability to maintain medical proficiency. Two new categories are recommended to complete the 4 types of care providers primarily to address the needs of those who will travel to the Moon and Mars. Physician astronaut - a physician, who in addition to being a mission specialist, will be required to maintain and enhance hidher medical proficiency while serving as an astronaut. Space surgeon - a physician astronaut given special training to address the unique health care requirements envisioned for expeditions such as those to Mars.

Towards successful Dissemination of Psychological First Aid: a study of provider training preferences.

PubMed

Hambrick, Erin P; Rubens, Sonia L; Vernberg, Eric M; Jacobs, Anne K; Kanine, Rebecca M

2014-04-01

Dissemination of Psychological First Aid (PFA) is challenging considering the complex nature of disaster response and the various disaster mental health (DMH) trainings available. To understand challenges to dissemination in community mental health centers (CMHCs), interviews were conducted with nine DMH providers associated with CMHCs. Consensual qualitative analysis was used to analyze data. Interviews were targeted toward understanding organizational infrastructure, DMH training requirements, and training needs. Results clarified challenges to DMH training in CMHCs and factors that may promote buy-in for trainings. For example, resources are limited and thus allocated for state and federal training requirements. Therefore, including PFA in these requirements could promote adoption. Additionally, a variety of training approaches that differ in content, style, and length would be useful. To conclude, a conceptual model for ways to promote buy-in for the PFA Guide is proposed.

Virtual reality for mine safety training.

PubMed

Filigenzi, M T; Orr, T J; Ruff, T M

2000-06-01

Mining has long remained one of America's most hazardous occupations. Researchers believe that by developing realistic, affordable VR training software, miners will be able to receive accurate training in hazard recognition and avoidance. In addition, the VR software will allow miners to follow mine evacuation routes and safe procedures without exposing themselves to danger. This VR software may ultimately be tailored to provide training in other industries, such as the construction, agricultural, and petroleum industries.

From job training to green jobs: a case study for a young adult employment program centered on environmental restoration in New York City, USA

Treesearch

Nancy Falxa-Raymond; Erika Svendsen; Lindsay K. Campbell

2013-01-01

The demand for a well-trained green-collar labor force will increase as many cities implement sustainability and green infrastructure plans. Additionally, many green jobs training programs are intended to provide pathways out of poverty for low-skilled workers. In this case study, we analyze the experiences of graduates from a New York City, USA green jobs training...

Implementation of online suicide-specific training for VA providers.

PubMed

Marshall, Elizabeth; York, Janet; Magruder, Kathryn; Yeager, Derik; Knapp, Rebecca; De Santis, Mark L; Burriss, Louisa; Mauldin, Mary; Sulkowski, Stan; Pope, Charlene; Jobes, David A

2014-10-01

Due to the gap in suicide-specific intervention training for mental health students and professionals, e-learning is one solution to improving provider skills in the Veterans Affairs (VA) health system. This study focused on the development and evaluation of an equivalent e-learning alternative to the Collaborative Assessment and Management of Suicidality (CAMS) in-person training approach at a Veteran Health Affairs medical center. The study used a multicenter, randomized, cluster, and three group design. the development of e-CAMS was an iterative process and included pilot testing. Eligible and consenting mental health providers, who completed a CAMS pre-survey, were randomized. Provider satisfaction was assessed using the standard VA evaluation of training consisting of 20 items. Two post training focus groups, divided by learning conditions, were conducted to assess practice adoption using a protocol focused on experiences with training and delivery of CAMS. A total of 215 providers in five sites were randomized to three conditions: 69 to e-learning, 70 to in-person, 76 to the control. The providers were primarily female, Caucasian, midlife providers. Based on frequency scores of satisfaction items, both learning groups rated the trainings positively. In focus groups representing divided by learning conditions, participants described positive reactions to CAMS training and similar individual and institutional barriers to full implementation of CAMS. This is the first evaluation study of a suicide-specific e-learning training within the VA. The e-CAMS appears equivalent to the in-person CAMS in terms of provider satisfaction with training and practice adoption, consistent with other comparisons of training deliveries across specialty areas. Additional evaluation of provider confidence and adoption and patient outcomes is in progress. The e-CAMS has the potential to provide ongoing training for VA and military mental health providers and serve as a tutorial for psychiatrists in preparation for specialty boards.

Postgraduate general dentistry residency: a clinical model.

PubMed

Gowan, J

1995-01-01

Dental graduates today are expected to be knowledgeable in many more areas than their predecessors. Changing technology and increased competition require entering the dental profession with more experience and skills. One approach to achieving this skill level is a postgraduate general dentistry residency in a clinical setting during the year following dental school graduation (PGY1). The clinical residency provides new dentists with additional hands-on training and reinforces classroom learning. HealthPartners was selected as a clinical rotation for residents in the advanced general dentistry program at the University of Minnesota Dental School. The program provides dental graduates in PGY1 training in all areas of practice. The HealthPartners rotation is highly unique. It is a staff model HMO with a clinical, multi-specialty setting. Today, HealthPartners--a Minnesota-based healthcare organization--has 116,000 members with prepaid dental benefits. Residents trained in the program develop increased skills in all areas of dental practice. In addition, they develop a good working knowledge in the basic sciences. Methods of instruction include didactic training in the form of seminars, lectures, and clinical training in HealthPartners' dental clinics.

The Florida Prostate Cancer Research Training Opportunities for Outstanding Leaders (ReTOOL) Program: Creating Opportunities for Minority HBCU Students

DTIC Science & Technology

2015-03-01

designated by other documentation. REPORT DOCUMENTATION PAGE Form Approved OMB No. 0704-0188 Public reporting burden for this collection of...have also established an Advanced ReTOOL program, which will provide additional summer training experiences and post -baccalaureate opportunities to...address cultural appropriateness of research conceptualization, design and implementation; (3) provide culturally appropriate cancer prevention, screening

"Ballistic Six" Upper-Extremity Plyometric Training for the Pediatric Volleyball Players.

PubMed

Turgut, Elif; Cinar-Medeni, Ozge; Colakoglu, Filiz F; Baltaci, Gul

2017-09-19

The Ballistic Six exercise program includes commonly used upper-body exercises, and the program is recommended for overhead throwing athletes. The purpose of the current study was to investigate the effects of a 12-week the Ballistic Six upper-extremity plyometric training program on upper-body explosive power, endurance, and reaction time in pediatric overhead athletes. Twenty-eight female pediatric volleyball players participated in the study. The participants were randomly divided into 2 study groups: an intervention group (upper-extremity plyometric training in addition to the volleyball training; n = 14) and a control group (the volleyball training only; n = 14). All the participants were assessed before and after a 12-week training program for upper-body power, strength and endurance, and reaction time. Statistical comparison was performed using an analysis of variance test. Comparisons showed that after a 12-week training program, the Ballistic Six upper-body plyometric training program resulted in more improvements in an overhead medicine ball throwing distance and a push-up performance, as well as greater improvements in the reaction time in the nonthrowing arm when compared with control training. In addition, a 12-week training program was found to be effective in achieving improvements in the reaction time in the throwing arm for both groups similarly. Compared with regular training, upper-body plyometric training resulted in additional improvements in upper-body power and strength and endurance among pediatric volleyball players. The findings of the study provide a basis for developing training protocols for pediatric volleyball players.

Catch the A-Train from the NASA GIBS/Worldview Platform

NASA Astrophysics Data System (ADS)

Schmaltz, J. E.; Alarcon, C.; Baynes, K.; Boller, R. A.; Cechini, M. F.; De Cesare, C.; De Luca, A. P.; Gunnoe, T.; King, B. A.; King, J.; Pressley, N. N.; Roberts, J. T.; Rodriguez, J.; Thompson, C. K.; Wong, M. M.

2016-12-01

The satellites and instruments of the Afternoon Train are providing an unprecedented combination of nearly simultaneous measurements. One of the challenges for researchers and applications users is to sift through these combinations to find particular sets of data that correspond to their interests. Using visualization of the data is one way to explore these combinations. NASA's Worldview tool is designed to do just that - to interactively browse full-resolution satellite imagery. Worldview (https://worldview.earthdata.nasa.gov/) is web-based and developed using open libraries and standards (OpenLayers, JavaScript, CSS, HTML) for cross-platform compatibility. It addresses growing user demands for access to full-resolution imagery by providing a responsive, interactive interface with global coverage and no artificial boundaries. In addition to science data imagery, Worldview provides ancillary datasets such as coastlines and borders, socio-economic layers, and satellite orbit tracks. Worldview interacts with the Earthdata Search Client to provide download of the data files associated with the imagery being viewed. The imagery used by Worldview is provided NASA's Global Imagery Browse Services (GIBS - https://earthdata.nasa.gov/gibs) which provide highly responsive, highly scalable imagery services. Requests are made via the OGC Web Map Tile Service (WMTS) standard. In addition to Worldview, other clients can be developed using a variety of web-based libraries, desktop and mobile app libraries, and GDAL script-based access. GIBS currently includes more than 106 science data sets from seven instruments aboard three of the A-Train satellites and new data sets are being added as part of the President's Big Earth Data Initiative (BEDI). Efforts are underway to include new imagery types, such as vectors and curtains, into Worldview/GIBS which will be used to visualize additional A-Train science parameters.

Developing educational competencies for dissemination and implementation research training programs: an exploratory analysis using card sorts.

PubMed

Padek, Margaret; Colditz, Graham; Dobbins, Maureen; Koscielniak, Nikolas; Proctor, Enola K; Sales, Anne E; Brownson, Ross C

2015-08-12

With demand increasing for dissemination and implementation (D&I) training programs in the USA and other countries, more structured, competency-based, and tested curricula are needed to guide training programs. There are many benefits to the use of competencies in practice-based education such as the establishment of rigorous standards as well as providing an additional metrics for development and growth. As the first aim of a D&I training grant, an exploratory study was conducted to establish a new set of D&I competencies to guide training in D&I research. Based upon existing D&I training literature, the leadership team compiled an initial list of competencies. The research team then engaged 16 additional colleagues in the area of D&I science to provide suggestions to the initial list. The competency list was then additionally narrowed to 43 unique competencies following feedback elicited from these D&I researchers. Three hundred additional D&I researchers were then invited via email to complete a card sort in which the list of competencies were sorted into three categories of experience levels. Participants had previous first-hand experience with D&I or knowledge translation training programs in the past. Participants reported their self-identified D&I expertise level as well as the country in which their home institution is located. A mean score was calculated for each competency based on their experience level categorization. From these mean scores, beginner-, intermediate-, and advanced-level tertiles were created for the competencies. The card sort request achieved a 41 % response rate (n = 124). The list of 43 competencies was organized into four broad domains and sorted based on their experience level score. Eleven competencies were classified into the "Beginner" category, 27 into "Intermediate," and 5 into "Advanced." Education and training developers can use this competency list to formalize future trainings in D&I research, create more evidence-informed curricula, and enable overall capacity building and accompanying metrics in the field of D&I training and research.

Job Corps Vocational Offerings Review. Final Report.

ERIC Educational Resources Information Center

Manpower Administration (DOL), Washington, DC. Job Corps.

The relative effectiveness of current Job Corps vocational offerings was evaluated, and occupations suitable for addition to the Job Corps vocational curricula were identified. Characteristics of Job Corps enrollees and the occupations in which training was provided were identified. To assess their comparative effectiveness, training occupations…

Crew resource management and teamwork training in health care: a review of the literature and recommendations for how to leverage such interventions to enhance patient safety.

PubMed

Maynard, M Travis; Marshall, David; Dean, Matthew D

2012-01-01

In an attempt to enhance patient safety, health care facilities are increasingly turning to crew resource management (CRM) and other teamwork training interventions. However, there is still quite a bit about such training interventions that remain unclear. Accordingly, our primary intent herein is to provide some clarity by providing a review of the literature, in hopes of highlighting the current state of the literature as well as identifying the areas that should be addressed by researchers in this field going forward. We searched various electronic databases and utilized numerous relevant search terms to maximize the likelihood of identifying all empirical research related to the use of CRM training within health care. Additionally, we conducted a manual search of the most relevant journals and also conducted a legacy search to identify even more articles. Furthermore, given that as a research team we have experience with CRM initiatives, we also integrate the lessons learned through this experience. Based on our review of the literature, CRM and teamwork training programs generally appear beneficial to individual employees, the groups and teams within such settings, and overall health care organizations. In addition to reviewing the literature that addressed CRM and teamwork training, we also highlight some of the more critical aspects of CRM training programs in order for such initiatives to be as successful as possible. Additionally, we detail various factors that appear essential to sustaining any benefits of CRM over the long haul.

[Advanced Composites Technology Initiatives

NASA Technical Reports Server (NTRS)

Julian, Mark R.

2002-01-01

This final report closes out the W02 NASA Grant #NCC5-646. The FY02 grant for advanced technology initiatives through the Advanced Composites Technology Institute in Bridgeport, WV, at the Robert C. Byrd Institute (RCBI) Bridgeport Manufacturing Technology Center, is complete; all funding has been expended. RCBI continued to expand access to technology; develop and implement a workforce-training curriculum; improve material development; and provide prototyping and demonstrations of new and advanced composites technologies for West Virginia composites firms. The FY 02 efforts supported workforce development, technical training and the HST development effort of a super-lightweight composite carrier prototype and expanded the existing technical capabilities of the growing aerospace industry across West Virginia to provide additional support for NASA missions. Additionally, the Composites Technology and Training Center was awarded IS0 9001 - 2000 certification and Cleanroom Class 1000 certification during this report period.

Investigation of the effectiveness of traffic sign training in terms of training methods and sign characteristics.

PubMed

Ng, Annie W Y; Chan, Alan H S

2011-06-01

This research investigated whether different training methods had any effect on the effectiveness of traffic sign training and whether there were any relationships between traffic sign characteristics and effectiveness of the training. Thirty-six participants were randomly assigned into 4 equal-sized groups (control, paired-associate learning, recall training, and recognition training) to study the learnability of Mainland China traffic signs. In paired-associate learning, participants studied each traffic sign along with a referent describing its meaning. In addition to being informed of the meaning of traffic signs, both recall training and recognition training provided participants with questions and feedback. For recall training, the questioning process was a recall task in which participants had to produce a meaning for a given traffic sign from memory. For recognition training, the questioning process was a recognition task that required participants to identify the most appropriate referent corresponding to a given sign. No traffic sign training was given to the control group. Each training method significantly improved comprehension of the meaning of traffic signs. Participants from recall training performed better in a posttraining test than those from paired-associate learning and recognition training, indicating that the recall training elicited a deeper level of learning. In addition, questioning and feedback had a positive influence on training effectiveness. Performance in the posttest was found to be better when the questioning process matched the test process. Regarding the traffic sign characteristics, semantic closeness had a long-lasting effect, in terms of the timescale of this experiment on traffic sign comprehension, and traffic signs were perceived as more meaningful after their intended meanings were studied. Recall training is more effective in enhancing comprehension of traffic signs than paired-associate learning and recognition training. The findings of this study provide a basis for useful recommendations for designing symbol-training programs to improve road safety for road users.

An institutional postdoctoral research training program: predictors of publication rate and federal funding success of its graduates.

PubMed

Ross, Randal G; Greco-Sanders, Linda; Laudenslager, Mark; Reite, Martin

2009-01-01

The National Institute of Mental Health funds institutional National Research Service Awards (NRSA) to provide postdoctoral research training. While peer-reviewed publications are the most common outcome measure utilized, there has been little discussion of how publications should be counted or what factors impact the long-term publication rates of trainees in these programs. The authors reviewed current curricula vitae from 92 graduates of an institutional NRSA and from the faculty mentors of that program to assess publications through 2005. Publications were weighted based on peer versus non-peer-reviewed and authorship position. Trainee and mentor factors were assessed for their impact on publication rates and on becoming principal investigators of larger scale federal grants such as a National Institutes of Health (NIH) R01. Weighted publication scores correlate with total publication rates at such a high rate that the two scores can be used interchangeably. Forty-three percent of graduates average at least one publication per year after completing the postdoctoral program; 20% were listed as an independent investigator on a larger federal grant. The number of publications published during postdoctoral training and additional funded training beyond that provided by the institutional NRSA are correlated with increased posttraining program publication rates; other factors including gender, terminal degree, number of publications prior to postdoctoral training, and mentor variables had no significant impact. Additional funded training, male gender, and increased time since completion of the training are associated with increased likelihood of larger grant federal funding. Weighting publications by whether they were peer-reviewed and by authorship position appears to have little benefit over a simple counting of the number of publications. Publication during research training and the pursuit of funding for additional individual research training may be appropriate short-term goals within an institutional research training program.

Surgical Safety Training of World Health Organization Initiatives.

PubMed

Davis, Christopher R; Bates, Anthony S; Toll, Edward C; Cole, Matthew; Smith, Frank C T; Stark, Michael

2014-01-01

Undergraduate training in surgical safety is essential to maximize patient safety. This national review quantified undergraduate surgical safety training. Training of 2 international safety initiatives was quantified: (1) World Health Organization (WHO) "Guidelines for Safe Surgery" and (2) Department of Health (DoH) "Principles of the Productive Operating Theatre." Also, 13 additional safety skills were quantified. Data were analyzed using Mann-Whitney U tests. In all, 23 universities entered the study (71.9% response). Safety skills from WHO and DoH documents were formally taught in 4 UK medical schools (17.4%). Individual components of the documents were taught more frequently (47.6%). Half (50.9%) of the additional safety skills identified were taught. Surgical societies supplemented safety training, although the total amount of training provided was less than that in university curricula (P < .0001). Surgical safety training is inadequate in UK medical schools. To protect patients and maximize safety, a national undergraduate safety curriculum is recommended. © 2013 by the American College of Medical Quality.

The Pediatric Obesity Initiative: development, implementation, and evaluation.

PubMed

Sample, Denise A; Carroll, Heather L; Barksdale, Debra J; Jessup, Ann

2013-09-01

Pediatric obesity rates have nearly tripled over the past three decades contributing to increased morbidity and mortality in the United States and around the world. Pediatric obesity is most prevalent in developed countries and affects all races, ethnicities, cultures, and age groups. To combat this epidemic locally, a team of dedicated providers developed a comprehensive evidenced-based toolkit and training program for clinical practices providing primary care services to children in a North Carolina county. The toolkit and training program were developed using the most current treatment guidelines for pediatric obesity and included resources developed by Healthy Carolinians. One unique feature of the training was a demonstration of motivational interviewing with additional resources included in the toolkit. Staff and providers in three pediatric practices and the local Health Department received the training. In a 3 months follow-up survey after the training, the providers indicated that the toolkit and training program were useful but that they still did not consistently use the guidelines or tools. Ensuring the use of available guidelines and resources by providers remains a challenge. Further study is needed on how to improve implementation of guidelines in primary care settings. ©2013 The Author(s) ©2013 American Association of Nurse Practitioners.

The motivation to learn: efficacy and relevance of the Oswestry postgraduate orthopaedic training programme.

PubMed Central

Morgan-Jones, R. L.; Wade, R.; Richardson, J. B.

1998-01-01

The efficacy and relevance of medical education has come under increased scrutiny in recent years. The shortening of basic surgical training and the introduction of 'seamless' higher surgical training has placed greater emphasis on the quality of education provided/facilitated by trainers. Additionally, study leave budgets are under increasing pressure from trainees wishing to attend courses or conferences, and regional postgraduate deans who wish to see a proportionally greater amount of training on an 'in-house' basis. Against this background we have reviewed the learning opportunities available on the Oswestry postgraduate programme to see if these opportunities provide adequate motivation to learn for the trainee. PMID:9771229

U.S. Southern Command Government Purchase Card Controls Need Improvement to Prevent Improper Purchases

DTIC Science & Technology

2014-12-19

track or maintain training records for ensuring A/BOs and cardholders received the initial and refresher trainings needed to properly use a GPC...required refresher training is completed. A/OPCs are also required to provide additional training on simplified acquisitions procedures to...Crystal Prestige, rectangle 8-3/4-inch 1 39.38 39.38 36 Crystal Service, Buffet 3186 1 40.00 40.00 37 Crystal Tray, Bread 2 25.00 50.00 38

Experimental field test of proposed anti-dart-out training programs. Volume 3, Program staff training materials and videotape/film

DOT National Transportation Integrated Search

1981-12-01

This report (Volume 3 of three volumes) provides detailed descriptions of additional program materials suggested for use with the recommended version of a child pedestrian safety program. Volume 1 of this report describes the conduct and results of t...

Fostering Critical Thinking through Interdisciplinary Cooperation: Integrating Secondary Level Physics into a Weight Training Unit.

ERIC Educational Resources Information Center

Downing, John H.; Lander, Jeffrey E.

1997-01-01

Integrating physical training with physics concepts gives teachers increased opportunities for exploration, problem solving, and concept application, while providing an additional medium for cooperative learning and mutual understanding of each others' goals and objectives. An interdisciplinary model requires alternative planning and preparation…

Counselor Training Manual for Resident Environmental Education Camp.

ERIC Educational Resources Information Center

Fortman, Kathleen J.

Designed for use with junior and senior high school students, this manual outlines procedures for recruiting and training counselors to work with upper elementary students in a resident outdoor education setting. Counselors can provide the additional leadership necessary when caring for large groups of students 24 hours a day. However, their…

Beyond Borders: Zoo as Training Location for Wildlife Biologists

ERIC Educational Resources Information Center

Melber, Leah M.; Bergren, Rachel; Santymire, Rachel

2011-01-01

The role of institutions such as zoos in global conservation efforts is critical. In addition to serving as informal learning centers for the general public, these institutions are well-positioned to provide training and professional development for the next generation of conservation scientists. And while many organizations traditionally have…

StairStepper: An Adaptive Remedial iSTART Module

ERIC Educational Resources Information Center

Perret, Cecile A.; Johnson, Amy M.; McCarthy, Kathryn S.; Guerrero, Tricia A.; Dai, Jianmin; McNamara, Danielle S.

2017-01-01

This paper introduces StairStepper, a new addition to Interactive Strategy Training for Active Reading and Thinking (iSTART), an intelligent tutoring system (ITS) that provides adaptive self-explanation training and practice. Whereas iSTART focuses on improving comprehension at levels geared toward answering challenging questions associated with…

The impact of emergency obstetric care training in Somaliland, Somalia.

PubMed

Ameh, Charles; Adegoke, Adetoro; Hofman, Jan; Ismail, Fouzia M; Ahmed, Fatuma M; van den Broek, Nynke

2012-06-01

To provide and evaluate in-service training in "Life Saving Skills - Emergency Obstetric and Newborn Care" in order to improve the availability of emergency obstetric care (EmOC) in Somaliland. In total, 222 healthcare providers (HCPs) were trained between January 2007 and December 2009. A before-after study was conducted using quantitative and qualitative methods to evaluate trainee reaction and change in knowledge, skills, and behavior, in addition to functionality of healthcare facilities, during and immediately after training, and at 3 and 6 months post-training. The HCPs reacted positively to the training, with a significant improvement in 50% of knowledge and 100% of skills modules assessed. The HCPs reported improved confidence in providing EmOC. Basic and comprehensive EmOC healthcare facilities provided 100% of expected signal functions-compared with 43% and 56%, respectively, at baseline-with trained midwives performing skills usually performed by medical doctors. Lack of drugs, supplies, medical equipment, and supportive policy were identified as barriers that could contribute to nonuse of new skills and knowledge acquired. The training impacted positively on the availability and quality of EmOC and resulted in "up-skilling" of midwives. Copyright © 2012 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

Cervical stability training with and without core stability training for patients with cervical disc herniation: A randomized, single-blind study.

PubMed

Buyukturan, B; Guclu-Gunduz, A; Buyukturan, O; Dadali, Y; Bilgin, S; Kurt, E E

2017-11-01

This study aims at evaluating and comparing the effects of cervical stability training to combined cervical and core stability training in patients with neck pain and cervical disc herniation. Fifty patients with neck pain and cervical disc herniation were included in the study, randomly divided into two groups as cervical stability and cervical-core stability. Training was applied three times a week in three phases, and lasted for a total duration of 8 weeks. Pain, activation and static endurance of deep cervical flexor muscles, static endurance of neck muscles, cross-sectional diameter of M. Longus Colli, static endurance of trunk muscles, disability and kinesiophobia were assessed. Pain, activation and static endurance of deep cervical flexors, static endurance of neck muscles, cross-sectional diameter of M. Longus Colli, static endurance of trunk muscles, disability and kinesiophobia improved in both groups following the training sessions (p < 0.05). Comparison of the effectiveness of these two training methods revealed that the cervical stability group produced a greater increase in the right transverse diameter of M. Longus Colli (p < 0.05). However, static endurance of trunk muscles and kinesiophobia displayed better improvement in the cervical-core stability group (p < 0.05). Cervical stability training provided benefit to patients with cervical disc herniation. The addition of core stability training did not provide any additional significant benefit. Further research is required to investigate the efficacy of combining other techniques with cervical stability training in patients with cervical disc herniation. Both cervical stability training and its combination with core stability training were significantly and similarly effective on neck pain and neck muscle endurance in patients with cervical disc herniation. © 2017 European Pain Federation - EFIC®.

Associations between state regulations, training length, perceived quality and job satisfaction among certified nursing assistants: cross-sectional secondary data analysis.

PubMed

Han, Kihye; Trinkoff, Alison M; Storr, Carla L; Lerner, Nancy; Johantgen, Meg; Gartrell, Kyungsook

2014-08-01

In the U.S., there are federal requirements on how much training and annual continuing education a certified nursing assistant must complete in order to be certified. The requirements are designed to enable them to provide competent and quality care to nursing home residents. Many states also require additional training and continuing education hours as improved nursing home quality indicators have been found to be related to increased training. This study investigated the associations among state level regulations, initial training quality and focus, and job satisfaction in certified nursing assistants. Cross-sectional secondary data analysis. This study used the National Nursing Home Survey and National Nursing Assistant Survey as well as data on state regulations of certified nursing assistant training. 2897 certified nursing assistants in 580 nursing homes who were currently working at a nursing home facility, who represented 680,846 certified nursing assistants in US. State regulations were related to initial training and job satisfaction among certified nursing assistants using chi square tests and binomial logistic regression models. Analyses were conducted using SAS-callable SUDAAN to correct for complex sampling design effects in the National Nursing Home Survey and National Nursing Assistant Survey. Models were adjusted for personal and facility characteristics. Certified nursing assistants reporting high quality training were more likely to work in states requiring additional initial training hours (p=0.02) and were more satisfied with their jobs (OR=1.51, 95% CI=1.09-2.09) than those with low quality training. In addition, those with more training focused on work life skills were 91% more satisfied (OR=1.91, 95% CI=1.41-2.58) whereas no relationship was found between training focused on basic care skills and job satisfaction (OR=1.36, 95% CI=0.99-1.84). Certified nursing assistants with additional initial training were more likely to report that their training was of high quality, and this was related to job satisfaction. Job satisfaction was also associated with receiving more training that focused on work life skills. Federal training regulations should reconsider additional hours for certified nursing assistant initial training, and include work life skills as a focus. As job satisfaction has been linked to nursing home turnover, attention to training may improve satisfaction, ultimately reducing staff turnover. Copyright © 2014 Elsevier Ltd. All rights reserved.

Does Teaching Problem-Solving Skills Matter? An Evaluation of Problem-Solving Skills Training for the Treatment of Social and Behavioral Problems in Children

ERIC Educational Resources Information Center

Bushman, Bryan B.; Peacock, Gretchen Gimpel

2010-01-01

Problem-solving skills training (PSST) has been proposed as a potentially effective addition to behavioral parent training (PT). However, it is not clear whether PSST specifically increases the benefits provided by PT. In this study, PT + PSST was compared to PT + nondirective therapy in a sample of 26 families. All parents received PT. Following…

An Open Architecture for Defense Virtual Environment Training Systems

DTIC Science & Technology

2003-09-01

Additionally, in the process, preventing the loss of life is also an important result. VRTEs can provide needed training that might otherwise not be...training is directly valuable in mission accomplishment and in preventing loss of life. "One of the biggest problems in both the military and...simplified; unique bones motion offers lifelike bouncing and twisting. 43 o Complete skeletal and muscle control features. o Inverse Kinematics

The Relationship of Repeated Technical Assistance Support Visits to the Delivery of Positive Health, Dignity, and Prevention (PHDP) Messages by Healthcare Providers in Mozambique: A Longitudinal Multilevel Analysis.

PubMed

Gutin, Sarah A; Amico, K Rivet; Hunguana, Elsa; Munguambe, António Orlando; Rose, Carol Dawson

Positive health, dignity, and prevention (PHDP) is Mozambique's strategy to engage clinicians in the delivery of prevention messages to their HIV-positive clients. This national implementation strategy uses provider trainings on offering key messages and focuses on intervening on 9 evidence-based risk reduction areas. We investigated the impact of longitudinal technical assistance (TA) as an addition to this basic training. We followed 153 healthcare providers in 5 Mozambican provinces over 6 months to evaluate the impact of on-site, observation-based TA on PHDP implementation. Longitudinal multilevel models were estimated to model change in PHDP message delivery over time among individual providers. With each additional TA visit, providers delivered about 1 additional PHDP message ( P < .001); clinicians and nonclinicians started at about the same baseline level, but clinicians improved more quickly ( P = .004). Message delivery varied by practice sector; maternal and child health sectors outperformed other sectors. Longitudinal TA helped reach the programmatic goals of the PHDP program in Mozambique.

Ubiquitous Connected Train Based on Train-to-Ground and Intra-Wagon Communications Capable of Providing on Trip Customized Digital Services for Passengers

PubMed Central

Salaberria, Itziar; Perallos, Asier; Azpilicueta, Leire; Falcone, Francisco; Carballedo, Roberto; Angulo, Ignacio; Elejoste, Pilar; Bahillo, Alfonso; Astrain, José Javier; Villadangos, Jesús

2014-01-01

During the last years, the application of different wireless technologies has been explored in order to enable Internet connectivity from vehicles. In addition, the widespread adoption of smartphones by citizens represents a great opportunity to integrate such nomadic devices inside vehicles in order to provide new and personalized on trip services for passengers. In this paper, a proposal of communication architecture to provide the ubiquitous connectivity needed to enhance the smart train concept is presented and preliminarily tested. It combines an intra-wagon communication system based on nomadic devices connected through a Bluetooth Piconet Network with a highly innovative train-to-ground communication system. In order to validate this communication solution, several tests and simulations have been performed and their results are described in this paper. PMID:24803192

Training in patient navigation: A review of the research literature

PubMed Central

Ustjanauskas, Amy E.; Bredice, Marissa; Nuhaily, Sumayah; Kath, Lisa; Wells, Kristen J.

2016-01-01

Despite the proliferation of patient navigation programs designed to increase timely receipt of health care, little is known about the content and delivery of patient navigation training, or best practices in this arena. The current study begins to address these gaps in understanding, as it is the first study to comprehensively review descriptions of patient navigation training in the peer-reviewed research literature. Seventy-five patient navigation efficacy studies published since 1995, identified through PubMed and by the authors, were included in this narrative review. Fifty-nine of the included studies (79%) mentioned patient navigation training, and fifty-five of these studies additionally provided a description of training. Most studies did not thoroughly document patient navigation training practices. Additionally, several topics integral to the role of patient navigators, as well as components of training central to successful adult learning, were not commonly described in the research literature. Descriptions of training also varied widely across studies in terms of duration, location, format, learning strategies employed, occupation of trainer, and content. These findings demonstrate the need for established standards of navigator training as well as future research on the optimal delivery and content of patient navigation training. PMID:26656600

Training in Patient Navigation: A Review of the Research Literature.

PubMed

Ustjanauskas, Amy E; Bredice, Marissa; Nuhaily, Sumayah; Kath, Lisa; Wells, Kristen J

2016-05-01

Despite the proliferation of patient navigation programs designed to increase timely receipt of health care, little is known about the content and delivery of patient navigation training, or best practices in this arena. The current study begins to address these gaps in understanding, as it is the first study to comprehensively review descriptions of patient navigation training in the peer-reviewed research literature. Seventy-five patient navigation efficacy studies published since 1995, identified through PubMed and by the authors, were included in this narrative review. Fifty-nine of the included studies (79%) mentioned patient navigation training, and 55 of these studies additionally provided a description of training. Most studies did not thoroughly document patient navigation training practices. Additionally, several topics integral to the role of patient navigators, as well as components of training central to successful adult learning, were not commonly described in the research literature. Descriptions of training also varied widely across studies in terms of duration, location, format, learning strategies employed, occupation of trainer, and content. These findings demonstrate the need for established standards of navigator training as well as for future research on the optimal delivery and content of patient navigation training. © 2015 Society for Public Health Education.

Evidence-based training and mentorship combined with enhanced outcomes surveillance to address the leading causes of neonatal mortality at the district hospital level in Ghana.

PubMed

Brantuo, Mary N A; Cristofalo, Elizabeth; Meheš, Mira M; Ameh, Juliana; Brako, Nana Okai; Boahene, Frederick; Adjei, Stella B; Opoku, Ernest; Banda, Harriet; Wang, Yu T; Forgor, Abdulai A; Punguire, Damien; Brightson, Kennedy; Sottie, Cynthia; Owusu-Agyei, Seth; Williams, John E; Sulemana, Abubakari; Oduro, Abraham R; Gyampong, Margaret; Sarpong, Doris; Andrews, Edith; Gyansa-Lutterodt, Martha; Hodgson, Abraham; Bannerman, Cynthia; Abdullah, Fizan

2014-04-01

To evaluate the impact of a district hospital intervention focused on enhancing healthcare provider capacity to address leading causes of neonatal death: birth asphyxia, infection and prematurity. The neonatal quality improvement initiative was launched at two intervention referral district hospitals in Ghana. Local Health and Demographic Surveillance Systems were enlisted to enhance recording of neonatal and infant deaths in the community and at the facility. After baseline site assessments, a team of local paediatric experts conducted three clinical trainings on-site at each intervention hospital. Assessments were conducted to evaluate participant knowledge before and after participation in training modules. Monthly mentorship visits provided additional training to support the adoption of essential early neonatal care practices. In the first year of implementation, the initiative provided focused clinical training to 278 participants. A comparison of pre- and post-training test results demonstrates significant improvement in provider knowledge (73% vs. 89% correct, P < 0.001), with even greater improvement among trainees receiving recurrent refresher training (86% vs. 94% correct, P < 0.001). Participant feedback following training revealed enthusiasm about the programme and improved confidence. Locally led initiatives that invest directly in healthcare provider education and health systems strengthening represent a promising avenue for reducing neonatal morbidity and mortality. The NQI initiative demonstrates the positive impact of a district hospital intervention that combines on-site training, mentorship and enhanced demographic surveillance. © 2014 John Wiley & Sons Ltd.

Detection of prostate cancer on multiparametric MRI

NASA Astrophysics Data System (ADS)

Seah, Jarrel C. Y.; Tang, Jennifer S. N.; Kitchen, Andy

2017-03-01

In this manuscript, we describe our approach and methods to the ProstateX challenge, which achieved an overall AUC of 0.84 and the runner-up position. We train a deep convolutional neural network to classify lesions marked on multiparametric MRI of the prostate as clinically significant or not. We implement a novel addition to the standard convolutional architecture described as auto-windowing which is clinically inspired and designed to overcome some of the difficulties faced in MRI interpretation, where high dynamic ranges and low contrast edges may cause difficulty for traditional convolutional neural networks trained on high contrast natural imagery. We demonstrate that this system can be trained end to end and outperforms a similar architecture without such additions. Although a relatively small training set was provided, we use extensive data augmentation to prevent overfitting and transfer learning to improve convergence speed, showing that deep convolutional neural networks can be feasibly trained on small datasets.

2010 Canadian Cardiovascular Society/Canadian Society of Echocardiography Guidelines for Training and Maintenance of Competency in Adult Echocardiography.

PubMed

Burwash, Ian G; Basmadjian, Arsene; Bewick, David; Choy, Jonathan B; Cujec, Bibiana; Jassal, Davinder S; MacKenzie, Scott; Nair, Parvathy; Rudski, Lawrence G; Yu, Eric; Tam, James W

2011-01-01

Guidelines for the provision of echocardiography in Canada were jointly developed and published by the Canadian Cardiovascular Society and the Canadian Society of Echocardiography in 2005. Since their publication, recognition of the importance of echocardiography to patient care has increased, along with the use of focused, point-of-care echocardiography by physicians of diverse clinical backgrounds and variable training. New guidelines for physician training and maintenance of competence in adult echocardiography were required to ensure that physicians providing either focused, point-of-care echocardiography or comprehensive echocardiography are appropriately trained and proficient in their use of echocardiography. In addition, revision of the guidelines was required to address technological advances and the desire to standardize echocardiography training across the country to facilitate the national recognition of a physician's expertise in echocardiography. This paper summarizes the new Guidelines for Physician Training and Maintenance of Competency in Adult Echocardiography, which are considerably more comprehensive than earlier guidelines and address many important issues not previously covered. These guidelines provide a blueprint for physician training despite different clinical backgrounds and help standardize physician training and training programs across the country. Adherence to the guidelines will ensure that physicians providing echocardiography have acquired sufficient expertise required for their specific practice. The document will also provide a framework for other national societies to standardize their training programs in echocardiography and will provide a benchmark by which competency in adult echocardiography may be measured. Copyright © 2011 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.

Resilience training with soldiers during basic combat training: randomisation by platoon.

PubMed

Adler, Amy B; Williams, Jason; McGurk, Dennis; Moss, Andrew; Bliese, Paul D

2015-03-01

Resilience Training has the potential to mitigate mental health symptoms when provided during initial military training. The present study examined the impact of Resilience Training on US soldier well-being and attitudes during Basic Combat Training. Platoons were randomly assigned to Resilience Training or Military History provided during the first few days of Basic Combat Training. Surveys were conducted at baseline, post-intervention, and 3, 6, and 9 weeks. The sample resulted in a total of 1,939 soldiers who completed at least the baseline and one follow-up survey. There were no significant differences between conditions in terms of depression symptoms, anxiety symptoms, or sleep problems. However, while anxiety decreased in both conditions, the rate of decrease was faster in the Resilience Training condition. In contrast, Resilience Training had a slower rate of increase in group cohesion over time than the Military History condition. In addition, Resilience Training was associated with greater confidence in helping others and received more positive ratings than Military History. Findings demonstrate that the brief Resilience Training studied here may have some utility in supporting mental health and peer support but may not benefit unit climate. © 2014 The International Association of Applied Psychology.

Fulfilling the Mission of Academic Medicine: Training Residents in the Health Needs of Prisoners

PubMed Central

Wakeman, Sarah E.

2010-01-01

The single mission of academic medicine is the pursuit of health for all. This mandate serves as a reminder to focus care on vulnerable and underserved populations. The 12 million Americans who cycle through correctional facilities each year are arguably among the most vulnerable populations in this country; predominantly black, with a high burden of disease and many barriers to care after release. Medical training programs should provide exposure to the health needs of prisoners. Residents could establish care with inmates prior to release and arrange follow-up in the community. This addition to training would not only provide care to this underserved group, but also would train residents in the myriad problems prisoners face, and foster social responsibility. PMID:20352517

Emergent Supervisors: Comparing Counseling Center and Non-Counseling-Center Interns' Supervisory Training Experiences

ERIC Educational Resources Information Center

Crook-Lyon, Rachel E.; Presnell, Jennifer; Silva, Lynda; Suyama, Mich; Stickney, Janine

2011-01-01

Focusing on supervision training is important for a variety of reasons. Many professionals, for example, stress both the positive and negative impact supervisors have on the development of counselor trainees. In addition, counselors are likely to provide supervision during their professional career. Furthermore, the role of supervisor is often…

The Effects of a Fluency Training Package on Paraprofessionals' Presentation of a Reading Intervention

ERIC Educational Resources Information Center

O'Keeffe, Breda V.; Slocum, Timothy A.; Magnusson, Renee

2013-01-01

Paraprofessionals are widely employed in response to intervention (RTI) settings to provide instruction to students at-risk for reading disabilities. However, little research has addressed effective and efficient ways to train these paraprofessionals to deliver instruction with high fidelity. In addition, given the limited time and finances…

Using Motivational Interviewing to Meet Core Competencies in Psychiatric Resident Training

ERIC Educational Resources Information Center

Kaplan, Sebastian; Elliott, Harold

2011-01-01

Objective: The authors propose that motivational interviewing (MI), a brief intervention designed to manage ambivalence regarding complex behavior change, is well suited for integration into psychiatric residency training programs. Methods: The authors provide a brief description of MI. In addition, based on a review of the literature the authors…

Relative Cost and Training Effectiveness of the 6883 Three-Dimensional Simulator and Actual Equipment.

DTIC Science & Technology

1980-09-01

evaluated. The objectis e of this study was to isolate classroom and field performance differences as a function of the training equipnment used and to...THIS PAtICmmUn bat. Saelrwo Item 20 (Continued): ausperviser followup questionnaires were administered in the field to provide additional feedback about...competent maintenance technicians to the field . As a train- ing device, actual equipment does not readily permit the controlled presentation of

NGSI student activities in open source information analysis in support of the training program of the U.S. DOE laboratories for the entry into force of the additional protocol

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

Sandoval, M Analisa; Uribe, Eva C; Sandoval, Marisa N

2009-01-01

In 2008 a joint team from Los Alamos National Laboratory (LANL) and Brookhaven National Laboratory (BNL) consisting of specialists in training of IAEA inspectors in the use of complementary access activities formulated a training program to prepare the U.S. Doe laboratories for the entry into force of the Additional Protocol. As a major part of the support of the activity, LANL summer interns provided open source information analysis to the LANL-BNL mock inspection team. They were a part of the Next Generation Safeguards Initiative's (NGSI) summer intern program aimed at producing the next generation of safeguards specialists. This paper describesmore » how they used open source information to 'backstop' the LANL-BNL team's effort to construct meaningful Additional Protocol Complementary Access training scenarios for each of the three DOE laboratories, Lawrence Livermore National Laboratory, Idaho National Laboratory, and Oak Ridge National Laboratory.« less

Comparison of the effects of an eight-week push-up program using stable versus unstable surfaces.

PubMed

Chulvi-Medrano, Iván; Martínez-Ballester, Esteban; Masiá-Tortosa, Laura

2012-12-01

Recently, the trend among physical training and rehabilitation professionals is the use of resistance exercise on unstable equipment in order to increase the effort of the agonist and stabilizing muscles. It is unknown if performing exercises on unstable surfaces provides a greater training stimulus as compared to training on a stable training surface. Therefore, the purpose of this research was to compare the effect that push-up training on stable and unstable surfaces had on strength performance in healthy young men. Thirty subjects with experience in resistance training participated in push-up training two days per week for eight weeks on one of three different surfaces: the floor (Tp), the T-Bow® (TBp) or the BOSU® (Bp). Strength, as measured by one repetition maximum (1-RM) and muscle endurance, as measured by number of pushups performed did not improve significantly (p>0.05) for any of the intervention groups. The addition of unstable surfaces in push-up training does not provide greater improvement in muscular strength and endurance than push up training performed on a stable surface in young men. 3b.

Impact of an Interprofessional Primary Care Training on Fear of Cancer Recurrence on Clinicians' Knowledge, Self-Efficacy, Anticipated Practice Behaviors, and Attitudes Toward Survivorship Care.

PubMed

Berrett-Abebe, Julie; Cadet, Tamara; Nekhlyudov, Larissa; Vitello, Joan; Maramaldi, Peter

2018-02-10

There are an estimated 15.5 million cancer survivors in the United States, with numbers projected to increase. Many cancer survivors are receiving survivorship care in primary care settings, yet primary care providers report a need for additional training on addressing medical and psychosocial concerns of cancer survivors. This paper presents findings from a pilot study on the effectiveness of a novel training for interprofessional primary care providers on the clinically significant issue of fear of cancer recurrence. The on-site training was provided to a total of 46 participants, including physicians (61%), physician assistants (11%), nurse practitioners (7%), nurses (17%), and social workers (4%) in six different primary care practices. The average number of years of professional experience was 18.8, with standard deviation of 10.9. Results of paired-sample t tests indicated that the training increased knowledge and self-efficacy of providers in identifying and addressing FCR. The training was well-received by participants, who had high confidence in implementing practice behavior changes, although they also identified barriers. Results suggest the feasibility of a brief training for continuing education and have implications for models of care delivery in cancer survivorship.

Advanced training systems

NASA Technical Reports Server (NTRS)

Savely, Robert T.; Loftin, R. Bowen

1990-01-01

Training is a major endeavor in all modern societies. Common training methods include training manuals, formal classes, procedural computer programs, simulations, and on-the-job training. NASA's training approach has focussed primarily on on-the-job training in a simulation environment for both crew and ground based personnel. NASA must explore new approaches to training for the 1990's and beyond. Specific autonomous training systems are described which are based on artificial intelligence technology for use by NASA astronauts, flight controllers, and ground based support personnel that show an alternative to current training systems. In addition to these specific systems, the evolution of a general architecture for autonomous intelligent training systems that integrates many of the features of traditional training programs with artificial intelligence techniques is presented. These Intelligent Computer Aided Training (ICAT) systems would provide much of the same experience that could be gained from the best on-the-job training.

Policy approach to nutrition and physical activity education in health care professional training1234

PubMed Central

Loy, Lisel; Zatz, Laura Y

2014-01-01

Nutrition and physical activity are key risk factors for a host of today's most prevalent and costly chronic conditions, such as obesity and diabetes; yet, health care providers are not adequately trained to educate patients on the components of a healthy lifestyle. The purpose of this article is to underscore the need for improved nutrition and physical activity training among health care professionals and to explore opportunities for how policy can help support a shift in training. We first identify key barriers to sufficient training in nutrition and physical activity. Then, we provide an overview of how recent changes in the government and institutional policy environment are supporting a shift toward prevention in our health care system and creating an even greater need for improved training of health care professionals in nutrition and physical activity. Last, we outline recommendations for additional policy changes that could drive enhanced training for health care professionals and recommend future directions in research. PMID:24646822

Radiologists' Training, Experience, and Attitudes About Elder Abuse Detection.

PubMed

Rosen, Tony; Bloemen, Elizabeth M; Harpe, Jasmin; Sanchez, Allen M; Mennitt, Kevin W; McCarthy, Thomas J; Nicola, Refky; Murphy, Kieran; LoFaso, Veronica M; Flomenbaum, Neal; Lachs, Mark S

2016-12-01

Elder abuse is underrecognized, and identification of subtle cases requires a high index of suspicion among all health care providers. Because many geriatric injury victims undergo radiographic imaging, diagnostic radiologists may be well positioned to identify injury patterns suggestive of abuse. Little is known about radiologists' experience with elder abuse. Our goal was to describe knowledge, attitudes, training, and practice experience in elder abuse detection among diagnostic radiologists. We conducted 19 interviews with diagnostic radiologists at a large urban academic medical center using a semistructured format. Data from these sessions were coded and analyzed to identify themes. Only two radiologists reported any formal or informal training in elder abuse detection. All subjects believed they had missed cases of elder abuse. Even experienced radiologists reported never having received a request from a referring physician to assess images for evidence suggestive of elder abuse. All subjects reported a desire for additional elder abuse training. Also, subjects identified radiographic findings or patterns potentially suggestive of elder abuse, including high-energy injuries such as upper rib fractures, injuries in multiple stages of healing, and injuries inconsistent with reported mechanism. Radiologists are uniquely positioned to identify elder abuse. Though training in detection is currently lacking, providers expressed a desire for increased knowledge. In addition, radiologists were able to identify radiographic findings suggestive of elder abuse. On the basis of these findings, we plan to conduct additional studies to define pathognomonic injury patterns and to explore how to empower radiologists to incorporate detection into their practice.

An interdisciplinary learning experience in neuro-optics.

PubMed

Anselmi, Francesca; Bertherat, Julien; Estebanez, Luc; van 't Hoff, Marcel; Zylbersztejn, Kathleen

2012-01-01

How can a Ph.D. student initially trained as a biologist take part in the development of a multineuronal recording method that requires cross interaction between physics, neurobiology and mathematics? Beyond student training in the laboratory, interdisciplinary research calls for a new style of academic training of young researchers. Here we present an innovative approach to graduate student academic training that fills the need for multidisciplinary knowledge and provides students, in addition, with a deeper understanding of the interdisciplinary approach to scientific research. Copyright © 2012 Elsevier Ltd. All rights reserved.

Public health financial management needs: report of a national survey.

PubMed

Costich, Julia F; Honoré, Peggy A; Scutchfield, F Douglas

2009-01-01

The work reported here builds on the identification of public health financial management practice competencies by a national expert panel. The next logical step was to provide a validity check for the competencies and identify priority areas for educational programming. We developed a survey for local public health finance officers based on the public health finance competencies and field tested it with a convenience sample of officials. We asked respondents to indicate the importance of each competency area and the need for training to improve performance; we also requested information regarding respondent education, jurisdiction size, and additional comments. Our local agency survey sample drew on the respondent list from the National Association of County and City Health Officials 2005 local health department survey, stratified by agency size and limited to jurisdiction populations of 25,000 to 1,000,000. Identifying appropriate respondents was a major challenge. The survey was fielded electronically, yielding 112 responses from 30 states. The areas identified as most important and needing most additional training were knowledge of budget activities, financial data interpretation and communication, and ability to assess and correct the organization's financial status. The majority of respondents had some postbaccalaureate education. Many provided additional comments and recommendations. Health department finance officers demonstrated a high level of general agreement regarding the importance of finance competencies in public health and the need for training. The findings point to a critical need for additional training opportunities that are accessible, cost-effective, and targeted to individual needs.

International Space Station Aeromedical Support in Star City, Russia

NASA Technical Reports Server (NTRS)

Cole, Richard; Chamberlin, Blake; Dowell, Gene; Castleberry, Tarah; Savage, Scott

2010-01-01

The Space Medicine Division at Johnson Space Center works with the International Space Station s international partners (IP) to accomplish assigned health care tasks. Each IP may assign a flight surgeon to support their assigned crewmembers during all phases of training, in-flight operations, and postflight activities. Because of the extensive amount of astronaut training conducted in Star City; NASA, in collaboration with its IPs, has elected to keep a flight surgeon assigned to NASA s Star City office to provide support to the U.S., Canadian, Japanese, and European astronauts during hazardous training activities and provide support for any contingency landings of Soyuz spacecraft in Kazakhstan. The physician also provides support as necessary to the Mission Control Center in Moscow for non-Russian crew-related activities. In addition, the physician in Star City provides ambulatory medical care to the non-Russian-assigned personnel in Star City and visiting dependents. Additional work involves all medical supplies, administration, and inventory. The Star City physician assists in medical evacuation and/or in obtaining support from western clinics in Moscow when required care exceeds local resources. Overall, the Russians are responsible for operations and the medical care of the entire crew when training in Star City and during launch/landing operations. However, they allow international partner flight surgeons to care for their crewmembers as agreed to in the ISS Medical Operations Requirements Document. Medical support focuses on pressurized, monitored, and other hazardous training activities. One of the most important jobs is to act as a medical advocate for the astronauts and to reduce the threat that these hazardous activities pose. Although the Russians have a robust medical system, evacuation may be needed to facilitate ongoing medical care. There are several international medical evacuation companies that provide this care.

Model Guided Design and Development Process for an Electronic Health Record Training Program

PubMed Central

He, Ze; Marquard, Jenna; Henneman, Elizabeth

2016-01-01

Effective user training is important to ensure electronic health record (EHR) implementation success. Though many previous studies report best practice principles and success and failure stories, current EHR training is largely empirically-based and often lacks theoretical guidance. In addition, the process of training development is underemphasized and underreported. A white paper by the American Medical Informatics Association called for models of user training for clinical information system implementation; existing instructional development models from learning theory provide a basis to meet this call. We describe in this paper our experiences and lessons learned as we adapted several instructional development models to guide our development of EHR user training. Specifically, we focus on two key aspects of this training development: training content and training process. PMID:28269940

Developing Collective Training for Small Unmanned Aerial Systems Employment

NASA Technical Reports Server (NTRS)

Durlach, Paula J.; Priest, Heather; Martin, Glenn A.; Saffold, Jay

2010-01-01

The projected use of small unmanned aerial systems (SUAS) in military operations will produce training requirements which go beyond current capabilities. The paper describes the development of prototype training procedures and accompanying research simulations to address this need. We initially constructed a testbed to develop simulation-based training for an SUAS operator equipped with a simulated vertical-lift and land SUAS. However, the required training will go beyond merely training an operator how to pilot an SUAS. In addition to tactics, techniques, and procedures for employment of SUASs, collective training methods must be trained. Moreover, the leader of a unit equipped with SUAS will need to learn how to plan missions which incorporate the SUAS, and take into account air space and frequency management considerations. The demands of the task require the leader to allocate personnel to the SUAS mission, communicate and coordinate with those personnel during the mission, and make use of the information provided. To help address these training issues, we expanded our research testbed to include a command and control node (C2 node), to enable communications between a leader and the SUAS operator. In addition, we added a virtual environment in which dismounted infantry missions can be conducted. This virtual environment provides the opportunity for interactions among human-controlled avatars and non-player characters (NPCs), plus authoring tools to construct scenarios. Using these NPCs, a collective exercise involving friendly, enemy, and civilian personnel can be conducted without the need for a human role-player for every entity. We will describe the results of our first experiment, which examined the ability of players to negotiate use of the C2 node and the virtual environment at the same time, in order to see if this is a feasible combination of tools for training development.

Increasing Use of Postpartum Family Planning and the Postpartum IUD: Early Experiences in West and Central Africa.

PubMed

Pleah, Tsigue; Hyjazi, Yolande; Austin, Suzanne; Diallo, Abdoulaye; Dao, Blami; Waxman, Rachel; Karna, Priya

2016-08-11

A global resurgence of interest in the intrauterine device (IUD) as an effective long-acting reversible contraceptive and in improving access to a wide range of contraceptive methods, as well as an emphasis on encouraging women to give birth in health care facilities, has led programs to introduce postpartum IUD (PPIUD) services into postpartum family planning (PPFP) programs. We describe strategic, organizational, and technical elements that contributed to early successes of a regional initiative in West and Central Africa to train antenatal, maternity, and postnatal care providers in PPFP counseling for the full range of available methods and in PPIUD service delivery. In November 2013, the initiative provided competency-based training in Guinea for providers from the main public teaching hospital in 5 selected countries (Benin, Chad, Côte d'Ivoire, Niger, and Senegal) with no prior PPFP counseling or PPIUD capacity. The training was followed by a transfer-of-learning visit and monitoring to support the trained providers. One additional country, Togo, replicated the initiative's model in 2014. Although nascent, this initiative has introduced high-quality PPFP and PPIUD services to the region, where less than 1% of married women of reproductive age use the IUD. In total, 21 providers were trained in PPFP counseling, 18 of whom were also trained in PPIUD insertion. From 2014 to 2015, more than 15,000 women were counseled about PPFP, and 2,269 women chose and received the PPIUD in Benin, Côte d'Ivoire, Niger, Senegal, and Togo. (Introduction of PPIUD services in Chad has been delayed.) South-South collaboration has been central to the initiative's accomplishments: Guinea's clinical centers of excellence and qualified trainers provided a culturally resonant example of a PPFP/PPIUD program, and trainings are creating a network of regional trainers to facilitate expansion. Two of the selected countries (Benin and Niger) have expanded their PPFP/PPUID training programs to additional sites. Inspired after learning about the initiative at a regional meeting, Togo has outperformed the original countries involved in the initiative by training more providers than the other countries. Challenges to scale-up include a lack of formal channels for reporting PPFP and PPIUD service delivery outcomes, inconsistent coordination of services across the reproductive health continuum of care, and slow uptake in some countries. Continued success will rely on careful recordkeeping, regular monitoring and feedback, and strategic data use to advocate scale-up. © Pleah et al.

Increasing Use of Postpartum Family Planning and the Postpartum IUD: Early Experiences in West and Central Africa

PubMed Central

Pleah, Tsigue; Hyjazi, Yolande; Austin, Suzanne; Diallo, Abdoulaye; Dao, Blami; Waxman, Rachel; Karna, Priya

2016-01-01

ABSTRACT A global resurgence of interest in the intrauterine device (IUD) as an effective long-acting reversible contraceptive and in improving access to a wide range of contraceptive methods, as well as an emphasis on encouraging women to give birth in health care facilities, has led programs to introduce postpartum IUD (PPIUD) services into postpartum family planning (PPFP) programs. We describe strategic, organizational, and technical elements that contributed to early successes of a regional initiative in West and Central Africa to train antenatal, maternity, and postnatal care providers in PPFP counseling for the full range of available methods and in PPIUD service delivery. In November 2013, the initiative provided competency-based training in Guinea for providers from the main public teaching hospital in 5 selected countries (Benin, Chad, Côte d’Ivoire, Niger, and Senegal) with no prior PPFP counseling or PPIUD capacity. The training was followed by a transfer-of-learning visit and monitoring to support the trained providers. One additional country, Togo, replicated the initiative’s model in 2014. Although nascent, this initiative has introduced high-quality PPFP and PPIUD services to the region, where less than 1% of married women of reproductive age use the IUD. In total, 21 providers were trained in PPFP counseling, 18 of whom were also trained in PPIUD insertion. From 2014 to 2015, more than 15,000 women were counseled about PPFP, and 2,269 women chose and received the PPIUD in Benin, Côte d’Ivoire, Niger, Senegal, and Togo. (Introduction of PPIUD services in Chad has been delayed.) South–South collaboration has been central to the initiative’s accomplishments: Guinea’s clinical centers of excellence and qualified trainers provided a culturally resonant example of a PPFP/PPIUD program, and trainings are creating a network of regional trainers to facilitate expansion. Two of the selected countries (Benin and Niger) have expanded their PPFP/PPUID training programs to additional sites. Inspired after learning about the initiative at a regional meeting, Togo has outperformed the original countries involved in the initiative by training more providers than the other countries. Challenges to scale-up include a lack of formal channels for reporting PPFP and PPIUD service delivery outcomes, inconsistent coordination of services across the reproductive health continuum of care, and slow uptake in some countries. Continued success will rely on careful recordkeeping, regular monitoring and feedback, and strategic data use to advocate scale-up. PMID:27540120

Tablet Computing in Clinical Training of Pediatric Residents.

PubMed

Howard, David J; Coovert, Sally A; Coovert, Michael D; Nelson, Robert M

2015-07-01

Medical residents receive both medical education and clinical skills training. New technologies and pedagogies are being developed to address each of these phases. Our research focuses on the efficacy of an iPad(®) (Apple, Cupertino, CA) for clinical skills training. For a period of 3 years, the University of South Florida provided incoming pediatric residents (n=94) with an iPad. At the end of the 3-year program, we surveyed the residents, measuring perceptions and satisfaction of iPad use in clinical training. Sixty percent of the residents responded to the survey. Ninety-three percent reported at least some iPad usage per day on clinical activities. We classified 13 facets of clinical training into three conceptual areas and provided figures detailing iPad use for each facet relative to other facets in the same cluster. The obtaining, management, and display of information are primary uses of iPad applications in clinical training. Finally, we provide information relative to perceived obstacles in clinical training, with weight of the device being the most frequently cited. The role of graduate medical education is changing with the introduction of new technologies. These technologies can differentially impact the various aspects of residency education and training. Residents reported using an iPad extensively in their clinical training. We argue that in addition to impacting traditional educational strategies, iPads can successfully facilitate aspects of clinical training in medical education.

Cost-effectiveness of training rural providers to identify and treat patients at risk for fragility fractures.

PubMed

Nelson, S D; Nelson, R E; Cannon, G W; Lawrence, P; Battistone, M J; Grotzke, M; Rosenblum, Y; LaFleur, J

2014-12-01

This is a cost-effectiveness analysis of training rural providers to identify and treat osteoporosis. Results showed a slight cost savings, increase in life years, increase in treatment rates, and decrease in fracture incidence. However, the results were sensitive to small differences in effectiveness, being cost-effective in 70 % of simulations during probabilistic sensitivity analysis. We evaluated the cost-effectiveness of training rural providers to identify and treat veterans at risk for fragility fractures relative to referring these patients to an urban medical center for specialist care. The model evaluated the impact of training on patient life years, quality-adjusted life years (QALYs), treatment rates, fracture incidence, and costs from the perspective of the Department of Veterans Affairs. We constructed a Markov microsimulation model to compare costs and outcomes of a hypothetical cohort of veterans seen by rural providers. Parameter estimates were derived from previously published studies, and we conducted one-way and probabilistic sensitivity analyses on the parameter inputs. Base-case analysis showed that training resulted in no additional costs and an extra 0.083 life years (0.054 QALYs). Our model projected that as a result of training, more patients with osteoporosis would receive treatment (81.3 vs. 12.2 %), and all patients would have a lower incidence of fractures per 1,000 patient years (hip, 1.628 vs. 1.913; clinical vertebral, 0.566 vs. 1.037) when seen by a trained provider compared to an untrained provider. Results remained consistent in one-way sensitivity analysis and in probabilistic sensitivity analyses, training rural providers was cost-effective (less than $50,000/QALY) in 70 % of the simulations. Training rural providers to identify and treat veterans at risk for fragility fractures has a potential to be cost-effective, but the results are sensitive to small differences in effectiveness. It appears that provider education alone is not enough to make a significant difference in fragility fracture rates among veterans.

Reduced Physical Fidelity Training Device Concepts for Army Maintenance Training.

DTIC Science & Technology

1978-09-01

rapidly. In addition, the task- orientet ’ nature of self-pacee training is creating a need f~r even more equipment to support this newer method of...substitution for AET devices might be considered, to specify the conceptual form for such RPF devices, and to provide proceduial guidance for the future ...describe the RPF alternatives that can be considered for future development by the Army, and to set forth a procedure for their evaluation. The

Nurse Training Act of 1975. Report Together with Additional Views and Minority Views [to Accompany H.R. 4115], Ninety-Fourth Congress, First Session, House of Representatives.

ERIC Educational Resources Information Center

Congress of the U.S., Washington, DC. House.

The report on the Nurse Training Act of 1975 focuses on the legislation to provide funds for nursing education through an amendment of title VIII of the Public Health Service Act. It proposes to continue, without change, for fiscal year 1975 the nurse training authorities of title VIII of the Act and to continue the authorities for fiscal years…

Vision Therapy News Backgrounder.

ERIC Educational Resources Information Center

American Optometric Association, St. Louis, MO.

The booklet provides an overview on vision therapy to aid writers, editors, and broadcasters help parents, teachers, older adults, and all consumers learn more about vision therapy. Following a description of vision therapy or vision training, information is provided on how and why vision therapy works. Additional sections address providers of…

23 CFR 230.111 - Implementation of special requirements for the provision of on-the-job training.

Code of Federal Regulations, 2010 CFR

2010-04-01

... to be provided training therein: (1) Availability of minorities, women, and disadvantaged for... contract. (5) Total normal work force that the average bidder could be expected to use. (6) Geographic location. (7) Type of work. (8) The need for additional journeymen in the area. (9) Recognition of the...

Student Teams' Development over Time: Tracing the Relationship between the Quality of Communication and Teams' Performance

ERIC Educational Resources Information Center

Pöysä-Tarhonen, Johanna; Elen, Jan; Tarhonen, Pasi

2016-01-01

Current discussions in higher education and alumni training acknowledge the challenges training programs face in responding to the authentic needs of the labor market. In addition to academic knowledge, higher education institutions are expected to provide general twenty-first-century skills, such as problem-solving, critical thinking,…

Education and Training in End-of-Life Care for Certified Nursing Assistants in Long-Term Care.

PubMed

Malik, Mansura; Chapman, Wendy

2017-02-01

The growth in the number of older adults in the United States requires appropriately prepared health care providers at all levels who will be able to effectively care for this population. First-line caregivers such as certified nursing assistants (CNAs) need education and training in end-of-life care so they can provide high-quality care for residents and families in the long-term-care (LTC) setting. CNAs were recruited from an LTC facility in western New York to attend an educational intervention consisting of six 45-minute sessions on various topics selected by the researchers using the curriculum from the Core Curriculum for the Hospice and Palliative Nursing Assistant. Pretests and posttests were administered to assess changes in knowledge, and a satisfaction survey was used for the CNAs to identify additional learning needs. Nineteen CNAs completed the six education and training sessions. Data analysis revealed a significant increase in knowledge for the participants. CNAs were also able to identify additional learning needs. Significant improvement in knowledge was seen after the CNAs attended the educational intervention. CNAs working in LTC facilities need education and training in end-of-life care so they can provide appropriate and effective care to residents and their families. Education and training for CNAs led to increased knowledge of end-of-life care and desire for more educational opportunities. J Contin Educ Nurs. 2017;48(2):81-85. Copyright 2017, SLACK Incorporated.

Comparison of Canadian and Swiss Surgical Training Curricula: Moving on Toward Competency-Based Surgical Education.

PubMed

Hoffmann, Henry; Oertli, Daniel; Mechera, Robert; Dell-Kuster, Salome; Rosenthal, Rachel; Reznick, Richard; MacDonald, Hugh

Quality of surgical training in the era of resident duty-hour restrictions (RDHR) is part of an ongoing debate. Most training elements are provided during surgical service. As exposure to surgical procedures is important but time-consuming, RDHR may affect quality of surgical training. Providing structured training elements may help to compensate for this shortcoming. This binational anonymous questionnaire-based study evaluates frequency, time, and structure of surgical training programs at 2 typical academic teaching hospitals with different RDHR. Departments of Surgery of University of Basel (Basel, Switzerland) and the Queen's University (Kingston, Ontario, Canada). Surgical consultants and residents of the Queen's University Hospital (Kingston, Ontario, Canada) and the University Hospital Basel (Basel, Switzerland) were eligible for this study. Questionnaire response rate was 37% (105/284). Queen's residents work 80 hours per week, receiving 7 hours of formal training (8.8% of workweek). Basel residents work 60 hours per week, including 1 hour of formal training (1.7% of working time). Queen's faculty and residents rated their program as "structured" or "rather structured" in contrast to Basel faculty and residents who rated their programs as "neutral" in structure or "unstructured." Respondents identified specific structured training elements more frequently at Queen's than in Basel. Two-thirds of residents responded that they seek out additional surgical experiences through voluntary extra work. Basel participants articulated a stronger need for improvement of current surgical training. Although Basel residents and consultants in both institutions fear negative influence of RDHR on the training program, this was not the case in Queen's residents. Providing more structured surgical training elements may be advantageous in providing optimal-quality surgical education in an era of work-hour restrictions. Copyright © 2016 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Transfer of Training from Virtual to Real Baseball Batting

PubMed Central

Gray, Rob

2017-01-01

The use of virtual environments (VE) for training perceptual-motors skills in sports continues to be a rapidly growing area. However, there is a dearth of research that has examined whether training in sports simulation transfers to the real task. In this study, the transfer of perceptual-motor skills trained in an adaptive baseball batting VE to real baseball performance was investigated. Eighty participants were assigned equally to groups undertaking adaptive hitting training in the VE, extra sessions of batting practice in the VE, extra sessions of real batting practice, and a control condition involving no additional training to the players’ regular practice. Training involved two 45 min sessions per week for 6 weeks. Performance on a batting test in the VE, in an on-field test of batting, and on a pitch recognition test was measured pre- and post-training. League batting statistics in the season following training and the highest level of competition reached in the following 5 years were also analyzed. For the majority of performance measures, the adaptive VE training group showed a significantly greater improvement from pre-post training as compared to the other groups. In addition, players in this group had superior batting statistics in league play and reached higher levels of competition. Training in a VE can be used to improve real, on-field performance especially when designers take advantage of simulation to provide training methods (e.g., adaptive training) that do not simply recreate the real training situation. PMID:29326627

The usefulness of traditional birth attendants to women living with HIV in resource-poor settings: the case of Mfuwe, Zambia.

PubMed

Muzyamba, Choolwe; Groot, Wim; Tomini, Sonila M; Pavlova, Milena

2017-01-01

Although there is increased attention on the role of trained traditional birth attendants (TBAs) in maternal care, most of the research has mainly focused on providing evidence of the relevance of trained TBAs to women in general without a specific focus on women who are HIV positive, despite them being most vulnerable. Therefore, the aim of this study is to fill this gap by assessing the relevance of trained TBAs to women living with HIV in resource-poor settings by using Zambia as a case study. Our data collection consisted of two focus group discussions, one involving HIV-positive women utilizing trained TBAs and the other with women not utilizing TBAs. Additionally, in-depth interviews were conducted with trained TBAs and health workers. Thematic analysis was used to analyze the data. In general, women living with HIV positively characterized the services of TBAs. In the face of an inefficient health system, trained TBAs were seen to be useful in providing efficient, cheap and quality care, counseling, and referral and logistical support, including treatment adherence support. In Zambia, trained TBAs and professional care are not mutually exclusive but complementary. There is no doubt that HIV-positive women need professionals to handle complications and offer antiretroviral treatment to ensure prevention of mother to child transmission (PMTCT). However, additional "soft" services offered by trained TBAs are equally important in the promotion of maternal health care among HIV-positive women. Thus, it seems there is more to gain by systematically allowing trained TBAs to work alongside professionals in a well-coordinated and complementary manner.

Vibration training: could it enhance the strength, power, or speed of athletes?

PubMed

Wilcock, Ian M; Whatman, Chris; Harris, Nigel; Keogh, Justin W L

2009-03-01

The aim of this literature review was to determine whether vibration training could produce chronic improvements in the physical performance of trained athletes. Although the main objective was to analyze any performance benefits, a brief review of possible mechanisms linked to performance enhancement is also included. Vibration causes an increase in the g-forces acting on the muscles, increasing the loading parameters of any exercise. Increased loading should aid muscle hypertrophy, and some authors have suggested that vibration may enhance neuromuscular potentiation. Considering the 6 studies on trained athletes, there does seem to be some evidence to suggest that vibration may provide a small benefit to maximal strength (1-repetition maximum) and power (countermovement jumps) of trained athletes. Speed does not seem to be enhanced by vibration training. There is a lack of evidence to support the theory that long-term vibration training increases neuromuscular potentiation in trained athletes. What mechanism(s) could be responsible for possible strength and power enhancement is unclear. Because whole-body vibration does not seem to be detrimental to performance when used in a controlled manner, it could provide an additional training stimulus for athletes. However, further research is required to determine optimum vibration training protocols and to clarify whether vibration training produces performance benefits greater than those of traditional training methods.

Options for Auditory Training for Adults with Hearing Loss.

PubMed

Olson, Anne D

2015-11-01

Hearing aid devices alone do not adequately compensate for sensory losses despite significant technological advances in digital technology. Overall use rates of amplification among adults with hearing loss remain low, and overall satisfaction and performance in noise can be improved. Although improved technology may partially address some listening problems, auditory training may be another alternative to improve speech recognition in noise and satisfaction with devices. The literature underlying auditory plasticity following placement of sensory devices suggests that additional auditory training may be needed for reorganization of the brain to occur. Furthermore, training may be required to acquire optimal performance from devices. Several auditory training programs that are readily accessible for adults with hearing loss, hearing aids, or cochlear implants are described. Programs that can be accessed via Web-based formats and smartphone technology are reviewed. A summary table is provided for easy access to programs with descriptions of features that allow hearing health care providers to assist clients in selecting the most appropriate auditory training program to fit their needs.

Practice patterns of graduates of 2- and 3-year family medicine programs: in Ontario, 1996 to 2004.

PubMed

Green, Michael; Birtwhistle, Richard; Macdonald, Ken; Kane, John; Schmelzle, Jason

2009-09-01

To compare patterns of practice between graduates of core 2-year family medicine (FM) training programs and those completing an additional postgraduate year (PGY3) of training. Retrospective cohort study using administrative data from the Ontario Health Insurance Plan. Ontario. Graduates of Ontario FM residency programs from 1996 to 2002 who provided insured services in Ontario for 1 or more fiscal years between 1996 and 2004. Proportion of physician years of service in which a minimum number of services were provided in each of the following categories: anesthesia, emergency medicine (EM), home visits, hospital visits, nursing home visits, intrapartum obstetrics, palliative care, office-only practice, and rural locations, as well as deciles for proportion of billings for emergency department work and "quasi-specialty" designations based on billing patterns. Results are stratified by type of training and years in practice. Graduates of PGY3 programs are significantly more likely to practise in a range of nonoffice settings than their counterparts who completed core 2-year FM training programs. Differences were the most marked in areas in which additional training had been undertaken, but also extended to other categories. There was no effect on the proportion practising in rural locations, unless the training was undertaken in a rural setting or in anesthesia. Physicians including EM in their practices were more likely to practise mostly or almost all EM if they had undertaken either EM programs or self-directed programs at non-northern training sites. Very few graduates of any type were classified as belonging to a quasi-specialty group, other than those who completed care of the elderly or palliative care (hospitalist) and anesthesia programs. Completion of a PGY3 program is strongly associated with increased participation in practice outside the office, particularly in the area of the training provided.

The effect of instability training on knee joint proprioception and core strength.

PubMed

Cuğ, Mutlu; Ak, Emre; Ozdemir, Recep Ali; Korkusuz, Feza; Behm, David G

2012-01-01

Although there are many studies demonstrating increased trunk activation under unstable conditions, it is not known whether this increased activation would translate into meaningful trunk strength with a prolonged training program. Additionally, while balance-training programs have been shown to improve stability, their effect on specific joint proprioception is not clear. Thus the objective of this study was to examine training adaptations associated with a 10-week instability-training program. Participants were tested pre- and post-training for trunk extension and flexion strength and knee proprioception. Forty-three participants participated in either a 10-week (3 days per week) instability-training program using Swiss balls and body weight as resistance or a control group (n = 17). The trained group increased (p < 0. 05) trunk extension peak torque/body weight (23.6%) and total work output (20.1%) from pre- to post-training while the control group decreased by 6.8% and 6.7% respectively. The exercise group increased their trunk flexion peak torque/body weight ratios by 18.1% while the control group decreased by 0.4%. Knee proprioception (combined right and left joint repositioning) improved 44.7% from pre- to post-training (p = 0.0006) and persisted (21.5%) for 9 months post-training. In addition there was a side interaction with the position sense of the right knee at 9 months showing 32.1% (p = 0.03) less deviation from the reference angle than the right knee during pre-testing. An instability-training program using Swiss balls with body weight as resistance can provide prolonged improvements in joint proprioception and core strength in previously untrained individuals performing this novel training stress which would contribute to general health. Key pointsAlthough traditional free weight resistance exercises have been recommended as most beneficial for improving strength and power in athletes (Behm et al., 2010b), an IT program using Swiss balls and body weight as a resistance may provide an alternative starting point for the sedentary untrained population.As it is well documented that force or strength is decreased when unbalanced (Behm et al., 2010b) and balance-training programs improve balance (Behm and Kean 2006), this type of instability RT program can provide significant adaptations to improve trunk strength especially with the untrained.This type of training should also be incorporated into a new program as the improvements in joint proprioception may help protect from joint injuries over a protracted period.The finding that improved joint proprioception persists for months after training should be emphasized to those individuals whose training is regularly or inconsistently interrupted.

49 CFR 172.203 - Additional description requirements.

Code of Federal Regulations, 2011 CFR

2011-10-01

..., TRAINING REQUIREMENTS, AND SECURITY PLANS Shipping Papers § 172.203 Additional description requirements. (a) Special permits. Except as provided in § 173.23 of this subchapter, each shipping paper issued in... to which the special permit applies. Each shipping paper issued in connection with a shipment made...

49 CFR 172.203 - Additional description requirements.

Code of Federal Regulations, 2012 CFR

2012-10-01

..., TRAINING REQUIREMENTS, AND SECURITY PLANS Shipping Papers § 172.203 Additional description requirements. (a) Special permits. Except as provided in § 173.23 of this subchapter, each shipping paper issued in... to which the special permit applies. Each shipping paper issued in connection with a shipment made...

49 CFR 172.203 - Additional description requirements.

Code of Federal Regulations, 2014 CFR

2014-10-01

..., TRAINING REQUIREMENTS, AND SECURITY PLANS Shipping Papers § 172.203 Additional description requirements. (a) Special permits. Except as provided in § 173.23 of this subchapter, each shipping paper issued in... to which the special permit applies. Each shipping paper issued in connection with a shipment made...

49 CFR 172.203 - Additional description requirements.

Code of Federal Regulations, 2013 CFR

2013-10-01

..., TRAINING REQUIREMENTS, AND SECURITY PLANS Shipping Papers § 172.203 Additional description requirements. (a) Special permits. Except as provided in § 173.23 of this subchapter, each shipping paper issued in... to which the special permit applies. Each shipping paper issued in connection with a shipment made...

Communication training for centre-based carers of children with severe or profound disabilities in the Western Cape, South Africa.

PubMed

Geiger, Martha

2012-01-01

The purpose of this paper is to provide a preliminary, qualitative review of an approach to training centre-based carers in supporting basic communication development and providing communication opportunities for the children with severe and profound disabilities in their care. In South Africa, these children are often the most neglected in terms of planning and providing appropriate interventions. For those with severe communication disabilities, an additional lack is in the area of the basic human right to meaningful interactions and communication. Sustainable strategies to provide opportunities for basic communication development of these children are urgently sought. Several effective international and local parent training programmes have been developed, but the urgent need remains to train centre-based carers who are taking care of groups of diversely disabled children in severely under-resourced settings . Non-profit organisations (NPOs) have been exploring practical centre-based approaches to skills sharing in physical rehabilitation, activities for daily living, feeding and support for basic communication development. As a freelance speech therapist contracted by four NPOs to implement hands-on training in basic communication for centre-based carers of non-verbal children, the author describes a training approach that evolved over three years, in collaboration with the carers and centre managements. Implications for training (for speech therapists and for community-based rehabilitation workers) and for further research are identified.

Radiologists’ Training, Experience, and Attitudes About Elder Abuse Detection

PubMed Central

Rosen, Tony; Bloemen, Elizabeth M.; Harpe, Jasmin; Sanchez, Allen M.; Mennitt, Kevin W.; McCarthy, Thomas J.; Nicola, Refky; Murphy, Kieran; LoFaso, Veronica M.; Flomenbaum, Neal; Lachs, Mark S.

2017-01-01

OBJECTIVE Elder abuse is underrecognized, and identification of subtle cases requires a high index of suspicion among all health care providers. Because many geriatric injury victims undergo radiographic imaging, diagnostic radiologists may be well positioned to identify injury patterns suggestive of abuse. Little is known about radiologists’ experience with elder abuse. Our goal was to describe knowledge, attitudes, training, and practice experience in elder abuse detection among diagnostic radiologists. SUBJECTS AND METHODS We conducted 19 interviews with diagnostic radiologists at a large urban academic medical center using a semistructured format. Data from these sessions were coded and analyzed to identify themes. RESULTS Only two radiologists reported any formal or informal training in elder abuse detection. All subjects believed they had missed cases of elder abuse. Even experienced radiologists reported never having received a request from a referring physician to assess images for evidence suggestive of elder abuse. All subjects reported a desire for additional elder abuse training. Also, subjects identified radiographic findings or patterns potentially suggestive of elder abuse, including high-energy injuries such as upper rib fractures, injuries in multiple stages of healing, and injuries inconsistent with reported mechanism. CONCLUSION Radiologists are uniquely positioned to identify elder abuse. Though training in detection is currently lacking, providers expressed a desire for increased knowledge. In addition, radiologists were able to identify radiographic findings suggestive of elder abuse. On the basis of these findings, we plan to conduct additional studies to define pathognomonic injury patterns and to explore how to empower radiologists to incorporate detection into their practice. PMID:27732066

The neuronal response to electrical constant-amplitude pulse train stimulation: additive Gaussian noise.

PubMed

Matsuoka, A J; Abbas, P J; Rubinstein, J T; Miller, C A

2000-11-01

Experimental results from humans and animals show that electrically evoked compound action potential (EAP) responses to constant-amplitude pulse train stimulation can demonstrate an alternating pattern, due to the combined effects of highly synchronized responses to electrical stimulation and refractory effects (Wilson et al., 1994). One way to improve signal representation is to reduce the level of across-fiber synchrony and hence, the level of the amplitude alternation. To accomplish this goal, we have examined EAP responses in the presence of Gaussian noise added to the pulse train stimulus. Addition of Gaussian noise at a level approximately -30 dB relative to EAP threshold to the pulse trains decreased the amount of alternation, indicating that stochastic resonance may be induced in the auditory nerve. The use of some type of conditioning stimulus such as Gaussian noise may provide a more 'normal' neural response pattern.

The Tripartite Seminars at the Russian Methodological and Training Center: An Overview of Progress in Nuclear Materials Control and Accounting in the Russian Federation

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

Pshakin, Gennady; Dickman, Deborah A.; Ryazanov, Boris

2003-09-16

The development of the Russian Methodological and Training Center (RMTC) has been an important element of collaboration between the Russian Federation (RF), the European Union and the US. The RMTC, located at the Institute of Physics and Power Engineering (IPPE) in Obninsk, Russia has been designated by the Russian Ministry of Atomic Energy (Minatom) to provide nuclear materials protection, control and Accounting training to Minatom and the Federal Nuclear and Radiation Safety Authority (Gosatomnadzor) personnel. In addition, the RMTC was chartered with the responsibility of providing a venue for exchange of experiences and information between Russian and international specialists.

The design and delivery of crew resource management training: exploiting available resources.

PubMed

Salas, E; Rhodenizer, L; Bowers, C A

2000-01-01

Despite widespread acceptance throughout commercial and military settings, crew resource management (CRM) training programs have not escaped doubts about their effectiveness. The current state of CRM training is an example of how an entire body of pertinent research and development has not had the impact on practice that it could. In this paper we outline additional resources (i.e., principles, information, findings, and guidelines) from the team training and training effectiveness research literatures that can be used to improve the design and delivery of CRM training. Some of the resources discussed include knowledge about training effectiveness, training teamwork-related skills, scenario design, and performance measurement. We conclude with a discussion of emerging resources as well as those that need to be developed. The purpose of this paper is to provide the CRM training developer with better access to resources that can be applied to the design and delivery of CRM training programs.

Food and Nutrition, In-Service Training for Extension Aides: A Problem-Centered Approach.

ERIC Educational Resources Information Center

Extension Service (USDA), Washington, DC.

This guide is intended to assist trainer agents in providing inservice training for extension aides working with low-income families whose resources are limited. Included are a list of reference materials from which additional information may be obtained as well as outlines for units of study on: (1) What Food Means To People, (2) Breads and…

Rules and tools that improved vaccines for children vaccine-ordering practices in Oregon: a 2010 pilot project.

PubMed

Hewett, Rafe; VanCuren, Anne; Trocio, Loralee; Beaudrault, Sara; Gund, Anona; Luther, Mimi; Groom, Holly

2013-01-01

This project's objective was to enhance efforts to improve vaccine-ordering efficiencies among targeted clinics using publicly purchased vaccines. Using an assessment of ordering behavior developed by the Centers for Disease Control and Prevention, we selected and trained immunization providers and assessed improvements in ordering behavior by comparing ordering patterns before and after the intervention. A total of 144 Vaccines for Children program providers in Oregon. We assessed 144 providers trained in the Economic Order Quantity process between January and November 2010. INTERVENTION (IF APPLICABLE): Providers were invited to participate in regional trainings. Trainings included assignment of ordering frequency and dissemination of tools to support adherence to the recommended ordering frequency. The percent increase in targeted clinics ordering according to recommended order frequency and the resulting decrease in orders placed, as an outcome of training and ordering tools. Only 35% of targeted providers were ordering according to the recommended ordering frequency before the project began. After completing training, utilizing ordering tools and ordering over a 7-month period, 78% of the targeted clinics were ordering according to the recommended frequency, a 120% increase in the number of clinics ordering with the recommended frequency. At baseline, targeted clinics placed 915 total vaccine orders over a 7-month period. After completing training and participating in the Economic Order Quantity process, only 645 orders were placed, a reduction of 30% . The initiative was successful in reducing the number of orders placed by Vaccines for Children providers in Oregon. A previous effort to reduce ordering, without the use of training or tools, did not achieve the same levels of provider compliance, suggesting that the addition of staff and development of tools were helpful in supporting behavior change and improving providers' ability to adhere to assigned order frequencies. Reducing order frequency results in more efficient vaccine ordering patterns and benefits vaccine distributors, Oregon Immunization Program staff, and provider staff.

Intelligent computer-aided training and tutoring

NASA Technical Reports Server (NTRS)

Loftin, R. Bowen; Savely, Robert T.

1991-01-01

Specific autonomous training systems based on artificial intelligence technology for use by NASA astronauts, flight controllers, and ground-based support personnel that demonstrate an alternative to current training systems are described. In addition to these specific systems, the evolution of a general architecture for autonomous intelligent training systems that integrates many of the features of traditional training programs with artificial intelligence techniques is presented. These Intelligent Computer-Aided Training (ICAT) systems would provide, for the trainee, much of the same experience that could be gained from the best on-the-job training. By integrating domain expertise with a knowledge of appropriate training methods, an ICAT session should duplicate, as closely as possible, the trainee undergoing on-the-job training in the task environment, benefitting from the full attention of a task expert who is also an expert trainer. Thus, the philosophy of the ICAT system is to emulate the behavior of an experienced individual devoting his full time and attention to the training of a novice - proposing challenging training scenarios, monitoring and evaluating the actions of the trainee, providing meaningful comments in response to trainee errors, responding to trainee requests for information, giving hints (if appropriate), and remembering the strengths and weaknesses displayed by the trainee so that appropriate future exercises can be designed.

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.

Development and Validation of a Training Program Using a Cognitive Behavioral Therapy Approach with the Purpose of Enabling Community Pharmacists to Provide Empathic Patient Counseling.

PubMed

Tanuma, Kazunori; Watanabe, Fumiyuki; Maeda, Hatsuyo; Shiina, Miki; Hara, Kazuo; Kamei, Miwako

2017-01-01

To enable community pharmacists to provide empathic patient counseling, we developed and validated a training program based on cognitive reframing, which is one of the cognitive behavioral therapies. We divided 24 community pharmacists into two groups, providing training to the intervention group. The duration of the training program was two hours per session, with a total of eight hours. We conducted a survey of the intervention group to evaluate their training experience. In addition, we performed two role-play scenarios on patient counseling using simulated patients, evaluating the patient counseling alliance scores and the degrees of the psychological distance between the patients and pharmacists. The degree of satisfaction correlated with four training items, including "explanation by comics". When pharmacists felt that the cognitive behavioral therapy approach was successful, no significant differences were found in the patient counseling alliance grades. However, the psychological distance between the patients and pharmacists was smaller. We were able to infer that a cognitive behavioral therapy approach could decrease the psychological distance between patients and pharmacists, thereby enabling empathic patient counseling.

Introducing the female condom through the public health sector: experiences from South Africa.

PubMed

Mantell, J E; Scheepers, E; Karim, Q A

2000-10-01

The successful implementation of new public health policy is influenced by provider preparedness and user acceptability of the new intervention. This paper describes the development and implementation of a participatory Training of Trainers (TOT) programme as a precursor to launch the South African government's female-initiated HIV prevention strategies in public health clinics. Three hundred peer-trainees from throughout South Africa were trained through a comprehensive, modular and interactive three-day workshop. The workshop content included: HIV/AIDS knowledge, beliefs and attitudes; values clarification regarding HIV infection and sexuality; sexual desensitization; 'hands-on' training in the use of and introduction of the female condom; and counselling, communication and programme planning skills. The TOT generated a cadre of knowledgeable health care workers for training others and provided a support structure at the service delivery level for ensuring potential users' access to the female condom within each province. Qualitative assessments of the training and trainer debriefing sessions suggest that the training was successful in increasing knowledge and promoting positive attitudes about female condoms. In addition, the expanded repertoire of problem-solving approaches left providers feeling confident about recommending this method to clients.

Wanted: interdisciplinary, multidisciplinary, and knowledge translation and exchange training for students of public health.

PubMed

Mishra, Lipi; Banerjee, Ananya T; MacLennan, Mary E; Gorczynski, Paul F; Zinszer, Kate A

2011-01-01

Students vocalized their concern with public health training programs in Canada at the 2010 CPHA Centennial Conference. Given these concerns, we reviewed the objectives and curricula of public health graduate (master's) programs in Canada. Our objective was to understand to what extent public and population health graduate programs in Canada support interdisciplinary, multidisciplinary and knowledge translation and exchange (KTE) training. This was achieved through a review of all public and population health master's programs in Canada identified from the public health graduate programs listed on the Public Health Agency of Canada website (n = 33) plus an additional four programs that were not originally captured on the list. Of the 37 programs reviewed, 28 (76%) stated that interdisciplinary, multidisciplinary or cross-disciplinary training opportunities are of value to their program, with 12 programs (32%) providing multidisciplinary or interdisciplinary training opportunities in their curriculum. Only 14 (38%) of the 37 programs provided value statements of KTE activities in their program goals or course objectives, with 10 (27%) programs offering KTE training in their curriculum. This review provides a glimpse into how public health programs in Canada value and support interdisciplinary and multidisciplinary collaboration as well as KTE activities.

Robot-Aided Neurorehabilitation: A Robot for Wrist Rehabilitation

PubMed Central

Krebs, Hermano Igo; Volpe, Bruce T.; Williams, Dustin; Celestino, James; Charles, Steven K.; Lynch, Daniel; Hogan, Neville

2009-01-01

In 1991, a novel robot, MIT-MANUS, was introduced to study the potential that robots might assist in and quantify the neuro-rehabilitation of motor function. MIT-MANUS proved an excellent tool for shoulder and elbow rehabilitation in stroke patients, showing in clinical trials a reduction of impairment in movements confined to the exercised joints. This successful proof of principle as to additional targeted and intensive movement treatment prompted a test of robot training examining other limb segments. This paper focuses on a robot for wrist rehabilitation designed to provide three rotational degrees-of-freedom. The first clinical trial of the device will enroll 200 stroke survivors. Ultimately 160 stroke survivors will train with both the proximal shoulder and elbow MIT-MANUS robot, as well as with the novel distal wrist robot, in addition to 40 stroke survivor controls. So far 52 stroke patients have completed the robot training (ongoing protocol). Here, we report on the initial results on 36 of these volunteers. These results demonstrate that further improvement should be expected by adding additional training to other limb segments. PMID:17894265

Robot-aided neurorehabilitation: a robot for wrist rehabilitation.

PubMed

Krebs, Hermano Igo; Volpe, Bruce T; Williams, Dustin; Celestino, James; Charles, Steven K; Lynch, Daniel; Hogan, Neville

2007-09-01

In 1991, a novel robot, MIT-MANUS, was introduced to study the potential that robots might assist in and quantify the neuro-rehabilitation of motor function. MIT-MANUS proved an excellent tool for shoulder and elbow rehabilitation in stroke patients, showing in clinical trials a reduction of impairment in movements confined to the exercised joints. This successful proof of principle as to additional targeted and intensive movement treatment prompted a test of robot training examining other limb segments. This paper focuses on a robot for wrist rehabilitation designed to provide three rotational degrees-of-freedom. The first clinical trial of the device will enroll 200 stroke survivors. Ultimately 160 stroke survivors will train with both the proximal shoulder and elbow MIT-MANUS robot, as well as with the novel distal wrist robot, in addition to 40 stroke survivor controls. So far 52 stroke patients have completed the robot training (ongoing protocol). Here, we report on the initial results on 36 of these volunteers. These results demonstrate that further improvement should be expected by adding additional training to other limb segments.

Views from GP and Psychiatric trainees about getting experience in each other's specialty during training: A way to develop a shared culture?

PubMed

Butler, Sophie; Mullin, Juliette; Zacharia, Tharun; Howe, Andrew; Mirvis, Ross; Jeffries-Chung, Camilla; Mirzadeh, Damian; Holt, Clare; Couppis, Orestes

2015-09-01

The need to deliver holistic medical care that addresses both physical and mental health requirements has never been more important. The UK medical training system has been designed to provide all medical graduates with a broad experience of different medical specialities and psychiatry prior to entering specialist training. Furthermore there is a distinct crossover between Psychiatric and General Practice training, with programmes providing trainees with the opportunity to work alongside each other in the care of mental health patients. The video presentation will explain the UK medical training system in more detail, before going on to explore how the organisation of training may foster a shared culture among different specialities and how it could form a model for improving parity of esteem of medical and physical health care. In addition it will discuss the strengths and weaknesses of this system from a trainee perspective and will conclude with comments from eminent Psychiatrists whom have special interests in medical training and developingparity of mental and physical health care.

Dental manpower development in the Pacific: case study in the Republic of the Marshall Islands.

PubMed

Tut, Ohnmar K; Langidrik, Justina R; Milgrom, Peter M

2007-03-01

This case study reports the ongoing progress and results of a manpower development program to expand indigenous dental personnel at four levels in the Republic of the Marshall Islands. The program was designed to: 1) increase the number of Marshallese students who successfully complete dentistry training; 2) recruit and train a group of Marshallese high school graduates in dental assisting for service in new preventive outreach programs within the community; 3) enhance the dental training of health assistants providing primary medical care to outer islands away from the main population centers of Majuro and Ebeye; and 4) provide in-service training on tooth decay prevention for Head Start teachers. The program resulted in the training of one Marshallese dentist and two Marshallese dental therapist, 16 primary care health aides who received oral health training for work in the outer island dispensaries, and 200 Head Start and kindergarten teachers who completed in-service training in oral health. Additional expertise was shared with other United States Affiliated Pacific Islands (USAPI) to enhance the dental workforce throughout the Pacific.

Association of reproductive health training on intention to provide services after residency: the family physician resident survey.

PubMed

Romero, Diana; Maldonado, Lisa; Fuentes, Liza; Prine, Linda

2015-01-01

High rates of unintended pregnancy and need for reproductive health services (RHS), including abortion, require continued efforts to train medical professionals and increase availability of these services. With US approval 12 years ago of Mifepristone, a medication abortion pill, abortion services are additionally amenable to primary care. Family physicians are a logical group to focus on given that they provide the bulk of primary care. We analyzed data from an annual survey (2007--2010) of third-year family medicine residents (n=284, response rate=48%--64%) in programs offering abortion training to examine the association between such training and self-reported competence and intentions to provide RHS (with a particular focus on abortion) upon graduation from residency. The majority of residents (75% in most cases) were trained in each of the RHS we asked about; relatively fewer trained in implant insertion (39%), electric vacuum aspiration (EVA) (58%), and manual vacuum aspiration (MVA) (69%). Perceived competence on the part of the graduating residents ranged from high levels in pregnancy options counseling (89%) and IUD insertion (85%) to lows in ultrasound and EVA (both 34%). Bivariate analysis revealed significant associations between number of procedures performed and future intentions to provide them. The association between competence and intentions persisted for all procedures in multivariate analysis, adjusting for number of procedures. Further, the total number of abortions performed during residency increased the odds of intending to provide MVA and medication abortion by 3% and 2%, respectively. Findings support augmenting training in RHS for family medicine residents, given that almost half (45%) of those trained intended to provide abortions. The volume of training should be increased so more residents feel competent, particularly in light of the fact that combined exposure to different abortion procedures has a cumulative impact on intention to provide MVA and medication abortion.

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

Diaconescu, Paula L.; Garcia, Evan

The objective of our research project was to study the reactivity of uranium complexes supported by ferrocene-based ligands. In addition, this research provides training of graduate students as the next generation of actinide scientists.

Impact of the Brain Injury Family Intervention (BIFI) training on rehabilitation providers: A mixed methods study.

PubMed

Meixner, Cara; O'Donoghue, Cynthia R; Hart, Vesna

2017-01-01

The psychological impact of TBI is vast, leading to adverse effects on survivors and their caregivers. Unhealthy family functioning may be mitigated by therapeutic strategies, particularly interdisciplinary family systems approaches like the well-documented Brain Injury Family Intervention (BIFI). Little is known about the experience of providers who offer such interventions. This mixed methods study aims to demonstrate that a structured three-day training on the BIFI protocol improves providers' knowledge and confidence in working with survivors and families, and that this outcome is sustainable. Participants were 34 providers who participated in an intensive training and completed a web-based survey at four points of time. Quantitative data were analyzed via Wilcoxon signed-rank tests and binomial test of proportions. Qualitative data were analyzed according to rigorous coding procedures. Providers' knowledge of brain injury and their ability to conceptualize treatment models for survivors and their families increased significantly and mostly remain consistent over time. Qualitative data point to additional gains, such as understanding of family systems. Past studies quantify the BIFI as an evidence-based intervention. This study supports the effectiveness of training and serves as first to demonstrate the benefit for providers short- and long-term.

Trained neurons-based motion detection in optical camera communications

NASA Astrophysics Data System (ADS)

Teli, Shivani; Cahyadi, Willy Anugrah; Chung, Yeon Ho

2018-04-01

A concept of trained neurons-based motion detection (TNMD) in optical camera communications (OCC) is proposed. The proposed TNMD is based on neurons present in a neural network that perform repetitive analysis in order to provide efficient and reliable motion detection in OCC. This efficient motion detection can be considered another functionality of OCC in addition to two traditional functionalities of illumination and communication. To verify the proposed TNMD, the experiments were conducted in an indoor static downlink OCC, where a mobile phone front camera is employed as the receiver and an 8 × 8 red, green, and blue (RGB) light-emitting diode array as the transmitter. The motion is detected by observing the user's finger movement in the form of centroid through the OCC link via a camera. Unlike conventional trained neurons approaches, the proposed TNMD is trained not with motion itself but with centroid data samples, thus providing more accurate detection and far less complex detection algorithm. The experiment results demonstrate that the TNMD can detect all considered motions accurately with acceptable bit error rate (BER) performances at a transmission distance of up to 175 cm. In addition, while the TNMD is performed, a maximum data rate of 3.759 kbps over the OCC link is obtained. The OCC with the proposed TNMD combined can be considered an efficient indoor OCC system that provides illumination, communication, and motion detection in a convenient smart home environment.

The Latent Factor--An Impetus for Employer Provided Education.

ERIC Educational Resources Information Center

Fusch, Gene E.

A new phenomenon is emerging: companies are diverging from human capital theory by providing employees a general education in addition to specific training at the workplace. Blue collar workers often do not pursue higher education due to perceived lack of opportunities. If an employer provides educational opportunities, blue collar workers may…

Utah ski patrol: assessing training types and resources.

PubMed

Sagalyn, Emily B; McDevitt, Marion C; Ernst, Ryan

2014-12-01

Skiers and snowboarders incur a variety of injuries and medical emergencies each year at ski resorts. The ski patrol is primarily responsible for initial triage, assessment and stabilization of these problems. The purpose of this study was to subjectively evaluate the type of training, resources, and equipment available to local ski patrols within Utah. Ski patrol directors at ski resorts in Utah were asked to complete a voluntary computerized survey. Of the 14 ski areas in Utah, ski patrol directors representing 8 resorts responded. The majority of patrols in Utah use Outdoor Emergency Care (OEC) as their primary education and certification source. Most programs also include site-specific training in addition to basic certification. All responding resorts had basic first responder equipment, including splinting devices, basic airway management, and hemorrhage control. Six of 8 responding resorts had affiliated clinics, and all had access to aeromedical transport. All of the responding ski patrol directors believed the current training level was adequate. Utah area ski patrollers frequently see trauma-related injuries and have the resources to assess and provide initial immobilization techniques. Many resorts have affiliated clinics with advanced providers, and all have access to aeromedical support to rapidly transfer patients to trauma centers. Medical directors may be of use for training as well as developing extended scope of practice protocols for advanced airway use or medication administration. Patrols may benefit from additional resort-specific training that addresses other frequently seen injuries or illnesses. Copyright © 2014 Wilderness Medical Society. Published by Elsevier Inc. All rights reserved.

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.

Casino Gaming Occupations: A Jackpot for Jobseekers.

ERIC Educational Resources Information Center

Tate, Patricia

2001-01-01

Focuses on gaming occupations in casinos, describing their duties, qualifications, training, and earnings. Also provides information about employment and outlook, benefits and drawbacks, and sources of additional information. (JOW)

26 CFR 1.132-2 - No-additional-cost services.

Code of Federal Regulations, 2011 CFR

2011-04-01

... capacity services such as hotel accommodations; transportation by aircraft, train, bus, subway, or cruise... transportation). Similarly, maid service provided to hotel employees renting hotel rooms on a space-available basis is merely incidental to the primary service being provided (i.e., hotel accommodations). (6...

26 CFR 1.132-2 - No-additional-cost services.

Code of Federal Regulations, 2010 CFR

2010-04-01

... capacity services such as hotel accommodations; transportation by aircraft, train, bus, subway, or cruise... transportation). Similarly, maid service provided to hotel employees renting hotel rooms on a space-available basis is merely incidental to the primary service being provided (i.e., hotel accommodations). (6...

[Research and Development of A Kinect Based Virtual System for Upper Limb Rehabilitation].

PubMed

Ding, Weili; Zheng, Yazhuo; Su, Yuping; Li, Xiaoli; Wei, Xiuli

2015-06-01

We developed a rehabilitation system by using the virtual reality technique and the Kinect in this paper. The system combines rehabilitation training with HMI and serious game organically, and provides a game and motion database to meet different patients' demands. Extended interface of game database is provided in two ways: personalized games can be developed by Virtools and Flash games which are suitable for patients' rehabilitation can be download from the Internet directly. In addition, the system provides patients with flexible interaction and easy control mode, and also presents real time data recording. An objective and subjective evaluation method is proposed to review the effectiveness of the rehabilitation training. According to the results of short questionnaires and the evaluation results of patients' rehabilitation training, the system compared with traditional rehabilitation can record and analyze the training data, which is useful to make rehabilitation plans. More entertainment and lower cost will increase patients' motivation, which helps to increase the rehabilitation effectiveness.

Developing Climate Resilience Toolkit Decision Support Training Sectio

NASA Astrophysics Data System (ADS)

Livezey, M. M.; Herring, D.; Keck, J.; Meyers, J. C.

2014-12-01

The Climate Resilience Toolkit (CRT) is a Federal government effort to address the U.S. President's Climate Action Plan and Executive Order for Climate Preparedness. The toolkit will provide access to tools and products useful for climate-sensitive decision making. To optimize the user experience, the toolkit will also provide access to training materials. The National Oceanic and Atmospheric Administration (NOAA) has been building a climate training capability for 15 years. The target audience for the training has historically been mainly NOAA staff with some modified training programs for external users and stakeholders. NOAA is now using this climate training capacity for the CRT. To organize the CRT training section, we collaborated with the Association of Climate Change Officers to determine the best strategy and identified four additional complimentary skills needed for successful decision making: climate literacy, environmental literacy, risk assessment and management, and strategic execution and monitoring. Developing the climate literacy skills requires knowledge of climate variability and change, as well as an introduction to the suite of available products and services. For the development of an environmental literacy category, specific topics needed include knowledge of climate impacts on specific environmental systems. Climate risk assessment and management introduces a process for decision making and provides knowledge on communication of climate information and integration of climate information in planning processes. The strategic execution and monitoring category provides information on use of NOAA climate products, services, and partnership opportunities for decision making. In order to use the existing training modules, it was necessary to assess their level of complexity, catalog them, and develop guidance for users on a curriculum to take advantage of the training resources to enhance their learning experience. With the development of this CRT training section, NOAA has made significant progress in sharing resources with the external community.

Music Games: Potential Application and Considerations for Rhythmic Training

PubMed Central

Bégel, Valentin; Di Loreto, Ines; Seilles, Antoine; Dalla Bella, Simone

2017-01-01

Rhythmic skills are natural and widespread in the general population. The majority can track the beat of music and move along with it. These abilities are meaningful from a cognitive standpoint given their tight links with prominent motor and cognitive functions such as language and memory. When rhythmic skills are challenged by brain damage or neurodevelopmental disorders, remediation strategies based on rhythm can be considered. For example, rhythmic training can be used to improve motor performance (e.g., gait) as well as cognitive and language skills. Here, we review the games readily available in the market and assess whether they are well-suited for rhythmic training. Games that train rhythm skills may serve as useful tools for retraining motor and cognitive functions in patients with motor or neurodevelopmental disorders (e.g., Parkinson’s disease, dyslexia, or ADHD). Our criteria were the peripheral used to capture and record the response, the type of response and the output measure. None of the existing games provides sufficient temporal precision in stimulus presentation and/or data acquisition. In addition, games do not train selectively rhythmic skills. Hence, the available music games, in their present form, are not satisfying for training rhythmic skills. Yet, some features such as the device used, the interface or the game scenario provide good indications for devising efficient training protocols. Guidelines are provided for devising serious music games targeting rhythmic training in the future. PMID:28611610

Music Games: Potential Application and Considerations for Rhythmic Training.

PubMed

Bégel, Valentin; Di Loreto, Ines; Seilles, Antoine; Dalla Bella, Simone

2017-01-01

Rhythmic skills are natural and widespread in the general population. The majority can track the beat of music and move along with it. These abilities are meaningful from a cognitive standpoint given their tight links with prominent motor and cognitive functions such as language and memory. When rhythmic skills are challenged by brain damage or neurodevelopmental disorders, remediation strategies based on rhythm can be considered. For example, rhythmic training can be used to improve motor performance (e.g., gait) as well as cognitive and language skills. Here, we review the games readily available in the market and assess whether they are well-suited for rhythmic training. Games that train rhythm skills may serve as useful tools for retraining motor and cognitive functions in patients with motor or neurodevelopmental disorders (e.g., Parkinson's disease, dyslexia, or ADHD). Our criteria were the peripheral used to capture and record the response, the type of response and the output measure. None of the existing games provides sufficient temporal precision in stimulus presentation and/or data acquisition. In addition, games do not train selectively rhythmic skills. Hence, the available music games, in their present form, are not satisfying for training rhythmic skills. Yet, some features such as the device used, the interface or the game scenario provide good indications for devising efficient training protocols. Guidelines are provided for devising serious music games targeting rhythmic training in the future.

Outreach training: the special interest group's report.

PubMed

Smith, M; Ash, P; Gilmour, A S M; Austin, T; Robinson, P G

2011-05-01

Following three sessions at ADEE Annual Meetings, the special interest group on outreach training presents a brief report of its proceedings. Outreach, here, is clinical teaching away from the home dental school. After covering the diversity and benefits of programmes, the report considers different models and the relationship between contexts and outcomes. It concludes that: outreach provides access to additional resources; programmes prepare students for the demands of the profession; a programme's design should harmonise with both its context and its objectives; and, the educational benefits warrant the additional organisation involved. © 2011 John Wiley & Sons A/S.

Integration of an Objective Structured Clinical Examination (OSCE) into the dental preliminary exams.

PubMed

Ratzmann, Anja; Wiesmann, Ulrich; Kordaß, Bernd

2012-01-01

In the pre-clinical phase of the study of dentistry at the University of Greifswald, the course "Early Patient Contact (EPC)" is conducted within the framework of Community Medicine/Dentistry. The course is based on three pillars: the patient visiting program, special problem-oriented seminars, and communication training for doctors. The essential goal consists of providing students with real patient contact right at the beginning of their study of dentistry, thus making the study of dentistry patient-based very early on. Students are trained in taking comprehensive anamneses and recording clinical findings. Within the framework of the dental preliminary exams, the course is evaluated using an OSCE on a standardized patient. Furthermore, the added value of an additional training unit (conducting anamnesis and clinical examination) in preparation for the OSCE was evaluated. The exam results of a group without training (control group) were compared with those of a group with training (intervention group). The intervention group performed significantly better than the control on the following items: the total number of points achieved on the OSCE early patient contact, and in the most important points of the anamnesis and clinical examination. In addition, the intervention group tended to score higher in terms of the item "oral health status". The present study showed a positive effect of an additional training unit on students' performance in the OSCE. Taking the limitations of the study and the results of a literature review into account, we recommend conducting such training as preparation for the OSCE.

Integrating electron microscopy into nanoscience and materials engineering programs

NASA Astrophysics Data System (ADS)

Cormia, Robert D.; Oye, Michael M.; Nguyen, Anh; Skiver, David; Shi, Meng; Torres, Yessica

2014-10-01

Preparing an effective workforce in high technology is the goal of both academic and industry training, and has been the engine that drives innovation and product development in the United States for over a century. During the last 50 years, technician training has comprised a combination of two-year academic programs, internships and apprentice training, and extensive On-the-Job Training (OJT). Recently, and especially in Silicon Valley, technicians have four-year college degrees, as well as relevant hands-on training. Characterization in general, and microscopy in particular, is an essential tool in process development, manufacturing and QA/QC, and failure analysis. Training for a broad range of skills and practice is challenging, especially for community colleges. Workforce studies (SRI/Boeing) suggest that even four year colleges often do not provide the relevant training and experience in laboratory skills, especially design of experiments and analysis of data. Companies in high-tech further report difficulty in finding skilled labor, especially with industry specific experience. Foothill College, in partnership with UCSC, SJSU, and NASA-Ames, has developed a microscopy training program embedded in a research laboratory, itself a partnership between university and government, providing hands-on experience in advanced instrumentation, experimental design and problem solving, with real-world context from small business innovators, in an environment called `the collaboratory'. The program builds on AFM-SEM training at Foothill, and provides affordable training in FE-SEM and TEM through a cost recovery model. In addition to instrument and engineering training, the collaboratory also supports academic and personal growth through a multiplayer social network of students, faculty, researchers, and innovators.

22 CFR 506.1 - Purpose of program.

Code of Federal Regulations, 2010 CFR

2010-04-01

... need for additional income, providing employment opportunities for women returning to the workforce and assisting students who must finance their own education or vocational training. In view of this, the...

A randomized controlled trial of simulation-based training for ear, nose, and throat emergencies.

PubMed

Smith, Matthew Edward; Navaratnam, Annakan; Jablenska, Lily; Dimitriadis, Panagiotis A; Sharma, Rishi

2015-08-01

Life-threatening ear, nose, and throat (ENT) emergencies are uncommon but require immediate skilled management. We investigated if traditional lecture-based teaching can be improved by a simulation and lecture hybrid approach. A single-blinded, prospective, randomized controlled trial. Two groups of interns with no previous ENT experience were randomized to one of two training groups: a simulation/lecture hybrid group or a lecture-only control group. Both groups received 90 minutes of training covering the assessment of critically ill patients and four ENT emergency topics. Both groups received the same initial lecture slides. The control group received additional slides, and the simulation group received simulated emergency scenario training using basic mannequins. Following the training, candidates were asked to provide feedback on their perception of training, and they were formally assessed with a standardized one-to-one viva. Thirty-eight interns were recruited: 18 in the control group and 20 in the simulation group. The candidates in the simulation group performed significantly better in all viva situations (P < .05) and had better perception of learning (P < .05). Additionally, the simulation group was more likely to recommend the training to a colleague (P < .05). We have demonstrated that replacing traditional lecture-based training with a mixture of lectures and emergency scenario simulation is more effective at preparing junior doctors for ENT emergencies, and better met their learning needs. Implementing this kind of teaching is feasible with a minimum of additional resources or time. 1b © 2015 The American Laryngological, Rhinological and Otological Society, Inc.

Deployed Analyst History Report, Volume 2. Analytic Support to Combat Operations in the Philippines (2011-2014)

DTIC Science & Technology

2015-12-01

Army Training and Doctrine Command (TRADOC) Analysis Center (TRAC) to the Philippines for Operation ENDURING FREEDOM – Philippines (OEF-P). PROJECT...management, doctrine and force development, training management, system testing, system acquisition, decision analysis, and resource management, as...influenced procurement decisions and reshaped Army doctrine . Additionally, CAA itself has benefited in numerous ways. Combat experience provides analysts

What Is the Impact of Online Training in Mind-Body Skills?

PubMed

Kemper, Kathi J; Lynn, Joanne; Mahan, John D

2015-10-01

Mind-body skills (MBS) training is popular, but in-person training can be inconvenient and costly. We assessed the impact of online MBS training on clinicians' and trainees' stress, mindfulness, and confidence in providing calm, compassionate care. This was a prospective cohort trial. Trainees entering medical school; graduate programs in nursing, social work, and dietetics; and residencies in family medicine and pediatrics at a large Midwestern academic health center were invited to complete online surveys before and 12 weeks after enrolling in online elective integrative health courses on MBS training or not. The elective offered no course credit and had no mandated deadlines for completion. At baseline, the 60 who engaged in MBS training were similar to the 43 who did not in terms of profession, gender, perceived stress levels, mindfulness, resilience, and compassion. MBS participants engaged in a median of 3 of 12 available modules with a bimodal distribution peaking at 1 to 2 and 12 modules. Twelve weeks later, those who participated in MBS showed significantly greater improvements in measures of stress, mindfulness, and confidence in providing calm, compassionate care than those who did not. Online elective training offers a feasible strategy to improve mindfulness, stress, and confidence in providing calm, compassionate care. Additional studies are needed to determine the impact of required versus elective courses, the optimal dosage and content of training, and the costs and benefits of online versus in-person training. © The Author(s) 2015.

Lessons from VET Providers Delivering Degrees

ERIC Educational Resources Information Center

Callan, Victor J.; Bowman, Kaye

2015-01-01

This report is focused on the strategic, capability and operational reasons why traditional vocational education and training (VET) providers move to the delivery of higher education qualifications in their own right, in addition to their vocational qualifications. It is particularly interested in associate and bachelor degrees. By undertaking six…

Professional paradox: identity formation in qualified doctors pursuing further training.

PubMed

Chan, Mercedes; Pratt, Dan; Poole, Gary; Sidhu, Ravi

2018-03-01

Many newly qualified specialists and subspecialists pursue additional training. Although their motivations are many, the pursuit of further training as an alternative to unemployment is an emerging trend. Paradoxically, doctors continue as trainees with a consultant's credentials, and without the guarantee of eventual employment. This study explores seven doctors' experiences, the effects of further training on their professional identity formation (PIF), and how these effects are reconciled on a personal and professional level. This phenomenological study involved interviews with seven qualified Canadian specialists (three were female) who pursued additional training in response to a lack of available positions in their respective specialties. Template analysis generated theoretical constructs of influences on their PIF, and characteristics of their lived experiences. Four themes shaped PIF: setting and context; language and communication; responsibilities and privileges; and participants' visions of their future selves. Professional identity formation (PIF) continued to develop in further training, but was inconsistently affirmed by participants' communities of practice. Four major themes characterised training experiences: prescription; managing multiple masters; limiting access to others and community ties; and constantly questioning the value of extra training. Qualified doctors traverse professional paradoxes as they seek further education with no guarantee of employment and provide consultant-level care as 'trainees'. An identity dissonance emerges that may continue until a clear identity is prescribed for them. Although disruptive to these doctors' PIF and personal and professional lives, the long-term effects of additional training are unknown. Its utility and influence on securing employment and future job satisfaction are areas for further research. © 2017 John Wiley & Sons Ltd and The Association for the Study of Medical Education.

Foreign Aid: An Introduction to U.S. Programs and Policy

DTIC Science & Technology

2009-02-10

additionally meeting U.S. humanitarian objectives. Microcredit programs may help develop local economies while at the same time providing food and...training and expertise to fledgling microcredit institutions. In recent years, antiretroviral drugs (ARVs) provided through PEPFAR programs to...For instance, grants are sometimes provided to microcredit organizations which in turn provide loans to microentrepreneurs. Through the USAID-funded

Concurrent Training for Sports Performance: The Two Sides of the Medal.

PubMed

Berryman, Nicolas; Mujika, Inigo; Bosquet, Laurent

2018-05-29

The classical work by Robert C. Hickson showed in 1980 that the addition of a resistance training protocol to a predominantly aerobic program could lead to impaired leg strength adaptations in comparison to a resistance-only training regimen. This interference phenomenon was later highlighted in many reports, including a meta-analysis. However, it seems that the interference effect has not been consistently reported, probably because of the complex interactions between training variables and methodological issues. On the other side of the medal, Dr Hickson and colleagues subsequently (1986) reported that a strength training mesocycle could be beneficial for endurance performance in running and cycling. In recent meta-analyses and review articles, it was demonstrated that such a training strategy could improve middle- and long-distance performance in many disciplines (running, cycling, cross-country skiing and swimming). Interestingly, it appears that improvements in the energy cost of locomotion could be associated with these performance enhancements. Despite these benefits, it was also reported that strength training could represent a detrimental stimulus for endurance performance if an inappropriate training plan has been prepared. Taken together, these observations suggest that coaches and athletes should be careful when concurrent training seems imperative in order to meet the complex physiological requirements of their sport. Therefore, this brief review will present a practical appraisal of concurrent training for sports performance. In addition, recommendations will be provided so that practitioners could adapt their interventions based on the training objectives.

A further evaluation of behavioral skills training for implementation of the picture exchange communication system.

PubMed

Homlitas, Christa; Rosales, Rocío; Candel, Lindsay

2014-01-01

We evaluated the effectiveness of a behavioral skills training package to teach implementation of Phases 1, 2, and 3A of the picture exchange communication system (PECS) to teachers employed at a therapeutic center for children with autism. Probes in the natural environment and follow-up were conducted with children who were assigned to work with the teachers in their own classrooms. Results provide additional support for the efficacy of behavioral skills training to teach implementation of PECS. © Society for the Experimental Analysis of Behavior.

78 FR 21610 - Expansion Funds for the Support of the Senior Medicare Patrol (SMP) Program

Federal Register 2010, 2011, 2012, 2013, 2014

2013-04-11

... the Support of the Senior Medicare Patrol (SMP) Program ACTION: Notice of intent to provide expansion... funds for the support of the Senior Medicare Patrol (SMP) Program. This additional funding opportunity... program capacity to recruit, train, and support the SMP volunteer network. In addition, this funding...

The future of surgical training in the context of the 'Shape of Training' Review: Consensus recommendations by the Association of Surgeons in Training.

PubMed

Harries, Rhiannon L; Williams, Adam P; Ferguson, Henry J M; Mohan, Helen M; Beamish, Andrew J; Gokani, Vimal J

2016-11-01

ASiT has long maintained that in order to provide the best quality care to patients in the UK and Republic of Ireland, it is critical that surgeons are trained to the highest standards. In addition, it is imperative that surgery remains an attractive career choice, with opportunities for career progression and job satisfaction to attract and retain the best candidates. In 2013, the Shape of Training review report set out recommendations for the structure and delivery of postgraduate training in light of an ever increasingly poly-morbid and ageing population. This consensus statement outlines ASIT's position regarding recommendations for improving surgical training and aims to help guide discussions with regard to future proposed changes to surgical training. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

Continuous Evaluation in Ethics Education: A Case Study.

PubMed

McIntosh, Tristan; Higgs, Cory; Mumford, Michael; Connelly, Shane; DuBois, James

2018-04-01

A great need for systematic evaluation of ethics training programs exists. Those tasked with developing an ethics training program may be quick to dismiss the value of training evaluation in continuous process improvement. In the present effort, we use a case study approach to delineate how to leverage formative and summative evaluation measures to create a high-quality ethics education program. With regard to formative evaluation, information bearing on trainee reactions, qualitative data from the comments of trainees, in addition to empirical findings, can ensure that the training program operates smoothly. Regarding summative evaluation, measures examining trainee cognition, behavior, and organization-level results provide information about how much trainees have changed as a result of taking the ethics training. The implications of effective training program evaluation are discussed.

Effects of brief training on use of automated external defibrillators by people without medical expertise.

PubMed

Mitchell, K Blake; Gugerty, Leo; Muth, Eric

2008-04-01

This study examined the effect of three types of brief training on the use of automatic external defibrillators (AEDs) by 43 lay users. Because AEDs were recently approved for home use, brief training for nonprofessional users needs investigation. During training, the exposure training group read an article about AEDs that provided no information on how to operate them; the low-training group inspected the AED and read the operating instructions in the paper-based manual but was not allowed to use the device; and the high-training group watched a training video and performed a mock resuscitation using the AED but no manikin. All participants returned 2 weeks later and performed a surprise simulated AED resuscitation on a manikin. Most participants in each training group met criteria of minimally acceptable performance during the simulated manikin resuscitation, as measured by time to first shock, pad placement accuracy, and safety check performance. All participants who committed errors were able to successfully recover from them to complete the resuscitation. Compared with exposure training, the low and high training had a beneficial effect on time to first shock and errors. Untrained users were able to adequately use this AED, demonstrating walk-up-and-use usability, but additional brief training improved user performance. This study demonstrated the importance of providing high-quality but brief training for home AED users. In conjunction with other findings, the current study helps demonstrate the need for well-designed training for consumer medical devices.

Crop Identification Technology Assessment for Remote Sensing (CITARS)

NASA Technical Reports Server (NTRS)

Bauer, M. E.; Cary, T. K.; Davis, B. J.; Swain, P. H.

1975-01-01

The results of classifications and experiments performed for the Crop Identification Technology Assessment for Remote Sensing (CITARS) project are summarized. Fifteen data sets were classified using two analysis procedures. One procedure used class weights while the other assumed equal probabilities of occurrence for all classes. In addition, 20 data sets were classified using training statistics from another segment or date. The results of both the local and non-local classifications in terms of classification and proportion estimation are presented. Several additional experiments are described which were performed to provide additional understanding of the CITARS results. These experiments investigated alternative analysis procedures, training set selection and size, effects of multitemporal registration, the spectral discriminability of corn, soybeans, and other, and analysis of aircraft multispectral data.

AED training and its impact on skill acquisition, retention and performance--a systematic review of alternative training methods.

PubMed

Yeung, Joyce; Okamoto, Deems; Soar, Jasmeet; Perkins, Gavin D

2011-06-01

The most popular method of training in basic life support and AED use remains instructor-led training courses. This systematic review examines the evidence for different training methods of basic life support providers (laypersons and healthcare providers) using standard instructor-led courses as comparators, to assess whether alternative method of training can lead to effective skill acquisition, skill retention and actual performance whilst using the AED. OVID Medline (including Medline 1950-November 2010; EMBASE 1988-November 2010) was searched using "training" OR "teaching" OR "education" as text words. Search was then combined by using AND "AED" OR "automatic external defibrillator" as MESH words. Additionally, the American Heart Association Endnote library was searched with the terms "AED" and "automatic external defibrillator". Resuscitation journal was hand searched for relevant articles. 285 articles were identified. After duplicates were removed, 172 references were reviewed for relevance. From this 22 papers were scrutinized and 18 were included. All were manikin studies. Four LOE 1 studies, seven LOE 2 studies and three LOE 4 studies were supportive of alternative AED training methods. One LOE 2 study was neutral. Three LOE 1 studies provided opposing evidence. There is good evidence to support alternative methods of AED training including lay instructors, self directed learning and brief training. There is also evidence to support that no training is needed but even brief training can improve speed of shock delivery and electrode pad placement. Features of AED can have an impact on its use and further research should be directed to making devices user-friendly and robust to untrained layperson. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

The future of family practice training in California.

PubMed Central

Midtling, J. E.; Barnett, P. G.; Blossom, H. J.; Burnett, W. H.

1990-01-01

Although the number of physicians in California has doubled since 1963, the number of family and general practice physicians has declined. The ratio of office-based primary care physicians to population has also decreased. Graduate medical education is funded largely from patient care revenues, but the low rate of reimbursement for ambulatory care makes training in primary care specialties especially dependent on public support. Medicare, the Veterans Administration, and the University of California provide more than $325 million a year in support of graduate medical education in California. Federal and state grant programs provide $5 million a year for family physician training in the state, but appropriations to these programs have been reduced in real terms. California family practice residencies are disproportionately located at county hospitals, where funding shortfalls make them especially vulnerable to cuts in grant programs. Additional resources will be needed if more family physicians are to be trained. Images PMID:2333709

The Effect of Instability Training on Knee Joint Proprioception and Core Strength

PubMed Central

Cuğ, Mutlu; Ak, Emre; Özdemir, Recep Ali; Korkusuz, Feza; Behm, David G

2012-01-01

Although there are many studies demonstrating increased trunk activation under unstable conditions, it is not known whether this increased activation would translate into meaningful trunk strength with a prolonged training program. Additionally, while balance-training programs have been shown to improve stability, their effect on specific joint proprioception is not clear. Thus the objective of this study was to examine training adaptations associated with a 10-week instability-training program. Participants were tested pre- and post-training for trunk extension and flexion strength and knee proprioception. Forty-three participants participated in either a 10-week (3 days per week) instability-training program using Swiss balls and body weight as resistance or a control group (n = 17). The trained group increased (p < 0. 05) trunk extension peak torque/body weight (23.6%) and total work output (20.1%) from pre- to post-training while the control group decreased by 6.8% and 6.7% respectively. The exercise group increased their trunk flexion peak torque/body weight ratios by 18.1% while the control group decreased by 0.4%. Knee proprioception (combined right and left joint repositioning) improved 44.7% from pre- to post-training (p = 0.0006) and persisted (21.5%) for 9 months post-training. In addition there was a side interaction with the position sense of the right knee at 9 months showing 32.1% (p = 0.03) less deviation from the reference angle than the right knee during pre-testing. An instability-training program using Swiss balls with body weight as resistance can provide prolonged improvements in joint proprioception and core strength in previously untrained individuals performing this novel training stress which would contribute to general health. Key pointsAlthough traditional free weight resistance exercises have been recommended as most beneficial for improving strength and power in athletes (Behm et al., 2010b), an IT program using Swiss balls and body weight as a resistance may provide an alternative starting point for the sedentary untrained population.As it is well documented that force or strength is decreased when unbalanced (Behm et al., 2010b) and balance-training programs improve balance (Behm and Kean 2006), this type of instability RT program can provide significant adaptations to improve trunk strength especially with the untrained.This type of training should also be incorporated into a new program as the improvements in joint proprioception may help protect from joint injuries over a protracted period.The finding that improved joint proprioception persists for months after training should be emphasized to those individuals whose training is regularly or inconsistently interrupted. PMID:24149355

In-service and pre-service teacher education in IBSE: The ESTABLISH approach

NASA Astrophysics Data System (ADS)

Ješková, Zuzana; Kireš, Marián; McLoughlin, Eilish; Finlayson, Odilla; Ottander, Christina; Ekborg, Margareta

2016-05-01

One of the main goals of the ESTABLISH 7fp project (available on line at http://www.establish-fp7.eu/) was the development and implementation of the professional development teacher education programmes (TEP) to support teachers in adopting inquiry-based strategies in their teaching. Within the project there was a model for in-service and pre-service teacher training in IBSE designed and implemented across 12 participating countries. The programme is based on 4 core elements and 4 additional elements that are built around the IBSE teaching units developed within the project. As accepted by ESTABLISH partners, all teacher training programmes include the minimum of the four elements, i.e. introduction to IBSE, industrial content knowledge, teacher as implementer and teacher as developer of IBSE teaching materials. There are also four additional elements designed in detail, i.e. ICT for IBSE, argumentation in the classroom, research and design projects for students, assessment of IBSE. These can be added to the programme optionally with regard to the level of teachers' IBSE skills and current situation in education and teachers' professional development within the country. This ESTABLISH model of TEP was followed in participating countries in order to change teachers' attitudes from traditional ways of teaching towards adopting inquiry strategies and their successful implementation in the classroom. Within the face-to-face workshops teachers experienced and developed their inquiry based teaching strategies using specifically developed materials. In addition, the e-platform has been developed to provide on-line support. This platform provides educators and teachers with all the necessary materials for the training and IBSE teaching units and other teaching materials for teachers' ongoing help. The teacher training programme was successfully implemented in Slovakia. There were two runs of teacher training workshops on IBSE already carried out. Moreover, the additional element ICT in IBSE was developed more deeply designing a separate teacher training course for it. The contribution discusses in more details the success and problems of implementation in the context of Slovak educational environment.

Can attenuation of attentional blink also evoke removal of repetition blindness?

PubMed

Choi, Hoon; Watanabe, Takeo

2014-06-01

A recent study showed that attentional blink (AB), which has been considered to reflect the capacity limitation of visual temporal attention, can be attenuated after a short period of the color-salient training, in which the second target (T2) within the AB period is given a salient color (Choi et al., 2012). The current study explored whether the effect of the color-salient training could be transferred to another phenomenon. In addition to AB, repetition blindness (RB) was employed, which is phenomenologically similar to, but fundamentally different from AB. After completion of the color-salient training with a nonrepeated T2 (corresponding to AB), RB was still observed, whereas AB was completely removed. However, the color-salient training with a repeated T2 (similar to RB) induced not only a significant reduction of RB but also an attenuation of AB. This result provides further evidence for dissociation between AB and RB. In addition, it implies that the color-salient training improves the attentional control mechanism related to target-distractor discrimination rather than to the perceptual system. Copyright © 2014 Elsevier Ltd. All rights reserved.

Mapping the literature of athletic training

PubMed Central

Delwiche, Frances A.; Hall, Ellen F.

2007-01-01

Purpose: This paper identifies the core literature of athletic training and determines which major databases provide the most thorough intellectual access to this literature. Methods: This study collected all cited references from 2002 to 2004 of three journals widely read by those in the athletic training field. Bradford's Law of Scattering was applied to the resulting list to determine the core journal titles in the discipline. Three major databases were reviewed for extent of their coverage of these core journals. Results: Of the total 8,678 citations, one-third referenced a compact group of 6 journals; another third of the citations referenced an additional 40 titles. The remaining 2,837 citations were scattered across 1,034 additional journal titles. Conclusions: The number and scatter of citations over a three-year period identified forty-six key journals in athletic training. The study results can inform athletic trainers of the core literature in their field, encourage database producers (e.g., MEDLINE, SPORTDiscus, CINAHL) to increase coverage of titles that are not indexed or underindexed, and guide purchasing decisions for libraries serving athletic training programs. PMID:17443253

Nevada Renewable Energy Training Project: Geothermal Power Plant Operators

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

Jim, Nichols

2014-04-29

The purpose of this project was to develop and institute a training program for certified geothermal power plant operators (GPO). An advisory board consisting of subject matter experts from the geothermal energy industry and academia identified the critical skill sets required for this profession. A 34-credit Certificate of Achievement (COA), Geothermal Power Plant Operator, was developed using eight existing courses and developing five new courses. Approval from the Nevada System of Higher Education Board of Regents was obtained. A 2,400 sq. ft. geothermal/fluid mechanics laboratory and a 3,000 sq. ft. outdoor demonstration laboratory were constructed for hands-on training. Students alsomore » participated in field trips to geothermal power plants in the region. The majority of students were able to complete the program in 2-3 semesters, depending on their level of math proficiency. Additionally the COA allowed students to continue to an Associate of Applied Science (AAS), Energy Technologies with an emphasis in Geothermal Energy (26 additional credits), if they desired. The COA and AAS are stackable degrees, which provide students with an ongoing career pathway. Articulation agreements with other NSHE institutions provide students with additional opportunities to pursue a Bachelor of Applied Science in Management or Instrumentation. Job placement for COA graduates has been excellent.« less

78 FR 52927 - Agency Information Collection Activities: Proposed Collection; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-27

... TeamSTEPPS[supreg] (aka Team Strategies and Tools for Enhancing Performance and Patient Safety) to provide an evidence-based suite of tools and strategies for training teamwork- based patient safety to... strategies provided in the program in action. In addition to developing Master Trainers, AHRQ has also...

45 CFR 1357.16 - Annual progress and services reports.

Code of Federal Regulations, 2010 CFR

2010-10-01

... in the statement of goals and objectives, or to the training plan, if necessary, to reflect changed... support services to be provided in the upcoming fiscal year highlighting any changes in services or... services to be provided in the upcoming fiscal year highlighting any additions or changes in services or...

Financing Lifelong Learning for All: An International Perspective. Working Paper.

ERIC Educational Resources Information Center

Burke, Gerald

Recent international discussions provide information on various countries' responses to lifelong learning, including the following: (1) existing unmet needs and emerging needs for education and training; (2) funds required compared with what was provided; and (3) methods for acquiring additional funds, among them efficiency measures leading to…

A Wellness Program for University Faculty and Staff.

ERIC Educational Resources Information Center

Tishler, J. Ward

A program designed to provide physical fitness, assessment, prescription, and training was developed in a university setting. In addition, health education was provided to participants concerning nutrition and stress management. A study sought to determine whether the health of professionals enrolled in the program could be significantly improved.…

VET Providers Planning to Deliver Degrees: Good Practice Guide

ERIC Educational Resources Information Center

National Centre for Vocational Education Research (NCVER), 2015

2015-01-01

This good practice guide is intended to assist public and private registered training organisations (RTOs) planning to commence higher education (HE) delivery. The guide is based on research undertaken by Victor Callan and Kaye Bowman, who completed case studies with six providers currently delivering higher education qualifications in addition to…

Camp for all connection: a community health information outreach project.

PubMed

Huber, Jeffrey T; Walsh, Teresa J; Varman, Beatriz

2005-07-01

The purpose of the Camp For All Connection project is to facilitate access to electronic health information resources at the Camp For All facility. Camp For All is a barrier-free camp working in partnership with organizations to enrich the lives of children and adults with chronic illnesses and disabilities and their families by providing camping and retreat experiences. The camp facility is located on 206 acres in Burton, Texas. The project partners are Texas Woman's University, Houston Academy of Medicine-Texas Medical Center Library, and Camp For All. The Camp For All Connection project placed Internet-connected workstations at the camp's health center in the main lodge and provided training in the use of electronic health information resources. A train-the-trainer approach was used to provide training to Camp For All staff. Project workstations are being used by health care providers and camp staff for communication purposes and to make better informed health care decisions for Camp For All campers. A post-training evaluation was administered at the end of the train-the-trainer session. In addition, a series of site visits and interviews was conducted with camp staff members involved in the project. The site visits and interviews allowed for ongoing dialog between project staff and project participants.

Effects and feasibility of a standardised orientation and mobility training in using an identification cane for older adults with low vision: design of a randomised controlled trial.

PubMed

Zijlstra, G A R; van Rens, G H M B; Scherder, E J A; Brouwer, D M; van der Velde, J; Verstraten, P F J; Kempen, G I J M

2009-08-27

Orientation and mobility training (O&M-training) in using an identification cane, also called symbol cane, is provided to people with low vision to facilitate independent participation in the community. In The Netherlands this training is mainly practice-based because a standardised and validly evaluated O&M-training in using the identification cane is lacking. Recently a standardised O&M-training in using the identification cane was developed. This training consists of two face-to-face sessions and one telephone session during which, in addition to usual care, the client's needs regarding mobility are prioritised, and cognitive restructuring techniques, action planning and contracting are applied to facilitate the use of the cane. This paper presents the design of a randomised controlled trial aimed to evaluate this standardised O&M-training in using the identification cane in older adults with low vision. A parallel group randomised controlled trial was designed to compare the standardised O&M-training with usual care, i.e. the O&M-training commonly provided by the mobility trainer. Community-dwelling older people who ask for support at a rehabilitation centre for people with visual impairment and who are likely to receive an O&M-training in using the identification cane are included in the trial (N = 190). The primary outcomes of the effect evaluation are ADL self care and visual functioning with respect to distance activities and mobility. Secondary outcomes include quality of life, feelings of anxiety, symptoms of depression, fear of falling, and falls history. Data for the effect evaluation are collected by means of telephone interviews at baseline, and at 5 and 17 weeks after the start of the O&M-training. In addition to an effect evaluation, a process evaluation to study the feasibility of the O&M-training is carried out. The screening procedure for eligible participants started in November 2007 and will continue until October 2009. Preliminary findings regarding the evaluation are expected in the course of 2010. If the standardised O&M-training is more effective than the current O&M-training or, in case of equal effectiveness, is considered more feasible, the training will be embedded in the Dutch national instruction for mobility trainers. ClinicalTrials.gov NCT00946062.

Robot-supported upper limb training in a virtual learning environment : a pilot randomized controlled trial in persons with MS.

PubMed

Feys, Peter; Coninx, Karin; Kerkhofs, Lore; De Weyer, Tom; Truyens, Veronik; Maris, Anneleen; Lamers, Ilse

2015-07-23

Despite the functional impact of upper limb dysfunction in multiple sclerosis (MS), effects of intensive exercise programs and specifically robot-supported training have been rarely investigated in persons with advanced MS. To investigate the effects of additional robot-supported upper limb training in persons with MS compared to conventional treatment only. Seventeen persons with MS (pwMS) (median Expanded Disability Status Scale of 8, range 3.5-8.5) were included in a pilot RCT comparing the effects of additional robot-supported training to conventional treatment only. Additional training consisted of 3 weekly sessions of 30 min interacting with the HapticMaster robot within an individualised virtual learning environment (I-TRAVLE). Clinical measures at body function (Hand grip strength, Motricity Index, Fugl-Meyer) and activity (Action Research Arm test, Motor Activity Log) level were administered before and after an intervention period of 8 weeks. The intervention group were also evaluated on robot-mediated movement tasks in three dimensions, providing active range of motion, movement duration and speed and hand-path ratio as indication of movement efficiency in the spatial domain. Non-parametric statistics were applied. PwMS commented favourably on the robot-supported virtual learning environment and reported functional training effects in daily life. Movement tasks in three dimensions, measured with the robot, were performed in less time and for the transporting and reaching movement tasks more efficiently. There were however no significant changes for any clinical measure in neither intervention nor control group although observational analyses of the included cases indicated large improvements on the Fugl-Meyer in persons with more marked upper limb dysfunction. Robot-supported training lead to more efficient movement execution which was however, on group level, not reflected by significant changes on standard clinical tests. Persons with more marked upper limb dysfunction may benefit most from additional robot-supported training, but larger studies are needed. This trial is registered within the registry Clinical Trials GOV ( NCT02257606 ).

An evaluation of transit procurement training.

PubMed

Noland, Robert B; Weiner, Marc D; Klein, Nicholas J; Puniello, Orin D

2017-04-01

We evaluated a training course called "Orientation to Transit Procurement", designed and conducted by the National Transit Institute. This course is designed to provide Federal Transit Administration (FTA) grantees an overview of regulations and best practices related to the procurement process. Our objective in conducting the evaluation was to understand how transit agency staff made changes in procurement practices in response to the course training. The evaluation was mixed mode: an Internet survey followed by in-depth interviews with a small group of respondents. Survey respondents were also provided with an open-ended question providing us with additional context for our evaluation. Results show that the training is substantially successful at meeting the goal of improving procurement practices at transit agencies; indeed, most respondents report making changes at their agencies as the proximate result of the training. This was at odds with our exploration of knowledge of procurement topics, as most respondents gave inaccurate answers on multiple-choice "knowledge questions". This may have been due to question structure or, more likely, the nature of online surveys. Suitable training on the procurement of information technology was also a main concern. The lack of training in this area is indicative of the broader challenge facing public transit agencies in how to incorporate new forms of technology into their existing practices and bureaucratic structures. Copyright © 2016 Elsevier Ltd. All rights reserved.

Team-training in healthcare: a narrative synthesis of the literature.

PubMed

Weaver, Sallie J; Dy, Sydney M; Rosen, Michael A

2014-05-01

Patients are safer and receive higher quality care when providers work as a highly effective team. Investment in optimising healthcare teamwork has swelled in the last 10 years. Consequently, evidence regarding the effectiveness for these interventions has also grown rapidly. We provide an updated review concerning the current state of team-training science and practice in acute care settings. A PubMed search for review articles examining team-training interventions in acute care settings published between 2000 and 2012 was conducted. Following identification of relevant reviews with searches terminating in 2008 and 2010, PubMed and PSNet were searched for additional primary studies published in 2011 and 2012. Primary outcomes included patient outcomes and quality indices. Secondary outcomes included teamwork behaviours, knowledge and attitudes. Both simulation and classroom-based team-training interventions can improve teamwork processes (eg, communication, coordination and cooperation), and implementation has been associated with improvements in patient safety outcomes. Thirteen studies published between 2011 and 2012 reported statistically significant changes in teamwork behaviours, processes or emergent states and 10 reported significant improvement in clinical care processes or patient outcomes, including mortality and morbidity. Effects were reported across a range of clinical contexts. Larger effect sizes were reported for bundled team-training interventions that included tools and organisational changes to support sustainment and transfer of teamwork competencies into daily practice. Overall, moderate-to-high-quality evidence suggests team-training can positively impact healthcare team processes and patient outcomes. Additionally, toolkits are available to support intervention development and implementation. Evidence suggests bundled team-training interventions and implementation strategies that embed effective teamwork as a foundation for other improvement efforts may offer greatest impact on patient outcomes.

Team-training in healthcare: a narrative synthesis of the literature

PubMed Central

Weaver, Sallie J; Dy, Sydney M; Rosen, Michael A

2014-01-01

Background Patients are safer and receive higher quality care when providers work as a highly effective team. Investment in optimising healthcare teamwork has swelled in the last 10 years. Consequently, evidence regarding the effectiveness for these interventions has also grown rapidly. We provide an updated review concerning the current state of team-training science and practice in acute care settings. Methods A PubMed search for review articles examining team-training interventions in acute care settings published between 2000 and 2012 was conducted. Following identification of relevant reviews with searches terminating in 2008 and 2010, PubMed and PSNet were searched for additional primary studies published in 2011 and 2012. Primary outcomes included patient outcomes and quality indices. Secondary outcomes included teamwork behaviours, knowledge and attitudes. Results Both simulation and classroom-based team-training interventions can improve teamwork processes (eg, communication, coordination and cooperation), and implementation has been associated with improvements in patient safety outcomes. Thirteen studies published between 2011 and 2012 reported statistically significant changes in teamwork behaviours, processes or emergent states and 10 reported significant improvement in clinical care processes or patient outcomes, including mortality and morbidity. Effects were reported across a range of clinical contexts. Larger effect sizes were reported for bundled team-training interventions that included tools and organisational changes to support sustainment and transfer of teamwork competencies into daily practice. Conclusions Overall, moderate-to-high-quality evidence suggests team-training can positively impact healthcare team processes and patient outcomes. Additionally, toolkits are available to support intervention development and implementation. Evidence suggests bundled team-training interventions and implementation strategies that embed effective teamwork as a foundation for other improvement efforts may offer greatest impact on patient outcomes. PMID:24501181

Robot-Assisted Proprioceptive Training with Added Vibro-Tactile Feedback Enhances Somatosensory and Motor Performance.

PubMed

Cuppone, Anna Vera; Squeri, Valentina; Semprini, Marianna; Masia, Lorenzo; Konczak, Jürgen

2016-01-01

This study examined the trainability of the proprioceptive sense and explored the relationship between proprioception and motor learning. With vision blocked, human learners had to perform goal-directed wrist movements relying solely on proprioceptive/haptic cues to reach several haptically specified targets. One group received additional somatosensory movement error feedback in form of vibro-tactile cues applied to the skin of the forearm. We used a haptic robotic device for the wrist and implemented a 3-day training regimen that required learners to make spatially precise goal-directed wrist reaching movements without vision. We assessed whether training improved the acuity of the wrist joint position sense. In addition, we checked if sensory learning generalized to the motor domain and improved spatial precision of wrist tracking movements that were not trained. The main findings of the study are: First, proprioceptive acuity of the wrist joint position sense improved after training for the group that received the combined proprioceptive/haptic and vibro-tactile feedback (VTF). Second, training had no impact on the spatial accuracy of the untrained tracking task. However, learners who had received VTF significantly reduced their reliance on haptic guidance feedback when performing the untrained motor task. That is, concurrent VTF was highly salient movement feedback and obviated the need for haptic feedback. Third, VTF can be also provided by the limb not involved in the task. Learners who received VTF to the contralateral limb equally benefitted. In conclusion, somatosensory training can significantly enhance proprioceptive acuity within days when learning is coupled with vibro-tactile sensory cues that provide feedback about movement errors. The observable sensory improvements in proprioception facilitates motor learning and such learning may generalize to the sensorimotor control of the untrained motor tasks. The implications of these findings for neurorehabilitation are discussed.

Passive haptics in a knee arthroscopy simulator: is it valid for core skills training?

PubMed

McCarthy, Avril D; Moody, Louise; Waterworth, Alan R; Bickerstaff, Derek R

2006-01-01

Previous investigation of a cost-effective virtual reality arthroscopic training system, the Sheffield Knee Arthroscopy Training System (SKATS), indicated the desirability of including haptic feedback. A formal task analysis confirmed the importance of knee positioning as a core skill for trainees learning to navigate the knee arthroscopically. The system cost and existing limb interface, which permits knee positioning, would be compromised by the addition of commercial active haptic devices available currently. The validation results obtained when passive haptic feedback (resistance provided by physical structures) is provided indicate that SKATS has construct, predictive and face validity for navigation and triangulation training. When tested using SKATS, experienced surgeons (n = 11) performed significantly faster, located significantly more pathologies, and showed significantly shorter arthroscope path lengths than a less experienced surgeon cohort (n = 12). After SKATS training sessions, novices (n = 3) showed significant improvements in: task completion time, shorter arthroscope path lengths, shorter probe path lengths, and fewer arthroscope tip contacts. Main improvements occurred after the first two practice sessions, indicating rapid familiarization and a training effect. Feedback from questionnaires completed by orthopaedic surgeons indicates that the system has face validity for its remit of basic arthroscopic training.

Automation, robotics, and inflight training for manned Mars missions

NASA Technical Reports Server (NTRS)

Holt, Alan C.

1986-01-01

The automation, robotics, and inflight training requirements of manned Mars missions will be supported by similar capabilities developed for the space station program. Evolutionary space station onboard training facilities will allow the crewmembers to minimize the amount of training received on the ground by providing extensive onboard access to system and experiment malfunction procedures, maintenance procedures, repair procedures, and associated video sequences. Considerable on-the-job training will also be conducted for space station management, mobile remote manipulator operations, proximity operations with the Orbital Maneuvering Vehicle (and later the Orbit Transfer Vehicle), and telerobotics and mobile robots. A similar approach could be used for manned Mars mission training with significant additions such as high fidelity image generation and simulation systems such as holographic projection systems for Mars landing, ascent, and rendezvous training. In addition, a substantial increase in the use of automation and robotics for hazardous and tedious tasks would be expected for Mars mission. Mobile robots may be used to assist in the assembly, test and checkout of the Mars spacecraft, in the handling of nuclear components and hazardous chemical propellent transfer operations, in major spacecraft repair tasks which might be needed (repair of a micrometeroid penetration, for example), in the construction of a Mars base, and for routine maintenance of the base when unmanned.

New Roles for Medical Assistants in Innovative Primary Care Practices.

PubMed

Chapman, Susan A; Blash, Lisel K

2017-02-01

To identify and describe new roles for medical assistants (MAs) in innovative care models that improve care while providing training and career advancement opportunities for MAs. Primary data collected at 15 case study sites; 173 key informant interviews and de-identified secondary data on staffing, wages, patient satisfaction, and health outcomes. Researchers used snowball sampling and screening calls to identify 15 organizations using MAs in new roles. Conducted site visits from 2010 to 2012 and updated information in 2014. Thematic analysis explored key topics: factors driving MA role innovation, role description, training required, and wage gains. Categorized outcome data in patient and staff satisfaction, quality of care, and efficiency. New MA roles included health coach, medical scribe, dual role translator, health navigator, panel manager, cross-trained flexible role, and supervisor. Implementation of new roles required extensive training. MA incentives and enhanced compensation varied by role type. New MA roles are part of a larger attempt to reform workflow and relieve primary care providers. Despite some evidence of success, spread has been limited. Key challenges to adoption included leadership and provider resistance to change, cost of additional MA training, and lack of reimbursement for nonbillable services. © Health Research and Educational Trust.

The Otolaryngologist's Role in Providing Gender-Affirming Care: An Opportunity for Improved Education and Training.

PubMed

Chaiet, Scott R; Yoshikawa, Noriko; Sturm, Angela; Flanary, Valerie; Ishman, Stacey; Streed, Carl G

2018-06-01

Currently, there are limited resources and training available for otolaryngologists and otolaryngology practice personnel to provide gender-affirming care for transgender or gender nonconforming patients. This unique patient population may present to our offices for gender-specific care or with complaints of the ear, nose, and throat unrelated to gender identity. Our current practice has unintentional but direct consequences on our patients care, as transgender patients often report negative experiences in the healthcare setting related to their gender identity. The absence of resources and training is also seen in other specialties. Physicians who create an environment where patients of all gender identities feel welcome can better meet their patients' health care needs. In addition, otolaryngologists can play a role in easing the gender dysphoria experienced by transgender patients. We suggest educational content should be created for and made available to otolaryngologists and office staff to provide gender-affirming care.

Business policy practices that predict sales of tobacco.

PubMed

Gangeness, Jeanine E; Evanson, Tracy; Webb, Derek

2006-11-01

This pilot study with tobacco merchants asked how policy practices may influence sales of tobacco to youth. This study compared tobacco merchant new employee training and business policies and practices to business compliance data. Licensed tobacco merchants in a rural Minnesota county were mailed surveys regarding their new employee training and business policies practices. The returned surveys (75.9%, N = 44) were compared with tobacco compliance results that indicated if the business sold tobacco to youth during a county compliance check. The major finding from this study was that the survey respondents who did not sell tobacco to youth provided training on fake identification cards (68.0%, n = 17). Tobacco merchants who provided additional information on fake identification cards (40%,n = 6), chi(2)(2, n = 43) 6.66, p = .036, were more likely to not sell tobacco to youth than the merchants who did not provide fake identification card information.

Nontechnical skills training for the operating room: A prospective study using simulation and didactic workshop.

PubMed

Pena, Guilherme; Altree, Meryl; Field, John; Sainsbury, David; Babidge, Wendy; Hewett, Peter; Maddern, Guy

2015-07-01

The best surgeons demonstrate skills beyond those required for the performance of technically competent surgery. These skills are described under the term nontechnical skills. Failure in these domains has been associated with adverse events inside the operating room. These nontechnical skills are not learned commonly in a structured manner during surgery training. The main purpose of this study was to explore the effects of participation in simulation-based training, either as a sole strategy or as part of a combined approach on surgeons and surgical trainees nontechnical skills performance in simulation environment. The study consisted of a single-blinded, prospective comparative trial. Forty participants were enrolled, all participating in 2 simulation sessions challenging nontechnical skills comprising 3 surgical scenarios. Seventeen participants attended a 1-day, nontechnical skills workshop between simulation sessions. Scenarios were video-recorded for assessment and debriefing purposes. Assessment was made by 2 observers using the Non-Technical Skills for Surgeons (NOTSS) scoring system. There was a significant improvement in nontechnical skills performance of both groups from the first to the second simulation session, for 2 of the 3 scenarios. No difference in performance between the simulation and the simulation plus workshop groups was noted. This study provides evidence that formal training in nontechnical skills is feasible and can impact positively participants' nontechnical performance in a simulated environment. The addition of a 1-day didactic workshop does not seem to provide additional benefit over simulation-based training as a sole strategy for nontechnical skills training. Copyright © 2015 Elsevier Inc. All rights reserved.

Outcome of a one-week intensive training workshop for veterinary diagnostic laboratory workers in Liberia.

PubMed

Williamson, Julie A; Tornquist, Susan J

2014-01-01

There is a huge unmet need for veterinary diagnostic laboratory services in developing nations such as Liberia. One way of bridging the service gap is for visiting experts to provide veterinary laboratory training to technicians in a central location in a short-course format. An intensive 1-week training workshop was organized for 18 student and faculty participants from the College of Agriculture and Integrated Development Studies (CAIDS) at Cuttington University in rural central Liberia. The training was designed and delivered by the non-governmental organization Veterinarians Without Borders US and funded through a Farmer-to-Farmer grant provided by the United States Agency for International Development. Although at the start of training none of the students had any veterinary laboratory experience, by the end of the course over 80% of the students were able to discuss appropriate care and use of a microscope and name at least three important components of laboratory record keeping; over 60% were able to describe how to make and stain a blood smear and how to perform a passive fecal flotation; and over 30% were able to describe what a packed cell volume is and how it is measured and name at least three criteria for classifying bacteria. The intensive training workshop greatly improved the knowledge of trainees about veterinary diagnostic laboratory techniques. The training provided initial skills to students and faculty who are awaiting the arrival of additional grant-funded laboratory equipment to continue their training.

Empowering Effective STEM Role Models to Promote STEM Equity in Local Communities

NASA Astrophysics Data System (ADS)

Harte, T.; Taylor, J.

2017-12-01

Empowering Effective STEM Role Models, a three-hour training developed and successfully implemented by NASA Langley Research Center's Science Directorate, is an effort to encourage STEM professionals to serve as role models within their community. The training is designed to help participants reflect on their identity as a role model and provide research-based strategies to effectively engage youth, particularly girls, in STEM (science, technology, engineering, and mathematics). Research shows that even though girls and boys do not demonstrate a significant difference in their ability to be successful in mathematics and science, there is a significant difference in their confidence level when participating in STEM subject matter and pursuing STEM careers. The Langley training model prepares professionals to disrupt this pattern and take on the habits and skills of effective role models. The training model is based on other successful models and resources for role modeling in STEM including SciGirls; the National Girls Collaborative; and publications by the American Association of University Women and the National Academies. It includes a significant reflection component, and participants walk through situation-based scenarios to practice a focused suite of research-based strategies. These strategies can be implemented in a variety of situations and adapted to the needs of groups that are underrepresented in STEM fields. Underpinning the training and the discussions is the fostering of a growth mindset and promoting perseverance. "The Power of Yet" becomes a means whereby role models encourage students to believe in themselves, working toward reaching their goals and dreams in the area of STEM. To provide additional support, NASA Langley role model trainers are available to work with a champion at other organizations to facilitate the training. This champion helps recruit participants, seeks leadership buy-in, and helps provide valuable insights for needs and interests specific to the organization. After the in-person training experience, participants receive additional follow-up support by working with their local champions and the NASA Langley trainers. The goal is to share the role model training model in an effort to empower STEM role models and assist in promoting STEM Equity in all communities.

Dissociable effects of game elements on motivation and cognition in a task-switching training in middle childhood

PubMed Central

Dörrenbächer, Sandra; Müller, Philipp M.; Tröger, Johannes; Kray, Jutta

2014-01-01

Although motivational reinforcers are often used to enhance the attractiveness of trainings of cognitive control in children, little is known about how such motivational manipulations of the setting contribute to separate gains in motivation and cognitive-control performance. Here we provide a framework for systematically investigating the impact of a motivational video-game setting on the training motivation, the task performance, and the transfer success in a task-switching training in middle-aged children (8–11 years of age). We manipulated both the type of training (low-demanding/single-task training vs. high-demanding/task-switching training) as well as the motivational setting (low-motivational/without video-game elements vs. high-motivational/with video-game elements) separately from another. The results indicated that the addition of game elements to a training setting enhanced the intrinsic interest in task practice, independently of the cognitive demands placed by the training type. In the task-switching group, the high-motivational training setting led to an additional enhancement of task and switching performance during the training phase right from the outset. These motivation-induced benefits projected onto the switching performance in a switching situation different from the trained one (near-transfer measurement). However, in structurally dissimilar cognitive tasks (far-transfer measurement), the motivational gains only transferred to the response dynamics (speed of processing). Hence, the motivational setting clearly had a positive impact on the training motivation and on the paradigm-specific task-switching abilities; it did not, however, consistently generalize on broad cognitive processes. These findings shed new light on the conflation of motivation and cognition in childhood and may help to refine guidelines for designing adequate training interventions. PMID:25431564

Exploratory development and services for preparing and examining ultrathin polished sections of lunar rocks and particulates, part 1

NASA Technical Reports Server (NTRS)

Beauchamp, R. H.; Williford, J. F.; Gafford, E. L.

1972-01-01

Development of improved procedures is reported for three classes of lunar materials: dense rocks, breccias, and particulates. High quality ultrathin sections of these materials are obtained. Lists of equipment and supplies, procedures, photomicrographic documentation, and training are provided. Advantages of ultrathin polished sections for conventional and unconventional optical microscopy methods are described. Recommendations are provided for use of ultrathin sections in lunar rock studies, for further refinement of ultrathinning procedures, and for additional training efforts to establish a capability at the Manned Space Center. For Part 2, See N72-50754.

Foreign Security Force Advisor Training, Doctrine, and Manning for 2015 and Beyond

DTIC Science & Technology

2016-03-01

training is required prior to additional deployments. Additionally , once enough survey data is gathered, the MCSCG could request another thesis student...better support the continued improvement in training and certification of teams prior to deployment. Additionally , the research found that the total...improvement in training and certification of teams prior to deployment. Additionally , the research found that the total compensation for one training

Causes of the triglyceride-lowering effect of exercise training in rats

NASA Technical Reports Server (NTRS)

Mondon, C. E.; Dolkas, C. B.; Tobey, T.; Reaven, G. M.

1984-01-01

Studies conducted with human subjects and laboratory animals have consistently shown a reduction in serum triglyceride (TG) in exercise-trained subjects. The obtained data have suggested that this decrease was due to a reduction in hepatic TG secretion. The present investigation, which was conducted with rats trained to attain a high level of spontaneous running activity, provides support for the earlier results. In addition, insights are obtained regarding the mechanism by which exercise lowers TG levels. Since the liver accounts for the vast majority of endogenous very low density lipoprotein (VLDL)-TG secretion, the fall in TG secretion rate seen in exercise-trained (ET) rats must be due to a reduction in hepatic TG secretion.

Utilizing feedback in adaptive SAR ATR systems

NASA Astrophysics Data System (ADS)

Horsfield, Owen; Blacknell, David

2009-05-01

Existing SAR ATR systems are usually trained off-line with samples of target imagery or CAD models, prior to conducting a mission. If the training data is not representative of mission conditions, then poor performance may result. In addition, it is difficult to acquire suitable training data for the many target types of interest. The Adaptive SAR ATR Problem Set (AdaptSAPS) program provides a MATLAB framework and image database for developing systems that adapt to mission conditions, meaning less reliance on accurate training data. A key function of an adaptive system is the ability to utilise truth feedback to improve performance, and it is this feature which AdaptSAPS is intended to exploit. This paper presents a new method for SAR ATR that does not use training data, based on supervised learning. This is achieved by using feature-based classification, and several new shadow features have been developed for this purpose. These features allow discrimination of vehicles from clutter, and classification of vehicles into two classes: targets, comprising military combat types, and non-targets, comprising bulldozers and trucks. The performance of the system is assessed using three baseline missions provided with AdaptSAPS, as well as three additional missions. All performance metrics indicate a distinct learning trend over the course of a mission, with most third and fourth quartile performance levels exceeding 85% correct classification. It has been demonstrated that these performance levels can be maintained even when truth feedback rates are reduced by up to 55% over the course of a mission.

IUD knowledge and experience among family medicine residents.

PubMed

Schubert, Finn D; Herbitter, Cara; Fletcher, Jason; Gold, Marji

2015-06-01

The intrauterine device (IUD) is a highly effective contraceptive method with few contraindications; however, clinician lack of training in insertion and misconceptions about IUD risks are barriers to utilization. Previous research has shown gaps in IUD training in family medicine residency programs. An online survey addressing experience with IUD insertion, knowledge of patient eligibility and IUD risks, and intent to insert IUDs in practice was circulated to residents at 15 US family medicine residency programs. Programs were eligible to participate if they were receiving funding to enhance training in family planning and abortion care and interested in additional support to enhance IUD training. The overall response rate for the surveys was 76.1% (332/436). Experience with the levonorgestrel intrauterine system was more common than with the copper IUD. Residents performed well on knowledge questions, but many would not insert in common patient scenarios in which insertion was not contraindicated, including a history of sexually transmitted infection in the past 6 months (48.2% would not insert), a history of ectopic pregnancy (37.0%), no pap smear in the past year (30.7%), or if the patient was not in a monogamous relationship (29.2%). The vast majority of residents (88.7%) reported that they were likely or very likely to provide IUDs in their future family medicine practice. Although residents overwhelmingly expressed interest in providing IUDs after residency, our results suggest that additional clinical and didactic training is needed, particularly interventions targeted at dispelling misconceptions about patient eligibility for IUDs.

Design and implementation of a virtual world training simulation of ICU first hour handover processes.

PubMed

Brown, Ross; Rasmussen, Rune; Baldwin, Ian; Wyeth, Peta

2012-08-01

Nursing training for an Intensive Care Unit (ICU) is a resource intensive process. High demands are made on staff, students and physical resources. Interactive, 3D computer simulations, known as virtual worlds, are increasingly being used to supplement training regimes in the health sciences; especially in areas such as complex hospital ward processes. Such worlds have been found to be very useful in maximising the utilisation of training resources. Our aim is to design and develop a novel virtual world application for teaching and training Intensive Care nurses in the approach and method for shift handover, to provide an independent, but rigorous approach to teaching these important skills. In this paper we present a virtual world simulator for students to practice key steps in handing over the 24/7 care requirements of intensive care patients during the commencing first hour of a shift. We describe the modelling process to provide a convincing interactive simulation of the handover steps involved. The virtual world provides a practice tool for students to test their analytical skills with scenarios previously provided by simple physical simulations, and live on the job training. Additional educational benefits include facilitation of remote learning, high flexibility in study hours and the automatic recording of a reviewable log from the session. To the best of our knowledge, we believe this is a novel and original application of virtual worlds to an ICU handover process. The major outcome of the work was a virtual world environment for training nurses in the shift handover process, designed and developed for use by postgraduate nurses in training. Copyright © 2012 Australian College of Critical Care Nurses Ltd. Published by Elsevier Ltd. All rights reserved.

The "global surgeon": is it time for modifications in the American surgical training paradigm?

PubMed

Ginwalla, Rashna F; Rustin, Rudolph B

2015-01-01

"Global surgery" is becoming an increasingly popular concept not only for new trainees, but also for established surgeons. The need to provide surgical care in low-resource settings is laudable, but the American surgical training system currently does not impart the breadth of skills required to provide quality care. We propose one possible model for a surgical fellowship program that provides those trainees who desire to practice in these settings a comprehensive experience that encompasses not only broad technical skills but also the opportunity to engage in policy and programmatic development and implementation. This is a descriptive commentary based on personal experience and a review of the literature. The proposed model is 2 years long, and can either be done after general surgery training as an additional "global surgery" fellowship or as part of a 3 + 2 general surgery + global surgery system. It would incorporate training in general surgery as well as orthopedics, urology, obstetrics & gynecology, neurosurgery, plastics & reconstructive surgery, as well as dedicated time for health systems training. Incorporating such training in a low-resource setting would be a requirement of such a program, in order to obtain field experience. Global surgery is a key word these days in attracting young trainees to academic surgical residency programs, yet they are subsequently inadequately trained to provide the required surgical services in these low-resource settings. Dedicated programmatic changes are required to allow those who choose to practice in these settings to obtain the full breadth of training needed to become safe, competent surgeons in such environments. Copyright © 2015 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Career Paths of Pathology Informatics Fellowship Alumni.

PubMed

Rudolf, Joseph W; Garcia, Christopher A; Hanna, Matthew G; Williams, Christopher L; Balis, Ulysses G; Pantanowitz, Liron; Tuthill, J Mark; Gilbertson, John R

2018-01-01

The alumni of today's Pathology Informatics and Clinical Informatics fellowships fill diverse roles in academia, large health systems, and industry. The evolving training tracks and curriculum of Pathology Informatics fellowships have been well documented. However, less attention has been given to the posttraining experiences of graduates from informatics training programs. Here, we examine the career paths of subspecialty fellowship-trained pathology informaticians. Alumni from four Pathology Informatics fellowship training programs were contacted for their voluntary participation in the study. We analyzed various components of training, and the subsequent career paths of Pathology Informatics fellowship alumni using data extracted from alumni provided curriculum vitae. Twenty-three out of twenty-seven alumni contacted contributed to the study. A majority had completed undergraduate study in science, technology, engineering, and math fields and combined track training in anatomic and clinical pathology. Approximately 30% (7/23) completed residency in a program with an in-house Pathology Informatics fellowship. Most completed additional fellowships (15/23) and many also completed advanced degrees (10/23). Common primary posttraining appointments included chief medical informatics officer (3/23), director of Pathology Informatics (10/23), informatics program director (2/23), and various roles in industry (3/23). Many alumni also provide clinical care in addition to their informatics roles (14/23). Pathology Informatics alumni serve on a variety of institutional committees, participate in national informatics organizations, contribute widely to scientific literature, and more than half (13/23) have obtained subspecialty certification in Clinical Informatics to date. Our analysis highlights several interesting phenomena related to the training and career trajectory of Pathology Informatics fellowship alumni. We note the long training track alumni complete in preparation for their careers. We believe flexible training pathways combining informatics and clinical training may help to alleviate the burden. We highlight the importance of in-house Pathology Informatics fellowships in promoting interest in informatics among residents. We also observe the many important leadership roles in academia, large community health systems, and industry available to early career alumni and believe this reflects a strong market for formally trained informaticians. We hope this analysis will be useful as we continue to develop the informatics fellowships to meet the future needs of our trainees and discipline.

Design and development of a virtual reality simulator for advanced cardiac life support training.

PubMed

Vankipuram, Akshay; Khanal, Prabal; Ashby, Aaron; Vankipuram, Mithra; Gupta, Ashish; DrummGurnee, Denise; Josey, Karen; Smith, Marshall

2014-07-01

The use of virtual reality (VR) training tools for medical education could lead to improvements in the skills of clinicians while providing economic incentives for healthcare institutions. The use of VR tools can also mitigate some of the drawbacks currently associated with providing medical training in a traditional clinical environment such as scheduling conflicts and the need for specialized equipment (e.g., high-fidelity manikins). This paper presents the details of the framework and the development methodology associated with a VR-based training simulator for advanced cardiac life support, a time critical, team-based medical scenario. In addition, we also report the key findings of a usability study conducted to assess the efficacy of various features of this VR simulator through a postuse questionnaire administered to various care providers. The usability questionnaires were completed by two groups that used two different versions of the VR simulator. One version consisted of the VR trainer with it all its features and a minified version with certain immersive features disabled. We found an increase in usability scores from the minified group to the full VR group.

Digital Video and the Internet: A Powerful Combination.

ERIC Educational Resources Information Center

Barron, Ann E.; Orwig, Gary W.

1995-01-01

Provides an overview of digital video and outlines hardware and software necessary for interactive training on the World Wide Web and for videoconferences via the Internet. Lists sites providing additional information on digital video, on CU-SeeMe software, and on MBONE (Multicast BackBONE), a technology that permits real-time transmission of…

Stroke Knowledge among Urban and Frontier First Responders and Emergency Medical Technicians in Montana

ERIC Educational Resources Information Center

McNamara, Michael J.; Oser, Carrie; Gohdes, Dorothy; Fogle, Crystelle C.; Dietrich, Dennis W.; Burnett, Anne; Okon, Nicholas; Russell, Joseph A.; DeTienne, James; Harwell, Todd S.; Helgerson, Steven D.

2008-01-01

Purpose: To assess stroke knowledge and practice among frontier and urban emergency medical services (EMS) providers and to evaluate the need for additional prehospital stroke training opportunities in Montana. Methods: In 2006, a telephone survey of a representative sample of EMS providers was conducted in Montana. Respondents were stratified…

Willingness of Rhode Island Dentists to Provide Limited Preventive Primary Care.

PubMed

Dang, Catherine Tuyet Mai; Shield, Renee R; Giddon, Donald B

2016-07-01

In response to the shortage of primary care physicians and the need for greater intercollaboration among health professionals, dentists with sufficient medical and surgical training are an untapped resource to provide limited preventive primary care (LPPC), such as chairside screening for chronic diseases. The objective of this study was to determine attitudes of Rhode Island dentists toward becoming more involved in the overall health of their patients. Using a 5-point scale (1 being highest), a pretested survey was administered to 92 respondent RI dentists who were asked to indicate their willingness to become more involved in patients' overall health, and undergo additional training to provide LPPC. Their moderate level of willingness was offset by great concern for liability, with older dentists being significantly more willing to assume these additional responsibilities than younger dentists (p< .05). Rank order of designation of oral health providers among dentist, dental physician, oral physician, odontologist, stomatologist, and stomiatrist was still dentist first, but with no significant difference between the mean ranks of dentist and oral physician.[Full article available at http://rimed.org/rimedicaljournal-2016-07.asp, free with no login].

Training clinicians to identify the hidden victims: children and adolescents who witness violence.

PubMed

Augustyn, Marilyn; Groves, Betsy McAlister

2005-12-01

In this article, we will provide an overview of the effects of witnessing violence on children and adolescents, discuss the importance of health clinicians inquiring about violence in the lives of children, and discuss the role of the clinician in educating parents about children's responses to violence. In addition, we will describe training resources that improve clinicians' skills at identifying and responding to children and their parents.

Adaptive Computerized Training System (ACTS): A Knowledge Base System for Electronic Troubleshooting

DTIC Science & Technology

1983-12-01

Design Z.3.1 Field System Z.3.e Research System Z.4 Information Flow and Management 2.4.1 Student Performance Recording .4.? Student Operational...could more easily relate to. In addition, many automated management tools were created to assist instructors with courseware authoring, student...ACTS was installed and demonstrated at Ft. Gordon. The training managers , instructors, and SMt’s who participated in those demonstrations provided

Education: The Heart of the Matter.

PubMed

Morriss, Wayne W; Milenovic, Miodrag S; Evans, Faye M

2018-04-01

There are inadequate numbers of anesthesia providers in many parts of the world. Good quality educational programs are needed to increase provider numbers, train leaders and teachers, and increase knowledge and skills. In some countries, considerable external support may be required to develop self-sustaining programs. There are some key themes related to educational programs in low- and middle-income countries:(1) Programs must be appropriate for the local environment-there is no "one-size-fits-all" program. In some countries, nonuniversity programs may be appropriate for training providers.(2) It is essential to train local teachers-a number of short courses provide teacher training. Overseas attachments may also play an important role in developing leadership and teaching capacity.(3) Interactive teaching techniques, such as small-group discussions and simulation, have been incorporated into many educational programs. Computer learning and videoconferencing offer additional educational possibilities.(4) Subspecialty education in areas such as obstetric anesthesia, pediatric anesthesia, and pain management are needed to develop leadership and increase capacity in subspecialty areas of practice. Examples include short subspecialty courses and clinical fellowships.(5) Collaboration and coordination are vital. Anesthesiologists need to work with ministries of health and other organizations to develop plans that are matched to need. External organizations can play an important role.(6) Excellent education is required at all levels. Training guidelines could help to standardize and improve training. Resources should be available for research, as well as monitoring and evaluation of educational programs.

Building and Maintaining Organizational Infrastructure to Attain Clinical Excellence.

PubMed

Lebak, Kelly; Lane, Jason; Taus, Richard; Kim, Hansol; Stecker, Michael S; Hall, Michael; Lane-Fall, Meghan B; Weiss, Mark S

2017-12-01

Active maintenance of highly functional teams is critical to ensuring safe, efficient patient care in the non-operating room anesthesia (NORA) suite. In addition to developing collaborative relationships and patient care protocols, individual and team training is needed. For anesthesiologists, this training must begin during residency. The training should be supplemented with continuing education in this field for providers who find themselves working in the NORA space. As NORA continues to grow, robust NORA-specific quality assurance and improvement programs will empower anesthesiologists with the tools they need to best care for these patients. Copyright © 2017 Elsevier Inc. All rights reserved.

The expert-generalist: a contradiction whose time has come.

PubMed

Fins, Joseph J

2015-08-01

The author suggests the creation of expert-generalists to help provide the additional cost-effective access to care necessitated by increased insurance coverage under the Affordable Care Act. Expert-generalists, a concept drawn from an extant Canadian model, would be a cohort of primary care physicians who obtain additional training in a subspecialty area, which would widen their practice portfolio and bring enhanced infrastructure to primary care settings. Expanding the reach of primary care into the realm of more advanced subspecialty practice could be a way to enhance both access to and quality of care in a cost-effective fashion, in part because the educational framework for additional training already exists. Trainees could opt for an extra year of training after traditional residency or return to training after years in practice. Properly trained, an expert-generalist would benefit both the quality of the patient experience and the bottom line by expertly triaging patients to determine who will truly benefit from specialty consultations, decreasing specialists' engagement with cases that do not require their higher-tier care. The author considers the merits of this proposal, as well as potential objections and implementation challenges. It is suggested that this model be adopted incrementally, using demonstration projects that could assess the impact of an expert-generalist initiative on the physician workforce and on patients' access to quality primary and specialty care.

Training auscultatory skills: computer simulated heart sounds or additional bedside training? A randomized trial on third-year medical students

PubMed Central

2010-01-01

Background The present study compares the value of additional use of computer simulated heart sounds, to conventional bedside auscultation training, on the cardiac auscultation skills of 3rd year medical students at Oslo University Medical School. Methods In addition to their usual curriculum courses, groups of seven students each were randomized to receive four hours of additional auscultation training either employing a computer simulator system or adding on more conventional bedside training. Cardiac auscultation skills were afterwards tested using live patients. Each student gave a written description of the auscultation findings in four selected patients, and was rewarded from 0-10 points for each patient. Differences between the two study groups were evaluated using student's t-test. Results At the auscultation test no significant difference in mean score was found between the students who had used additional computer based sound simulation compared to additional bedside training. Conclusions Students at an early stage of their cardiology training demonstrated equal performance of cardiac auscultation whether they had received an additional short auscultation course based on computer simulated training, or had had additional bedside training. PMID:20082701

Vision training methods for sports concussion mitigation and management.

PubMed

Clark, Joseph F; Colosimo, Angelo; Ellis, James K; Mangine, Robert; Bixenmann, Benjamin; Hasselfeld, Kimberly; Graman, Patricia; Elgendy, Hagar; Myer, Gregory; Divine, Jon

2015-05-05

There is emerging evidence supporting the use vision training, including light board training tools, as a concussion baseline and neuro-diagnostic tool and potentially as a supportive component to concussion prevention strategies. This paper is focused on providing detailed methods for select vision training tools and reporting normative data for comparison when vision training is a part of a sports management program. The overall program includes standard vision training methods including tachistoscope, Brock's string, and strobe glasses, as well as specialized light board training algorithms. Stereopsis is measured as a means to monitor vision training affects. In addition, quantitative results for vision training methods as well as baseline and post-testing *A and Reaction Test measures with progressive scores are reported. Collegiate athletes consistently improve after six weeks of training in their stereopsis, *A and Reaction Test scores. When vision training is initiated as a team wide exercise, the incidence of concussion decreases in players who participate in training compared to players who do not receive the vision training. Vision training produces functional and performance changes that, when monitored, can be used to assess the success of the vision training and can be initiated as part of a sports medical intervention for concussion prevention.

A Survey of Hospice Volunteer Coordinators: Training Methods and Objectives of Current Hospice Volunteer Training Programs.

PubMed

Brock, Cara M; Herndon, Christopher M

2017-06-01

Currently more than 5800 hospice organizations operate in the United States. 1 Hospice organizations are required by the Centers for Medicare and Medicaid Services (CMS) to use volunteers for services provided to patients. 2 Although CMS regulates the amount of hours hospice volunteers should provide, there are currently no national requirements for objectives of training. 3 The purpose of this study was to gather information from a sample of hospices regarding volunteer coordinator background, current training for volunteers, importance of training objectives, and any comments regarding additional objectives. Representative state hospice organizations were contacted by e-mail requesting their participation and distribution of the survey throughout their member hospices. The survey asked demographical questions, along with ratings of training components based on perceived level of importance and time spent on each objective. A total of 90 surveys were received, and the response rate was undeterminable. Results showed the majority of hospices were nonprofit, had less than 100 currently trained volunteers, and maintained an average daily patient census of less than 50. Questions regarding training programs indicated that most use live lecture methods of approximately 19 hours or less in duration. Overall, responding hospice organizations agreed that all objectives surveyed were important in training volunteers. The small number of respondents to this survey makes generalization nationwide difficult, however it is a strong starting point for the development of further surveys on hospice volunteer training and achieving a standardized set of training objectives and delivery methods.

A comparison of traditional handwashing training with active handwashing training in the food handler industry.

PubMed

Lillquist, Dean R; McCabe, Mary L; Church, Kurt Haden

2005-01-01

The Centers for Disease Control and Prevention (CDC) have stated that poor personal hygiene is the third most commonly reported food preparation practice contributing to foodborne disease and h further claimed that contaminated hands may be the most important means by which enteric viruses are transmitted. The study reported here compared the effectiveness of traditional (lecture/video) training with that of traditional training that provided an added active (hands-on) component for the retention of handwashing procedures two weeks after the initial training. Sixty-six food handlers attending training courses were included in the study. All participants received the same lecture/video presentation. Twenty-two (33 percent) of the participants received an additional interactive training component. All participants were tested by a 20-item written test on the day of training. Two weeks after the training, 25 to 30 percent of participants from each group were retested. Results revealed that the participants involved in the interactive training had statistically significant better test performances both on the day of training and on the two-week retest.

Efficacy of Multiple-Talker Phonetic Identification Training in Postlingually Deafened Cochlear Implant Listeners.

PubMed

Miller, Sharon E; Zhang, Yang; Nelson, Peggy B

2016-02-01

This study implemented a pretest-intervention-posttest design to examine whether multiple-talker identification training enhanced phonetic perception of the /ba/-/da/ and /wa/-/ja/ contrasts in adult listeners who were deafened postlingually and have cochlear implants (CIs). Nine CI recipients completed 8 hours of identification training using a custom-designed training package. Perception of speech produced by familiar talkers (talkers used during training) and unfamiliar talkers (talkers not used during training) was measured before and after training. Five additional untrained CI recipients completed identical pre- and posttests over the same time course as the trainees to control for procedural learning effects. Perception of the speech contrasts produced by the familiar talkers significantly improved for the trained CI listeners, and effects of perceptual learning transferred to unfamiliar talkers. Such training-induced significant changes were not observed in the control group. The data provide initial evidence of the efficacy of the multiple-talker identification training paradigm for CI users who were deafened postlingually. This pattern of results is consistent with enhanced phonemic categorization of the trained speech sounds.

Interdisciplinary Transgender Veteran Care: Development of a Core Curriculum for VHA Providers.

PubMed

Shipherd, Jillian C; Kauth, Michael R; Firek, Anthony F; Garcia, Ranya; Mejia, Susan; Laski, Sandra; Walden, Brent; Perez-Padilla, Sonia; Lindsay, Jan A; Brown, George; Roybal, Lisa; Keo-Meier, Colton L; Knapp, Herschel; Johnson, Laura; Reese, Rebecca L; Byne, William

2016-01-01

Purpose: The Veteran's Health Administration (VHA) has created a training program for interdisciplinary teams of providers on the unique treatment needs of transgender veterans. An overview of this program's structure and content is described along with an evaluation of each session and the program overall. Methods: A specialty care team delivered 14 didactic courses supplemented with case consultation twice per month over the course of 7 months through video teleconferencing to 16 teams of learners. Each team, consisting of at least one mental health provider (e.g., social worker, psychologist, or psychiatrist) and one medical provider (e.g., physician, nurse, physician assistant, advanced practice nurse, or pharmacist), received training and consultation on transgender veteran care. Results: In the first three waves of learners, 111 providers across a variety of disciplines attended the sessions and received training. Didactic topics included hormone therapy initiation and adjustments, primary care issues, advocacy within the system, and psychotherapy issues. Responses were provided to 39 veteran-specific consult questions to augment learning. Learners reported an increase in knowledge plus an increase in team cohesion and functioning. As a result, learners anticipated treating more transgender veterans in the future. Conclusion: VHA providers are learning about the unique healthcare needs of transgender veterans and benefitting from the training opportunity offered through the Transgender Specialty Care Access Network-Extension of Community Healthcare Outcomes program. The success of this program in training interdisciplinary teams of providers suggests that it might serve as a model for other large healthcare systems. In addition, it provides a path forward for individual learners (both within VHA and in the community) who wish to increase their knowledge.

Interdisciplinary Transgender Veteran Care: Development of a Core Curriculum for VHA Providers

PubMed Central

Shipherd, Jillian C.; Kauth, Michael R.; Firek, Anthony F.; Garcia, Ranya; Mejia, Susan; Laski, Sandra; Walden, Brent; Perez-Padilla, Sonia; Lindsay, Jan A.; Brown, George; Roybal, Lisa; Keo-Meier, Colton L.; Knapp, Herschel; Johnson, Laura; Reese, Rebecca L.; Byne, William

2016-01-01

Abstract Purpose: The Veteran's Health Administration (VHA) has created a training program for interdisciplinary teams of providers on the unique treatment needs of transgender veterans. An overview of this program's structure and content is described along with an evaluation of each session and the program overall. Methods: A specialty care team delivered 14 didactic courses supplemented with case consultation twice per month over the course of 7 months through video teleconferencing to 16 teams of learners. Each team, consisting of at least one mental health provider (e.g., social worker, psychologist, or psychiatrist) and one medical provider (e.g., physician, nurse, physician assistant, advanced practice nurse, or pharmacist), received training and consultation on transgender veteran care. Results: In the first three waves of learners, 111 providers across a variety of disciplines attended the sessions and received training. Didactic topics included hormone therapy initiation and adjustments, primary care issues, advocacy within the system, and psychotherapy issues. Responses were provided to 39 veteran-specific consult questions to augment learning. Learners reported an increase in knowledge plus an increase in team cohesion and functioning. As a result, learners anticipated treating more transgender veterans in the future. Conclusion: VHA providers are learning about the unique healthcare needs of transgender veterans and benefitting from the training opportunity offered through the Transgender Specialty Care Access Network–Extension of Community Healthcare Outcomes program. The success of this program in training interdisciplinary teams of providers suggests that it might serve as a model for other large healthcare systems. In addition, it provides a path forward for individual learners (both within VHA and in the community) who wish to increase their knowledge. PMID:29159298

34 CFR 387.30 - What additional selection criteria are used under this program?

Code of Federal Regulations, 2012 CFR

2012-07-01

... achievement of the established project objectives of the training project; (ii) The curriculum and teaching methods provide for an integration of theory and practice relevant to the educational objectives of the...

34 CFR 387.30 - What additional selection criteria are used under this program?

Code of Federal Regulations, 2010 CFR

2010-07-01

... achievement of the established project objectives of the training project; (ii) The curriculum and teaching methods provide for an integration of theory and practice relevant to the educational objectives of the...

34 CFR 387.30 - What additional selection criteria are used under this program?

Code of Federal Regulations, 2013 CFR

2013-07-01

... achievement of the established project objectives of the training project; (ii) The curriculum and teaching methods provide for an integration of theory and practice relevant to the educational objectives of the...

Reliability of the individual components of the Canadian Armed Forces Physical Employment Standard.

PubMed

Stockbrugger, Barry G; Reilly, Tara J; Blacklock, Rachel E; Gagnon, Patrick J

2018-01-29

This investigation recruited 24 participants from both the Canadian Armed Forces (CAF) and civilian populations to complete 4 separate trials at "best effort" of each of the 4 components in the CAF Physical Employment Standard named the FORCE Evaluation: Fitness for Operational Requirements of CAF Employment. Analyses were performed to examine the level of variability and reliability within each component. The results demonstrate that candidates should be provided with at least 1 retest if they have recently completed at least 2 previous best effort attempts as per the protocol. In addition, the minimal detectable difference is given for each of the 4 components in seconds which identifies the threshold for subsequent action, either retest or remedial training, for those unable to meet the minimum standard. These results will educate the delivery of this employment standard, function as a method of accommodation, in addition to providing direction for physical training programs.

Combined isometric and vibration training does not enhance strength beyond that of isometric training alone.

PubMed

Fisher, J; Van-Dongen, M; Sutherland, R

2014-10-08

Research considering combined vibration and strength training is extensive yet results are equivocal. However, to date there appears no research which has considered the combination of both direct vibration and whole---body vibration when used in an isometric deadlift position. The aims of this study were to compare groups performing isometric training with and without direct and whole---body vibration. Twenty four participants (19---24 years) were randomly divided into: isometric training with vibration (ST+VT: n=8), isometric training without vibration (ST: n=8), and control (CON: n=8). Within the training groups participants trained twice per week, for 6 weeks, performing 6---sets of maximal isometric deadlift contractions, increasing in duration from 30 seconds to 40 seconds (weeks 1---6). Hip and knee angle was maintained at 60° and 110°, respectively for both testing and training. Training sessions for ST+VT were identical to ST with the addition of a direct vibratory stimulus through hand---held straps and whole---body vibration via standing on vibration a platform. The amplitude remained constant (2mm) throughout the intervention whilst the frequency increased from 35Hz to 50Hz. Pre--- and post---test isometric strength was measured using an isometric deadlift dynamometer. Results revealed significant increases in isometric strength for both ST+VT (p < 0.001, 23.8%) and ST (p < 0.001, 32.5%) compared to CON, with no significant differences between ST+VT and ST training groups. The present study provides evidence to suggest that there are no greater gains to be incurred by the addition of a vibratory stimulus to traditional strength training.

Combined isometric and vibration training does not enhance strength beyond that of isometric training alone.

PubMed

Fisher, J; Van-Dongen, M; Sutherland, R

2015-09-01

Research considering combined vibration and strength training is extensive yet results are equivocal. However, to date there appears no research which has considered the combination of both direct vibration and whole-body vibration when used in an isometric deadlift position. The aim of this study was to compare groups performing isometric training with and without direct and whole-body vibration. Twenty four participants (19-24 years) were randomly divided into: isometric training with vibration (ST+VT: N.=8), isometric training without vibration (ST: N.=8), and control (CON: N.=8). Within the training groups participants trained twice per week, for 6 weeks, performing 6-sets of maximal isometric deadlift contractions, increasing in duration from 30 seconds to 40 seconds (weeks 1-6). Hip and knee angle was maintained at 60° and 110°, respectively for both testing and training. Training sessions for ST+VT were identical to ST with the addition of a direct vibratory stimulus through hand-held straps and whole-body vibration via standing on vibration a platform. The amplitude remained constant (2 mm) throughout the intervention whilst the frequency increased from 35Hz to 50Hz. Pre- and post-test isometric strength was measured using an isometric deadlift dynamometer. Results revealed significant increases in isometric strength for both ST+VT (P<0.001, 23.8%) and ST (P<0.001, 32.5%) compared to CON, with no significant differences between ST+VT and ST training groups. The present study provides evidence to suggest that there are no greater gains to be incurred by the addition of a vibratory stimulus to traditional strength training.

Experiential versus rational training: a comparison of student attitudes toward homosexuality.

PubMed

Guth, Lorraine J; Lopez, David F; Rojas, Julio; Clements, Kimberly D; Tyler, J Michael

2004-01-01

Based on Epstein's (1994a) cognitive-experiential self-theory, two new training interventions were designed to teach students about gay, lesbian and bisexual issues. The efficacy of these theoretically based interventions was assessed in a short-term (7-week, three occasion) longitudinal study. Fifty undergraduate psychology students were randomly assigned to one of three treatment groups: Rational Training, Experiential Training, or Control Group. A residualized change score procedure was used to analyze change in levels of sexual prejudice and affect across the three types of measurement (pre-test, post-test, and follow-up). A 3 (Rational Training, Experiential Training, Control Group) x 2 (Low Sexual Prejudice, High Sexual Prejudice) MANOVA revealed that after the training, participants in the Experiential Group (affective training) had more accepting attitudes toward homosexuality compared to the Control Group. In addition, participants in the Experiential Group experienced more positive affect compared to the Rational and Control Groups and experienced more negative affect compared to the Rational Group. Findings are discussed and suggestions for future research are provided.

Efficacy of Environmental Health E-Training for Journalists

PubMed Central

Parin, Megan L.; Yancey, Elissa; Beidler, Caroline; Haynes, Erin N.

2015-01-01

Communities report a low level of trust in environmental health media coverage. In order to support risk communication objectives, the goals of the research study were to identify whether or not there is a gap in environmental reporting training for journalists, to outline journalists’ methods for gathering environmental health news, to observe journalists’ attitudes toward environmental health training and communication, and to determine if electronic training (online/e-training) can effectively train journalists in environmental health topics. The results indicated that environmental journalists have very little to no formal environmental journalism training. In addition, a significant percentage of journalists do not have any formal journalism education. Respondents most preferred to receive continuing environmental journalism training online. Online instruction was also perceived as effective in increasing knowledge and providing necessary reporting tools, even among participants adverse to online instructional methods. Our findings highlight the changing media climate’s need for an increase in electronic journalism education opportunities to support environmental health journalism competencies among working professional journalists. PMID:26998499

The use of contextual cues to improve warning symbol comprehension: making the connection for older adults.

PubMed

Lesch, Mary F; Powell, W Ryan; Horrey, William J; Wogalter, Michael S

2013-01-01

This study teased apart the effects of comprehensibility and complexity on older adults' comprehension of warning symbols by manipulating the relevance of additional information in further refining the meaning of the symbol. Symbols were systematically altered such that increased visual complexity (in the form of contextual cues) resulted in increased comprehensibility. One hundred older adults, aged 50-71 years, were tested on their comprehension of these symbols before and after training. High comprehensibility-complexity symbols were found to be better understood than low- or medium-comprehensibility-complexity symbols and the effectiveness of the contextual cues varied as a function of training. Therefore, the nature of additional detail determines whether increased complexity is detrimental or beneficial to older adults' comprehension - if the additional details provide 'cues to knowledge', older adults' comprehension improves as a result of the increased complexity. However, some cues may require training in order to be effective. Research suggests that older adults have greater difficulty in understanding more complex symbols. However, we found that when the complexity of symbols was increased through the addition of contextual cues, older adults' comprehension actually improved. Contextual cues aid older adults in making the connection between the symbol and its referent.

Cross-cultural communication capabilities of U.S. military trainers: host nation perspective.

PubMed

Mahmood, Maysaa; Alameri, Ali; Jawad, Shakir; Alani, Yasir; Zuerlein, Scott; Nakano, Gregg; Anderson, Warner; Beadling, Charles

2013-06-01

A survey was conducted to assess trainee perception of the cross-cultural communication competency of U.S. military trainers and their satisfaction with the training they received. Findings from the survey show that U.S. military trainers rely significantly on local interpreters. This indicates variability in the ability of the trainers to communicate effectively with host nation partners, the variability being dependent on the capabilities of the individual interpreter. The findings illustrate the importance of providing military health personnel with training on how to work effectively with interpreters. The use of supplementary resources such as electronic translation devises when the interpreter is not capable of conveying health-related training information with the desired level of accuracy is recommended. Expanding the availability of general cultural training, which provides baseline information on local values, traditions, and customs in addition to health-specific cultural orientation, is also recommended to help military health trainers customize their training content and methods to fit the local environment. Reprint & Copyright © 2013 Association of Military Surgeons of the U.S.

The IAEA’s activities on radiation protection in interventional cardiology

PubMed Central

Rehani, MM

2007-01-01

The International Atomic Energy Agency (IAEA) under its mandate of developing and applying standards of radiation safety has initiated a number of activities in recent years on radiation protection in interventional cardiology. These activities are implemented through four mechanisms, namely training, providing information through the website, research projects and assistance to Member States through Technical Cooperation (TC) projects. Major international initiatives have been taken in the area of training where more than half a dozen regional training courses have been conducted for cardiologists from over 50 countries. Additionally four national training events for over 300 medical and paramedical staff members involved in interventional procedures were held. The training material is freely available on CD from the IAEA. The newly established website provides information on radiation protection issues [1]. Two coordinated research projects have just been completed where peak skin doses to patients undergoing high dose interventional procedures were studied and factors to manage patient doses were identified. The technical cooperation projects involving protection in cardiac interventional procedures have 30 countries as participants. PMID:21614275

Less is more: latent learning is maximized by shorter training sessions in auditory perceptual learning.

PubMed

Molloy, Katharine; Moore, David R; Sohoglu, Ediz; Amitay, Sygal

2012-01-01

The time course and outcome of perceptual learning can be affected by the length and distribution of practice, but the training regimen parameters that govern these effects have received little systematic study in the auditory domain. We asked whether there was a minimum requirement on the number of trials within a training session for learning to occur, whether there was a maximum limit beyond which additional trials became ineffective, and whether multiple training sessions provided benefit over a single session. We investigated the efficacy of different regimens that varied in the distribution of practice across training sessions and in the overall amount of practice received on a frequency discrimination task. While learning was relatively robust to variations in regimen, the group with the shortest training sessions (∼8 min) had significantly faster learning in early stages of training than groups with longer sessions. In later stages, the group with the longest training sessions (>1 hr) showed slower learning than the other groups, suggesting overtraining. Between-session improvements were inversely correlated with performance; they were largest at the start of training and reduced as training progressed. In a second experiment we found no additional longer-term improvement in performance, retention, or transfer of learning for a group that trained over 4 sessions (∼4 hr in total) relative to a group that trained for a single session (∼1 hr). However, the mechanisms of learning differed; the single-session group continued to improve in the days following cessation of training, whereas the multi-session group showed no further improvement once training had ceased. Shorter training sessions were advantageous because they allowed for more latent, between-session and post-training learning to emerge. These findings suggest that efficient regimens should use short training sessions, and optimized spacing between sessions.

Less Is More: Latent Learning Is Maximized by Shorter Training Sessions in Auditory Perceptual Learning

PubMed Central

Molloy, Katharine; Moore, David R.; Sohoglu, Ediz; Amitay, Sygal

2012-01-01

Background The time course and outcome of perceptual learning can be affected by the length and distribution of practice, but the training regimen parameters that govern these effects have received little systematic study in the auditory domain. We asked whether there was a minimum requirement on the number of trials within a training session for learning to occur, whether there was a maximum limit beyond which additional trials became ineffective, and whether multiple training sessions provided benefit over a single session. Methodology/Principal Findings We investigated the efficacy of different regimens that varied in the distribution of practice across training sessions and in the overall amount of practice received on a frequency discrimination task. While learning was relatively robust to variations in regimen, the group with the shortest training sessions (∼8 min) had significantly faster learning in early stages of training than groups with longer sessions. In later stages, the group with the longest training sessions (>1 hr) showed slower learning than the other groups, suggesting overtraining. Between-session improvements were inversely correlated with performance; they were largest at the start of training and reduced as training progressed. In a second experiment we found no additional longer-term improvement in performance, retention, or transfer of learning for a group that trained over 4 sessions (∼4 hr in total) relative to a group that trained for a single session (∼1 hr). However, the mechanisms of learning differed; the single-session group continued to improve in the days following cessation of training, whereas the multi-session group showed no further improvement once training had ceased. Conclusions/Significance Shorter training sessions were advantageous because they allowed for more latent, between-session and post-training learning to emerge. These findings suggest that efficient regimens should use short training sessions, and optimized spacing between sessions. PMID:22606309

Training And Supervision Did Not Meaningfully Improve Quality Of Care For Pregnant Women Or Sick Children In Sub-Saharan Africa.

PubMed

Leslie, Hannah H; Gage, Anna; Nsona, Humphreys; Hirschhorn, Lisa R; Kruk, Margaret E

2016-09-01

In-service training courses and supportive supervision of health workers are among the most common interventions to improve the quality of health care in low- and middle-income countries. Despite extensive investment from donors, evaluations of the long-term effect of these two interventions are scarce. We used nationally representative surveys of health systems in seven countries in sub-Saharan Africa to examine the association of in-service training and supervision with provider quality in antenatal and sick child care. The results of our analysis showed that observed quality of care was poor, with fewer than half of evidence-based actions completed by health workers, on average. In-service training and supervision were associated with quality of sick child care; they were associated with quality of antenatal care only when provided jointly. All associations were modest-at most, improvements related to interventions were equivalent to 2 additional provider actions out of the 18-40 actions expected per visit. In-service training and supportive supervision as delivered were not sufficient to meaningfully improve the quality of care in these countries. Greater attention to the quality of health professional education and national health system performance will be required to provide the standard of health care that patients deserve. Project HOPE—The People-to-People Health Foundation, Inc.

[Surgery as specialization for female physicians: Results from course evaluations and alumni studies at MHH].

PubMed

Paulmann, V; Fischer, V; Dudzinska, A; Pabst, R

2015-06-01

There is a lack of young surgeons in Germany. In order to provide a successful learning environment in medical education and to attract more physicians, training concepts need to be regularly controlled. Evaluation results compiled over several years from the Hanover Medical School (MHH) were analyzed for gender-related differences. In addition to overall satisfaction with practical training items were included that consider aspects of interaction between students and instructors. Furthermore, alumni studies provided data on the postgraduate specialty choice made by MHH students. Surgical training is integrated into medical education as block training periods of various durations. Against the background of an increased percentage of women in medicine this article analyzed whether surgery is evaluated differently between female and male medical students with respect to their experiences in clinical teaching. Evaluations of clinical training in surgery demonstrated that female and male medical students do not differ substantially with respect to the teaching quality; however, young female physicians choose surgery as a professional option less frequently than men. A systematic review of clinical training evaluations is crucial to identify weaknesses of current curricula. More empirical data from other faculties can induce discussions about the attractiveness of surgery as a profession.

How prepared are college freshmen athletes for the rigors of college strength and conditioning? A survey of college strength and conditioning coaches.

PubMed

Wade, Susan M; Pope, Zachary C; Simonson, Shawn R

2014-10-01

Training programs for high school athletes have changed over the last 20 years. High school physical education classes have transformed into sport-specific conditioning classes with intensities matching college or professional athlete programming. In addition, involvement in private, sport-specific, training increased; but despite these advanced training methods, are high school athletes prepared for collegiate sport competition? An anonymous survey was sent to 195 Division I strength and conditioning coaches (SCC) to discern incoming college freshman athletes' physical and psychological preparedness for the rigors of collegiate training and sport competition. Fifty-seven (29%) responses were received. Strength and conditioning coaches stated that incoming college freshman athletes lack lower extremity strength, overall flexibility, and core strength as well as proper Olympic lifting technique. Strength and conditioning coaches also stated that athletes lacked the mental toughness to endure collegiate sport training in addition to claiming incoming athletes lacked knowledge of correct nutrition and recovery principles. These results suggest a lack of collegiate training/sport preparedness of high school athletes. High school strength and conditioning specialist's goal is to produce better athletes and doing so requires the strength and conditioning coach/trainer to have knowledge of how to train high school athletes. One way to assure adequate knowledge of strength and conditioning training principles is for high school coaches/trainers to be certified in the field. Strength and conditioning certifications among high school strength and conditioning coaches/trainers would encourage developmentally appropriate training and would provide universities with athletes who are prepared for the rigors of collegiate sport training/competition.

Pitfalls in communication with Hispanic and African-American patients: do translators help or harm?

PubMed

Brooks, T R

1992-11-01

The Martin Luther King County General Hospital, Los Angeles, California, provides services for an equal number of Hispanics (most are recent immigrants from Mexico) and African Americans who have lived in the community since before the Watts riot in 1965. The hospital is staffed by a large percentage of foreign-trained doctors and other personnel who speak some English, but suffer from a lack of understanding of the Hispanic as well as the African-American patients. Very few trained interpreters are provided for the Spanish-speaking population, and no interpreters are provided for African Americans. A 100-question survey on common African-American expressions was conducted in the Department of Family Medicine, as well as an opinion poll to determine if adequate understanding existed between patients and providers. The data revealed that native African-American providers understood significantly more African-American expressions than foreign, white, and Hispanic providers. The opinion poll also revealed inadequate translation of medical complaints from patients through interpreters. In addition, the poll found that diagnoses and instructions were not adequately related to the patients. Furthermore, it was felt that trained interpreters should be provided for all patients who presented communication problems.

Evaluation of mental health first aid training in a diverse community setting.

PubMed

Morawska, Alina; Fletcher, Renee; Pope, Susan; Heathwood, Ellen; Anderson, Emily; McAuliffe, Christine

2013-02-01

Mental health first aid (MHFA) training has been disseminated in the community and has yielded positive outcomes in terms of increasing help-seeking behaviour and mental health literacy. However, there has been limited research investigating the effectiveness of this programme in multicultural communities. Given the increasing levels of multiculturalism in many countries, as well as the large number of barriers presented to these groups when trying to seek help for mental illnesses, the present study aimed to investigate the effectiveness of MHFA in these settings. A total of 458 participants, who were recruited from multicultural organizations, participated in a series of MHFA training courses. Participants completed questionnaires pre and post the training course, and 6-month follow-up interviews were conducted with a subsample of participants. Findings suggested that MHFA training increased participant recognition of mental illnesses, concordance with primary care physicians about treatments, confidence in providing first aid, actual help provided to others, and a reduction in stigmatizing attitudes. A 6-month follow up also yielded positive long-term effects of MHFA. The results have implications for further dissemination and the use of MHFA in diverse communities. In addition, the results highlight the need for mental health training in health-care service providers. © 2012 The Authors. International Journal of Mental Health Nursing © 2012 Australian College of Mental Health Nurses Inc.

Role of Pharmacy Residency Training in Career Planning: A Student's Perspective.

PubMed

McElhaney, Ashley; Weber, Robert J

2014-12-01

Pharmacy students typically become more focused on career planning and assessment in the final year of their PharmD training. Weighing career options in the advanced pharmacy practice experience year can be both exciting and stressful. The goal of this article is to provide a primer on how pharmacy students can assess how a residency can fit into career planning. This article will describe the various career paths available to graduating students, highlight ways in which a residency can complement career choices, review the current state of the job market for pharmacists, discuss the current and future plans for residency programs, and present thoughts from some current and former residents on why they chose to complete a residency. Most career paths require some additional training, and a residency provides appropriate experience very quickly compared to on-the-job training. Alternative plans to residency training must also be considered, as there are not enough residency positions for candidates. Directors of pharmacy must consider several factors when giving career advice on pharmacy residency training to pharmacy students; they should provide the students with an honest assessment of their work skills and their abilities to successfully complete a residency. This assessment will help the students to set a plan for improvement and give them a better chance at being matched to a pharmacy residency.

Role of Pharmacy Residency Training in Career Planning: A Student’s Perspective

PubMed Central

McElhaney, Ashley; Weber, Robert J.

2014-01-01

Pharmacy students typically become more focused on career planning and assessment in the final year of their PharmD training. Weighing career options in the advanced pharmacy practice experience year can be both exciting and stressful. The goal of this article is to provide a primer on how pharmacy students can assess how a residency can fit into career planning. This article will describe the various career paths available to graduating students, highlight ways in which a residency can complement career choices, review the current state of the job market for pharmacists, discuss the current and future plans for residency programs, and present thoughts from some current and former residents on why they chose to complete a residency. Most career paths require some additional training, and a residency provides appropriate experience very quickly compared to on-the-job training. Alternative plans to residency training must also be considered, as there are not enough residency positions for candidates. Directors of pharmacy must consider several factors when giving career advice on pharmacy residency training to pharmacy students; they should provide the students with an honest assessment of their work skills and their abilities to successfully complete a residency. This assessment will help the students to set a plan for improvement and give them a better chance at being matched to a pharmacy residency. PMID:25673897

A rater training protocol to assess team performance.

PubMed

Eppich, Walter; Nannicelli, Anna P; Seivert, Nicholas P; Sohn, Min-Woong; Rozenfeld, Ranna; Woods, Donna M; Holl, Jane L

2015-01-01

Simulation-based methodologies are increasingly used to assess teamwork and communication skills and provide team training. Formative feedback regarding team performance is an essential component. While effective use of simulation for assessment or training requires accurate rating of team performance, examples of rater-training programs in health care are scarce. We describe our rater training program and report interrater reliability during phases of training and independent rating. We selected an assessment tool shown to yield valid and reliable results and developed a rater training protocol with an accompanying rater training handbook. The rater training program was modeled after previously described high-stakes assessments in the setting of 3 facilitated training sessions. Adjacent agreement was used to measure interrater reliability between raters. Nine raters with a background in health care and/or patient safety evaluated team performance of 42 in-situ simulations using post-hoc video review. Adjacent agreement increased from the second training session (83.6%) to the third training session (85.6%) when evaluating the same video segments. Adjacent agreement for the rating of overall team performance was 78.3%, which was added for the third training session. Adjacent agreement was 97% 4 weeks posttraining and 90.6% at the end of independent rating of all simulation videos. Rater training is an important element in team performance assessment, and providing examples of rater training programs is essential. Articulating key rating anchors promotes adequate interrater reliability. In addition, using adjacent agreement as a measure allows differentiation between high- and low-performing teams on video review. © 2015 The Alliance for Continuing Education in the Health Professions, the Society for Academic Continuing Medical Education, and the Council on Continuing Medical Education, Association for Hospital Medical Education.

Ursolic acid supplementation decreases markers of skeletal muscle damage during resistance training in resistance-trained men: a pilot study

PubMed Central

Bang, Hyun Seok; Seo, Dae Yun; Chung, Young Min; Kim, Do Hyung; Lee, Sam-Jun; Lee, Sung Ryul; Kwak, Hyo-Bum; Kim, Tae Nyun; Kim, Min; Oh, Kyoung-Mo; Son, Young Jin; Kim, Sanghyun

2017-01-01

Ursolic acid (UA) supplementation was previously shown to improve skeletal muscle function in resistance-trained men. This study aimed to determine, using the same experimental paradigm, whether UA also has beneficial effects on exercise-induced skeletal muscle damage markers including the levels of cortisol, B-type natriuretic peptide (BNP), myoglobin, creatine kinase (CK), creatine kinase-myocardial band (CK-MB), and lactate dehydrogenase (LDH) in resistance-trained men. Sixteen healthy participants were randomly assigned to resistance training (RT) or RT+UA groups (n=8 per group). Participants were trained according to the RT program (60~80% of 1 repetition, 6 times/week), and the UA group was additionally given UA supplementation (450 mg/day) for 8 weeks. Blood samples were obtained before and after intervention, and cortisol, BNP, myoglobin, CK, CK-MB, and LDH levels were analyzed. Subjects who underwent RT alone showed no significant change in body composition and markers of skeletal muscle damage, whereas RT+UA group showed slightly decreased body weight and body fat percentage and slightly increased lean body mass, but without statistical significance. In addition, UA supplementation significantly decreased the BNP, CK, CK-MB, and LDH levels (p<0.05). In conclusion, UA supplementation alleviates increased skeletal muscle damage markers after RT. This finding provides evidence for a potential new therapy for resistance-trained men. PMID:29200908

Evaluation of pyramid training as a method to increase diagnostic sampling capacity during an emergency veterinary response to a swine disease outbreak.

PubMed

Canon, Abbey J; Lauterbach, Nicholas; Bates, Jessica; Skoland, Kristin; Thomas, Paul; Ellingson, Josh; Ruston, Chelsea; Breuer, Mary; Gerardy, Kimberlee; Hershberger, Nicole; Hayman, Kristen; Buckley, Alexis; Holtkamp, Derald; Karriker, Locke

2017-06-15

OBJECTIVE To develop and evaluate a pyramid training method for teaching techniques for collection of diagnostic samples from swine. DESIGN Experimental trial. SAMPLE 45 veterinary students. PROCEDURES Participants went through a preinstruction assessment to determine their familiarity with the equipment needed and techniques used to collect samples of blood, nasal secretions, feces, and oral fluid from pigs. Participants were then shown a series of videos illustrating the correct equipment and techniques for collecting samples and were provided hands-on pyramid-based instruction wherein a single swine veterinarian trained 2 or 3 participants on each of the techniques and each of those participants, in turn, trained additional participants. Additional assessments were performed after the instruction was completed. RESULTS Following the instruction phase, percentages of participants able to collect adequate samples of blood, nasal secretions, feces, and oral fluid increased, as did scores on a written quiz assessing participants' ability to identify the correct equipment, positioning, and procedures for collection of samples. CONCLUSIONS AND CLINICAL RELEVANCE Results suggested that the pyramid training method may be a feasible way to rapidly increase diagnostic sampling capacity during an emergency veterinary response to a swine disease outbreak.

Evaluation of a telehealth training package to remotely train staff to conduct a preference assessment.

PubMed

Higgins, William J; Luczynski, Kevin C; Carroll, Regina A; Fisher, Wayne W; Mudford, Oliver C

2017-04-01

Recent advancements in telecommunication technologies make it possible to conduct a variety of healthcare services remotely (e.g., behavioral-analytic intervention services), thereby bridging the gap between qualified providers and consumers in isolated locations. In this study, web-based telehealth technologies were used to remotely train direct-care staff to conduct a multiple-stimulus-without-replacement preference assessment. The training package included three components: (a) a multimedia presentation; (b) descriptive feedback from previously recorded baseline sessions; and (c) scripted role-play with immediate feedback. A nonconcurrent, multiple-baseline-across-participants design was used to demonstrate experimental control. Training resulted in robust and immediate improvements, and these effects maintained during 1- to 2-month follow-up observations. In addition, participants expressed high satisfaction with the web-based materials and the overall remote-training experience. © 2017 Society for the Experimental Analysis of Behavior.

Effects of virtual reality training on mobility and physical function in stroke.

PubMed

Malik, Arshad Nawaz; Masood, Tahir

2017-10-01

Stroke is a common disabling condition which declines the functional and mobility level. The purpose of the case series was to determine the effect of virtual reality training on sensorimotor function and mobility level in stroke patients. Ten male (40-60 year) patients of stroke (08 Infarction, 02 Haemorrhagic) were selected from Physiotherapy department of Pakistan Railway Hospital, Rawalpindi. The additional virtual reality training (15-20 minutes) was provided 03 days per week for 06weeks along with task oriented training. All patients were assessed through Fugl-Meyer Assessment-Lower Extremity (FMA-LE) and Timed Get Up and Go Test (TUG) at baseline and after 06 weeks of training. The results showed that there was significant improvement in mobility level of stroke patients. It is concluded that combination of task oriented and virtual reality training considerably improves the physical performance and mobility level in stroke patients.

Developments in spiritual care education in German - speaking countries

PubMed Central

2014-01-01

Background This article examines spiritual care training provided to healthcare professionals in Germany, Austria and Switzerland. The paper reveals the current extent of available training while defining the target group(s) and teaching aims. In addition to those, we will provide an analysis of delivered competencies, applied teaching and performance assessment methods. Methods In 2013, an anonymous online survey was conducted among the members of the International Society for Health and Spiritual Care. The survey consisted of 10 questions and an open field for best practice advice. SPSS21 was used for statistical data analysis and the MAXQDA2007 for thematic content analysis. Results 33 participants participated in the survey. The main providers of spiritual care training are hospitals (36%, n = 18). 57% (n = 17) of spiritual care training forms part of palliative care education. 43% (n = 13) of spiritual care education is primarily bound to the Christian tradition. 36% (n = 11) of provided trainings have no direct association with any religious conviction. 64% (n = 19) of respondents admitted that they do not use any specific definition for spiritual care. 22% (n = 14) of available spiritual care education leads to some academic degree. 30% (n = 19) of training form part of an education programme leading to a formal qualification. Content analysis revealed that spiritual training for medical students, physicians in paediatrics, and chaplains take place only in the context of palliative care education. Courses provided for multidisciplinary team education may be part of palliative care training. Other themes, such as deep listening, compassionate presence, bedside spirituality or biographical work on the basis of logo-therapy, are discussed within the framework of spiritual care. Conclusions Spiritual care is often approached as an integral part of grief management, communication/interaction training, palliative care, (medical) ethics, psychological or religious counselling or cultural competencies. Respondents point out the importance of competency based spiritual care education, practical training and maintaining the link between spiritual care education and clinical practice. Further elaboration on the specifics of spiritual care core competencies, teaching and performance assessment methods is needed. PMID:24898431

CRM Assessment: Determining the Generalization of Rater Calibration Training. Summary of Research Report: Gold Standards Training

NASA Technical Reports Server (NTRS)

Baker, David P.

2002-01-01

The extent to which pilot instructors are trained to assess crew resource management (CRM) skills accurately during Line-Oriented Flight Training (LOFT) and Line Operational Evaluation (LOE) scenarios is critical. Pilot instructors must make accurate performance ratings to ensure that proper feedback is provided to flight crews and appropriate decisions are made regarding certification to fly the line. Furthermore, the Federal Aviation Administration's (FAA) Advanced Qualification Program (AQP) requires that instructors be trained explicitly to evaluate both technical and CRM performance (i.e., rater training) and also requires that proficiency and standardization of instructors be verified periodically. To address the critical need for effective pilot instructor training, the American Institutes for Research (AIR) reviewed the relevant research on rater training and, based on "best practices" from this research, developed a new strategy for training pilot instructors to assess crew performance. In addition, we explored new statistical techniques for assessing the effectiveness of pilot instructor training. The results of our research are briefly summarized below. This summary is followed by abstracts of articles and book chapters published under this grant.

Adapting postdoctoral training to interdisciplinary science in the 21st century: the Cancer Prevention Fellowship Program at the National Cancer Institute.

PubMed

Chang, Shine; Hursting, Stephen D; Perkins, Susan N; Dores, Graça M; Weed, Douglas L

2005-03-01

Preparing junior scientists for careers in the health sciences has become an immense challenge for many reasons, including the emerging demand for multidisciplinary approaches to solving problems in the health sciences. For those choosing careers in hybrid and interdisciplinary fields, the "traditional" postdoctoral training model may not perform well, particularly in light of other problems that plague postdoctoral success. New approaches are required. Using the interdisciplinary field of cancer prevention as an example, the authors describe the Cancer Prevention Fellowship Program (CPFP) of the National Cancer Institute, a three-year postdoctoral program of which the goal is to provide its fellows with a strong foundation in cancer prevention through education, mentored research, and structured professional development training activities that emphasize multidisciplinary approaches and leadership skills. Over time, the CPFP has incorporated the best aspects of the traditional postdoctoral training model with newer training approaches in an effort to overcome existing problems in postdoctoral training and to address the additional complexities inherent in training those who seek careers in interdisciplinary science. Many aspects of the CPFP, including an efficient infrastructure, a dedicated staff, a capacity to provide educational activities, and the provision of rich research opportunities, may translate well to other postdoctoral programs that face similar issues.

The Development of an Interactive Computer-Based Training Program for Timely and Humane On-Farm Pig Euthanasia.

PubMed

Mullins, Caitlyn R; Pairis-Garcia, Monique D; Campler, Magnus R; Anthony, Raymond; Johnson, Anna K; Coleman, Grahame J; Rault, Jean-Loup

2018-02-05

With extensive knowledge and training in the prevention, management, and treatment of disease conditions in animals, veterinarians play a critical role in ensuring good welfare on swine farms by training caretakers on the importance of timely euthanasia. To assist veterinarians and other industry professionals in training new and seasoned caretakers, an interactive computer-based training program was created. It consists of three modules, each containing five case studies, which cover three distinct production stages (breeding stock, piglets, and wean to grower-finisher pigs). Case study development was derived from five specific euthanasia criteria defined in the 2015 Common Swine Industry Audit, a nationally recognized auditing program used in the US. Case studies provide information regarding treatment history, clinical signs, and condition severity of the pig and prompt learners to make management decisions regarding pig treatment and care. Once a decision is made, feedback is provided so learners understand the appropriateness of their decision compared to current industry guidelines. In addition to training farm personnel, this program may also be a valuable resource if incorporated into veterinary, graduate, and continuing education curricula. This innovative tool represents the first interactive euthanasia-specific training program in the US swine industry and offers the potential to improve timely and humane on-farm pig euthanasia.

Police arrest and self-defence skills: performance under anxiety of officers with and without additional experience in martial arts.

PubMed

Renden, Peter G; Landman, Annemarie; Savelsbergh, Geert J P; Oudejans, Raôul R D

2015-01-01

We investigated whether officers with additional martial arts training experience performed better in arrest and self-defence scenarios under low and high anxiety and were better able to maintain performance under high anxiety than officers who just rely on regular police training. We were especially interested to find out whether training once a week would already lead to better performance under high anxiety. Officers with additional experience in kickboxing or karate/jiu-jitsu (training several times per week), or krav maga (training once a week) and officers with no additional experience performed several arrest and self-defence skills under low and high anxiety. Results showed that officers with additional experience (also those who trained once a week) performed better under high anxiety than officers with no additional experience. Still, the additional experience did not prevent these participants from performing worse under high anxiety compared to low anxiety. Implications for training are discussed. Practitioner summary: Dutch police officers train their arrest and self-defence skills only four to six hours per year. Our results indicate that doing an additional martial arts training once a week may lead to better performance under anxiety, although it cannot prevent that performance decreases under high anxiety compared to low anxiety.

Engaging healthcare providers to implement HIV pre-exposure prophylaxis.

PubMed

Krakower, Douglas; Mayer, Kenneth H

2012-11-01

Recent randomized controlled trials have demonstrated that HIV pre-exposure prophylaxis (PrEP) can decrease HIV incidence among several at-risk populations, including men who have sex with men, serodiscordant couples, and heterosexual men and women. As PrEP is a biomedical intervention that requires clinical monitoring and a high level of medication adherence, maximizing the public health effectiveness of PrEP in real-world settings will require the training of a cadre of healthcare providers to prescribe PrEP. Therefore it is critical to understand provider knowledge, practices, and attitudes towards PrEP prescribing, and to develop strategies for engaging and training providers to provide PrEP. Limited numbers of studies have focused on PrEP implementation by healthcare providers. These studies suggest that some providers are knowledgeable about PrEP, but many are not, or express misgivings. Although many clinicians report willingness to provide PrEP, few have prescribed PrEP in clinical practice. Provider comfort and skills in HIV risk assessment are suboptimal, which could limit identification of individuals who are most likely to benefit from PrEP use. Further studies to understand facilitators and barriers to HIV-risk assessment and PrEP prescribing by practicing clinicians are needed. Innovative training strategies and decision-support interventions for providers could optimize PrEP implementation and therefore merit additional research.

Exploring virtual mental practice in maintenance task training.

PubMed

Bauerle, Tim; Brnich, Michael J; Navoyski, Jason

- This paper aims to contribute to a general understanding of mental practice by investigating the utility of and participant reaction to a virtual reality maintenance training among underground coal mine first responders. - Researchers at the National Institute for Occupational Safety and Health's Office of Mine Safety and Health Research (OMSHR) developed software to provide opportunities for mine rescue team members to learn to inspect, assemble and test their closed-circuit breathing apparatus and to practice those skills. In total, 31 mine rescue team members utilized OMSHR's BG 4 Benching Trainer software and provided feedback to the development team. After training, participants completed a brief post-training questionnaire, which included demographics, perceived training climate and general training evaluation items. - The results overall indicate a generally positive reaction to and high perceived utility of the BG 4 benching software. In addition, the perceived training climate appears to have an effect on the perceived utility of the mental practice virtual reality game, with benchmen from mines with more positive training climates reporting greater perceived efficacy in the training's ability to prepare trainees for real emergencies. - This paper helps to broaden current applications of mental practice and is one of the few empirical investigations into a non-rehabilitation virtual reality extension of mental practice. This paper also contributes to the growing literature advocating for greater usage of accurate and well-informed mental practice techniques, tools and methodologies, especially for occupational populations with limitations on exposure to hands-on training.

Adaptive scenarios: a training model for today's public health workforce.

PubMed

Uden-Holman, Tanya; Bedet, Jennifer; Walkner, Laurie; Abd-Hamid, Nor Hashidah

2014-01-01

With the current economic climate, money for training is scarce. In addition, time is a major barrier to participation in trainings. To meet the public health workforce's rising demand for training, while struggling with less time and fewer resources, the Upper Midwest Preparedness and Emergency Response Learning Center has developed a model of online training that provides the public health workforce with individually customized, needs-based training experiences. Adaptive scenarios are rooted in case-based reasoning, a learning approach that focuses on the specific knowledge needed to solve a problem. Proponents of case-based reasoning argue that learners benefit from being able to remember previous similar situations and reusing information and knowledge from that situation. Adaptive scenarios based on true-to-life job performance provide an opportunity to assess skills by presenting the user with choices to make in a problem-solving context. A team approach was used to develop the adaptive scenarios. Storylines were developed that incorporated situations aligning with the knowledge, skills, and attitudes outlined in the Public Health Preparedness and Response Core Competency Model. This article examines 2 adaptive scenarios: "Ready or Not? A Family Preparedness Scenario" and "Responding to a Crisis: Managing Emotions and Stress Scenario." The scenarios are available on Upper Midwest Preparedness and Emergency Response Learning Center's Learning Management System, the Training Source (http://training-source.org). Evaluation data indicate that users' experiences have been positive. Integrating the assessment and training elements of the scenarios so that the training experience is uniquely adaptive to each user is one of the most efficient ways to provide training. The opportunity to provide individualized, needs-based training without having to administer separate assessments has the potential to save time and resources. These adaptive scenarios continue to be marketed to target audiences through partner organizations, various Web sites, electronic newsletters, and social media. Next steps include the implementation of a 6-month follow-up evaluation, using Kirkpatrick level III. Kirkpatrick level III evaluation measures whether there was actual transfer of learning to the work setting.

Integrating Soft Set Theory and Fuzzy Linguistic Model to Evaluate the Performance of Training Simulation Systems

PubMed Central

Chang, Kuei-Hu; Chang, Yung-Chia; Chain, Kai; Chung, Hsiang-Yu

2016-01-01

The advancement of high technologies and the arrival of the information age have caused changes to the modern warfare. The military forces of many countries have replaced partially real training drills with training simulation systems to achieve combat readiness. However, considerable types of training simulation systems are used in military settings. In addition, differences in system set up time, functions, the environment, and the competency of system operators, as well as incomplete information have made it difficult to evaluate the performance of training simulation systems. To address the aforementioned problems, this study integrated analytic hierarchy process, soft set theory, and the fuzzy linguistic representation model to evaluate the performance of various training simulation systems. Furthermore, importance–performance analysis was adopted to examine the influence of saving costs and training safety of training simulation systems. The findings of this study are expected to facilitate applying military training simulation systems, avoiding wasting of resources (e.g., low utility and idle time), and providing data for subsequent applications and analysis. To verify the method proposed in this study, the numerical examples of the performance evaluation of training simulation systems were adopted and compared with the numerical results of an AHP and a novel AHP-based ranking technique. The results verified that not only could expert-provided questionnaire information be fully considered to lower the repetition rate of performance ranking, but a two-dimensional graph could also be used to help administrators allocate limited resources, thereby enhancing the investment benefits and training effectiveness of a training simulation system. PMID:27598390

Integrating Soft Set Theory and Fuzzy Linguistic Model to Evaluate the Performance of Training Simulation Systems.

PubMed

Chang, Kuei-Hu; Chang, Yung-Chia; Chain, Kai; Chung, Hsiang-Yu

2016-01-01

The advancement of high technologies and the arrival of the information age have caused changes to the modern warfare. The military forces of many countries have replaced partially real training drills with training simulation systems to achieve combat readiness. However, considerable types of training simulation systems are used in military settings. In addition, differences in system set up time, functions, the environment, and the competency of system operators, as well as incomplete information have made it difficult to evaluate the performance of training simulation systems. To address the aforementioned problems, this study integrated analytic hierarchy process, soft set theory, and the fuzzy linguistic representation model to evaluate the performance of various training simulation systems. Furthermore, importance-performance analysis was adopted to examine the influence of saving costs and training safety of training simulation systems. The findings of this study are expected to facilitate applying military training simulation systems, avoiding wasting of resources (e.g., low utility and idle time), and providing data for subsequent applications and analysis. To verify the method proposed in this study, the numerical examples of the performance evaluation of training simulation systems were adopted and compared with the numerical results of an AHP and a novel AHP-based ranking technique. The results verified that not only could expert-provided questionnaire information be fully considered to lower the repetition rate of performance ranking, but a two-dimensional graph could also be used to help administrators allocate limited resources, thereby enhancing the investment benefits and training effectiveness of a training simulation system.

Pediatric dentistry for the general practitioner: satisfying the need for additional education and training opportunities.

PubMed

Stewart, Ray E; Sanger, Roger G

2014-11-01

The Pediatric Oral Health Access Program is a joint project of the California Dental Association and the California Society of Pediatric Dentistry. The results have been remarkable in terms of the number of underserved children who have received oral health services. What is less certain is the number of general dentists who, as a result of the training, have been able and willing to provide comprehensive care to more and younger children.

Method and apparatus for in-process sensing of manufacturing quality

DOEpatents

Hartman, Daniel A [Santa Fe, NM; Dave, Vivek R [Los Alamos, NM; Cola, Mark J [Santa Fe, NM; Carpenter, Robert W [Los Alamos, NM

2005-02-22

A method for determining the quality of an examined weld joint comprising the steps of providing acoustical data from the examined weld joint, and performing a neural network operation on the acoustical data determine the quality of the examined weld joint produced by a friction weld process. The neural network may be trained by the steps of providing acoustical data and observable data from at least one test weld joint, and training the neural network based on the acoustical data and observable data to form a trained neural network so that the trained neural network is capable of determining the quality of a examined weld joint based on acoustical data from the examined weld joint. In addition, an apparatus having a housing, acoustical sensors mounted therein, and means for mounting the housing on a friction weld device so that the acoustical sensors do not contact the weld joint. The apparatus may sample the acoustical data necessary for the neural network to determine the quality of a weld joint.

A 3D virtual reality simulator for training of minimally invasive surgery.

PubMed

Mi, Shao-Hua; Hou, Zeng-Gunag; Yang, Fan; Xie, Xiao-Liang; Bian, Gui-Bin

2014-01-01

For the last decade, remarkable progress has been made in the field of cardiovascular disease treatment. However, these complex medical procedures require a combination of rich experience and technical skills. In this paper, a 3D virtual reality simulator for core skills training in minimally invasive surgery is presented. The system can generate realistic 3D vascular models segmented from patient datasets, including a beating heart, and provide a real-time computation of force and force feedback module for surgical simulation. Instruments, such as a catheter or guide wire, are represented by a multi-body mass-spring model. In addition, a realistic user interface with multiple windows and real-time 3D views are developed. Moreover, the simulator is also provided with a human-machine interaction module that gives doctors the sense of touch during the surgery training, enables them to control the motion of a virtual catheter/guide wire inside a complex vascular model. Experimental results show that the simulator is suitable for minimally invasive surgery training.

Method and Apparatus for In-Process Sensing of Manufacturing Quality

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

Hartman, D.A.; Dave, V.R.; Cola, M.J.

2005-02-22

A method for determining the quality of an examined weld joint comprising the steps of providing acoustical data from the examined weld joint, and performing a neural network operation on the acoustical data determine the quality of the examined weld joint produced by a friction weld process. The neural network may be trained by the steps of providing acoustical data and observable data from at least one test weld joint, and training the neural network based on the acoustical data and observable data to form a trained neural network so that the trained neural network is capable of determining themore » quality of a examined weld joint based on acoustical data from the examined weld joint. In addition, an apparatus having a housing, acoustical sensors mounted therein, and means for mounting the housing on a friction weld device so that the acoustical sensors do not contact the weld joint. The apparatus may sample the acoustical data necessary for the neural network to determine the quality of a weld joint.« less

Parent perceptions of an adapted evidence-based practice for toddlers with autism in a community setting

PubMed Central

Stahmer, Aubyn C; Brookman-Frazee, Lauren; Rieth, Sarah R; Stoner, Julia Trigeiro; Feder, Joshua D; Searcy, Karyn; Wang, Tiffany

2016-01-01

Although data from parent-implemented Naturalistic Developmental Behavioral Interventions have shown positive effects on decreasing core symptoms of autism, there has been limited examination of the effectiveness of Naturalistic Developmental Behavioral Interventions in community settings. In addition, parent perspectives of their involvement in parent-implemented early intervention programs have not been well studied. Using both qualitative and quantitative data to examine parent perspectives and the perceived feasibility of parent training by community providers, 13 families were followed as they received training in the Naturalistic Developmental Behavioral Intervention, Project ImPACT. Data indicate that parent training by community providers is feasible and well received, and parents find value in participating in intervention and perceive benefit for their children. Recommendations for adaptation of program elements and future research are discussed. PMID:27121242

Robotics, motor learning, and neurologic recovery.

PubMed

Reinkensmeyer, David J; Emken, Jeremy L; Cramer, Steven C

2004-01-01

Robotic devices are helping shed light on human motor control in health and injury. By using robots to apply novel force fields to the arm, investigators are gaining insight into how the nervous system models its external dynamic environment. The nervous system builds internal models gradually by experience and uses them in combination with impedance and feedback control strategies. Internal models are robust to environmental and neural noise, generalized across space, implemented in multiple brain regions, and developed in childhood. Robots are also being used to assist in repetitive movement practice following neurologic injury, providing insight into movement recovery. Robots can haptically assess sensorimotor performance, administer training, quantify amount of training, and improve motor recovery. In addition to providing insight into motor control, robotic paradigms may eventually enhance motor learning and rehabilitation beyond the levels possible with conventional training techniques.

75 FR 22864 - In the Matter of CAN USA, Inc., Harvey, Louisiana; General License Pursuant to 10 CFR 150.20...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-30

... response to the NRC's offer, CAN USA requested use of the NRC ADR process to resolve issues associated with... apparent violations, which include: (1) Providing additional training to radiographers, assistant... radiographic operations as customer transport allowed; and (5) Providing more ``real-time'' notifications of...

Generative Adversarial Networks: An Overview

NASA Astrophysics Data System (ADS)

Creswell, Antonia; White, Tom; Dumoulin, Vincent; Arulkumaran, Kai; Sengupta, Biswa; Bharath, Anil A.

2018-01-01

Generative adversarial networks (GANs) provide a way to learn deep representations without extensively annotated training data. They achieve this through deriving backpropagation signals through a competitive process involving a pair of networks. The representations that can be learned by GANs may be used in a variety of applications, including image synthesis, semantic image editing, style transfer, image super-resolution and classification. The aim of this review paper is to provide an overview of GANs for the signal processing community, drawing on familiar analogies and concepts where possible. In addition to identifying different methods for training and constructing GANs, we also point to remaining challenges in their theory and application.

Treadmill training improves overground walking economy in Parkinson's disease: a randomized, controlled pilot study.

PubMed

Fernández-Del-Olmo, Miguel Angel; Sanchez, Jose Andres; Bello, Olalla; Lopez-Alonso, Virginia; Márquez, Gonzalo; Morenilla, Luis; Castro, Xabier; Giraldez, Manolo; Santos-García, Diego

2014-01-01

Gait disturbances are one of the principal and most incapacitating symptoms of Parkinson's disease (PD). In addition, walking economy is impaired in PD patients and could contribute to excess fatigue in this population. An important number of studies have shown that treadmill training can improve kinematic parameters in PD patients. However, the effects of treadmill and overground walking on the walking economy remain unknown. The goal of this study was to explore the walking economy changes in response to a treadmill and an overground training program, as well as the differences in the walking economy during treadmill and overground walking. Twenty-two mild PD patients were randomly assigned to a treadmill or overground training group. The training program consisted of 5 weeks (3 sessions/week). We evaluated the energy expenditure of overground walking, before and after each of the training programs. The energy expenditure of treadmill walking (before the program) was also evaluated. The treadmill, but not the overground training program, lead to an improvement in the walking economy (the rate of oxygen consumed per distance during overground walking at a preferred speed) in PD patients. In addition, walking on a treadmill required more energy expenditure compared with overground walking at the same speed. This study provides evidence that in mild PD patients, treadmill training is more beneficial compared with that of walking overground, leading to a greater improvement in the walking economy. This finding is of clinical importance for the therapeutic administration of exercise in PD.

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).

The ethical commitments of academic faculty in psychiatric education.

PubMed

Green, Stephen A

2006-01-01

This article explores the commitment of faculty to ethics training in psychiatric education. Although psychiatry has insufficiently addressed the profession's need for ethics training in education, program directors acknowledge its critical importance, and its positive impact has been demonstrated. Additionally, residents often seek ethics training as part of their instruction. The author suggests that academic faculty could respond to the profession's inadequate treatment of ethics training by helping trainees develop moral agency--the ability to recognize, assess, and respond to ethical dilemmas; decide what constitutes right or wrong care; and act accordingly. The author also describes how this objective could be met by promoting professionalism and offering didactic instruction that address substantive and process issues regarding psychiatric care. Specific recommendations are provided.

Can we HIIT cancer if we attack inflammation?

PubMed

Papadopoulos, Efthymios; Santa Mina, Daniel

2018-01-01

Physical exercise offers numerous health-related benefits to individuals with cancer. Epidemiologic research has primarily been concerned with conventional exercise training that aligns with the recommendations of 150 min of moderate to vigorous physical activity per week. These recommendations are safe and effective at improving physical and psychosocial outcomes. Given the extensive evidence for generalized physical activity, researchers have begun to explore novel training regimens that may provide additional health benefits and/or improved adherence. Specifically, exercise at higher intensities may offer more or different benefits than conventional training approaches with potentially profound effects on the tumor microenvironment. This commentary focuses on the physiological effects of high-intensity interval training, also known as "HIIT," and its potential antineoplastic properties.

Extracting duration information in a picture category decoding task using hidden Markov Models

NASA Astrophysics Data System (ADS)

Pfeiffer, Tim; Heinze, Nicolai; Frysch, Robert; Deouell, Leon Y.; Schoenfeld, Mircea A.; Knight, Robert T.; Rose, Georg

2016-04-01

Objective. Adapting classifiers for the purpose of brain signal decoding is a major challenge in brain-computer-interface (BCI) research. In a previous study we showed in principle that hidden Markov models (HMM) are a suitable alternative to the well-studied static classifiers. However, since we investigated a rather straightforward task, advantages from modeling of the signal could not be assessed. Approach. Here, we investigate a more complex data set in order to find out to what extent HMMs, as a dynamic classifier, can provide useful additional information. We show for a visual decoding problem that besides category information, HMMs can simultaneously decode picture duration without an additional training required. This decoding is based on a strong correlation that we found between picture duration and the behavior of the Viterbi paths. Main results. Decoding accuracies of up to 80% could be obtained for category and duration decoding with a single classifier trained on category information only. Significance. The extraction of multiple types of information using a single classifier enables the processing of more complex problems, while preserving good training results even on small databases. Therefore, it provides a convenient framework for online real-life BCI utilizations.

Development of an Integrated Countermeasure Device for Use in Long-Duration Space Flight

NASA Technical Reports Server (NTRS)

Streeper, Tim; Cavanagh, Peter R.; Hanson, Andrea M.; Carpenter, Dana; Saeed, Isra; Kornak, John; Frassetto, Lynda; Grodsinsky, Carlos; Funk, Justin; Lee, Stuart M. C.;

Development of an integrated countermeasure device for use in long-duration spaceflight

NASA Astrophysics Data System (ADS)

Streeper, T.; Cavanagh, P. R.; Hanson, A. M.; Carpenter, R. D.; Saeed, I.; Kornak, J.; Frassetto, L.; Grodsinsky, C.; Funk, J.; Lee, S. M. C.; Spiering, B. A.; Bloomberg, J.; Mulavara, A.; Sibonga, J.; Lang, T.

2011-06-01

Prolonged weightlessness is associated with declines in musculoskeletal, cardiovascular, and sensorimotor health. Consequently, in-flight countermeasures are required to preserve astronaut health. We developed and tested a novel exercise countermeasure device (CCD) for use in spaceflight with the aim of preserving musculoskeletal and cardiovascular health along with an incorporated balance training component. Additionally, the CCD features a compact footprint, and a low power requirement. Methods: After design and development of the CCD, we carried out a training study to test its ability to improve cardiovascular and muscular fitness in healthy volunteers. Fourteen male and female subjects (41.4±9.0 years, 69.5±15.4 kg) completed 12 weeks (3 sessions per week) of concurrent strength and endurance training on the CCD. All training was conducted with the subject in orthostasis. When configured for spaceflight, subjects will be fixed to the device via a vest with loop attachments secured to subject load devices. Subjects were tested at baseline and after 12 weeks for 1-repetition max leg press strength (1RM), peak oxygen consumption (VO 2peak), and isokinetic joint torque (ISO) at the hip, knee, and ankle. Additionally, we evaluated subjects after 6 weeks of training for changes in VO 2peak and 1RM. Results: VO 2peak and 1RM improved after 6 weeks, with additional improvements after 12 weeks (1.95±0.5, 2.28±0.5, 2.47±0.6 L min -1, and 131.2±63.9,182.8±75.0, 207.0±75.0 kg) for baseline, 6 weeks, and 12 weeks, respectively. ISO for hip adduction, adduction, and ankle plantar flexion improved after 12 weeks of training (70.3±39.5, 76.8±39.2, and 55.7±21.7 N m vs. 86.1±37.3, 85.1±34.3, and 62.1±26.4 N m, respectively). No changes were observed for ISO during hip flexion, knee extension, or knee flexion. Conclusions: The CCD is effective at improving cardiovascular fitness and isotonic leg strength in healthy adults. Further, the improvement in hip adductor and abductor torque provides support that the CCD may provide additional protection for the preservation of bone health at the hip.

Music Therapy and Spiritual Care in End-of-Life: A Qualitative Inquiry into Ethics and Training Issues Identified by Chaplains and Music Therapists.

PubMed

Masko, Meganne K

2016-01-01

Music therapists are increasingly employed by hospices. As such, they are often called upon to provide additional spiritual care to patients receiving end-of-life care. However, researchers have not yet examined the appropriateness of music therapists providing spiritual care as part of the hospice team, or ethics and training issues related to music therapist-led spiritual care. The purpose of this study was to explore the thoughts and attitudes of hospice chaplains and music therapists (MTs) about ethics and training issues related to music therapists providing spiritual care as part of the hospice interdisciplinary team. The study used semi-structured interviews with a purposive sample of music therapists and chaplains specializing in hospice care as part of a larger exploratory mixed methods study. Each interview was recorded, transcribed, and analyzed using a two-step process including both a modified phenomenological inductive approach and thematic analysis. Participants discussed ethics and training issues related to the provision of music therapist-led spiritual care as part of the hospice team. These issues included scope of practice, cultural competence and maintaining personal boundaries, and spiritual care training topics such as educational content and educational methods. While it was clear that both chaplains and music therapists felt it was appropriate for music therapists to provide spiritual care as part of the hospice team, there is a need for formal and informal spiritual care training for music therapists doing this type of work. Training should potentially include information about comparative religions, cultural competence, scope of practice, and maintaining personal boundaries. © the American Music Therapy Association 2016. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Improving Culturally Appropriate Care Using a Community-Based Participatory Research Approach: Evaluation of a Multicomponent Cultural Competency Training Program, Arkansas, 2015–2016

PubMed Central

Long, Christopher R.; Rowland, Brett; Moore, Sarah; Wilmoth, Ralph; Ayers, Britni

2017-01-01

Introduction The United States continues to become more racially and ethnically diverse, and racial/ethnic minority communities encounter sociocultural barriers to quality health care, including implicit racial/ethnic bias among health care providers. In response, health care organizations are developing and implementing cultural competency curricula. Using a community-based participatory research (CBPR) approach, we developed and evaluated a cultural competency training program to improve the delivery of culturally appropriate care in Marshallese and Hispanic communities. Methods We used a mixed-methods evaluation approach based on the Kirkpatrick model of training evaluation. We collected quantitative evaluation data immediately after each training session (March 19, 2015–November 30, 2016) and qualitative data about implementation at 2 points: immediately after each session and 6 months after training. Individuals and organizational units provided qualitative data. Results We delivered 1,250 units of in-person training at 25 organizations. Participants reported high levels of changes in knowledge (91.2%), competence (86.6%), and performance (87.2%) as a result of the cultural competency training. Organizations reported making policy and environmental changes. Conclusion Initial outcomes demonstrate the value of developing and implementing cultural competency training programs using a CBPR approach. Additional research is needed to determine the effect on long-term patient outcomes. PMID:28771402

Aquatic Exercise Training is Effective in Maintaining Exercise Performance in Trained Heart Failure Patients: A Randomised Crossover Pilot Trial.

PubMed

Adsett, Julie; Morris, Norman; Kuys, Suzanne; Hwang, Rita; Mullins, Robert; Khatun, Mohsina; Paratz, Jennifer; Mudge, Alison

2017-06-01

Providing flexible models and a variety of exercise options are fundamental to supporting long-term exercise participation for patients with heart failure (HF). The aim of this pilot study was to determine the feasibility and efficacy of aquatic exercise training during a maintenance phase for a clinical heart failure population. In this 2 x 2 crossover design trial, individuals who had previously completed HF rehabilitation were randomised into either a land-based or aquatic training program once per week for six weeks, after which time they changed to the alternate exercise training protocol for an additional six weeks. Six-minute walk test (6MWT), grip strength, walk speed, and measures of balance were compared for the two training protocols. Fifty-one participants (43 males, mean age 69.2 yrs) contributed data for the analysis. Both groups maintained function during the follow-up period, however improvements in 6MWT were greater in the land-based training group (95% CI: 0.7, 22.5; p=0.038), by a mean difference of 10.8 metres. No significant difference was observed for other parameters when the two training protocols were compared. Attending an aquatic exercise program once per week is feasible for patients with stable HF and may provide a suitable option to maintain functional performance in select patients. Crown Copyright © 2016. Published by Elsevier B.V. All rights reserved.

Additive manufacturing technology in reconstructive surgery.

PubMed

Fuller, Scott C; Moore, Michael G

2016-10-01

Technological advances have been part and parcel of modern reconstructive surgery, in that practitioners of this discipline are continually looking for innovative ways to perfect their craft and improve patient outcomes. We are currently in a technological climate wherein advances in computers, imaging, and science have coalesced with resulting innovative breakthroughs that are not merely limited to improved outcomes and enhanced patient care, but may provide novel approaches to training the next generation of reconstructive surgeons. New developments in software and modeling platforms, imaging modalities, tissue engineering, additive manufacturing, and customization of implants are poised to revolutionize the field of reconstructive surgery. The interface between technological advances and reconstructive surgery continues to expand. Additive manufacturing techniques continue to evolve in an effort to improve patient outcomes, decrease operative time, and serve as instructional tools for the training of reconstructive surgeons.

Exercise Prescriptions for Training and Rehabilitation in Patients with Heart and Lung Disease.

PubMed

Palermo, Pietro; Corrà, Ugo

2017-07-01

Rehabilitation in patients with advanced cardiac and pulmonary disease has been shown to increase survival and improve quality of life, among many other benefits. Exercise training is the fundamental ingredient in these rehabilitation programs. However, determining the amount of exercise is not straightforward or uniform. Most rehabilitation and training programs fix the time of exercise and set the exercise intensity to the goals of the rehabilitation program and the exercise-related hurdles of the individual. The exercise training intensity prescription must balance the desired gain in conditioning with safety. Symptom-limited cardiopulmonary exercise testing is the fundamental tool to identify the exercise intensity and define the appropriate training. In addition, cardiopulmonary exercise testing provides an understanding of the systems involved in oxygen transport and utilization, making it possible to identify the factors limiting exercise capacity in individual patients.

Telehealth innovations in health education and training.

PubMed

Conde, José G; De, Suvranu; Hall, Richard W; Johansen, Edward; Meglan, Dwight; Peng, Grace C Y

2010-01-01

Telehealth applications are increasingly important in many areas of health education and training. In addition, they will play a vital role in biomedical research and research training by facilitating remote collaborations and providing access to expensive/remote instrumentation. In order to fulfill their true potential to leverage education, training, and research activities, innovations in telehealth applications should be fostered across a range of technology fronts, including online, on-demand computational models for simulation; simplified interfaces for software and hardware; software frameworks for simulations; portable telepresence systems; artificial intelligence applications to be applied when simulated human patients are not options; and the development of more simulator applications. This article presents the results of discussion on potential areas of future development, barries to overcome, and suggestions to translate the promise of telehealth applications into a transformed environment of training, education, and research in the health sciences.

The core content of clinical ultrasonography fellowship training.

PubMed

Lewiss, Resa E; Tayal, Vivek S; Hoffmann, Beatrice; Kendall, John; Liteplo, Andrew S; Moak, James H; Panebianco, Nova; Noble, Vicki E

2014-04-01

The purpose of developing a core content for subspecialty training in clinical ultrasonography (US) is to standardize the education and qualifications required to provide oversight of US training, clinical use, and administration to improve patient care. This core content would be mastered by a fellow as a separate and unique postgraduate training, beyond that obtained during an emergency medicine (EM) residency or during medical school. The core content defines the training parameters, resources, and knowledge of clinical US necessary to direct clinical US divisions within medical specialties. Additionally, it is intended to inform fellowship directors and candidates for certification of the full range of content that might appear in future examinations. This article describes the development of the core content and presents the core content in its entirety. © 2014 by the Society for Academic Emergency Medicine.

Gait training strategies to optimize walking ability in people with stroke: A synthesis of the evidence

PubMed Central

Tang, Pei Fang

2011-01-01

Stroke is a leading cause of long-term disability. Impairments resulting from stroke lead to persistent difficulties with walking and subsequently, improved walking ability is one of the highest priorities for people living with a stroke. In addition, walking ability has important health implications in providing protective effects against secondary complications common after a stroke such as heart disease or osteoporosis. This paper systematically reviews common gait training strategies (neurodevelopmental techniques, muscle strengthening, treadmill training, intensive mobility exercises) to improve walking ability. The results (descriptive summaries as well as pooled effect sizes) from randomized controlled trials are presented and implications for optimal gait training strategies are discussed. Novel and emerging gait training strategies are highlighted and research directions proposed to enable the optimal recovery and maintenance of walking ability. PMID:17939776

Agency Problems and Airport Security: Quantitative and Qualitative Evidence on the Impact of Security Training.

PubMed

de Gramatica, Martina; Massacci, Fabio; Shim, Woohyun; Turhan, Uğur; Williams, Julian

2017-02-01

We analyze the issue of agency costs in aviation security by combining results from a quantitative economic model with a qualitative study based on semi-structured interviews. Our model extends previous principal-agent models by combining the traditional fixed and varying monetary responses to physical and cognitive effort with nonmonetary welfare and potentially transferable value of employees' own human capital. To provide empirical evidence for the tradeoffs identified in the quantitative model, we have undertaken an extensive interview process with regulators, airport managers, security personnel, and those tasked with training security personnel from an airport operating in a relatively high-risk state, Turkey. Our results indicate that the effectiveness of additional training depends on the mix of "transferable skills" and "emotional" buy-in of the security agents. Principals need to identify on which side of a critical tipping point their agents are to ensure that additional training, with attached expectations of the burden of work, aligns the incentives of employees with the principals' own objectives. © 2016 Society for Risk Analysis.

Building capacity in the rural physiotherapy workforce: a paediatric training partnership.

PubMed

Williams, E N; McMeeken, J M

2014-01-01

Building capacity in the rural physiotherapy workforce: a paediatric training partnership' provided 6 months postgraduate paediatric clinical and academic training for two physiotherapists in rural Australia. It is described as a model for improving services and workforce retention. The need for 'an appropriate, skilled and well-supported health workforce' is the third goal in Australia's National Strategic Framework for Rural and Remote Health 2011. The World Health Organization recently published its first global policy for improving the retention of rural and remote health workers. Education is its first recommendation and aims to 'design continuing education and professional development programmes that meet the needs of rural health workers and that are accessible from where they live and work, so as to support their retention …'. Additionally, '… to be successful, continuing education needs to be linked to career paths, as well as with other education interventions'. The problem is a lack of paediatric physiotherapy expertise in rural areas due to an absence of postgraduate clinical training opportunities in the rural workforce. The result is fragmented local services for families who are forced to travel to metropolitan services, costly in terms of both time and money. The aims were to improve local paediatric physiotherapy clinical services, provide physiotherapists additional access to professional development and subsequently provide a career path to retain these health professionals. Evaluation of the project used purpose-built questionnaires as there are no specific indicators to monitor the performance of systems and services that are available to children and families in Australia. The paediatric physiotherapy training program was enabled through initial funding for a 12-month pilot project. Further government funding built on that success for this reported 6-month project. Funding to employ the postgraduate physiotherapists was essential to the success of the clinical training program, and lack of future funding is a barrier to its sustainability. The program included the consolidation of the initial management and education committees and the expert reference group. Weekly tutorials, case studies and presentations formed an important part of clinical rotation between hospital outpatients, specialist school and the disability sector. This increased the provision of skilled paediatric physiotherapy services close to home in a timely fashion not previously available. Concurrently, the training increased the clinicians' paediatric knowledge and confidence, promoting workforce retention by providing a career pathway. The senior clinicians who provided clinical supervision reported that it enabled succession planning through introduction of appropriately skilled younger peers to their clinical practice. Project recommendations are that funding and stakeholder partnerships are necessary to enable health professionals to undertake postgraduate clinical training in paediatrics in rural areas. The partnership should include education providers (university), rural health service providers (hospital) and community or disability services (government and non-government) with financial recognition of expertise in the rural workforce for clinical supervision. The training experience was reported as a very positive experience from trainees, families, clinical supervisors, managers, academics and paediatricians. Lack of continued funding to educate skilled postgraduate paediatric physiotherapy clinicians means that rural children with physical disabilities will continue to be disadvantaged.

An alternating treatment comparison of oral and total communications training programs with echolalic autistic children.

PubMed Central

Barrera, R D; Sulzer-Azaroff, B

1983-01-01

An alternating treatment comparison was conducted of the relative effectiveness of oral and total communication training models for teaching expressive labeling skills to three echolalic autistic children. The results of this comparison demonstrated that total communication proved to be the most successful approach with each of the subjects. In addition, the replication of these findings both within and across subjects suggest that total communication may be, in general, the most effective of these two training models for teaching basic vocal language skills to echolalic children. A number of hypotheses are presented that may provide a basis for the demonstrated effect. PMID:6654770

Exposing Clinicians to Exposure: A Randomized Controlled Dissemination Trial of Exposure Therapy for Anxiety Disorders

PubMed Central

Harned, Melanie S.; Dimeff, Linda A.; Woodcock, Eric A.; Kelly, Tim; Zavertnik, Jake; Contreras, Ignacio; Danner, Sankirtana M.

2014-01-01

Objective The present study evaluated three technology-based methods of training mental health providers in exposure therapy (ET) for anxiety disorders. Training methods were designed to address common barriers to the dissemination of ET, including limited access to training, negative clinician attitudes toward ET, and lack of support during and following training. Method Clinicians naïve to ET (N=181, Mage = 37.4, 71.3% female, 72.1% Caucasian) were randomly assigned to: 1) an interactive, multimedia online training (OLT), 2) OLT plus a brief, computerized motivational enhancement intervention (OLT+ME), or 3) OLT + ME plus a web-based learning community (OLT+ME+LC). Assessments were completed at baseline, post-training, and 6 and 12 weeks following training. Outcomes include satisfaction, knowledge, self-efficacy, attitudes, self-reported clinical use, and observer-rated clinical proficiency. Results All three training methods led to large and comparable improvements in self-efficacy and clinical use of ET, indicating that OLT alone was sufficient for improving these outcomes. The addition of the ME intervention did not significantly improve outcomes in comparison to OLT alone. Supplementing the OLT with both the ME intervention and the LC significantly improved attitudes and clinical proficiency in comparison to OLT alone. The OLT+ME+LC condition was superior to both other conditions in increasing knowledge of ET. Conclusions Multi-component trainings that address multiple potential barriers to dissemination appear to be most effective in improving clinician outcomes. Technology-based training methods offer a satisfactory, effective, and scalable way to train mental health providers in evidence-based treatments such as ET. PMID:25311284

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.

Strategic Potential of the Late Ottoman Empire

DTIC Science & Technology

2001-01-01

pluristic society and separation of powers . Additionally, the U.S. should provide training and assistance to the military and police regarding the...convince Turkey’s leaders that strength in diversity and through separation of powers will promote greater internal security and prosperity

Visual Purple, the Next Generation Crisis Management Decision Training Tool

DTIC Science & Technology

2001-09-01

talents of professional Hollywood screenwriters during the scripting and writing process of the simulations. Additionally, cinematic techniques learned...cultural, and language experts for research development. Additionally, GTA provides country specific support in script writing and cinematic resources as...The result is an entirely new dimension of realism that traditional exercises often fail to capture. The scenario requires the participant to make the

An equal start: absence of group differences in cognitive, social, and neural measures prior to music or sports training in children.

PubMed

Habibi, Assal; Ilari, Beatriz; Crimi, Kevin; Metke, Michael; Kaplan, Jonas T; Joshi, Anand A; Leahy, Richard M; Shattuck, David W; Choi, So Y; Haldar, Justin P; Ficek, Bronte; Damasio, Antonio; Damasio, Hanna

2014-01-01

Several studies comparing adult musicians and non-musicians have provided compelling evidence for functional and anatomical differences in the brain systems engaged by musical training. It is not known, however, whether those differences result from long-term musical training or from pre-existing traits favoring musicality. In an attempt to begin addressing this question, we have launched a longitudinal investigation of the effects of childhood music training on cognitive, social and neural development. We compared a group of 6- to 7-year old children at the start of intense after-school musical training, with two groups of children: one involved in high intensity sports training but not musical training, another not involved in any systematic training. All children were tested with a comprehensive battery of cognitive, motor, musical, emotional, and social assessments and underwent magnetic resonance imaging and electroencephalography. Our first objective was to determine whether children who participate in musical training were different, prior to training, from children in the control groups in terms of cognitive, motor, musical, emotional, and social behavior measures as well as in structural and functional brain measures. Our second objective was to determine whether musical skills, as measured by a music perception assessment prior to training, correlates with emotional and social outcome measures that have been shown to be associated with musical training. We found no neural, cognitive, motor, emotional, or social differences among the three groups. In addition, there was no correlation between music perception skills and any of the social or emotional measures. These results provide a baseline for an ongoing longitudinal investigation of the effects of music training.

Sequencing Effects of Balance and Plyometric Training on Physical Performance in Youth Soccer Athletes.

PubMed

Hammami, Raouf; Granacher, Urs; Makhlouf, Issam; Behm, David G; Chaouachi, Anis

2016-12-01

Hammami, R, Granacher, U, Makhlouf, I, Behm, DG, and Chaouachi, A. Sequencing effects of balance and plyometric training on physical performance in youth soccer athletes. J Strength Cond Res 30(12): 3278-3289, 2016-Balance training may have a preconditioning effect on subsequent power training with youth. There are no studies examining whether the sequencing of balance and plyometric training has additional training benefits. The objective was to examine the effect of sequencing balance and plyometric training on the performance of 12- to 13-year-old athletes. Twenty-four young elite soccer players trained twice per week for 8 weeks either with an initial 4 weeks of balance training followed by 4 weeks of plyometric training (BPT) or 4 weeks of plyometric training proceeded by 4 weeks of balance training (PBT). Testing was conducted pre- and posttraining and included medicine ball throw; horizontal and vertical jumps; reactive strength; leg stiffness; agility; 10-, 20-, and 30-m sprints; Standing Stork balance test; and Y-Balance test. Results indicated that BPT provided significantly greater improvements with reactive strength index, absolute and relative leg stiffness, triple hop test, and a trend for the Y-Balance test (p = 0.054) compared with PBT. Although all other measures had similar changes for both groups, the average relative improvement for the BPT was 22.4% (d = 1.5) vs. 15.0% (d = 1.1) for the PBT. BPT effect sizes were greater with 8 of 13 measures. In conclusion, although either sequence of BPT or PBT improved jumping, hopping, sprint acceleration, and Standing Stork and Y-Balance, BPT initiated greater training improvements in reactive strength index, absolute and relative leg stiffness, triple hop test, and the Y-Balance test. BPT may provide either similar or superior performance enhancements compared with PBT.

An equal start: absence of group differences in cognitive, social, and neural measures prior to music or sports training in children

PubMed Central

Habibi, Assal; Ilari, Beatriz; Crimi, Kevin; Metke, Michael; Kaplan, Jonas T.; Joshi, Anand A.; Leahy, Richard M.; Shattuck, David W.; Choi, So Y.; Haldar, Justin P.; Ficek, Bronte; Damasio, Antonio; Damasio, Hanna

2014-01-01

Several studies comparing adult musicians and non-musicians have provided compelling evidence for functional and anatomical differences in the brain systems engaged by musical training. It is not known, however, whether those differences result from long-term musical training or from pre-existing traits favoring musicality. In an attempt to begin addressing this question, we have launched a longitudinal investigation of the effects of childhood music training on cognitive, social and neural development. We compared a group of 6- to 7-year old children at the start of intense after-school musical training, with two groups of children: one involved in high intensity sports training but not musical training, another not involved in any systematic training. All children were tested with a comprehensive battery of cognitive, motor, musical, emotional, and social assessments and underwent magnetic resonance imaging and electroencephalography. Our first objective was to determine whether children who participate in musical training were different, prior to training, from children in the control groups in terms of cognitive, motor, musical, emotional, and social behavior measures as well as in structural and functional brain measures. Our second objective was to determine whether musical skills, as measured by a music perception assessment prior to training, correlates with emotional and social outcome measures that have been shown to be associated with musical training. We found no neural, cognitive, motor, emotional, or social differences among the three groups. In addition, there was no correlation between music perception skills and any of the social or emotional measures. These results provide a baseline for an ongoing longitudinal investigation of the effects of music training. PMID:25249961

Vision Training Methods for Sports Concussion Mitigation and Management

PubMed Central

Clark, Joseph F.; Colosimo, Angelo; Ellis, James K.; Mangine, Robert; Bixenmann, Benjamin; Hasselfeld, Kimberly; Graman, Patricia; Elgendy, Hagar; Myer, Gregory; Divine, Jon

2015-01-01

There is emerging evidence supporting the use vision training, including light board training tools, as a concussion baseline and neuro-diagnostic tool and potentially as a supportive component to concussion prevention strategies. This paper is focused on providing detailed methods for select vision training tools and reporting normative data for comparison when vision training is a part of a sports management program. The overall program includes standard vision training methods including tachistoscope, Brock’s string, and strobe glasses, as well as specialized light board training algorithms. Stereopsis is measured as a means to monitor vision training affects. In addition, quantitative results for vision training methods as well as baseline and post-testing *A and Reaction Test measures with progressive scores are reported. Collegiate athletes consistently improve after six weeks of training in their stereopsis, *A and Reaction Test scores. When vision training is initiated as a team wide exercise, the incidence of concussion decreases in players who participate in training compared to players who do not receive the vision training. Vision training produces functional and performance changes that, when monitored, can be used to assess the success of the vision training and can be initiated as part of a sports medical intervention for concussion prevention. PMID:25992878

Effect of Above Real Time Training and Post Flight Feedback in Training of Novice Pilots in a PC-Based Flight Simulator

NASA Technical Reports Server (NTRS)

Khan, M. Javed; Rossi, Marcia; Heath, Bruce E.; Ali, Syed firasat; Crane, Peter; Knighten, Tremaine; Culpepper, Christi

2003-01-01

The use of Post-Flight Feedback (PFFB) and Above Real-Time Training (ARTT) while training novice pilots to perform a coordinated level turn on a PC-based flight simulator was investigated. One group trained at 1.5 ARTT followed by an equal number of flights at 2.0 ARTT; the second group experienced Real Time Training (RTT). The total number of flights for both groups was equal. Each group was further subdivided into two groups one of which was provided PFFB while the other was not. Then, all participants experienced two challenging evaluation missions in real time. Performance was assessed by comparing root-mean-square error in bank-angle and altitude. Participants in the 1.512.0 ARTT No-PFFB sequence did not show improvement in performance across training sessions. An ANOVA on performance in evaluation flights found that the PFFB groups performed significantly better than those with No-PFFB. Also, the RTT groups performed significantly better than the ARTT groups. Data from two additional groups trained under a 2.011.5 ARTT PFFB and No-PFFB regimes were collected and combined with data from the previously Trainers, Real-time simulation, Personal studied groups and reanalyzed to study the computers, Man-in-the-loop simulation influence of sequence. An ANOVA on test trials found no significant effects between groups. Under training situations involving ARTT we recommend that appropriate PFFB be provided.

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.

The impact of transmural multiprofessional simulation-based obstetric team training on perinatal outcome and quality of care in the Netherlands

PubMed Central

2014-01-01

Background Perinatal mortality and morbidity in the Netherlands is relatively high compared to other European countries. Our country has a unique system with an independent primary care providing care to low-risk pregnancies and a secondary/tertiary care responsible for high-risk pregnancies. About 65% of pregnant women in the Netherlands will be referred from primary to secondary care implicating multiple medical handovers. Dutch audits concluded that in the entire obstetric collaborative network process parameters could be improved. Studies have shown that obstetric team training improves perinatal outcome and that simulation-based obstetric team training implementing crew resource management (CRM) improves team performance. In addition, deliberate practice (DP) improves medical skills. The aim of this study is to analyse whether transmural multiprofessional simulation-based obstetric team training improves perinatal outcome. Methods/Design The study will be implemented in the south-eastern part of the Netherlands with an annual delivery rate of over 9,000. In this area secondary care is provided by four hospitals. Each hospital with referring primary care practices will form a cluster (study group). Within each cluster, teams will be formed of different care providers representing the obstetric collaborative network. CRM and elements of DP will be implemented in the training. To analyse the quality of care as perceived by patients, the Pregnancy and Childbirth Questionnaire (PCQ) will be used. Furthermore, self-reported collaboration between care providers will be assessed. Team performance will be measured by the Clinical Teamwork Scale (CTS). We employ a stepped-wedge trial design with a sequential roll-out of the trainings for the different study groups. Primary outcome will be perinatal mortality and/or admission to a NICU. Secondary outcome will be team performance, quality of care as perceived by patients, and collaboration among care providers. Conclusion The effect of transmural multiprofessional simulation-based obstetric team training on perinatal outcome has never been studied. We hypothesise that this training will improve perinatal outcome, team performance, and quality of care as perceived by patients and care providers. Trial registration The Netherlands National Trial Register, http://www.trialregister.nl/NTR4576, registered June 1, 2014 PMID:25145317

Prison Inmate Training and Rehabilitation Act of 1993. Hearing on H.R. 703 Prison Inmate Training and Rehabilitation Act of 1993, before the Subcommittee on Intellectual Property and Judicial Administration of the Committee on the Judiciary. House of Representatives, One Hundred Third Congress, Second Session.

ERIC Educational Resources Information Center

Congress of the U.S., Washington, DC. House Committee on the Judiciary.

This congressional hearing considers legislation intended to provide additional work opportunities for inmates in the federal prison system and to help reduce the reliance of federal prison industries on traditional industries. Testimony includes statements, letters, written statements, and other materials presented by the following: U.S. senators…

Machine Tool Advanced Skills Technology (MAST). Common Ground: Toward a Standards-Based Training System for the U.S. Machine Tool and Metal Related Industries. Volume 15: Administrative Information, of a 15-Volume Set of Skill Standards and Curriculum Training Materials for the Precision Manufacturing Industry.

ERIC Educational Resources Information Center

Texas State Technical Coll., Waco.

This volume developed by the Machine Tool Advanced Skill Technology (MAST) program contains key administrative documents and provides additional sources for machine tool and precision manufacturing information and important points of contact in the industry. The document contains the following sections: a foreword; grant award letter; timeline for…

An assisted navigation training framework based on judgment theory using sparse and discrete human-machine interfaces.

PubMed

Lopes, Ana C; Nunes, Urbano

2009-01-01

This paper aims to present a new framework to train people with severe motor disabilities steering an assisted mobile robot (AMR), such as a powered wheelchair. Users with high level of motor disabilities are not able to use standard HMIs, which provide a continuous command signal (e. g. standard joystick). For this reason HMIs providing a small set of simple commands, which are sparse and discrete in time must be used (e. g. scanning interface, or brain computer interface), making very difficult to steer the AMR. In this sense, the assisted navigation training framework (ANTF) is designed to train users driving the AMR, in indoor structured environments, using this type of HMIs. Additionally it provides user characterization on steering the robot, which will later be used to adapt the AMR navigation system to human competence steering the AMR. A rule-based lens (RBL) model is used to characterize users on driving the AMR. Individual judgment performance choosing the best manoeuvres is modeled using a genetic-based policy capturing (GBPC) technique characterized to infer non-compensatory judgment strategies from human decision data. Three user models, at three different learning stages, using the RBL paradigm, are presented.

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.

Contingency-based emotional resilience: effort-based reward training and flexible coping lead to adaptive responses to uncertainty in male rats

PubMed Central

Lambert, Kelly G.; Hyer, Molly M.; Rzucidlo, Amanda A.; Bergeron, Timothy; Landis, Timothy; Bardi, Massimo

2014-01-01

Emotional resilience enhances an animal's ability to maintain physiological allostasis and adaptive responses in the midst of challenges ranging from cognitive uncertainty to chronic stress. In the current study, neurobiological factors related to strategic responses to uncertainty produced by prediction errors were investigated by initially profiling male rats as passive, active or flexible copers (n = 12 each group) and assigning to either a contingency-trained or non-contingency trained group. Animals were subsequently trained in a spatial learning task so that problem solving strategies in the final probe task, as well-various biomarkers of brain activation and plasticity in brain areas associated with cognition and emotional regulation, could be assessed. Additionally, fecal samples were collected to further determine markers of stress responsivity and emotional resilience. Results indicated that contingency-trained rats exhibited more adaptive responses in the probe trial (e.g., fewer interrupted grooming sequences and more targeted search strategies) than the noncontingent-trained rats; additionally, increased DHEA/CORT ratios were observed in the contingent-trained animals. Diminished activation of the habenula (i.e., fos-immunoreactivity) was correlated with resilience factors such as increased levels of DHEA metabolites during cognitive training. Of the three coping profiles, flexible copers exhibited enhanced neuroplasticity (i.e., increased dentate gyrus doublecortin-immunoreactivity) compared to the more consistently responding active and passive copers. Thus, in the current study, contingency training via effort-based reward (EBR) training, enhanced by a flexible coping style, provided neurobiological resilience and adaptive responses to prediction errors in the final probe trial. These findings have implications for psychiatric illnesses that are influenced by altered stress responses and decision-making abilities (e.g., depression). PMID:24808837

Contingency-based emotional resilience: effort-based reward training and flexible coping lead to adaptive responses to uncertainty in male rats.

PubMed

Lambert, Kelly G; Hyer, Molly M; Rzucidlo, Amanda A; Bergeron, Timothy; Landis, Timothy; Bardi, Massimo

2014-01-01

Emotional resilience enhances an animal's ability to maintain physiological allostasis and adaptive responses in the midst of challenges ranging from cognitive uncertainty to chronic stress. In the current study, neurobiological factors related to strategic responses to uncertainty produced by prediction errors were investigated by initially profiling male rats as passive, active or flexible copers (n = 12 each group) and assigning to either a contingency-trained or non-contingency trained group. Animals were subsequently trained in a spatial learning task so that problem solving strategies in the final probe task, as well-various biomarkers of brain activation and plasticity in brain areas associated with cognition and emotional regulation, could be assessed. Additionally, fecal samples were collected to further determine markers of stress responsivity and emotional resilience. Results indicated that contingency-trained rats exhibited more adaptive responses in the probe trial (e.g., fewer interrupted grooming sequences and more targeted search strategies) than the noncontingent-trained rats; additionally, increased DHEA/CORT ratios were observed in the contingent-trained animals. Diminished activation of the habenula (i.e., fos-immunoreactivity) was correlated with resilience factors such as increased levels of DHEA metabolites during cognitive training. Of the three coping profiles, flexible copers exhibited enhanced neuroplasticity (i.e., increased dentate gyrus doublecortin-immunoreactivity) compared to the more consistently responding active and passive copers. Thus, in the current study, contingency training via effort-based reward (EBR) training, enhanced by a flexible coping style, provided neurobiological resilience and adaptive responses to prediction errors in the final probe trial. These findings have implications for psychiatric illnesses that are influenced by altered stress responses and decision-making abilities (e.g., depression).

Importance of leadership in cardiac arrest situations: from simulation to real life and back.

PubMed

Hunziker, Sabnina; Tschan, Franziska; Semmer, Norbert K; Marsch, Stephan

2013-04-18

The 2010 American Heart Association guidelines now recommend leadership training in Advanced Cardiac Life Support courses. In this review we provide a comprehensive summary of data derived from clinical studies that investigated the importance of leadership in cardiopulmonary resuscitation (CPR). Only a few, mostly observational, studies have been conducted under real-life conditions because of the high heterogeneity of the situations, difficulties in capturing the initial phase of CPR, and ethical issues. Well-controlled studies in the human simulator can fill existing gaps and provide important insights. High-fidelity video-assisted simulator studies from different research groups have shown that a prolonged process of teambuilding is associated with significant shortcomings in CPR, whereas effective leadership improves team performance. In addition, randomised controlled studies have provided evidence that medical students receiving leadership training subsequently showed improved CPR performance, which was sustained after a follow up of 4 months. In addition, leadership is influenced by gender and other factors such as emotional stress. Future studies are needed to investigate cultural differences and how findings from the simulator can be transferred to real-life situations.

Training of Working Memory Impacts Neural Processing of Vocal Pitch Regulation

PubMed Central

Li, Weifeng; Guo, Zhiqiang; Jones, Jeffery A.; Huang, Xiyan; Chen, Xi; Liu, Peng; Chen, Shaozhen; Liu, Hanjun

2015-01-01

Working memory training can improve the performance of tasks that were not trained. Whether auditory-motor integration for voice control can benefit from working memory training, however, remains unclear. The present event-related potential (ERP) study examined the impact of working memory training on the auditory-motor processing of vocal pitch. Trained participants underwent adaptive working memory training using a digit span backwards paradigm, while control participants did not receive any training. Before and after training, both trained and control participants were exposed to frequency-altered auditory feedback while producing vocalizations. After training, trained participants exhibited significantly decreased N1 amplitudes and increased P2 amplitudes in response to pitch errors in voice auditory feedback. In addition, there was a significant positive correlation between the degree of improvement in working memory capacity and the post-pre difference in P2 amplitudes. Training-related changes in the vocal compensation, however, were not observed. There was no systematic change in either vocal or cortical responses for control participants. These findings provide evidence that working memory training impacts the cortical processing of feedback errors in vocal pitch regulation. This enhanced cortical processing may be the result of increased neural efficiency in the detection of pitch errors between the intended and actual feedback. PMID:26553373

WIC providers' perspectives on offering smoking cessation interventions.

PubMed

Aquilino, Mary Lober; Goody, Cynthia M; Lowe, John B

2003-01-01

To examine the perspectives of WIC clinic providers on offering smoking cessation interventions for pregnant women. Four focus groups consisting of WIC nurses, dietitians, and social workers (N = 25) were conducted at WIC clinics in eastern Iowa. Researchers developed discussion guidelines to determine how WIC providers currently approached pregnant women who smoke cigarettes and what they considered barriers to providing effective smoking cessation interventions. Code mapping was used to analyze focus group discussions. Factors influencing the ability of WIC staff to provide a smoking cessation intervention for pregnant women included available time, clinic priorities, staff approaches to clients, and staff training. In addition, providers expressed concerns about educational materials for clients as well as additional client issues that prevented smoking cessation. The absence of mechanisms to track clinic outcomes related to smoking cessation was also noted. WIC providers have time limitations that may necessitate minimal or low-intensity interventions for smoking cessation, but did not know that such approaches are actually effective. WIC providers require more education about the entire issue of smoking cessation in order to become more proactive in their attempts to help pregnant women quit. Training that enhances self-efficacy and understanding of the impact of smoking on mothers, infants, and children should be initiated to motivate staff to intervene. Another strategy to motivate WIC staff in this regard could be tracking clinic outcomes in helping women to quit smoking or prevent relapse.

A Usability and Learnability Case Study of Glass Flight Deck Interfaces and Pilot Interactions through Scenario-based Training

NASA Astrophysics Data System (ADS)

De Cino, Thomas J., II

In the aviation industry, digitally produced and presented flight, navigation, and aircraft information is commonly referred to as glass flight decks. Glass flight decks are driven by computer-based subsystems and have long been a part of military and commercial aviation sectors. Over the past 15 years, the General Aviation (GA) sector of the aviation industry has become a recent beneficiary of the rapid advancement of computer-based glass flight deck (GFD) systems. While providing the GA pilot considerable enhancements in the quality of information about the status and operations of the aircraft, training pilots on the use of glass flight decks is often delivered with traditional methods (e.g. textbooks, PowerPoint presentations, user manuals, and limited computer-based training modules). These training methods have been reported as less than desirable in learning to use the glass flight deck interface. Difficulties in achieving a complete understanding of functional and operational characteristics of the GFD systems, acquiring a full understanding of the interrelationships of the varied subsystems, and handling the wealth of flight information provided have been reported. Documented pilot concerns of poor user experience and satisfaction, and problems with the learning the complex and sophisticated interface of the GFD are additional issues with current pilot training approaches. A case study was executed to explore ways to improve training using GFD systems at a Midwestern aviation university. The researcher investigated if variations in instructional systems design and training methods for learning glass flight deck technology would affect the perceptions and attitudes of pilots of the learnability (an attribute of usability) of the glass flight deck interface. Specifically, this study investigated the effectiveness of scenario-based training (SBT) methods to potentially improve pilot knowledge and understanding of a GFD system, and overall pilot user experience and satisfaction. Participants overwhelmingly reported positive learning experiences from scenario-based GFD systems flight training, noting that learning and knowledge construction were improved over other training received in the past. In contrast, participants rated the usability and learnability of the GFD training systems low, reporting various problems with the systems' interface, and the learnability (first-time use) of the complex GFD system. However, issues with usability of the GFD training systems did not reduce or change participant attitudes towards learning and mastering GFD systems; to the contrary, all participants requested additional coursework opportunities to train on GFD systems with the scenario-based flight training format.

Final Technical Report - DE-EE0003542

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

Haley, James D

Wind has provided energy for thousands of years: some of the earliest windmill engineering designs date back to ancient Babylonia and India where wind would be used as a source of irrigation. Today, wind is the quickest growing resource in Americas expanding energy infrastructure. However, to continue to positively diversify Americas energy portfolio and further reduce the countrys reliance of foreign oil, the industry must grow substantially over the next two decades in both turbine installations and skilled industrial manpower to support. The wind sector is still an emergent industry requiring maturation and development of its labor force: dedicated trainingmore » is needed to provide the hard and soft skills to support the increasingly complex wind turbine generators as the technology evolves. Furthermore, the American workforce is facing a steep decline in available labor resources as the baby boomer generation enters retirement age. It is therefore vital that a process is quickly created for supporting the next generation of wind technicians. However, the manpower growth must incorporate three key components. First, the safety and technical training curriculum must be standardized across the industry - current wind educational programs are disparate and dedicated standardization programs must be further refined and implemented. Second, it is essential that the wind sector avoid disrupting other energy production industries by cannibalizing workers, which would indirectly affect the rest of Americas energy portfolio. The future wind workforce must be created organically utilizing either young people entering the workforce or train personnel emerging from careers outside of energy production. Third, the training must be quick and efficient as large amounts of wind turbines are being erected each year and this growth is expected to continue until at least 2035. One source that matches these three requirements is personnel transitioning from military service to the civilian sector. Utilizing the labor pool of transitioning military personnel and a dedicated training program specifically tailored to military hard and soft skills, the wind workforce can rapidly expand with highly skilled personnel. A tailored training program also provides career opportunities to an underutilized labor force as the personnel return from active military duty. This projects goal was to create a Wind Workforce Development Program that streamlines the wind technician training process using industry-leading safety programs and building on existing military experience. The approach used was to gather data from the wind industry, develop the curriculum and test the process to ensure it provides adequate training to equip the technicians as they transition from the military into wind. The platform for the curriculum development is called Personal Qualification Standards (PQS), which is based on the program of the same name from the United States Navy. Not only would the program provide multiple delivery methods of training (including classroom, computer-based training and on-the-job training), but it also is a familiar style of training to many military men and women. By incorporating a familiar method of training, it encourages active participation in the training and reduces the time for personnel to grasp the concept and flow of the training requirements. The program was tested for thoroughness, schedule and efficacy using a 5-person pilot phase during the last two years. The results of the training were a reduction in time to complete training and increased customer satisfaction on client project sites. However, there were obstacles that surfaced and required adaptation throughout the project including method of delivery, curriculum development and project schedules and are discussed in detail throughout the report. There are several key recommendations in the report that discuss additional training infrastructure, scalability within additional alternative energy markets and organizational certification through standardization committees.« less

78 FR 35976 - Petitions for Modification of Application of Existing Mandatory Safety Standards

Federal Register 2010, 2011, 2012, 2013, 2014

2013-06-14

.... (4) Training will be provided for operators to lower the grader blade to provide additional stopping... surface: (1) The operator will pump expanding cement slurry down the well to form a plug which runs from... operator will pump expanding cement slurry down the well to form a plug which runs from at least 200 feet...

Illinois Pesticide Applicator Study Guide. A Training Manual for Private and Commercial Pesticide Applicators and Operators. Special Publication 39.

ERIC Educational Resources Information Center

Bever, Wayne; And Others

This study guide is designed to provide the necessary information to prepare for certification as a private or commercial pesticide applicator. In addition to providing basic information covering the various sections of the amended Federal Insecticide, Fungicide, and Rodenticide Act, it contains a glossary of common pesticide terms, a list of…

Defense Cybersecurity: Opportunities Exist for DOD to Share Cybersecurity Resources with Small Businesses

DTIC Science & Technology

2015-09-01

risk self- Communications identified by small businesses . The guidance Commission includes links to addit ional cybersecurity resources...Working Group 4: Final Report. The report’s appendix provides cybersecurity risk management and best practice recommendations for small and medium...including small businesses . Cybersecurity education for risk assessment and planning. These programs provide education and training that small

Defense Civil Support: DOD Has Made Progress Incorporating the Homeland Response Force into the Chemical, Biological, Radiological, and Nuclear Response Enterprise

DTIC Science & Technology

2016-06-01

Weapons of Mass Destruction: Additional Steps Could Enhance the Effectiveness of the National Guard’s Life- Saving Response Forces, GAO-12-114...perform its mission to save lives and reduce human suffering. The Defense Readiness Reporting System consists of two parts—a rating on whether the HRF is...plans. 28Three HRF Commanders reported that additional personnel are trained or vaccinated , but did not provide a specific percentage of additional

Effect of Newborn Resuscitation Training on Health Worker Practices in Pumwani Hospital, Kenya

PubMed Central

Opiyo, Newton; Were, Fred; Govedi, Fridah; Fegan, Greg; Wasunna, Aggrey; English, Mike

2008-01-01

Background Birth asphyxia kills 0.7 to 1.6 million newborns a year globally with 99% of deaths in developing countries. Effective newborn resuscitation could reduce this burden of disease but the training of health-care providers in low income settings is often outdated. Our aim was to determine if a simple one day newborn resuscitation training (NRT) alters health worker resuscitation practices in a public hospital setting in Kenya. Methods/Principal Findings We conducted a randomised, controlled trial with health workers receiving early training with NRT (n = 28) or late training (the control group, n = 55). The training was adapted locally from the approach of the UK Resuscitation Council. The primary outcome was the proportion of appropriate initial resuscitation steps with the frequency of inappropriate practices as a secondary outcome. Data were collected on 97 and 115 resuscitation episodes over 7 weeks after early training in the intervention and control groups respectively. Trained providers demonstrated a higher proportion of adequate initial resuscitation steps compared to the control group (trained 66% vs control 27%; risk ratio 2.45, [95% CI 1.75–3.42], p<0.001, adjusted for clustering). In addition, there was a statistically significant reduction in the frequency of inappropriate and potentially harmful practices per resuscitation in the trained group (trained 0.53 vs control 0.92; mean difference 0.40, [95% CI 0.13–0.66], p = 0.004). Conclusions/Significance Implementation of a simple, one day newborn resuscitation training can be followed immediately by significant improvement in health workers' practices. However, evidence of the effects on long term performance or clinical outcomes can only be established by larger cluster randomised trials. Trial Registration Controlled-Trials.com ISRCTN92218092 PMID:18270586

On a wing and a prayer: an assessment of modularized crew resource management training for health care professionals.

PubMed

Clay-Williams, Robyn; Greenfield, David; Stone, Judy; Braithwaite, Jeffrey

2014-01-01

Evidence suggests that Crew Resource Management (CRM), a form of team training, is beneficial. In CRM training, participants learn individual portable team skills such as communication and decision making through group discussion and activities. However, the usual 1-day course format is not always compatible with health care organizational routines. A modular training format, while theoretically sound, is untested for interprofessional team training. The aim of this study was to explore the potential for modularized CRM training to be delivered to a group of interprofessional learners. Modularized CRM training, consisting of two 2-hour workshops, was delivered to health care workers in an Australian tertiary hospital. Kirkpatrick's evaluation model provided a framework for the study. Baseline attitude surveys were conducted prior to each workshop. Participants completed a written questionnaire at the end of each workshop that examined their motivations, reactions to the training, and learner demographics. An additional survey, administered 6 weeks post training, captured self-assessed behavior data. Twenty-three individuals from a range of professions and clinical streams participated. One in 5 participants (22%) reported that they translated teamwork skills to the workplace. While positive about the workshop format and content, many respondents identified personal, team, and organizational barriers to the application of the workshop techniques. CRM training when delivered in a modular format has positive outcomes. Following the training, some respondents overcame workplace barriers to attempt to change negative workplace behavior. This progress provides cautious optimism for the potential for modular CRM training to benefit groups of interprofessional health staff. © 2014 The Alliance for Continuing Education in the Health Professions, the Society for Academic Continuing Medical Education, and the Council on Continuing Medical Education, Association for Hospital Medical Education.

Computerized visual feedback: an adjunct to robotic-assisted gait training.

PubMed

Banz, Raphael; Bolliger, Marc; Colombo, Gery; Dietz, Volker; Lünenburger, Lars

2008-10-01

Robotic devices for walking rehabilitation allow new possibilities for providing performance-related information to patients during gait training. Based on motor learning principles, augmented feedback during robotic-assisted gait training might improve the rehabilitation process used to regain walking function. This report presents a method to provide visual feedback implemented in a driven gait orthosis (DGO). The purpose of the study was to compare the immediate effect on motor output in subjects during robotic-assisted gait training when they used computerized visual feedback and when they followed verbal instructions of a physical therapist. Twelve people with neurological gait disorders due to incomplete spinal cord injury participated. Subjects were instructed to walk within the DGO in 2 different conditions. They were asked to increase their motor output by following the instructions of a therapist and by observing visual feedback. In addition, the subjects' opinions about using visual feedback were investigated by a questionnaire. Computerized visual feedback and verbal instructions by the therapist were observed to result in a similar change in motor output in subjects when walking within the DGO. Subjects reported that they were more motivated and concentrated on their movements when using computerized visual feedback compared with when no form of feedback was provided. Computerized visual feedback is a valuable adjunct to robotic-assisted gait training. It represents a relevant tool to increase patients' motor output, involvement, and motivation during gait training, similar to verbal instructions by a therapist.

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.

Educating residents in behavioral health care and collaboration: integrated clinical training of pediatric residents and psychology fellows.

PubMed

Pisani, Anthony R; leRoux, Pieter; Siegel, David M

2011-02-01

Pediatric residency practices face the challenge of providing both behavioral health (BH) training for pediatricians and psychosocial care for children. The University of Rochester School of Medicine and Dentistry and Rochester General Hospital developed a joint training program and continuity clinic infrastructure in which pediatric residents and postdoctoral psychology fellows train and practice together. The integrated program provides children access to BH care in a primary care setting and gives trainees the opportunity to integrate collaborative BH care into their regular practice routines. During 1998-2008, 48 pediatric residents and 8 psychology fellows trained in this integrated clinical environment. The program's accomplishments include longevity, faculty and fiscal stability, sustained support from pediatric leadership and community payers, the development in residents and faculty of greater comfort in addressing BH problems and collaborating with BH specialists, and replication of the model in two other primary care settings. In addition to quantitative program outcomes data, the authors present a case example that illustrates how the integrated program works and achieves its goals. They propose that educating residents and psychology trainees side by side in collaborative BH care is clinically and educationally valuable and potentially applicable to other settings. A companion report published in this issue provides results from a study comparing the perceptions of pediatric residents whose primary care continuity clinic took place in this integrated setting with those of residents from the same pediatric residency who had their continuity clinic training in a nonintegrated setting.

AcademyHealth's Delivery System Science Fellowship: Training Embedded Researchers to Design, Implement, and Evaluate New Models of Care.

PubMed

Kanani, Nisha; Hahn, Erin; Gould, Michael; Brunisholz, Kimberly; Savitz, Lucy; Holve, Erin

2017-07-01

AcademyHealth's Delivery System Science Fellowship (DSSF) provides a paid postdoctoral pragmatic learning experience to build capacity within learning healthcare systems to conduct research in applied settings. The fellowship provides hands-on training and professional leadership opportunities for researchers. Since its inception in 2012, the program has grown rapidly, with 16 health systems participating in the DSSF to date. In addition to specific projects conducted within health systems (and numerous publications associated with those initiatives), the DSSF has made several broader contributions to the field, including defining delivery system science, identifying a set of training objectives for researchers working in delivery systems, and developing a national collaborative network of care delivery organizations, operational leaders, and trainees. The DSSF is one promising approach to support higher-value care by promoting continuous learning and improvement in health systems. © 2017 Society of Hospital Medicine.

The effects of augmented visual feedback during balance training in Parkinson's disease: study design of a randomized clinical trial.

PubMed

van den Heuvel, Maarten R C; van Wegen, Erwin E H; de Goede, Cees J T; Burgers-Bots, Ingrid A L; Beek, Peter J; Daffertshofer, Andreas; Kwakkel, Gert

2013-10-04

Patients with Parkinson's disease often suffer from reduced mobility due to impaired postural control. Balance exercises form an integral part of rehabilitative therapy but the effectiveness of existing interventions is limited. Recent technological advances allow for providing enhanced visual feedback in the context of computer games, which provide an attractive alternative to conventional therapy. The objective of this randomized clinical trial is to investigate whether a training program capitalizing on virtual-reality-based visual feedback is more effective than an equally-dosed conventional training in improving standing balance performance in patients with Parkinson's disease. Patients with idiopathic Parkinson's disease will participate in a five-week balance training program comprising ten treatment sessions of 60 minutes each. Participants will be randomly allocated to (1) an experimental group that will receive balance training using augmented visual feedback, or (2) a control group that will receive balance training in accordance with current physical therapy guidelines for Parkinson's disease patients. Training sessions consist of task-specific exercises that are organized as a series of workstations. Assessments will take place before training, at six weeks, and at twelve weeks follow-up. The functional reach test will serve as the primary outcome measure supplemented by comprehensive assessments of functional balance, posturography, and electroencephalography. We hypothesize that balance training based on visual feedback will show greater improvements on standing balance performance than conventional balance training. In addition, we expect that learning new control strategies will be visible in the co-registered posturographic recordings but also through changes in functional connectivity.

Exploring virtual mental practice in maintenance task training

PubMed Central

Bauerle, Tim; Brnich, Michael J.; Navoyski, Jason

2016-01-01

Purpose – This paper aims to contribute to a general understanding of mental practice by investigating the utility of and participant reaction to a virtual reality maintenance training among underground coal mine first responders. Design/methodology/approach – Researchers at the National Institute for Occupational Safety and Health's Office of Mine Safety and Health Research (OMSHR) developed software to provide opportunities for mine rescue team members to learn to inspect, assemble and test their closed-circuit breathing apparatus and to practice those skills. In total, 31 mine rescue team members utilized OMSHR's BG 4 Benching Trainer software and provided feedback to the development team. After training, participants completed a brief post-training questionnaire, which included demographics, perceived training climate and general training evaluation items. Findings – The results overall indicate a generally positive reaction to and high perceived utility of the BG 4 benching software. In addition, the perceived training climate appears to have an effect on the perceived utility of the mental practice virtual reality game, with benchmen from mines with more positive training climates reporting greater perceived efficacy in the training's ability to prepare trainees for real emergencies. Originality/value – This paper helps to broaden current applications of mental practice and is one of the few empirical investigations into a non-rehabilitation virtual reality extension of mental practice. This paper also contributes to the growing literature advocating for greater usage of accurate and well-informed mental practice techniques, tools and methodologies, especially for occupational populations with limitations on exposure to hands-on training. PMID:27594801

Financing Graduate Medical Education to Meet the Needs of Children and the Future Pediatrician Workforce.

PubMed

2016-04-01

The American Academy of Pediatrics (AAP) believes that an appropriately financed graduate medical education (GME) system is critical to ensuring that sufficient numbers of trained pediatricians are available to provide optimal health care to all children. A shortage of pediatric medical subspecialists and pediatric surgical specialists currently exists in the United States, and this shortage is likely to intensify because of the growing numbers of children with chronic health problems and special health care needs. It is equally important to maintain the supply of primary care pediatricians. The AAP, therefore, recommends that children's hospital GME positions funded by the Health Resources and Services Administration be increased to address this escalating demand for pediatric health services. The AAP also recommends that GME funding for pediatric physician training provide full financial support for all years of training necessary to meet program requirements. In addition, all other entities that gain from GME training should participate in its funding in a manner that does not influence curriculum, requirements, or outcomes. Furthermore, the AAP supports funding for training innovations that improve the health of children. Finally, the AAP recommends that all institutional recipients of GME funding allocate these funds directly to the settings where training occurs in a transparent manner. Copyright © 2016 by the American Academy of Pediatrics.

ENERGY SYSTEM DEVELOPMENT AND LOAD MANAGEMENT THROUGH THE REHABILITATION AND RETURN TO PLAY PROCESS.

PubMed

Morrison, Scot; Ward, Patrick; duManoir, Gregory R

2017-08-01

Return-to-play from injury is a complex process involving many factors including the balancing of tissue healing rates with the development of biomotor abilities. This process requires interprofessional cooperation to ensure success. An often-overlooked aspect of return-to-play is the development and maintenance of sports specific conditioning while monitoring training load to ensure that the athlete's training stimulus over the rehabilitation period is appropriate to facilitate a successful return to play. The purpose of this clinical commentary is to address the role of energy systems training as part of the return-to-play process. Additionally the aim is to provide practitioners with an overview of practical sports conditioning training methods and monitoring strategies to allow them to direct and quantify the return-to-play process. 5.

Design and Implementation of an International Training Program on Repository Development and Management

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

Vugrin, K.W.; Twitchell, Ch.A.

2008-07-01

Korea Hydro and Nuclear Power Co., Ltd. (KHNP) is an electric company in the Republic of Korea with twenty operational nuclear power plants and eight additional units that are either planned or currently under construction. Regulations require that KHNP manage the radioactive waste generated by their nuclear power plants. In the course of planning low, intermediate, and high level waste storage facilities, KHNP sought interaction with an acknowledged expert in the field of radioactive waste management and, consequently, contacted Sandia National Laboratories (SNL). KHNP has contracted with SNL to provide a year long training program on repository science. This papermore » discusses the design of the curriculum, specific plans for execution of the training program, and recommendations for smooth implementation of international training programs. (authors)« less

Final Technical Report. Training in Building Audit Technologies

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

Brosemer, Kathleen

In 2011, the Tribe proposed and was awarded the Training in Building Audit Technologies grant from the DOE in the amount of $55,748 to contract for training programs for infrared cameras, blower door technology applications and building systems. The coursework consisted of; Infrared Camera Training: Level I - Thermal Imaging for Energy Audits; Blower Door Analysis and Building-As-A-System Training, Building Performance Institute (BPI) Building Analyst; Building Envelope Training, Building Performance Institute (BPI) Envelope Professional; and Audit/JobFLEX Tablet Software. Competitive procurement of the training contractor resulted in lower costs, allowing the Tribe to request and receive DOE approval to additionally purchasemore » energy audit equipment and contract for residential energy audits of 25 low-income Tribal Housing units. Sault Tribe personnel received field training to supplement the classroom instruction on proper use of the energy audit equipment. Field experience was provided through the second DOE energy audits grant, allowing Sault Tribe personnel to join the contractor, Building Science Academy, in conducting 25 residential energy audits of low-income Tribal Housing units.« less

Examining learner-centered training with teen volunteer staff at an aquarium

NASA Astrophysics Data System (ADS)

Bautista, Raelene M.

This research project examined the effects of a training program that focused on helping youth volunteers create a learner-centered interaction at an Aquarium. This study explored whether this learner centered training resulted in an increased ability to identify learner-centered engagement as well as reported changes in practice. Most research on training programs and professional development, that introduces learner-centered strategies examines adult teachers working in formal environments. This study examined youth volunteer staff in an informal science institution that participated in a weekly one-hour training for four weeks during their eight week long summer volunteer program. The data showed that some of topics introduced in the learner centered training, such as the importance of visitors' prior knowledge and the use of objects, were identified more often as good practice after the training. In addition, participants seemed to hold on to some of their original perceptions of good practices, such as providing positive reinforcement and modifying their physical posture to make the visitors feel comfortable. The investigation also revealed that conversation patterns changed in some participants' practice as a result of the training.

The use of contextual cues to improve warning symbol comprehension: making the connection for older adults

PubMed Central

Lesch, Mary F.; Powell, W. Ryan; Horrey, William J.; Wogalter, Michael S.

2013-01-01

This study teased apart the effects of comprehensibility and complexity on older adults' comprehension of warning symbols by manipulating the relevance of additional information in further refining the meaning of the symbol. Symbols were systematically altered such that increased visual complexity (in the form of contextual cues) resulted in increased comprehensibility. One hundred older adults, aged 50–71 years, were tested on their comprehension of these symbols before and after training. High comprehensibility–complexity symbols were found to be better understood than low- or medium-comprehensibility–complexity symbols and the effectiveness of the contextual cues varied as a function of training. Therefore, the nature of additional detail determines whether increased complexity is detrimental or beneficial to older adults' comprehension – if the additional details provide ‘cues to knowledge’, older adults' comprehension improves as a result of the increased complexity. However, some cues may require training in order to be effective. Practitioner Summary: Research suggests that older adults have greater difficulty in understanding more complex symbols. However, we found that when the complexity of symbols was increased through the addition of contextual cues, older adults' comprehension actually improved. Contextual cues aid older adults in making the connection between the symbol and its referent. PMID:23767856

Data classification using metaheuristic Cuckoo Search technique for Levenberg Marquardt back propagation (CSLM) algorithm

NASA Astrophysics Data System (ADS)

Nawi, Nazri Mohd.; Khan, Abdullah; Rehman, M. Z.

2015-05-01

A nature inspired behavior metaheuristic techniques which provide derivative-free solutions to solve complex problems. One of the latest additions to the group of nature inspired optimization procedure is Cuckoo Search (CS) algorithm. Artificial Neural Network (ANN) training is an optimization task since it is desired to find optimal weight set of a neural network in training process. Traditional training algorithms have some limitation such as getting trapped in local minima and slow convergence rate. This study proposed a new technique CSLM by combining the best features of two known algorithms back-propagation (BP) and Levenberg Marquardt algorithm (LM) for improving the convergence speed of ANN training and avoiding local minima problem by training this network. Some selected benchmark classification datasets are used for simulation. The experiment result show that the proposed cuckoo search with Levenberg Marquardt algorithm has better performance than other algorithm used in this study.

Computerized training management system

DOEpatents

Rice, H.B.; McNair, R.C.; White, K.; Maugeri, T.

1998-08-04

A Computerized Training Management System (CTMS) is disclosed for providing a procedurally defined process that is employed to develop accreditable performance based training programs for job classifications that are sensitive to documented regulations and technical information. CTMS is a database that links information needed to maintain a five-phase approach to training-analysis, design, development, implementation, and evaluation independent of training program design. CTMS is designed using R-Base{trademark}, an-SQL compliant software platform. Information is logically entered and linked in CTMS. Each task is linked directly to a performance objective, which, in turn, is linked directly to a learning objective; then, each enabling objective is linked to its respective test items. In addition, tasks, performance objectives, enabling objectives, and test items are linked to their associated reference documents. CTMS keeps all information up to date since it automatically sorts, files and links all data; CTMS includes key word and reference document searches. 18 figs.

Computerized training management system

DOEpatents

Rice, Harold B.; McNair, Robert C.; White, Kenneth; Maugeri, Terry

1998-08-04

A Computerized Training Management System (CTMS) for providing a procedurally defined process that is employed to develop accreditable performance based training programs for job classifications that are sensitive to documented regulations and technical information. CTMS is a database that links information needed to maintain a five-phase approach to training-analysis, design, development, implementation, and evaluation independent of training program design. CTMS is designed using R-Base.RTM., an-SQL compliant software platform. Information is logically entered and linked in CTMS. Each task is linked directly to a performance objective, which, in turn, is linked directly to a learning objective; then, each enabling objective is linked to its respective test items. In addition, tasks, performance objectives, enabling objectives, and test items are linked to their associated reference documents. CTMS keeps all information up to date since it automatically sorts, files and links all data; CTMS includes key word and reference document searches.

Recurrent neural network based virtual detection line

NASA Astrophysics Data System (ADS)

Kadikis, Roberts

2018-04-01

The paper proposes an efficient method for detection of moving objects in the video. The objects are detected when they cross a virtual detection line. Only the pixels of the detection line are processed, which makes the method computationally efficient. A Recurrent Neural Network processes these pixels. The machine learning approach allows one to train a model that works in different and changing outdoor conditions. Also, the same network can be trained for various detection tasks, which is demonstrated by the tests on vehicle and people counting. In addition, the paper proposes a method for semi-automatic acquisition of labeled training data. The labeling method is used to create training and testing datasets, which in turn are used to train and evaluate the accuracy and efficiency of the detection method. The method shows similar accuracy as the alternative efficient methods but provides greater adaptability and usability for different tasks.

Telehealth Innovations in Health Education and Training

PubMed Central

De, Suvranu; Hall, Richard W.; Johansen, Edward; Meglan, Dwight; Peng, Grace C.Y.

2010-01-01

Abstract Telehealth applications are increasingly important in many areas of health education and training. In addition, they will play a vital role in biomedical research and research training by facilitating remote collaborations and providing access to expensive/remote instrumentation. In order to fulfill their true potential to leverage education, training, and research activities, innovations in telehealth applications should be fostered across a range of technology fronts, including online, on-demand computational models for simulation; simplified interfaces for software and hardware; software frameworks for simulations; portable telepresence systems; artificial intelligence applications to be applied when simulated human patients are not options; and the development of more simulator applications. This article presents the results of discussion on potential areas of future development, barries to overcome, and suggestions to translate the promise of telehealth applications into a transformed environment of training, education, and research in the health sciences. PMID:20155874

Prediction of air pollutant concentration based on sparse response back-propagation training feedforward neural networks.

PubMed

Ding, Weifu; Zhang, Jiangshe; Leung, Yee

2016-10-01

In this paper, we predict air pollutant concentration using a feedforward artificial neural network inspired by the mechanism of the human brain as a useful alternative to traditional statistical modeling techniques. The neural network is trained based on sparse response back-propagation in which only a small number of neurons respond to the specified stimulus simultaneously and provide a high convergence rate for the trained network, in addition to low energy consumption and greater generalization. Our method is evaluated on Hong Kong air monitoring station data and corresponding meteorological variables for which five air quality parameters were gathered at four monitoring stations in Hong Kong over 4 years (2012-2015). Our results show that our training method has more advantages in terms of the precision of the prediction, effectiveness, and generalization of traditional linear regression algorithms when compared with a feedforward artificial neural network trained using traditional back-propagation.

The social context of the aeronautical education experience of African-American civilian, commercial, and military pilots

NASA Astrophysics Data System (ADS)

Walker, Taurean Mashawn

The purpose of this research is to explore the social context (the nature and cultural environment) of the aeronautical training experience of African-American civilian, commercial, and military pilots. This research highlights the challenges African-American pilots are exposed to in addition to drawing parallels between the social context and the obstacles they are subjected to along the way. This study is valuable for stakeholders, African-American pilot aspirants, aviation corporations, Federal Aviation Administration, flight schools - in the aviation industry in understanding ways to initiate a paradigm shift and increase awareness about representation and participation of African-American aviation professionals. The qualitative approach was selected to gather a better understanding of the sociological hurdles black aviators face while going through the journey of becoming a pilot. Hardiman (2010) states, "While quantitative research is valuable, qualitative research provides the researcher the ability to view real world situations as they naturally unfold" ( p. 25). According to OBAP (2014), less than 2% of pilots in the United States are African-American. The experiences shared by the participants can provide helpful insight of possible policy implications for the aeronautical industry. There were three research questions in the study: 1) What factors hindered pilot training? 2) What were the resilience factors experienced during pilot training? 3) What were the defining features of the social context surrounding pilot training? Semi-structured, face-to-face interviews were conducted of six professional pilots. A qualitative data analysis was conducted to illustrate the context of the social challenges during the course of pilot training. Three themes were revealed: 1) access, 2) perception of inferiority, and 3) support. Implications of the significance of providing social networks to expose African-Americans to aviation were discussed. Additional means of access and exposure of African-Americans to aviation is essential for further research.

The effect of a community mental health training program for multidisciplinary staff.

PubMed

Yang, Bing Xiang; Stone, Teresa E; Davis, Scott A

2018-06-01

Primary health workers play a critical role in providing health education to people with mental disorders. In China community health workers working with people with mental health problems lack experience and training in this area. Additionally, coordination between hospital and community staff is not well established. The aim of this study was to provide an interdisciplinary community mental health training program and to evaluate the effect of the training on staff knowledge about mental health and confidence in their roles. A three-day community mental health training program was offered specifically for interdisciplinary mental health professionals. Using a one-group pre-test post-test design, participants completed a self-assessment of mental health concepts and program evaluation which included asking participants to rate their satisfaction using a five-point Likert scale and to respond to open-ended questions. Forty-eight participants including health professionals from colleges, hospital and community health centers were recruited. Only 8.7% of participants had ever received community mental health training. Post-test evaluation demonstrated improvements in knowledge, and most participants were very satisfied with the program. The findings indicate that this brief interdisciplinary training program had a positive effect in improving knowledge about community mental health concepts and confidence in dealing with people with mental health disorders for multidisciplinary staff working in primary health care areas. Copyright © 2017 Elsevier Inc. All rights reserved.

Continuous medical education (CME): do we need CME for paediatric environmental medicine in Europe?

PubMed

Boese-O'Reilly, Stephan

2007-10-01

The knowledge about the influence of environmental hazards on children's health is increasing enormously. European Ministers of Health and Environment, like many other stakeholders, identified the environmental hazards in Europe for the health of children as so serious, that they called for a "Children's Environment and Health Action Plan for Europe (CEHAPE)" approved in June 2004. The knowledge of paediatricians and other health care providers on children's health and environment in Europe is insufficient, due to the lack of training in environmental medicine for medical students, clinical trainees and postgraduates. Only continuous medical education in environmental medicine can help to fill this gap of knowledge and is thereby urgently needed. The World Health Organization developed a training package for health care providers for children's health and environment, containing excellent material for paediatric training events. The International Network on Children's Health, Environment and Safety (INCHES) developed additional training material for paediatricians within the Children's Health, Environment and Safety Training (CHEST) project. The German Network Children's Health and Environment offers training for paediatric doctors' assistants in primary prevention. To improve knowledge about children's health and environment at all levels in paediatric settings, greater efforts of national institutions, paediatric associations and other institutions are necessary. It is time to strengthen existing structures and to introduce, where necessary, new structures for training in environmental medicine.

BUMPER v1.0: a Bayesian user-friendly model for palaeo-environmental reconstruction

NASA Astrophysics Data System (ADS)

Holden, Philip B.; Birks, H. John B.; Brooks, Stephen J.; Bush, Mark B.; Hwang, Grace M.; Matthews-Bird, Frazer; Valencia, Bryan G.; van Woesik, Robert

2017-02-01

We describe the Bayesian user-friendly model for palaeo-environmental reconstruction (BUMPER), a Bayesian transfer function for inferring past climate and other environmental variables from microfossil assemblages. BUMPER is fully self-calibrating, straightforward to apply, and computationally fast, requiring ˜ 2 s to build a 100-taxon model from a 100-site training set on a standard personal computer. We apply the model's probabilistic framework to generate thousands of artificial training sets under ideal assumptions. We then use these to demonstrate the sensitivity of reconstructions to the characteristics of the training set, considering assemblage richness, taxon tolerances, and the number of training sites. We find that a useful guideline for the size of a training set is to provide, on average, at least 10 samples of each taxon. We demonstrate general applicability to real data, considering three different organism types (chironomids, diatoms, pollen) and different reconstructed variables. An identically configured model is used in each application, the only change being the input files that provide the training-set environment and taxon-count data. The performance of BUMPER is shown to be comparable with weighted average partial least squares (WAPLS) in each case. Additional artificial datasets are constructed with similar characteristics to the real data, and these are used to explore the reasons for the differing performances of the different training sets.

BUMPER: the Bayesian User-friendly Model for Palaeo-Environmental Reconstruction

NASA Astrophysics Data System (ADS)

Holden, Phil; Birks, John; Brooks, Steve; Bush, Mark; Hwang, Grace; Matthews-Bird, Frazer; Valencia, Bryan; van Woesik, Robert

2017-04-01

We describe the Bayesian User-friendly Model for Palaeo-Environmental Reconstruction (BUMPER), a Bayesian transfer function for inferring past climate and other environmental variables from microfossil assemblages. The principal motivation for a Bayesian approach is that the palaeoenvironment is treated probabilistically, and can be updated as additional data become available. Bayesian approaches therefore provide a reconstruction-specific quantification of the uncertainty in the data and in the model parameters. BUMPER is fully self-calibrating, straightforward to apply, and computationally fast, requiring 2 seconds to build a 100-taxon model from a 100-site training-set on a standard personal computer. We apply the model's probabilistic framework to generate thousands of artificial training-sets under ideal assumptions. We then use these to demonstrate both the general applicability of the model and the sensitivity of reconstructions to the characteristics of the training-set, considering assemblage richness, taxon tolerances, and the number of training sites. We demonstrate general applicability to real data, considering three different organism types (chironomids, diatoms, pollen) and different reconstructed variables. In all of these applications an identically configured model is used, the only change being the input files that provide the training-set environment and taxon-count data.

Improving care quality and preventing maltreatment in institutional care - a feasibility study with caregivers.

PubMed

Hermenau, Katharin; Kaltenbach, Elisa; Mkinga, Getrude; Hecker, Tobias

2015-01-01

Institutionalized children in low-income countries often face maltreatment and inadequate caregiving. In addition to prior traumatization and other childhood adversities in the family of origin, abuse and neglect in institutional care are linked to various mental health problems. By providing a manualized training workshop for caregivers, we aimed at improving care quality and preventing maltreatment in institutional care. In Study 1, 29 participating caregivers rated feasibility and efficacy of the training immediately before, directly after, and 3 months following the training workshop. The results showed high demand, good feasibility, high motivation, and acceptance of caregivers. They reported improvements in caregiver-child relationships, as well as in the children's behavior. Study 2 assessed exposure to maltreatment and the mental health of 28 orphans living in one institution in which all caregivers had been trained. The children were interviewed 20 months before, 1 month before, and 3 months after the training. Children reported a decrease in physical maltreatment and assessments showed a decrease in mental health problems. Our approach seems feasible under challenging circumstances and provides first hints for its efficacy. These promising findings call for further studies testing the efficacy and sustainability of this maltreatment prevention approach.

Grip force control during virtual object interaction: effect of force feedback,accuracy demands, and training.

PubMed

Gibo, Tricia L; Bastian, Amy J; Okamura, Allison M

2014-03-01

When grasping and manipulating objects, people are able to efficiently modulate their grip force according to the experienced load force. Effective grip force control involves providing enough grip force to prevent the object from slipping, while avoiding excessive force to avoid damage and fatigue. During indirect object manipulation via teleoperation systems or in virtual environments, users often receive limited somatosensory feedback about objects with which they interact. This study examines the effects of force feedback, accuracy demands, and training on grip force control during object interaction in a virtual environment. The task required subjects to grasp and move a virtual object while tracking a target. When force feedback was not provided, subjects failed to couple grip and load force, a capability fundamental to direct object interaction. Subjects also exerted larger grip force without force feedback and when accuracy demands of the tracking task were high. In addition, the presence or absence of force feedback during training affected subsequent performance, even when the feedback condition was switched. Subjects' grip force control remained reminiscent of their employed grip during the initial training. These results motivate the use of force feedback during telemanipulation and highlight the effect of force feedback during training.

Improving care quality and preventing maltreatment in institutional care – a feasibility study with caregivers

PubMed Central

Hermenau, Katharin; Kaltenbach, Elisa; Mkinga, Getrude; Hecker, Tobias

2015-01-01

Institutionalized children in low-income countries often face maltreatment and inadequate caregiving. In addition to prior traumatization and other childhood adversities in the family of origin, abuse and neglect in institutional care are linked to various mental health problems. By providing a manualized training workshop for caregivers, we aimed at improving care quality and preventing maltreatment in institutional care. In Study 1, 29 participating caregivers rated feasibility and efficacy of the training immediately before, directly after, and 3 months following the training workshop. The results showed high demand, good feasibility, high motivation, and acceptance of caregivers. They reported improvements in caregiver–child relationships, as well as in the children’s behavior. Study 2 assessed exposure to maltreatment and the mental health of 28 orphans living in one institution in which all caregivers had been trained. The children were interviewed 20 months before, 1 month before, and 3 months after the training. Children reported a decrease in physical maltreatment and assessments showed a decrease in mental health problems. Our approach seems feasible under challenging circumstances and provides first hints for its efficacy. These promising findings call for further studies testing the efficacy and sustainability of this maltreatment prevention approach. PMID:26236248

Promoting patient participation in healthcare interactions through communication skills training: A systematic review.

PubMed

D'Agostino, Thomas A; Atkinson, Thomas M; Latella, Lauren E; Rogers, Madeline; Morrissey, Dana; DeRosa, Antonio P; Parker, Patricia A

2017-07-01

To present literature on training patients in the use of effective communication skills. Systematic searches were conducted in six databases. References were screened for inclusion through several phases. Extracted data included intervention study design, sample characteristics, content and structure of training programs, outcomes assessed, and findings reported. A total of 32 unique intervention studies were included. Most targeted primary care or cancer patients and used a randomized controlled study design. Interventions used a variety of training formats and modes of delivering educational material. Reported findings suggest that communication training is an effective approach to increase patients' total level of active participation in healthcare interactions and that some communication behaviors may be more amenable to training (e.g., expressing concerns). Trained patients do not have longer visits and tend to receive more information from their providers. Most studies have found no relationship between communication training and improved health, psychosocial wellbeing, or treatment-related outcomes. Findings reinforce the importance and potential benefits of patient communication training. Additional research is warranted to determine the most efficacious training programs with the strongest potential for dissemination. Copyright © 2017 Elsevier B.V. All rights reserved.

Adolescent medicine training in pediatric residency programs.

PubMed

Fox, Harriette B; McManus, Margaret A; Klein, Jonathan D; Diaz, Angela; Elster, Arthur B; Felice, Marianne E; Kaplan, David W; Wibbelsman, Charles J; Wilson, Jane E

2010-01-01

The aim of this study was to provide an assessment of pediatric residency training in adolescent medicine. We conducted 2 national surveys: 1 of pediatric residency program directors and the other of faculty who are responsible for the adolescent medicine block rotation for pediatric residents to elicit descriptive and qualitative information concerning the nature of residents' ambulatory care training experience in adolescent medicine and the workforce issues that affect the experience. Required adolescent medicine topics that are well covered pertain to normal development, interviewing, and sexual issues. Those least well covered concern the effects of violence, motor vehicle safety, sports medicine, and chronic illness. Shortages of adolescent medicine specialists, addictions counselors, psychiatrists, and other health professionals who are knowledgeable about adolescents frequently limit pediatric residency training in adolescent medicine. Considerable variation exists in the timing of the mandatory adolescent medicine block rotation, the clinic sites used for ambulatory care training, and the range of services offered at the predominant training sites. In addition, residents' continuity clinic experience often does not include adolescent patients; thus, pediatric residents do not have opportunities to establish ongoing therapeutic relationships with adolescents over time. Both program and rotation directors had similar opinions about adolescent medicine training. Significant variation and gaps exist in adolescent medicine ambulatory care training in pediatric residency programs throughout the United States. For addressing the shortcomings in many programs, the quality of the block rotation should be improved and efforts should be made to teach adolescent medicine in continuity, general pediatric, and specialty clinics. In addition, renewed attention should be given to articulating the core competencies needed to care for adolescents.

A path towards uncertainty assignment in an operational cloud-phase algorithm from ARM vertically pointing active sensors

DOE PAGES

Riihimaki, Laura D.; Comstock, Jennifer M.; Anderson, Kevin K.; ...

2016-06-10

Knowledge of cloud phase (liquid, ice, mixed, etc.) is necessary to describe the radiative impact of clouds and their lifetimes, but is a property that is difficult to simulate correctly in climate models. One step towards improving those simulations is to make observations of cloud phase with sufficient accuracy to help constrain model representations of cloud processes. In this study, we outline a methodology using a basic Bayesian classifier to estimate the probabilities of cloud-phase class from Atmospheric Radiation Measurement (ARM) vertically pointing active remote sensors. The advantage of this method over previous ones is that it provides uncertainty informationmore » on the phase classification. We also test the value of including higher moments of the cloud radar Doppler spectrum than are traditionally used operationally. Using training data of known phase from the Mixed-Phase Arctic Cloud Experiment (M-PACE) field campaign, we demonstrate a proof of concept for how the method can be used to train an algorithm that identifies ice, liquid, mixed phase, and snow. Over 95 % of data are identified correctly for pure ice and liquid cases used in this study. Mixed-phase and snow cases are more problematic to identify correctly. When lidar data are not available, including additional information from the Doppler spectrum provides substantial improvement to the algorithm. As a result, this is a first step towards an operational algorithm and can be expanded to include additional categories such as drizzle with additional training data.« less

A path towards uncertainty assignment in an operational cloud-phase algorithm from ARM vertically pointing active sensors

NASA Astrophysics Data System (ADS)

Riihimaki, Laura D.; Comstock, Jennifer M.; Anderson, Kevin K.; Holmes, Aimee; Luke, Edward

2016-06-01

Knowledge of cloud phase (liquid, ice, mixed, etc.) is necessary to describe the radiative impact of clouds and their lifetimes, but is a property that is difficult to simulate correctly in climate models. One step towards improving those simulations is to make observations of cloud phase with sufficient accuracy to help constrain model representations of cloud processes. In this study, we outline a methodology using a basic Bayesian classifier to estimate the probabilities of cloud-phase class from Atmospheric Radiation Measurement (ARM) vertically pointing active remote sensors. The advantage of this method over previous ones is that it provides uncertainty information on the phase classification. We also test the value of including higher moments of the cloud radar Doppler spectrum than are traditionally used operationally. Using training data of known phase from the Mixed-Phase Arctic Cloud Experiment (M-PACE) field campaign, we demonstrate a proof of concept for how the method can be used to train an algorithm that identifies ice, liquid, mixed phase, and snow. Over 95 % of data are identified correctly for pure ice and liquid cases used in this study. Mixed-phase and snow cases are more problematic to identify correctly. When lidar data are not available, including additional information from the Doppler spectrum provides substantial improvement to the algorithm. This is a first step towards an operational algorithm and can be expanded to include additional categories such as drizzle with additional training data.

Strength Training with Repetitions to Failure does not Provide Additional Strength and Muscle Hypertrophy Gains in Young Women

PubMed Central

Martorelli, Saulo; Cadore, Eduardo Lusa; Izquierdo, Mikel; Celes, Rodrigo; Martorelli, André; Cleto, Vitor Alonso; Alvarenga, José Gustavo; Bottaro, Martim

2017-01-01

This study investigated the effects of a 10-week resistance training to failure on neuromuscular adaptations in young women. Eighty-nine active young women were randomly assigned to one of three groups: 1) repetitions to failure (RF; three sets of repetitions to failure); 2) repetitions not to failure with equalized volume (RNFV; four sets of 7 repetitions); and 3) repetitions not to failure (RNF; three sets of 7 repetitions). All groups performed the elbow flexor exercise (bilateral biceps curl) and trained 2 days per week using 70% of 1RM. There were significant increases (p<0.05) in muscle strength after 5 (15.9% for RF, 18.4% for RNF, and 19.9% for RNFV) and 10 (28.3% for RF, 26.8% for RNF, and 28.3% for RNFV) weeks of training, with no significant differences between groups. Additionally, muscular endurance increased after 5 and 10 weeks, with no differences between groups. However, peak torque (PT) increased significantly at 180°.s-1 in the RNFV (13.7%) and RNF (4.1%) groups (p<0.05), whereas no changes were observed in the RF group (-0.5%). Muscle thickness increased significantly (p<0.05) in the RF and RNFV groups after 5 (RF: 8.4% and RNFV: 2.3%) and 10 weeks of training (RF: 17.5%, and RNFV: 8.5%), whereas no significant changes were observed in the RNF group (3.9 and 2.1% after 5 and 10 weeks, respectively). These data suggest that short-term training of repetitions to failure do not yield additional overall neuromuscular improvements in young women. PMID:28713535

Music and Dyslexia: A New Musical Training Method to Improve Reading and Related Disorders

PubMed Central

Habib, Michel; Lardy, Chloé; Desiles, Tristan; Commeiras, Céline; Chobert, Julie; Besson, Mireille

2016-01-01

Numerous arguments in the recent neuroscientific literature support the use of musical training as a therapeutic tool among the arsenal already available to therapists and educators for treating children with dyslexia. In the present study, we tested the efficacy of a specially-designed Cognitivo-Musical Training (CMT) method based upon three principles: (1) music-language analogies: training dyslexics with music could contribute to improve brain circuits which are common to music and language processes; (2) the temporal and rhythmic features of music, which could exert a positive effect on the multiple dimensions of the “temporal deficit” characteristic of some types of dyslexia; and (3) cross-modal integration, based on converging evidence of impaired connectivity between brain regions in dyslexia and related disorders. Accordingly, we developed a series of musical exercises involving jointly and simultaneously sensory (visual, auditory, somatosensory) and motor systems, with special emphasis on rhythmic perception and production in addition to intensive training of various features of the musical auditory signal. Two separate studies were carried out, one in which dyslexic children received intensive musical exercises concentrated over 18 h during 3 consecutive days, and the other in which the 18 h of musical training were spread over 6 weeks. Both studies showed significant improvements in some untrained, linguistic and non-linguistic variables. The first one yielded significant improvement in categorical perception and auditory perception of temporal components of speech. The second study revealed additional improvements in auditory attention, phonological awareness (syllable fusion), reading abilities, and repetition of pseudo-words. Importantly, most improvements persisted after an untrained period of 6 weeks. These results provide new additional arguments for using music as part of systematic therapeutic and instructional practice for dyslexic children. PMID:26834689

[Undergraduate training in physician-patient communication].

PubMed

Berney, Alexandre; Pécoud, Pascale; Bourquin, Céline; Stiefel, Friedrich

2017-02-08

In addition to providing psychiatric care to patients with somatic diseases, liaison psychiatry plays an important role in the teaching of the relational aspects of the clinical encounter between patients and clinicians. This series of three articles proposes a critical reflection on this topic, and presents examples of undergraduate and postgraduate teaching programs developed by the psychiatric liaison service at Lausanne University Hospital. This article describes the general context of undergraduate teaching, and focuses on our training with simulated patient of a breaking bad news situation, taking place during the fourth year of medical studies. Individual supervision, provided for each student, is discussed as a relatively unique opportunity within the curriculum of medical school.

Physical Health Care for People with Severe Mental Illness: the Attitudes, Practices, and Training Needs of Nurses in Three Asian Countries.

PubMed

Bressington, Daniel; Badnapurkar, Ashish; Inoue, Sachiko; Ma, Hin Yeung; Chien, Wai Tong; Nelson, Deborah; Gray, Richard

2018-02-15

People with severe mental illness (SMI) have considerable unmet physical health needs and an increased risk of early mortality. This cross-sectional survey utilized the Physical Health Attitude Scale (PHASe) to examine the attitudes, practices, and training needs of nurses towards physical health care of people with SMI in three Asian countries (Hong Kong, Japan, Qatar). Cross-country differences were explored and linear regression was used to investigate if nurses' attitudes and confidence were associated with their level of involvement in physical health care. A total of 481 questionnaires were returned. Hong Kong nurses were less involved in physical health care than those from Japan and Qatar. Nurses' attitudes and confidence were significant predictors of their participation in managing physical health. Compared with western countries, more nurses in this study felt that mental illness was a barrier to improving physical health. Three-quarters reported that they needed additional training in promoting cardiometabolic health. The perceived need for additional training in physical health care was held by Mental Health Nurses (MHN) irrespective of their type of nursing registration and nationality. Nurse educators and service providers should reconsider the physical health care training requirements of nurses working in mental health settings in order to improve the physical health of people with SMI.

Learning to prescribe - pharmacists' experiences of supplementary prescribing training in England.

PubMed

Cooper, Richard J; Lymn, Joanne; Anderson, Claire; Avery, Anthony; Bissell, Paul; Guillaume, Louise; Hutchinson, Allen; Murphy, Elizabeth; Ratcliffe, Julie; Ward, Paul

2008-12-05

The introduction of non-medical prescribing for professions such as pharmacy and nursing in recent years offers additional responsibilities and opportunities but attendant training issues. In the UK and in contrast to some international models, becoming a non-medical prescriber involves the completion of an accredited training course offered by many higher education institutions, where the skills and knowledge necessary for prescribing are learnt. to explore pharmacists' perceptions and experiences of learning to prescribe on supplementary prescribing (SP) courses, particularly in relation to inter-professional learning, course content and subsequent use of prescribing in practice. A postal questionnaire survey was sent to all 808 SP registered pharmacists in England in April 2007, exploring demographic, training, prescribing, safety culture and general perceptions of SP. After one follow-up, 411 (51%) of pharmacists responded. 82% agreed SP training was useful, 58% agreed courses provided appropriate knowledge and 62% agreed that the necessary prescribing skills were gained. Clinical examination, consultation skills training and practical experience with doctors were valued highly; pharmacology training and some aspects of course delivery were criticised. Mixed views on inter-professional learning were reported - insights into other professions being valued but knowledge and skills differences considered problematic. 67% believed SP and recent independent prescribing (IP) should be taught together, with more diagnostic training wanted; few pharmacists trained in IP, but many were training or intending to train. There was no association between pharmacists' attitudes towards prescribing training and when they undertook training between 2004 and 2007 but earlier cohorts were more likely to be using supplementary prescribing in practice. Pharmacists appeared to value their SP training and suggested improvements that could inform future courses. The benefits of inter-professional learning, however, may conflict with providing profession-specific training. SP training may be perceived to be an instrumental 'stepping stone' in pharmacists' professional project of gaining full IP status.

Salivary testosterone is related to self-selected training load in elite female athletes.

PubMed

Cook, Christian J; Beaven, C Martyn

2013-05-27

Testosterone has been related to improved acute neuromuscular performance in athletic populations. It is our contention that testosterone may also contribute to improved volitional motivation and, when monitored longitudinally, may provide one proxy marker for readiness to perform. Twelve female netball players provided saliva samples prior to five standardized training sessions in which they completed a maximal-distance medicine ball throw, and then 3 sets of bench press and then back squat using a self-selected load perceived to equal a 3-repetition maximum load. Additional repetitions were encouraged when possible and total voluntary workload was calculated from the product of the load lifted and repetitions performed. Relative salivary testosterone levels as a group were correlated with bench press (r=0.8399; p=0.0007) and squat (r=0.6703; p=0.0171) self-selected workload, as well as maximal medicine ball throw performance (r=0.7062; p=0.0103). Individual salivary testosterone, when viewed relatively over time, demonstrated strong relationships with self-selected workloads during an in-season training period in female netball players. As such, daily variations in testosterone may provide information regarding voluntary training motivation and readiness to perform in elite athletic populations. Psychological and behavioral aspects of testosterone may have the potential to enhance training adaptation by complementing the known anabolic and permissive properties of testosterone. Copyright © 2013 Elsevier Inc. All rights reserved.

Attention and working memory training: A feasibility study in children with neurodevelopmental disorders.

PubMed

Kerns, Kimberly A; Macoun, Sarah; MacSween, Jenny; Pei, Jacqueline; Hutchison, Marnie

2017-01-01

The current study investigated the efficacy of a game-based process specific intervention for improving attention and working memory in children with Fetal Alcohol Spectrum Disorders (FASD) and Autism Spectrum Disorders (ASD). The Caribbean Quest (CQ) is a 'serious game' that consists of five hierarchically structured tasks, delivered in an adaptive format, targeting different aspects of attention and/or working memory. In addition to game play, the intervention incorporates metacognitive strategies provided by trained educational assistants (EAs), to facilitate generalization and far transfer to academic and daily skills. EAs delivered the intervention to children (ages 6-13) during their regular school day, providing children with instruction in metacognitive strategies to improve game play, with participants completing approximately 12 hours of training over an 8 to 12 school week period. Pre- and post-test analyses revealed significant improvement on measures of working memory and attention, including reduced distractibility and improved divided attention skills. Additionally, children showed significant gains in performance on an academic measure of reading fluency, suggesting that training-related gains in attention and working memory transferred to classroom performance. Exit interviews with EAs revealed that the intervention was easily delivered within the school day, that children enjoyed the intervention, and that children transferred metacognitive strategies learned in game play into the classroom. Preliminary results support this game-based process specific intervention as a potentially effective treatment and useful tool for supporting cognitive improvements in children with FASD or ASD, when delivered as part of an overall treatment plan.

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 retraining for organizational impairment in obsessive-compulsive disorder.

PubMed

Buhlmann, Ulrike; Deckersbach, Thilo; Engelhard, Iris; Cook, Laura M; Rauch, Scott L; Kathmann, Norbert; Wilhelm, Sabine; Savage, Cary R

2006-11-15

Individuals with obsessive-compulsive disorder (OCD) have difficulties in organizing information during encoding associated with subsequent memory impairments. This study was designed to investigate whether impairments in organization in individuals with OCD can be alleviated with cognitive training. Thirty-five OCD subjects and 36 controls copied and recalled the Rey-Osterrieth Complex Figure Test (RCFT) [Osterrieth, P.A., 1944. Le test de copie d'une figure complexe: Contribution a l'étude de la perception et de la memoire (The test of copying a complex figure: A contribution to the study of perception and memory). Archive de Psychologie 30, 286-350.] before being randomly assigned to a training or non-training condition. The training condition was designed to improve the ability to organize complex visuospatial information in a meaningful way. The intervention phase was followed by another copy and recall trial of the RCFT. Both OCD and control subjects who underwent training improved more in organization and memory than subjects who did not receive organizational training, providing evidence that the training procedure was effective. OCD subjects improved more in organizational during encoding than control subjects, irrespective of whether or not they had received training. This suggests that organization impairment in OCD affects primarily the ability to spontaneously utilize strategies when faced with complex, ambiguous information but that the ability to implement such strategies when provided with additional trials is preserved. These findings support a distinction in OCD between failure to utilize a strategy and incapacity to implement a strategy.

A generalized LSTM-like training algorithm for second-order recurrent neural networks

PubMed Central

Monner, Derek; Reggia, James A.

2011-01-01

The Long Short Term Memory (LSTM) is a second-order recurrent neural network architecture that excels at storing sequential short-term memories and retrieving them many time-steps later. LSTM’s original training algorithm provides the important properties of spatial and temporal locality, which are missing from other training approaches, at the cost of limiting it’s applicability to a small set of network architectures. Here we introduce the Generalized Long Short-Term Memory (LSTM-g) training algorithm, which provides LSTM-like locality while being applicable without modification to a much wider range of second-order network architectures. With LSTM-g, all units have an identical set of operating instructions for both activation and learning, subject only to the configuration of their local environment in the network; this is in contrast to the original LSTM training algorithm, where each type of unit has its own activation and training instructions. When applied to LSTM architectures with peephole connections, LSTM-g takes advantage of an additional source of back-propagated error which can enable better performance than the original algorithm. Enabled by the broad architectural applicability of LSTM-g, we demonstrate that training recurrent networks engineered for specific tasks can produce better results than single-layer networks. We conclude that LSTM-g has the potential to both improve the performance and broaden the applicability of spatially and temporally local gradient-based training algorithms for recurrent neural networks. PMID:21803542

40 CFR 300.175 - Federal agencies: additional responsibilities and assistance.

Code of Federal Regulations, 2014 CFR

2014-07-01

... substances on lands under its jurisdiction. (ii) The Agriculture Research Service (ARS) administers an... nutrition. The ARS has the capabilities to provide regulation of, and evaluation and training for, employees exposed to biological, chemical, radiological, and industrial hazards. In emergency situations, the ARS...

40 CFR 300.175 - Federal agencies: additional responsibilities and assistance.

Code of Federal Regulations, 2011 CFR

2011-07-01

... substances on lands under its jurisdiction. (ii) The Agriculture Research Service (ARS) administers an... nutrition. The ARS has the capabilities to provide regulation of, and evaluation and training for, employees exposed to biological, chemical, radiological, and industrial hazards. In emergency situations, the ARS...

40 CFR 300.175 - Federal agencies: additional responsibilities and assistance.

Code of Federal Regulations, 2013 CFR

2013-07-01

... substances on lands under its jurisdiction. (ii) The Agriculture Research Service (ARS) administers an... nutrition. The ARS has the capabilities to provide regulation of, and evaluation and training for, employees exposed to biological, chemical, radiological, and industrial hazards. In emergency situations, the ARS...

40 CFR 300.175 - Federal agencies: additional responsibilities and assistance.

Code of Federal Regulations, 2012 CFR

2012-07-01

... substances on lands under its jurisdiction. (ii) The Agriculture Research Service (ARS) administers an... nutrition. The ARS has the capabilities to provide regulation of, and evaluation and training for, employees exposed to biological, chemical, radiological, and industrial hazards. In emergency situations, the ARS...

40 CFR 300.175 - Federal agencies: additional responsibilities and assistance.

Code of Federal Regulations, 2010 CFR

2010-07-01

... substances on lands under its jurisdiction. (ii) The Agriculture Research Service (ARS) administers an... nutrition. The ARS has the capabilities to provide regulation of, and evaluation and training for, employees exposed to biological, chemical, radiological, and industrial hazards. In emergency situations, the ARS...

Suicide Prevention in a Treatment Setting.

ERIC Educational Resources Information Center

Litman, Robert E.

1995-01-01

The author anticipates that sophisticated interactive computer programs will be effective in improving screening and case finding of the suicidal and that they will become invaluable in improving training for primary care providers and outpatient mental health workers. Additionally, improved communication networks will help maintain continuity of…

Urban-Rural Differences in School Nurses' Asthma Training Needs and Access to Asthma Resources.

PubMed

Carpenter, Delesha M; Estrada, Robin Dawson; Roberts, Courtney A; Elio, Alice; Prendergast, Melissa; Durbin, Kathy; Jones, Graceann Clyburn; North, Steve

Few studies have examined school nurses preferences' for asthma training. Our purpose was to: 1) assess school nurses' perceived asthma training needs, 2) describe nurses' access to asthma educational resources, and 3) identify urban-rural differences in training needs and access to resources in southern states. A convenience sample of school nurses (n=162) from seven counties (two urban and five rural) in North Carolina and South Carolina completed an online, anonymous survey. Chi-square tests were used to examine urban-rural differences. Although most nurses (64%) had received asthma training within the last five years, urban nurses were more likely to have had asthma training than rural nurses (χ 2 =10.84, p=0.001). A majority of nurses (87%) indicated they would like to receive additional asthma training. Approximately half (45%) of nurses reported access to age-appropriate asthma education materials, but only 16% reported that their schools implemented asthma education programs. Urban nurses were more likely than rural nurses to have access to asthma education programs (χ 2 =4.10, p=0.04) and age-appropriate asthma education materials (χ 2 =8.86, p=0.003). Few schools are implementing asthma education programs. Rural nurses may be disadvantaged in terms of receiving asthma training and having access to asthma education programs and materials. Schools are an ideal setting for delivering age-appropriate asthma education. By providing school nurses with access to age-appropriate asthma education resources and additional asthma training, we can help them overcome several of the barriers that impede their ability to deliver asthma care to their students. Copyright © 2017 Elsevier Inc. All rights reserved.

The Center of Excellence for Hypersonics Training and Research at the University of Texas at Austin

NASA Technical Reports Server (NTRS)

Dolling, David S.

1993-01-01

Over the period of this grant (1986-92), 23 graduate students were supported by the Center and received education and training in hypersonics through MS and Ph.D. programs. An additional 8 Ph.D. candidates and 2 MS candidates, with their own fellowship support, were attracted to The University of Texas and were recruited into the hypersonics program because of the Center. Their research, supervised by the 10 faculty involved in the Center, resulted in approximately 50 publications and presentations in journals and at national and international technical conferences. To provide broad-based training, a new hypersonics curriculum was created, enabling students to take 8 core classes in theoretical, computational, and experimental hypersonics, and other option classes over a two to four semester period. The Center also developed an active continuing education program. The Hypersonics Short Course was taught 3 times, twice in the USA and once in Europe. Approximately 300 persons were attracted to hear lectures by more than 25 of the leading experts in the field. In addition, a hypersonic aerodynamics short course was offered through AIAA, as well as short courses on computational fluid dynamics (CFD) and advanced CFD. The existence of the Center also enabled faculty to leverage a substantial volume of additional funds from other agencies, for research and graduate student training. Overall, this was a highly successful and highly visible program.

Redes En Acción. Increasing Hispanic participation in cancer research, training, and awareness.

PubMed

Ramirez, Amelie G; Talavera, Gregory A; Marti, Jose; Penedo, Frank J; Medrano, Martha A; Giachello, Aida L; Pérez-Stable, Eliseo J

2006-10-15

Hispanics are affected by many health care disparities. The National Cancer Institute (NCI), through its Special Populations Branch, is supporting networking and capacity-building activities designed to increase Hispanic participation and leadership in cancer research. Redes En Acción established a national network of cancer research centers, community-based organizations, and federal partners to facilitate opportunities for junior Hispanic scientists to participate in training and research projects on cancer control. Since 2000, Redes En Acción has established a network of more than 1800 Hispanic leaders involved in cancer research and education. The project has sustained 131 training positions and submitted 29 pilot projects to NCI for review, with 16 awards for a total of $800,000, plus an additional $8.8 million in competing grant funding based on pilot study results to date. Independent research has leveraged an additional $32 million in non-Redes funding, and together the national and regional network sites have participated in more than 1400 community and professional awareness events. In addition, the program conducted extensive national survey research that provided the basis for the Redes En Acción Latino Cancer Report, a national agenda on Hispanic cancer issues. Redes En Acción has increased participation in cancer control research, training, and awareness among Hispanic scientists and within Hispanic communities. Cancer 2006. (c) 2006 American Cancer Society.

Enhancement of cognitive and neural functions through complex reasoning training: evidence from normal and clinical populations

PubMed Central

Chapman, Sandra B.; Mudar, Raksha A.

2014-01-01

Public awareness of cognitive health is fairly recent compared to physical health. Growing evidence suggests that cognitive training offers promise in augmenting cognitive brain performance in normal and clinical populations. Targeting higher-order cognitive functions, such as reasoning in particular, may promote generalized cognitive changes necessary for supporting the complexities of daily life. This data-driven perspective highlights cognitive and brain changes measured in randomized clinical trials that trained gist reasoning strategies in populations ranging from teenagers to healthy older adults, individuals with brain injury to those at-risk for Alzheimer's disease. The evidence presented across studies support the potential for Gist reasoning training to strengthen cognitive performance in trained and untrained domains and to engage more efficient communication across widespread neural networks that support higher-order cognition. The meaningful benefits of Gist training provide compelling motivation to examine optimal dose for sustained benefits as well as to explore additive benefits of meditation, physical exercise, and/or improved sleep in future studies. PMID:24808834

Reward magnitude, but not time of day, influences the trial-spacing effect in autoshaping with rats.

PubMed

Thomas, B; Huneycutt, D; Papini, M R

1998-12-01

The arousal hypothesis of the trial-spacing effect suggests that spaced-trial training increases emotional arousal and thus invigorates Pavlovian behavior, relative to massed-trial conditions. Emotional arousal was manipulated by varying reinforcer magnitude during training (either one or five food pellets/trial, across groups). In addition, autoshaping training was administered either in the morning (0900 h) or in the evening (1700 h). Rats were housed in an enclosed colony room and exposed to a regular light:dark cycle (light from 0700 to 1900 h). Available evidence indicates that reinforcer magnitude and time of day are related to arousal levels. As expected, a larger reinforcer magnitude led to a highly significant trial spacing effect. Evening training led to a higher response rate than morning training, but the trial-spacing effect was equally strong whether training was administered in the morning or in the evening. These results provide partial support for the arousal hypothesis and are discussed in the context of research on schedule-induced behavior.

Effects of virtual reality-based training and task-oriented training on balance performance in stroke patients.

PubMed

Lee, Hyung Young; Kim, You Lim; Lee, Suk Min

2015-06-01

[Purpose] This study aimed to investigate the clinical effects of virtual reality-based training and task-oriented training on balance performance in stroke patients. [Subjects and Methods] The subjects were randomly allocated to 2 groups: virtual reality-based training group (n = 12) and task-oriented training group (n = 12). The patients in the virtual reality-based training group used the Nintendo Wii Fit Plus, which provided visual and auditory feedback as well as the movements that enabled shifting of weight to the right and left sides, for 30 min/day, 3 times/week for 6 weeks. The patients in the task-oriented training group practiced additional task-oriented programs for 30 min/day, 3 times/week for 6 weeks. Patients in both groups also underwent conventional physical therapy for 60 min/day, 5 times/week for 6 weeks. [Results] Balance and functional reach test outcomes were examined in both groups. The results showed that the static balance and functional reach test outcomes were significantly higher in the virtual reality-based training group than in the task-oriented training group. [Conclusion] This study suggested that virtual reality-based training might be a more feasible and suitable therapeutic intervention for dynamic balance in stroke patients compared to task-oriented training.

Effects of virtual reality-based training and task-oriented training on balance performance in stroke patients

PubMed Central

Lee, Hyung Young; Kim, You Lim; Lee, Suk Min

2015-01-01

[Purpose] This study aimed to investigate the clinical effects of virtual reality-based training and task-oriented training on balance performance in stroke patients. [Subjects and Methods] The subjects were randomly allocated to 2 groups: virtual reality-based training group (n = 12) and task-oriented training group (n = 12). The patients in the virtual reality-based training group used the Nintendo Wii Fit Plus, which provided visual and auditory feedback as well as the movements that enabled shifting of weight to the right and left sides, for 30 min/day, 3 times/week for 6 weeks. The patients in the task-oriented training group practiced additional task-oriented programs for 30 min/day, 3 times/week for 6 weeks. Patients in both groups also underwent conventional physical therapy for 60 min/day, 5 times/week for 6 weeks. [Results] Balance and functional reach test outcomes were examined in both groups. The results showed that the static balance and functional reach test outcomes were significantly higher in the virtual reality-based training group than in the task-oriented training group. [Conclusion] This study suggested that virtual reality-based training might be a more feasible and suitable therapeutic intervention for dynamic balance in stroke patients compared to task-oriented training. PMID:26180341

Training the approximate number system improves math proficiency.

PubMed

Park, Joonkoo; Brannon, Elizabeth M

2013-10-01

Humans and nonhuman animals share an approximate number system (ANS) that permits estimation and rough calculation of quantities without symbols. Recent studies show a correlation between the acuity of the ANS and performance in symbolic math throughout development and into adulthood, which suggests that the ANS may serve as a cognitive foundation for the uniquely human capacity for symbolic math. Such a proposition leads to the untested prediction that training aimed at improving ANS performance will transfer to improvement in symbolic-math ability. In the two experiments reported here, we showed that ANS training on approximate addition and subtraction of arrays of dots selectively improved symbolic addition and subtraction. This finding strongly supports the hypothesis that complex math skills are fundamentally linked to rudimentary preverbal quantitative abilities and provides the first direct evidence that the ANS and symbolic math may be causally related. It also raises the possibility that interventions aimed at the ANS could benefit children and adults who struggle with math.

Visual feedback attenuates mean concentric barbell velocity loss, and improves motivation, competitiveness, and perceived workload in male adolescent athletes.

PubMed

Weakley, Jonathon Js; Wilson, Kyle M; Till, Kevin; Read, Dale B; Darrall-Jones, Joshua; Roe, Gregory; Phibbs, Padraic J; Jones, Ben

2017-07-12

It is unknown whether instantaneous visual feedback of resistance training outcomes can enhance barbell velocity in younger athletes. Therefore, the purpose of this study was to quantify the effects of visual feedback on mean concentric barbell velocity in the back squat, and to identify changes in motivation, competitiveness, and perceived workload. In a randomised-crossover design (Feedback vs. Control) feedback of mean concentric barbell velocity was or was not provided throughout a set of 10 repetitions in the barbell back squat. Magnitude-based inferences were used to assess changes between conditions, with almost certainly greater differences in mean concentric velocity between the Feedback (0.70 ±0.04 m·s) and Control (0.65 ±0.05 m·s) observed. Additionally, individual repetition mean concentric velocity ranged from possibly (repetition number two: 0.79 ±0.04 vs. 0.78 ±0.04 m·s) to almost certainly (repetition number 10: 0.58 ±0.05 vs. 0.49 ±0.05 m·s) greater when provided feedback, while almost certain differences were observed in motivation, competitiveness, and perceived workload, respectively. Providing adolescent male athletes with visual kinematic information while completing resistance training is beneficial for the maintenance of barbell velocity during a training set, potentially enhancing physical performance. Moreover, these improvements were observed alongside increases in motivation, competitiveness and perceived workload providing insight into the underlying mechanisms responsible for the performance gains observed. Given the observed maintenance of barbell velocity during a training set, practitioners can use this technique to manipulate training outcomes during resistance training.

Effectiveness of acute in-hospital physiotherapy with knee-extension strength training in reducing strength deficits in patients with a hip fracture: A randomised controlled trial

PubMed Central

2017-01-01

Question Is acute in-hospital physiotherapy with additional progressive knee-extension strength training (ST) of the fractured limb more effective in reducing knee-extension strength deficit at follow-up compared to physiotherapy without strength training in patients with a hip fracture? Design Assessor blinded, randomised controlled trial with intention-to-treat analysis. Participants 90 patients with a hip fracture admitted to an acute orthopaedic Hip Fracture Unit at a university hospital between October 2013 and May 2015. Intervention Daily physiotherapy with or without progressive knee-extension strength training (10RM), 3 x 10 repetitions, of the fractured limb using ankle weight cuffs conducted by ward physical therapists during hospital stay. Outcome measures Primary outcome was the change in maximal isometric knee-extension strength in the fractured limb in percentage of the non-fractured limb from inclusion to postoperative day 10 or discharge (follow-up). Secondary outcome was Timed Up and Go test measured early after surgery and at follow-up. Results In the intention-to-treat analysis of between-group differences, the primary outcome improved 8.1% (95% CI -2.3; 18.4) by additional strength training from baseline to follow-up. In the per-protocol analysis of non-missing data, significant between-group improvements by 10.5% (95% CI 0.3; 20.7) were found in favour of additional ST. No significant between-group differences were found in any secondary outcome. Conclusion Physiotherapy with addition of 5 sessions of ST yielded no additional improvements compared to physiotherapy without strength training in reducing the knee-extension strength deficit at follow-up in patients with a hip fracture. It is debatable whether larger improvements than the observed 8–10% can be expected given that only five exercise sessions, on average, were completed. In fragile patients with a hip fracture in the acute phase, where the ability to participate in functional exercise is compromised, we still consider early strength training a possibility to improve outcomes of clinical importance, given the results of the per-protocol analysis. The present data provides an important basis and call for future investigations including longer term interventions. Trial registration Clinicaltrials.gov NCT00848913 PMID:28662153

Evaluating the effect of the Helping Mothers Survive Bleeding after Birth (HMS BAB) training in Tanzania and Uganda: study protocol for a randomised controlled trial.

PubMed

Hanson, Claudia; Pembe, Andrea B; Alwy, Fadhlun; Atuhairwe, Susan; Leshabari, Sebalda; Morris, Jessica; Kaharuza, Frank; Marrone, Gaetano

2017-07-06

Postpartum haemorrhage complicates approximately 10% of all deliveries and contributes to at least a quarter of all maternal deaths worldwide. The competency-based Helping Mothers Survive Bleeding after Birth (HMS BAB) training was developed to support evidence-based management of postpartum haemorrhage. This one-day training includes low-cost MamaNatalie® birthing simulators and addresses both prevention and first-line treatment of haemorrhage. While evidence is accumulating that the training improves health provider's knowledge, skills and confidence, evidence is missing as to whether this translates into improved practices and reduced maternal morbidity and mortality. This cluster-randomised trial aims to assess whether this training package - involving a one-day competency-based HMS BAB in-facility training provided by certified trainers followed by 8 weeks of in-service peer-based practice - has an effect on the occurrence of haemorrhage-related morbidity and mortality. In Tanzania and Uganda we randomise 20 and 18 districts (clusters) respectively, with half receiving the training intervention. We use unblinded matched-pair randomisation to balance district health system characteristics and the main outcome, which is in-facility severe morbidity due to haemorrhage defined by the World Health Organizationation-promoted disease and management-based near-miss criteria. Data are collected continuously in the intervention and comparison districts throughout the 6-month baseline and the 9-month intervention phase, which commences after the training intervention. Trained facility midwives or clinicians review severe maternal complications to identify near misses on a daily basis. They abstract the case information from case notes and enter it onto programmed tablets where it is uploaded. Intention-to-treat analysis will be used, taking the matched design into consideration using paired t test statistics to compare the outcomes between the intervention and comparison districts. We also assess the impact pathway from the effects of the training on the health provider's skills, care and interventions and health system readiness. This trial aims to generate evidence on the effect and limitations of this well-designed training package supported by birthing simulations. While the lack of blinding of participants and data collectors provides an inevitable limitation of this trial, the additional evaluation along the pathway of implementation will provide solid evidence on the effects of this HMS BAB training package. Pan African Clinical Trials Registry, PACTR201604001582128 . Registered on 12 April 2016.

Pathology resident attitudes and opinions about pathologists' assistants.

PubMed

Grzybicki, Dana Marie; Vrbin, Colleen M

2003-06-01

Changes in health care economics and organization have resulted in increased use of nonphysician providers in most health care settings. Attitudinal acceptance of nonphysician providers is important in the current health care environment. To obtain descriptive information regarding pathology resident attitudes and opinions about pathologists' assistants in anatomic pathology practice and to assess the implications of resident attitudes and opinions for pathology practice and training. A self-administered, mailed, voluntary, anonymous questionnaire was distributed to a cross-sectional sample of pathology residents in the United States (2531 pathology residents registered as resident members of one of the national pathology professional organizations). The questionnaire contained (1) items relating to resident demographics and program characteristics, (2) Likert-scale response items containing positive and negative statements about pathologists' assistants, (3) a multiple-choice item related to pathologists' assistants scope of practice, and (4) an open-ended item inviting additional comments. Both quantitative and qualitative analysis of responses was performed. The overall response rate was 19.4% (n = 490); 50% of the respondents were women, and 77% reported use of pathologists' assistants in their program. Most respondents were 25 to 35 years old and in postgraduate years 3 through 5 of their training, and most were located in the Midwestern United States. The majority of residents expressed overall positive attitudes and opinions about pathologists' assistants and felt that pathologists' assistants enhanced resident training by optimizing resident workload. A minority (10%-20%) of residents expressed negative attitudes or opinions about pathologists' assistants. Additionally, some residents reported a lack of knowledge about pathologists' assistants' training or roles. Increased resident education and open discussion concerning pathologists' assistants may be beneficial for optimizing resident attitudes about and training experiences with pathologists' assistants.

A Sample of What We Have Learned from A-Train Cloud Measurements

NASA Technical Reports Server (NTRS)

Joiner, Joanna; Vasilkov, Alexander; Ziemke, Jerry; Chandra, Sushil; Spurr, Robert; Bhartia, P. K.; Krotkov, Nick; Sneep, Maarten; Menzel, Paul; Platnick, Steve;

The role of sensory augmentation for people with vestibular deficits: Real-time balance aid and/or rehabilitation device?

PubMed

Sienko, K H; Whitney, S L; Carender, W J; Wall, C

2017-01-01

This narrative review highlights findings from the sensory augmentation field for people with vestibular deficits and addresses the outstanding questions that are critical to the translation of this technology into clinical and/or personal use. Prior research has demonstrated that the real-time use of visual, vibrotactile, auditory, and multimodal sensory augmentation technologies can improve balance during static and dynamic stance tasks within a laboratory setting. However, its application in improving gait requires additional investigation, as does its efficacy as a rehabilitation device for people with vestibular deficits. In some locomotor studies involving sensory augmentation, gait velocity decreased and secondary task performance worsened, and subjects negatively altered their segmental control strategies when cues were provided following short training sessions. A further question is whether the retention and/or carry-over effects of training with a sensory augmentation technology exceed the retention and/or carry-over effects of training alone, thereby supporting its use as a rehabilitation device. Preliminary results suggest that there are short-term improvements in balance performance following a small number of training sessions with a sensory augmentation device. Long-term clinical and home-based controlled training studies are needed. It is hypothesized that sensory augmentation provides people with vestibular deficits with additional sensory input to promote central compensation during a specific exercise/activity; however, research is needed to substantiate this theory. Major obstacles standing in the way of its use for these critical applications include determining exercise/activity specific feedback parameters and dosage strategies. This paper summarizes the reported findings that support sensory augmentation as a balance aid and rehabilitation device, but does not critically examine efficacy or the quality of the research methods used in the reviewed studies.

Mentoring Strategies and Outcomes of Two Federally Funded Cancer Research Training Programs for Underrepresented Students in the Biomedical Sciences.

PubMed

Ford, Marvella E; Abraham, Latecia M; Harrison, Anita L; Jefferson, Melanie S; Hazelton, Tonya R; Varner, Heidi; Cannady, Kimberly; Frichtel, Carla S; Bagasra, Omar; Davis, Leroy; Rivers, David E; Slaughter, Sabra C; Salley, Judith D

2016-06-01

The US is experiencing a severe shortage of underrepresented biomedical researchers. The purpose of this paper is to present two case examples of cancer research mentoring programs for underrepresented biomedical sciences students. The first case example is a National Institutes of Health/National Cancer Institute (NIH/NCI) P20 grant titled "South Carolina Cancer Disparities Research Center (SC CaDRe)" Training Program, contributing to an increase in the number of underrepresented students applying to graduate school by employing a triple-level mentoring strategy. Since 2011, three undergraduate and four graduate students have participated in the P20 SC CaDRe program. One graduate student published a peer-reviewed scientific paper. Two graduate students (50 %) have completed their master's degrees, and the other two graduate students will receive their degrees in spring 2015. Two undergraduate students (67 %) are enrolled in graduate or professional school (grad./prof. school), and the other graduate student is completing her final year of college. The second case example is a prostate cancer-focused Department of Defense grant titled "The SC Collaborative Undergraduate HBCU Student Summer Training Program," providing 24 students training since 2009. Additionally, 47 students made scientific presentations, and two students have published peer-reviewed scientific papers. All 24 students took a GRE test preparation course; 15 (63 %) have applied to graduate school, and 11 of them (73 %) are enrolled in grad./prof. school. Thirteen remaining students (54 %) are applying to grad./prof. school. Leveraged funding provided research-training opportunities to an additional 201 National Conference on Health Disparities Student Forum participants and to 937 Ernest E. Just Research Symposium participants at the Medical University of South Carolina.

Developing the next generation of dissemination and implementation researchers: insights from initial trainees.

PubMed

Stamatakis, Katherine A; Norton, Wynne E; Stirman, Shannon W; Melvin, Cathy; Brownson, Ross C

2013-03-12

Dissemination and implementation (D&I) research is a relatively young discipline, underscoring the importance of training and career development in building and sustaining the field. As such, D&I research faces several challenges in designing formal training programs and guidance for career development. A cohort of early-stage investigators (ESI) recently involved in an implementation research training program provided a resource for formative data in identifying needs and solutions around career development. Responses outlined fellows' perspectives on the perceived usefulness and importance of, as well as barriers to, developing practice linkages, acquiring additional methods training, academic advancement, and identifying institutional supports. Mentorship was a cross-cutting issue and was further discussed in terms of ways it could foster career advancement in the context of D&I research. Advancing an emerging field while simultaneously developing an academic career offers a unique challenge to ESIs in D&I research. This article summarizes findings from the formative data that outlines some directions for ESIs and provides linkages to the literature and other resources on key points.

[Medical doctor in mountain rescue service - a profession's perspective].

PubMed

Putzke, Matthias

2008-01-01

Helicopter emergency services (HEMS) carrying doctors trained in emergency medicine represent a well established system for primary care with increasing professionalism since their implementation in the seventies until now. However, considerable differences persist in Europe concerning the structure as well as integration of the system in the entire organisation of area-wide demands. Based on the particular geographic conditions in the alps which are highly associated with challenges for man and material a dense network of helicopter airbases has been established. Hence, this system accounts for the social, economical and touristic requirements of this region in terms of providing sufficient emergency medical treatment. In addition to statutory and professional provisions qualification requirements for emergency doctors comprehend extensive alpine training. Primarily this provides personal safety as well as security for the entire team and the patient which particularly applies for technical rope rescue. Advanced all-season training is compulsory due to seasonal differences in casualties. Well harmonized training with cross-border validity is not available to-date. Hence, the development of obligatory standard operating procedures should be the major goal of medical associations and societies.

Selective control of gait subtasks in robotic gait training: foot clearance support in stroke survivors with a powered exoskeleton

PubMed Central

2013-01-01

Background Robot-aided gait training is an emerging clinical tool for gait rehabilitation of neurological patients. This paper deals with a novel method of offering gait assistance, using an impedance controlled exoskeleton (LOPES). The provided assistance is based on a recent finding that, in the control of walking, different modules can be discerned that are associated with different subtasks. In this study, a Virtual Model Controller (VMC) for supporting one of these subtasks, namely the foot clearance, is presented and evaluated. Methods The developed VMC provides virtual support at the ankle, to increase foot clearance. Therefore, we first developed a new method to derive reference trajectories of the ankle position. These trajectories consist of splines between key events, which are dependent on walking speed and body height. Subsequently, the VMC was evaluated in twelve healthy subjects and six chronic stroke survivors. The impedance levels, of the support, were altered between trials to investigate whether the controller allowed gradual and selective support. Additionally, an adaptive algorithm was tested, that automatically shaped the amount of support to the subjects’ needs. Catch trials were introduced to determine whether the subjects tended to rely on the support. We also assessed the additional value of providing visual feedback. Results With the VMC, the step height could be selectively and gradually influenced. The adaptive algorithm clearly shaped the support level to the specific needs of every stroke survivor. The provided support did not result in reliance on the support for both groups. All healthy subjects and most patients were able to utilize the visual feedback to increase their active participation. Conclusion The presented approach can provide selective control on one of the essential subtasks of walking. This module is the first in a set of modules to control all subtasks. This enables the therapist to focus the support on the subtasks that are impaired, and leave the other subtasks up to the patient, encouraging him to participate more actively in the training. Additionally, the speed-dependent reference patterns provide the therapist with the tools to easily adapt the treadmill speed to the capabilities and progress of the patient. PMID:23336754

Training hospital providers in basic CPR skills in Botswana: Acquisition, retention and impact of novel training techniques☆

PubMed Central

Meaney, Peter A.; Sutton, Robert M.; Tsima, Billy; Steenhoff, Andrew P.; Shilkofski, Nicole; Boulet, John R.; Davis, Amanda; Kestler, Andrew M.; Church, Kasey K.; Niles, Dana E.; Irving, Sharon Y.; Mazhani, Loeto; Nadkarni, Vinay M.

2013-01-01

Objective Globally, one third of deaths each year are from cardiovascular diseases, yet no strong evidence supports any specific method of CPR instruction in a resource-limited setting. We hypothesized that both existing and novel CPR training programs significantly impact skills of hospital-based healthcare providers (HCP) in Botswana. Methods HCP were prospectively randomized to 3 training groups: instructor led, limited instructor with manikin feedback, or self-directed learning. Data was collected prior to training, immediately after and at 3 and 6 months. Excellent CPR was prospectively defined as having at least 4 of 5 characteristics: depth, rate, release, no flow fraction, and no excessive ventilation. GEE was performed to account for within subject correlation. Results Of 214 HCP trained, 40% resuscitate ≥1/month, 28% had previous formal CPR training, and 65% required additional skills remediation to pass using AHA criteria. Excellent CPR skill acquisition was significant (infant: 32% vs. 71%, p < 0.01; adult 28% vs. 48%, p < 0.01). Infant CPR skill retention was significant at 3 (39% vs. 70%, p < 0.01) and 6 months (38% vs. 67%, p < 0.01), and adult CPR skills were retained to 3 months (34% vs. 51%, p = 0.02). On multivariable analysis, low cognitive score and need for skill remediation, but not instruction method, impacted CPR skill performance. Conclusions HCP in resource-limited settings resuscitate frequently, with little CPR training. Using existing training, HCP acquire and retain skills, yet often require remediation. Novel techniques with increased student: instructor ratio and feedback manikins were not different compared to traditional instruction. PMID:22561463

Intelligent computer-aided training authoring environment

NASA Technical Reports Server (NTRS)

Way, Robert D.

1994-01-01

Although there has been much research into intelligent tutoring systems (ITS), there are few authoring systems available that support ITS metaphors. Instructional developers are generally obliged to use tools designed for creating on-line books. We are currently developing an authoring environment derived from NASA's research on intelligent computer-aided training (ICAT). The ICAT metaphor, currently in use at NASA has proven effective in disciplines from satellite deployment to high school physics. This technique provides a personal trainer (PT) who instructs the student using a simulated work environment (SWE). The PT acts as a tutor, providing individualized instruction and assistance to each student. Teaching in an SWE allows the student to learn tasks by doing them, rather than by reading about them. This authoring environment will expedite ICAT development by providing a tool set that guides the trainer modeling process. Additionally, this environment provides a vehicle for distributing NASA's ICAT technology to the private sector.

Effectiveness of a Voice Training Program for Student Teachers on Vocal Health.

PubMed

Richter, Bernhard; Nusseck, Manfred; Spahn, Claudia; Echternach, Matthias

2016-07-01

The effectiveness of a preventive training program on vocal health for German student teachers was investigated on specific vocal parameters. The voice quality as described by the Dysphonia Severity Index of 204 student teachers (training group: n = 123; control group: n = 81) was measured at the beginning and at the end of the student teachers training period (duration 1.5 years). Additionally, for investigating the voice-carrying capacity, a vocal loading test (VLT) was performed. Finally, participants had to provide a subjective judgment of a possible Voice Handicap Index. The training program improved the voice quality of the trained group compared with that of the control group, whose voice quality declined. The trained group was also able to better sustain their voice quality across the VLT than the control group. Both groups, however, reported a similar increase in subjective vocal strain. The presented training program clearly showed a positive impact on the voice quality and the vocal capacity. The results maintain the importance of such a training program to be integrated in the education and occupational routine of teachers. Copyright © 2016 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

Cadaver-based training is superior to simulation training for cricothyrotomy and tube thoracostomy.

PubMed

Takayesu, James Kimo; Peak, David; Stearns, Dana

2017-02-01

Emergency medicine (EM) training mandates that residents be able to competently perform low-frequency critical procedures upon graduation. Simulation is the main method of training in addition to clinical patient care. Access to cadaver-based training is limited due to cost and availability. The relative fidelity and perceived value of cadaver-based simulation training is unknown. This pilot study sought to describe the relative value of cadaver training compared to simulation for cricothyrotomy and tube thoracostomy. To perform a pilot study to assess whether there is a significant difference in fidelity and educational experience of cadaver-based training compared to simulation training. To understand how important this difference is in training residents in low-frequency procedures. Twenty-two senior EM residents (PGY3 and 4) who had completed standard simulation training on cricothyrotomy and tube thoracostomy participated in a formalin-fixed cadaver training program. Participants were surveyed on the relative fidelity of the training using a 100 point visual analogue scale (VAS) with 100 defined as equal to performing the procedure on a real patient. Respondents were also asked to estimate how much the cadaveric training improved the comfort level with performing the procedures on a scale between 0 and 100 %. Open-response feedback was also collected. The response rate was 100 % (22/22). The average fidelity of the cadaver versus simulation training was 79.9 ± 7.0 vs. 34.7 ± 13.4 for cricothyrotomy (p < 0.0001) and 86 ± 8.6 vs. 38.4 ± 19.3 for tube thoracostomy (p < 0.0001). Improvement in comfort levels performing procedures after the cadaveric training was rated as 78.5 ± 13.3 for tube thoracostomy and 78.7 ± 14.3 for cricothyrotomy. All respondents felt this difference in fidelity to be important for procedural training with 21/22 respondents specifically citing the importance of superior landmark and tissue fidelity compared to simulation training. Cadaver-based training provides superior landmark and tissue fidelity compared to simulation training and may be a valuable addition to EM residency training for certain low-frequency procedures.

The Treatment of Sexual Dysfunction in a University Health Service Setting

ERIC Educational Resources Information Center

Babineau, Raymond; Schwartz, Allan J.

1977-01-01

Experience of the authors indicates that solo therapists with adequate background in individual and couple therapy, who also have additional training/experience in sex therapy, can provide treatment for sexual dysfunction to student couples in a health service setting with encouraging results. (MB)

Student - Counselor Health Careers Guidebook.

ERIC Educational Resources Information Center

Mountain States Regional Medical Program, Great Falls, MT. Montana Div.

This reference handbook is designed to provide vocational counselors with background information on a wide range of occupations related to medicine. Nearly 60 careers are described with educational requirements, salaries, schools where training may be obtained, and sources of additional information. An address list of associations and a health…

Competency-Based Performance Improvement: A Strategy for Organizational Change.

ERIC Educational Resources Information Center

Dubois, David D.

This book, which focuses on actual practitioners' experiences, outlines a systematic approach to improving individual workers' performance as part of an overall strategy for organizational change. Frameworks are provided for conceptualizing and implementing exemplary training practices. In addition, steps in achieving the practices and pitfalls to…

RCRA, Superfund and EPCRA hotline training module. Introduction to: Superfund accelerated cleanup model (updated February 1998); Directive

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

NONE

1998-06-01

This module presents the primary aspects of SACM compared to the traditional Superfund response process. In addition, this module discusses presumptive remedies by covering what they are, and providing an overview of the guidance EPA has developed.

Additional Guidance and Training Needed to Improve Afghan National Army Pharmaceutical Distribution

DTIC Science & Technology

2012-05-07

capacity for Afghan-led security. To help accomplish part of that mission, CSTC-A provided oversight and mentoring of the ANA pharmaceutical...National Military Hospital Ketamine 4575 4755 180 Tramadol 1650 1700 50 Insulin-Regular 274 280 6 Mebendazol 1164 1100 (64

A Multimodal Mindfulness Training to Address Mental Health Symptoms in Providers Who Care for and Interact With Children in Relation to End-of-Life Care.

PubMed

O'Mahony, Sean; Gerhart, James; Abrams, Ira; Greene, Michelle; McFadden, Rory; Tamizuddin, Sara; Levy, Mitchell M

2017-11-01

Medical providers may face unique emotional challenges when confronted with the suffering of chronically ill, dying, and bereaved children. This study assessed the preliminary outcomes of participation in a group-based multimodal mindfulness training pilot designed to reduce symptoms of burnout and mental health symptoms in providers who interact with children in the context of end-of-life care. A total of 13 medical providers who care for children facing life-threatening illness or bereaved children participated in a 9-session multimodal mindfulness session. Mental health symptoms and burnout were assessed prior to the program, at the program midpoint, and at the conclusion of the program. Participation in the pilot was associated with significant reductions in depressive and posttraumatic stress disorder (PTSD) symptoms among providers ( P < .05). Mindfulness-based programs may help providers recognize and address symptoms of depression and PTSD. Additional research is needed to enhance access and uptake of programming among larger groups of participants.

Automating radiologist workflow, part 3: education and training.

PubMed

Reiner, Bruce

2008-12-01

The current model for radiologist education consists largely of mentorship during residency, followed by peer-to-peer training thereafter. The traditional focus of this radiologist education has historically been restricted to anatomy, pathology, and imaging modality. This "human" mentoring model becomes a limiting factor in the current practice environment because of rapid and dramatic changes in imaging and information technologies, along with the increased time demands placed on practicing radiologists. One novel way to address these burgeoning education and training challenges is to leverage technology, with the creation of user-specific and context-specific automated workflow templates. These automated templates would provide a low-stress, time-efficient, and easy-to-use equivalent of "computerized" mentoring. A radiologist could identify the workflow template of interest on the basis of the specific computer application, pathology, anatomy, or modality of interest. While the corresponding workflow template is activated, the radiologist "student" could effectively start and stop at areas of interest and use the functionality of an electronic wizard to identify additional educational resource of interest. An additional training feature of the technology is the ability to review "proven" cases for the purposes of establishing competence and credentialing.

Impact of NGO training and support intervention on diarrhoea management practices in a rural community of Bangladesh: an uncontrolled, single-arm trial.

PubMed

Rahman, Ahmed S; Islam, Mohammad Rafiqul; Koehlmoos, Tracey P; Raihan, Mohammad Jyoti; Hasan, Mohammad Mehedi; Ahmed, Tahmeed; Larson, Charles P

2014-01-01

The evolving Non-Governmental Organization (NGO) sector in Bangladesh provides health services directly, however some NGOs indirectly provide services by working with unlicensed providers. The primary objective of this study was to examine the impact of NGO training of unlicensed providers on diarrhoea management and the scale up of zinc treatment in rural populations. An uncontrolled, single-arm trial for a training and support intervention on diarrhoea outcomes was employed in a rural sub-district of Bangladesh during 2008. Two local NGOs and their catchment populations were chosen for the study. The intervention included training of unlicensed health care providers in the management of acute childhood diarrhoea, particularly emphasizing zinc treatment. In addition, community-based promotion of zinc treatment was carried out. Baseline and endline ecologic surveys were carried out in intervention and control villages to document changes in treatments received for diarrhoea in under-five children. Among surveyed household with an active or recent acute childhood diarrhoea episode, 69% sought help from a health provider. Among these, 62.8% visited an unlicensed private provider. At baseline, 23.9% vs. 22% of control and intervention group children with diarrhoea had received zinc of any type. At endline (6 months later) this had changed to 15.3% vs. 30.2%, respectively. The change in zinc coverage was significantly higher in the intervention villages (p<0.01). Adherence with giving zinc for 10 days or more was significantly higher in the intervention households (9.2% vs. 2.5%; p<0.01). Child's age, duration of diarrhoea, type of diarrhoea, parental year of schooling as well as oral rehydration solution (ORS) and antibiotic usage were significant predictors of zinc usage. Training of unlicensed healthcare providers through NGOs increased zinc coverage in the diarrhoea management of under-five children in rural Bangladesh households. ClinicalTrials.gov NCT02143921.

Older driver training using video and global positioning system technology--a randomized controlled trial.

PubMed

Porter, Michelle M

2013-05-01

There is emerging evidence that older driver training programs with on-road instruction are more effective than driver education programs that are conducted only in the classroom. Although most programs have provided this additional in-vehicle training with a driving instructor and a dual-braked vehicle, technology could assist in providing this feedback. It was hypothesized that participants who received video and global positioning system (GPS) feedback (Video group) in addition to classroom education would improve to a greater extent than those who received a classroom-based course alone (Education) or Control participants. Fifty-four participants (32 men and 22 women), 70-89 years old, randomized to one of the three groups, completed the study. All participants underwent pre- and postintervention driving tests, in their own vehicle, on a standardized route, that were recorded with video and GPS equipment. The Video group met with a driving instructor to receive feedback on their driving errors in their preintervention driving test. A blinded assessor scored all driving tests in random order. The Video group significantly reduced their driving errors by 25% (p < .05) following the intervention, whereas the other two groups did not change significantly. Fifty-two percent of participants from the Video group improved their global safety rating, whereas only 5.3% in the Control and 22.2% in the Education groups did. This study suggests that direct driving feedback using video and GPS technology could be an effective and novel means to provide older driver education.

Working With Solar System Ambassadors

NASA Astrophysics Data System (ADS)

Ferrari, K.

2001-11-01

The Solar System Ambassadors Program is a public outreach program designed to work with motivated volunteers across the nation. These competitively selected volunteers organize and conduct public events that communicate exciting discoveries and plans in Solar System research, exploration and technology through non-traditional forums; e.g. community service clubs, libraries, museums, planetariums, "star parties," mall displays, etc. Each Ambassador participates in on-line (web-based) training sessions that provide interaction with NASA scientists, engineers and project team members. As such, each Ambassador's experience with the space program becomes personalized. Training sessions provide Ambassadors with general background on each mission and educate them concerning specific mission milestones, such as launches, planetary flybys, first image returns, arrivals, and ongoing key discoveries. Additionally, projects provide limited supplies of videos, slide sets, booklets, pamphlets, posters, postcards, lithographs, on-line materials, resource links and information. In addition to participating in on-line trainings with Ambassadors, scientists will be given the opportunity to interact with, and mentor volunteer Ambassadors at regional, weekend conferences designed to strengthen the Ambassadors' knowledge of space science and exploration, thereby improving the space science message that goes out to the general public through these enthusiastic volunteers. Integrating volunteers across the country in a public-engagement program helps optimize project funding set aside for education and outreach purposes, establishing a nationwide network of regional contacts. At the same time, members of communities across the country become an extended part of each mission's team and an important interface between the space exploration community and the general public at large.

Race/ethnicity, color-blind racial attitudes, and multicultural counseling competence: the moderating effects of multicultural counseling training.

PubMed

Chao, Ruth Chu-Lien; Wei, Meifen; Good, Glenn E; Flores, Lisa Y

2011-01-01

Increasing trainees' multicultural counseling competence (MCC) has been a hot topic in counseling. Scholars have identified predictors (e.g., race/ethnicity, color-blindness) of MCC, and educators provide multicultural training for trainees. Using a sample of 370 psychology trainees, this study examined whether multicultural training (a) moderated racial/ethnic differences on MCC and (b) changed the relationship between color-blindness and MCC. Results indicated a significant interaction effect of race/ethnicity (i.e., White vs. ethnic minority) and multicultural training on multicultural awareness, but not on multicultural knowledge. Specifically, at lower levels of training, racial/ethnic minority trainees had significantly higher multicultural awareness than their White counterparts; at higher levels of training, no significant difference was found. Described differently, more training significantly enhanced Whites' multicultural awareness, but did not enhance racial/ethnic minority trainees' awareness. Additionally, there was a significant interaction effect of color-blindness and multicultural training on multicultural knowledge, but not on multicultural awareness. The association between color-blindness and multicultural knowledge was stronger at higher levels of multicultural training than at lower levels of training. Alternatively, the effect of training on enhancing knowledge was stronger for those with lower color-blindness than for those with higher color-blindness.

Effects of different pretreatments on the performance of ceramic ultrafiltration membrane during the treatment of oil sands tailings pond recycle water: a pilot-scale study.

PubMed

Loganathan, Kavithaa; Chelme-Ayala, Pamela; El-Din, Mohamed Gamal

2015-03-15

Membrane filtration is an effective treatment method for oil sands tailings pond recycle water (RCW); however, membrane fouling and rapid decrease in permeate flux caused by colloids, organic matter, and bitumen residues present in the RCW hinder its successful application. This pilot-scale study investigated the impact of different pretreatment steps on the performance of a ceramic ultrafiltration (CUF) membrane used for the treatment of RCW. Two treatment trains were examined: treatment train 1 consisted of coagulant followed by a CUF system, while treatment train 2 included softening (Multiflo™ system) and coagulant addition, followed by a CUF system. The results indicated that minimum pretreatment (train 1) was required for almost complete solids removal. The addition of a softening step (train 2) provided an additional barrier to membrane fouling by reducing hardness-causing ions to negligible levels. More than 99% removal of turbidity and less than 20% removal of total organic carbon were achieved regardless of the treatment train used. Permeate fluxes normalized at 20 °C of 127-130 L/m(2) h and 111-118 L/m(2) h, with permeate recoveries of 90-93% and 90-94% were observed for the treatment trains 1 and 2, respectively. It was also found that materials deposited onto the membrane surface had an impact on trans-membrane pressure and influenced the required frequencies of chemically enhanced backwashes (CEBs) and clean-in-place (CIP) procedures. The CIP performed was successful in removing fouling and scaling materials such that the CUF performance was restored to baseline levels. The results also demonstrated that due to their low turbidity and silt density index values, permeates produced in this pilot study were suitable for further treatment by high pressure membrane processes. Copyright © 2015 Elsevier Ltd. All rights reserved.

Multiculturalism and Athletic Training Education: Implications for Educational and Professional Progress

PubMed Central

2003-01-01

Objective: To introduce athletic training educators and practicing professionals to the pedagogic concept and professional benefits that multicultural education, awareness, and training might provide if implemented in athletic training education. Data Sources: I reviewed textbook chapters and articles used in the course of my doctoral studies and searched the archives of Diversity Digest and Academic Medicine for the years 1998 to 2002 with the key words multiculturalism, diversity, cultural competence, education, and learning. I obtained additional information by cross-referencing pertinent articles. Data Synthesis: I present a rational argument for the inclusion of a critical pedagogy into the field of athletic training education. I outline the infrastructure in the professional field of athletic training, review some of the literature on critical multicultural theory and pedagogy, and examine some of the potential cognitive and intellectual implications of diversity and multicultural education. Conclusions/Recommendations: Future work in this area should focus on various and creative strategies for implementing a multicultural agenda in athletic training curricula and on the analysis of the associated benefits and outcomes of such educational strategies. PMID:16558679

Using the mind as a simulator: a randomized controlled trial of mental training.

PubMed

Eldred-Evans, David; Grange, Philippe; Cheang, Adrian; Yamamoto, Hidekazu; Ayis, Salma; Mulla, Mubashir; Immenroth, Marc; Sharma, Davendra; Reedy, Gabriel

2013-01-01

Laparoscopic simulators have been introduced as safe and effective methods of developing basic skills. Mental training is a novel training method likened to using the mind as a simulator to mentally rehearse the movements of a task or operation. It is widely used by professional athletes and musicians and has been suggested as a technique that could be used by surgical trainees. The purpose of this study was to assess the use of mental training in developing basic laparoscopic skills in novices. Sixty-four medical students without laparoscopic experience were randomized into 4 groups. The first 3 groups were trained to cut a circle on a box trainer. Group 1 received no additional training (BT), Group 2 received additional virtual reality training (BT + VRS), and Group 3 received additional mental training (BT + MT). The fourth group was trained on a virtual reality simulator with additional mental training (box-free). The following 4 assessment criterias: time, accuracy, precision and overall performance were measured on both the box-trainer and virtual simulator. The mental training group (BT + MT) demonstrated improved laparoscopic skills over both assessments. The improvement in skills in the VRS group (BT + VRS) was limited to VRS assessment and not observed in the box assessment. The fourth group (box-free) had the worst performance on both methods of assessment. The addition of mental training led to improved laparoscopic skills development. It is a flexible technique and has the potential to challenge VRS as a more cost-effective training method associated with lower capital investment. Given the benefits of mental training with further research, it could be considered for inclusion in training curricula. Copyright © 2013 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Major challenges to scale up of visual inspection-based cervical cancer prevention programs: the experience of Guatemalan NGOs.

PubMed

Chary, Anita Nandkumar; Rohloff, Peter J

2014-08-01

Like many other low- and middle-income countries, Guatemala has adopted visual inspection with acetic acid (VIA) as a low-resource alternative to the Pap smear for cervical cancer screening. Nongovernmental organizations (NGOs) introduced VIA to Guatemala in 2004, and a growing number of NGOs, working both independently and in collaboration with the Guatemalan Ministry of Health, employ VIA in cervical cancer prevention programs today. While much research describes VIA efficacy and feasibility in Latin America, little is known about NGO involvement with VIA programming or experiences with VIA outside the context of clinical trials and pilot projects in the region. To explore challenges faced by NGOs implementing VIA programs in Guatemala, we conducted semi-structured interviews with 36 NGO staff members involved with 20 VIA programs as direct service providers, program administrators, and training course instructors. Additionally, we collected data through observation at 30 NGO-sponsored cervical cancer screening campaigns, 8 cervical cancer prevention conferences, and 1 week-long NGO-sponsored VIA training course. Frequently highlighted challenges included staff turnover, concerns over training quality, a need for opportunities for continued supervision, and problems with cryotherapy referrals when immediate treatment for VIA-positive women was unavailable. Reducing staff turnover, budgeting to train replacement providers, standardizing training curricula, and offering continued supervision are key strategies to improve VIA service quality and program sustainability. Alternative training methods, such as on-the-job mentoring and course prerequisites of online learning, could help increase training time available for clinical supervision. Efforts should be made to ensure that VIA testing is coupled with immediate cryotherapy, that providers trained in VIA are also trained in cryotherapy, and that cryotherapy supplies and equipment are maintained. Where this is not possible and only VIA screening is available, referral systems must be strengthened.

Major challenges to scale up of visual inspection-based cervical cancer prevention programs: the experience of Guatemalan NGOs

PubMed Central

Chary, Anita Nandkumar; Rohloff, Peter J

2014-01-01

ABSTRACT Background: Like many other low- and middle-income countries, Guatemala has adopted visual inspection with acetic acid (VIA) as a low-resource alternative to the Pap smear for cervical cancer screening. Nongovernmental organizations (NGOs) introduced VIA to Guatemala in 2004, and a growing number of NGOs, working both independently and in collaboration with the Guatemalan Ministry of Health, employ VIA in cervical cancer prevention programs today. While much research describes VIA efficacy and feasibility in Latin America, little is known about NGO involvement with VIA programming or experiences with VIA outside the context of clinical trials and pilot projects in the region. Methods: To explore challenges faced by NGOs implementing VIA programs in Guatemala, we conducted semi-structured interviews with 36 NGO staff members involved with 20 VIA programs as direct service providers, program administrators, and training course instructors. Additionally, we collected data through observation at 30 NGO-sponsored cervical cancer screening campaigns, 8 cervical cancer prevention conferences, and 1 week-long NGO-sponsored VIA training course. Results: Frequently highlighted challenges included staff turnover, concerns over training quality, a need for opportunities for continued supervision, and problems with cryotherapy referrals when immediate treatment for VIA-positive women was unavailable. Conclusions: Reducing staff turnover, budgeting to train replacement providers, standardizing training curricula, and offering continued supervision are key strategies to improve VIA service quality and program sustainability. Alternative training methods, such as on-the-job mentoring and course prerequisites of online learning, could help increase training time available for clinical supervision. Efforts should be made to ensure that VIA testing is coupled with immediate cryotherapy, that providers trained in VIA are also trained in cryotherapy, and that cryotherapy supplies and equipment are maintained. Where this is not possible and only VIA screening is available, referral systems must be strengthened. PMID:25276590

USGS Training in Afghanistan: Modern Earthquake Hazards Assessments

NASA Astrophysics Data System (ADS)

Medlin, J. D.; Garthwaite, M.; Holzer, T.; McGarr, A.; Bohannon, R.; Bergen, K.; Vincent, T.

2007-05-01

Afghanistan is located in a tectonically active region where ongoing deformation has generated rugged mountainous terrain, and where large earthquakes occur frequently. These earthquakes can present a significant hazard, not only from strong ground shaking, but also from liquefaction and extensive land sliding. The magnitude 6.1 earthquake of March 25, 2002 highlighted the vulnerability of Afghanistan to such hazards, and resulted in over 1000 fatalities. The USGS has provided the first of a series of Earth Science training courses to the Afghan Geological Survey (AGS). This course was concerned with modern earthquake hazard assessments, and is an integral part of a larger USGS effort to provide a comprehensive seismic-hazard assessment for Afghanistan. Funding for these courses is provided by the US Agency for International Development Afghanistan Reconstruction Program. The particular focus of this training course, held December 2-6, 2006 in Kabul, was on providing a background in the seismological and geological methods relevant to preparing for future earthquakes. Topics included identifying active faults, modern tectonic theory, geotechnical measurements of near-surface materials, and strong-motion seismology. With this background, participants may now be expected to educate other members of the community and be actively involved in earthquake hazard assessments themselves. The December, 2006, training course was taught by four lecturers, with all lectures and slides being presented in English and translated into Dari. Copies of the lectures were provided to the students in both hardcopy and digital formats. Class participants included many of the section leaders from within the AGS who have backgrounds in geology, geophysics, and engineering. Two additional training sessions are planned for 2007, the first entitled "Modern Concepts in Geology and Mineral Resource Assessments," and the second entitled "Applied Geophysics for Mineral Resource Assessments."

Building a patient-centered and interprofessional training program with patients, students and care professionals: study protocol of a participatory design and evaluation study.

PubMed

Vijn, Thomas W; Wollersheim, Hub; Faber, Marjan J; Fluit, Cornelia R M G; Kremer, Jan A M

2018-05-30

A common approach to enhance patient-centered care is training care professionals. Additional training of patients has been shown to significantly improve patient-centeredness of care. In this participatory design and evaluation study, patient education and medical education will be combined by co-creating a patient-centered and interprofessional training program, wherein patients, students and care professionals learn together to improve patient-centeredness of care. In the design phase, scientific literature regarding interventions and effects of student-run patient education will be synthesized in a scoping review. In addition, focus group studies will be performed on the preferences of patients, students, care professionals and education professionals regarding the structure and content of the training program. Subsequently, an intervention plan of the training program will be constructed by combining these building blocks. In the evaluation phase, patients with a chronic disease, that is rheumatoid arthritis, diabetes and hypertension, and patients with an oncologic condition, that is colonic cancer and breast cancer, will learn together with medical students, nursing students and care professionals in training program cycles of three months. Process and effect evaluation will be performed using the plan-do-study-act (PDSA) method to evaluate and optimize the training program in care practice and medical education. A modified control design will be used in PDSA-cycles to ensure that students who act as control will also benefit from participating in the program. Our participatory design and evaluation study provides an innovative approach in designing and evaluating an intervention by involving participants in all stages of the design and evaluation process. The approach is expected to enhance the effectiveness of the training program by assessing and meeting participants' needs and preferences. Moreover, by using fast PDSA cycles and a modified control design in evaluating the training program, the training program is expected to be efficiently and rapidly implemented into and adjusted to care practice and medical education.

The Effects of Individualized Resistance Strength Programs on Knee Muscular Imbalances in Junior Elite Soccer Players

PubMed Central

Śliwowski, Robert; Jadczak, Łukasz; Hejna, Rafał; Wieczorek, Andrzej

2015-01-01

The purpose of this study was to investigate the effects of a resistance training program on the muscular strength of soccer players’ knees that initially presented unilateral and bilateral differences. For this study, a team of 24 male well-trained junior soccer players was divided into two strength program training groups: a Resistance Training Control Group (RTCG) composed of 10 players that did not have muscular imbalances and a Resistance Training Experimental Group (RTEG) composed of 14 players that had muscular imbalances. All players followed a resistance training program for six weeks, two times per week, during the transition period. The program of individualized strength training consisted of two parts. The first part, which was identical in terms of the choice of training loads, was intended for both training groups and contained two series of exercises including upper and lower body exercises. The second part of the program was intended only for RTEG and consisted of two additional series for the groups of muscles that had identified unilateral and bilateral differences. The applied program showed various directions in the isokinetic profile of changes. In the case of RTCG, the adaptations related mainly to the quadriceps muscle (the peak torque (PT) change for the dominant leg was statistically significant (p < 0.05)). There were statistically significant changes in RTEG (p < 0.05) related to PT for the hamstrings in both legs, which in turn resulted in an increase in the conventional hamstring/quadriceps ratio (H/Q). It is interesting that the statistically significant (p < 0.05) changes were noted only for the dominant leg. No statistically significant changes in bilateral differences (BD) were noted in either group. These results indicate that individualized resistance training programs could provide additional benefits to traditional strength training protocols to improve muscular imbalances in post-adolescent soccer players. PMID:26630271

Introduction to the Special Section on Teaching, Training, and Supervision in Personality and Psychological Assessment.

PubMed

Smith, Justin D

2017-01-01

This special section contains empirical and conceptual articles pertaining to the broad topic of teaching, training, and supervision of assessment. Despite some evidence of a decline in recent decades, assessment remains a defining practice of professional psychologists in many subfields, including clinical, counseling, school, and neuropsychology, that consumes a consequential proportion of their time. To restore assessment to its rightful place of prominence, a clear agenda needs to be developed for advancing teaching and training methods, increasing instruction to state-of-the-art methods, and defining aims that could be elucidated through empirical inquiry. The 7 articles in this special section provide a developmental perspective of these issues that collectively provide practical tools for instructors and begin to set the stage for a research agenda in this somewhat neglected area of study that is vital to the identity of professional psychology. Additionally, 2 comments are provided by distinguished figures in the field concerning the implications of the articles in the special section to health services psychology and the competencies-based movement in applied psychology.

A Group Interview Regarding Disaster Preparedness for Food Assistance in a University that Offers a Training Course for Registered Dietitians

PubMed Central

Ito, Seira; Sudo, Noriko; Fujiwara, Yoko

2014-01-01

Mass care feeding for disaster evacuees is an important component of public health preparedness. If universities that offer a training course for registered dietitians could provide food assistance to the evacuated people in their campus, it could contribute to maintain their health. Many universities are expected to become a base of support activities for people affected by disaster. This study aimed to reveal disaster preparedness in a university that offers a training course for registered dietitians, from the aspect of provision of mass care feeding. As Japan has 124 universities that offer such training courses, this case study could serve as a useful reference for them and contribute to the improvement of health of the affected people. A group interview was conducted in University A in 2012. The participants included two faculty members in the course, a vice president, a staff member, and a faculty member in charge of disaster preparedness and response. Stockpiled foods were limited to dry bread and pre-processed rice. No alternative heat sources were stored. It was concluded that to provide nutrients other than carbohydrate, hot meals should be served for the evacuees. Additionally, it would be difficult to provide meal service when the essential utilities such as gas and electricity are disrupted. PMID:25114569

Evaluation of a low-cost 3D sound system for immersive virtual reality training systems.

PubMed

Doerr, Kai-Uwe; Rademacher, Holger; Huesgen, Silke; Kubbat, Wolfgang

2007-01-01

Since Head Mounted Displays (HMD), datagloves, tracking systems, and powerful computer graphics resources are nowadays in an affordable price range, the usage of PC-based "Virtual Training Systems" becomes very attractive. However, due to the limited field of view of HMD devices, additional modalities have to be provided to benefit from 3D environments. A 3D sound simulation can improve the capabilities of VR systems dramatically. Unfortunately, realistic 3D sound simulations are expensive and demand a tremendous amount of computational power to calculate reverberation, occlusion, and obstruction effects. To use 3D sound in a PC-based training system as a way to direct and guide trainees to observe specific events in 3D space, a cheaper alternative has to be provided, so that a broader range of applications can take advantage of this modality. To address this issue, we focus in this paper on the evaluation of a low-cost 3D sound simulation that is capable of providing traceable 3D sound events. We describe our experimental system setup using conventional stereo headsets in combination with a tracked HMD device and present our results with regard to precision, speed, and used signal types for localizing simulated sound events in a virtual training environment.

Experiential Learning Through Participatory Action Research in Public Health Supports Community-Based Training of Future Health Professionals

PubMed Central

Marriott, Lisa K.; Lipus, Adam C.; Choate, Laurie; Smith, Jamie; Coppola, Leigh; Cameron, William E.; Shannon, Jackilen

2016-01-01

Engaging community members in research can help cultivate effective partnerships while providing experiential training and continuing education opportunities. Several studies have involved communities in this way, though many have been small in the scale of community involvement or have included little detail of the institutional review board process by which community members became approved researchers in the study. This article presents findings on an evaluation of the training procedures and experiences of 703 first-time community-based volunteer researchers who were recruited in their communities and trained on-site to enroll research participants, collect data, and provide individualized consultation of results at travelling health education and research fairs. Open-ended registration prompts and postfair surveys assessed volunteers’ reasons for participating, comfort with their volunteer experiences, and attitudes toward the biomedical research process. An open-ended survey assessed two key community partners’ perspectives about their organizations’ involvement with supporting the research throughout the process. Volunteers reported their experience to be a unique training opportunity, citing its ability to help them engage with their community, advance research, and obtain additional experience in their health field of interest, particularly nursing, allied health, and medicine-related careers. Community partners cited that their community’s participation as volunteer researchers served as a tool to educate the larger community about research, which enabled other research projects to gain acceptance. Together, these results demonstrate that using volunteer researchers can strengthen community research partnerships while providing valuable training experience in public health research for current and aspiring health personnel. PMID:27536722

Crop identification technology assessment for remote sensing (CITARS). Volume 6: Data processing at the laboratory for applications of remote sensing

NASA Technical Reports Server (NTRS)

Bauer, M. E.; Cary, T. K.; Davis, B. J.; Swain, P. H.

1975-01-01

The results of classifications and experiments for the crop identification technology assessment for remote sensing are summarized. Using two analysis procedures, 15 data sets were classified. One procedure used class weights while the other assumed equal probabilities of occurrence for all classes. Additionally, 20 data sets were classified using training statistics from another segment or date. The classification and proportion estimation results of the local and nonlocal classifications are reported. Data also describe several other experiments to provide additional understanding of the results of the crop identification technology assessment for remote sensing. These experiments investigated alternative analysis procedures, training set selection and size, effects of multitemporal registration, spectral discriminability of corn, soybeans, and other, and analyses of aircraft multispectral data.

End-of-life care policies and practices in pediatric skilled nursing facilities.

PubMed

Friedman, Sandra L; Helm, David T; Woodman, Ashley C

2014-11-01

Although most children with intellectual and developmental disabilities reside in the community, a subset of children with severe intellectual disability and complex medical needs reside in pediatric skilled nursing facilities. These children have elevated mortality with end-of-life care (EOLC) routinely provided. The present study explored policies and practice in such settings by surveying administrators, nursing directors, and medical directors in facilities across the United States. In addition to EOLC policies and practices, staff reported on their understanding of definitions of do-not-resuscitate orders, family involvement in EOLC planning, and the availability of in-service training. The presence of an official EOLC policy was associated with higher ratings of perception of effectiveness among staff. Staff felt more prepared and comfortable providing EOLC when in-service training was provided. © The Author(s) 2013.

Assessing bioterrorism preparedness and response of rural veterinarians: experiences and training needs.

PubMed

Hsu, Chiehwen Ed; Jacobson, Holly; Feldman, Katherine; Miller, Jerry A; Rodriguez, Lori; Soto Mas, Francisco

2008-01-01

Veterinarians play a unique role in emergency preparedness and response, and federal agencies and academic institutions therefore allocate considerable resources to provide training to enhance their readiness. However, the level of preparedness of veterinarians in many rural regions is yet to be improved. This article reports an assessment of the bioterrorism preparedness, specifically the experience and training needs, of rural veterinarians in North Texas. The study employed a cross-sectional design with a study population that included all veterinarians (N = 352) in the 37 counties within Texas Department of State Health Services Regions 2 and 3. Data on veterinarians practicing or residing in the target region were obtained from the Texas State Board of Veterinary Medical Examiners. The response rate was 35% (n = 121). Results indicate that chemical exposure was the condition most frequently seen and treated, followed by botulism and anthrax. The majority (80%) of respondents indicated that they had not previously participated in training related to bioterrorism preparedness, and many (41%) also indicated a willingness to participate in a state health department-initiated bioterrorism response plan. However, only 18% were confident in their ability to diagnose and treat bioterrorism cases. These results suggest that many North Texas veterinarians practicing in rural regions could benefit from additional training in bioterrorism preparedness and response. An area in particular need of further training is the diagnosis and treatment of Category A agents. Federal, state, and local health agencies are urged to increase training opportunities and to make additional efforts to involve veterinarians in bioterrorism preparedness and response.

A preliminary report of music-based training for adult cochlear implant users: Rationales and development.

PubMed

Gfeller, Kate; Guthe, Emily; Driscoll, Virginia; Brown, Carolyn J

2015-09-01

This paper provides a preliminary report of a music-based training program for adult cochlear implant (CI) recipients. Included in this report are descriptions of the rationale for music-based training, factors influencing program development, and the resulting program components. Prior studies describing experience-based plasticity in response to music training, auditory training for persons with hearing impairment, and music training for CI recipients were reviewed. These sources revealed rationales for using music to enhance speech, factors associated with successful auditory training, relevant aspects of electric hearing and music perception, and extant evidence regarding limitations and advantages associated with parameters for music training with CI users. This informed the development of a computer-based music training program designed specifically for adult CI users. Principles and parameters for perceptual training of music, such as stimulus choice, rehabilitation approach, and motivational concerns were developed in relation to the unique auditory characteristics of adults with electric hearing. An outline of the resulting program components and the outcome measures for evaluating program effectiveness are presented. Music training can enhance the perceptual accuracy of music, but is also hypothesized to enhance several features of speech with similar processing requirements as music (e.g., pitch and timbre). However, additional evaluation of specific training parameters and the impact of music-based training on speech perception of CI users is required.

A preliminary report of music-based training for adult cochlear implant users: rationales and development

PubMed Central

Gfeller, Kate; Guthe, Emily; Driscoll, Virginia; Brown, Carolyn J.

2015-01-01

Objective This paper provides a preliminary report of a music-based training program for adult cochlear implant (CI) recipients. Included in this report are descriptions of the rationale for music-based training, factors influencing program development, and the resulting program components. Methods Prior studies describing experience-based plasticity in response to music training, auditory training for persons with hearing impairment, and music training for cochlear implant recipients were reviewed. These sources revealed rationales for using music to enhance speech, factors associated with successful auditory training, relevant aspects of electric hearing and music perception, and extant evidence regarding limitations and advantages associated with parameters for music training with CI users. This information formed the development of a computer-based music training program designed specifically for adult CI users. Results Principles and parameters for perceptual training of music, such as stimulus choice, rehabilitation approach, and motivational concerns were developed in relation to the unique auditory characteristics of adults with electric hearing. An outline of the resulting program components and the outcome measures for evaluating program effectiveness are presented. Conclusions Music training can enhance the perceptual accuracy of music, but is also hypothesized to enhance several features of speech with similar processing requirements as music (e.g., pitch and timbre). However, additional evaluation of specific training parameters and the impact of music-based training on speech perception of CI users are required. PMID:26561884

Effects of a training in the Disability Assessment Structured Interview on the interviews of Dutch insurance physicians.

PubMed

Spanjer, Jerry; van de Mei, Sijrike; Cornelius, Bert; Brouwer, Sandra; van der Klink, Jac

2016-08-01

The Disability Assessment Structured Interview (DASI) is a semi-structured interview for assessing functional limitations of claimants in a work disability evaluation. The aim of this study is to evaluate the effect of a 3-day DASI training course on the quality of assessment interviews of insurance physicians (IPs). In a pretest-posttest study, 55 IPs employed at the Dutch National Institute for Employee Benefits Schemes completed a 3-day DASI training. Before (T0), directly after the training (T1) and after 3 months follow-up (T2), these IPs filled out questionnaires that measured knowledge, skills, attitude and self-efficacy. Furthermore, in 10 disability assessment cases interview duration, IP's satisfaction, amount of acquired information and confidence of judgement were measured. Finally, the amount of information reported was measured in three randomly selected disability assessment reports of each IP. IP's knowledge, skills and self-efficacy improved significantly after the training. The attitude of the IPs changed towards a more open attitude and structuring of the interview. Satisfaction about the interview, amount of acquired information and confidence of their judgement all increased. The DASI training improved the quality of assessment interviews of IPs. A semi-structured interview, like the DASI, can help physicians to pay more attention to activity limitations and participation in addition to medical information. Implications for Rehabilitation Experienced IPs are able to change their disability assessment interview routine after training. In determining work ability, IPs should pay more attention to claimant's activity limitations and participation in addition to medical information. A semi-structured interview as the DASI can help IPs to pay more attention to claimant's functioning. A 3-day DASI training for IPs can increase their confidence in their judgement and provides significantly more information in their assessment reports.

[Health-related strength and power training in seniors: Purpose and recommendations].

PubMed

Donath, Lars; Faude, Oliver; Bopp, Micha; Zahner, Lukas

2015-05-01

The proportion of older people in western societies rapidly increases. Aging-induced disease conditions accompanied with declines in cardiocirculatory and neuromuscular performance constitute a major individual and economic health burden. Besides decreasing vascular and cardiac function during the process of aging, a loss of skeletal muscle mass, muscle structure and function seem to mainly account for decreasing maximal strength, strength development and strength endurance. These findings adversely interfer with static and dynamic postural control and may lead to an increased risk of falling with impairments of autonomy and quality of life. Traditional strength training recommendations basing on health-related exercise prescriptions for elderly people have been proven to counteract or at least attenuate aging-induced declines of neuromuscular muscular function. Multimodal and combined strength and balance training deliver additional improvements of neuromuscular capacity. Recent evidence additionally underpin the need of trunk muscle training and claimed for regimes considering explosive and high-velocity strength training in seniors. High quality RCTs revealed notable strength training effects on mobility, autonomy, quality of life and the reduction of the risk of falling (up to 50%). Available evidence also indicates that various strength training regimes elicit preventive and therapeutic effects on osteoporosis, diabetes type 2 and other chronic diseases, with effect sizes comparable to medication intake. Thus, health care providers, health insurances, Employers' Liability Insurance Associations and politicians should promote infrastructural developments that enable feasible and cost-effective access to health-related fitness centers or other sport facilities (e. g. sport clubs). These environmental requirements should be embedded in multi-centric education programs and campaigns that might enable regularly conducted strength and endurance training perceived as beneficial and valuable from an individual health care perspective.

Effects of 𝛽-Hydroxy-𝛽-methylbutyrate-free Acid Supplementation on Strength, Power and Hormonal Adaptations Following Resistance Training

PubMed Central

Asadi, Abbas; Arazi, Hamid

2017-01-01

Background: β-Hydroxy-β-methylbutyrate-free acid (HMB-FA) has been ingested prior to exercise to reduce muscle damage, however the effects of HMB-FA supplementation on hormonal, strength and power adaptation are unclear. Methods: Sixteen healthy men were matched and randomized into two groups and performed six-week resistance training while supplementing with either HMB-FA or placebo (3 g per day). The subjects were evaluated for 1 repetition maximum (1RM) bench press and leg press and vertical jump (VJ) prior to and after training intervention. In addition, blood samples were obtained before and after resistance training to evaluate resting growth hormone (GH), insulin like growth factor 1 (IGF-1), testosterone (TEST), cortisol (CORT), and adrenocorticotropic hormone (ACTH) responses. The HMB-FA supplementation group showed greater gains compared with the placebo group in peak power (effect size ES = 0.26 vs. 0.01) and 1RM leg press (ES = 1.52 vs. 0.96). In addition, the HMB-FA supplementation group indicated greater decrements in ACTH and CORT responses to training in comparison to the placebo group (p < 0.05). Likewise, in GH (ES = 1.41 vs. 0.12) and IGF-1 (ES = 0.83 vs. 0.41), the HMB-FA indicated greater training effects when compared with the placebo group. Conclusions: These findings provide further support for the potential anabolic benefits associated with HMB-FA supplementation. PMID:29207472

Evaluating an automated haptic simulator designed for veterinary students to learn bovine rectal palpation.

PubMed

Baillie, Sarah; Crossan, Andrew; Brewster, Stephen A; May, Stephen A; Mellor, Dominic J

2010-10-01

Simulators provide a potential solution to some of the challenges faced when teaching internal examinations to medical or veterinary students. A virtual reality simulator, the Haptic Cow, has been developed to teach bovine rectal palpation to veterinary students, and significant training benefits have been demonstrated. However, the training needs to be delivered by an instructor, a requirement that limits availability. This article describes the development and evaluation of an automated version that students could use on their own. An automated version was developed based on a recording of an expert's examination. The performance of two groups of eight students was compared. All students had undergone the traditional training in the course, namely lectures and laboratory practicals, and then group S used the simulator whereas group R had no additional training. The students were set the task of finding the uterus when examining cows. The simulator was then made available to students, and feedback about the "usability" was gathered with a questionnaire. The group whose training had been supplemented with a simulator session were significantly better at finding the uterus. The questionnaire feedback was positive and indicated that students found the simulator easy to use. The automated simulator equipped students with useful skills for examining cows. In addition, a simulator that does not need the presence of an instructor will increase the availability of training for students and be a more sustainable option for institutions.

Initial Verification of GEOS-4 Aerosols Using CALIPSO and MODIS: Scene Classification

NASA Technical Reports Server (NTRS)

Welton, Ellsworth J.; Colarco, Peter R.; Hlavka, Dennis; Levy, Robert C.; Vaughan, Mark A.; daSilva, Arlindo

2007-01-01

A-train sensors such as MODIS and MISR provide column aerosol properties, and in the process a means of estimating aerosol type (e.g. smoke vs. dust). Correct classification of aerosol type is important because retrievals are often dependent upon selection of the right aerosol model. In addition, aerosol scene classification helps place the retrieved products in context for comparisons and analysis with aerosol transport models. The recent addition of CALIPSO to the A-train now provides a means of classifying aerosol distribution with altitude. CALIPSO level 1 products include profiles of attenuated backscatter at 532 and 1064 nm, and depolarization at 532 nm. Backscatter intensity, wavelength ratio, and depolarization provide information on the vertical profile of aerosol concentration, size, and shape. Thus similar estimates of aerosol type using MODIS or MISR are possible with CALIPSO, and the combination of data from all sensors provides a means of 3D aerosol scene classification. The NASA Goddard Earth Observing System general circulation model and data assimilation system (GEOS-4) provides global 3D aerosol mass for sulfate, sea salt, dust, and black and organic carbon. A GEOS-4 aerosol scene classification algorithm has been developed to provide estimates of aerosol mixtures along the flight track for NASA's Geoscience Laser Altimeter System (GLAS) satellite lidar. GLAS launched in 2003 and did not have the benefit of depolarization measurements or other sensors from the A-train. Aerosol typing from GLAS data alone was not possible, and the GEOS-4 aerosol classifier has been used to identify aerosol type and improve the retrieval of GLAS products. Here we compare 3D aerosol scene classification using CALIPSO and MODIS with the GEOS-4 aerosol classifier. Dust, smoke, and pollution examples will be discussed in the context of providing an initial verification of the 3D GEOS-4 aerosol products. Prior model verification has only been attempted with surface mass comparisons and column optical depth from AERONET and MODIS.

Knee functional recovery and limb-to-limb symmetry restoration after anterior cruciate ligament (ACL) rupture and ACL reconstruction

NASA Astrophysics Data System (ADS)

Nawasreh, Zakariya Hussein

Anterior cruciate ligament (ACL) rupture is a common sport injury of young athletes who participate in jumping, cutting, and pivoting activities. Although ACL reconstruction (ACLR) surgery has the goal of enabling athletes to return to preinjury activity levels, treatment results often fall short of this goal. The outcomes after ACLR are variable and less than optimal with low rate of return to preinjury activity level and high risk for second ACL injury. Factors related to the knee functional limitations, strength deficits, and limb-to-limb movement asymmetry may be associated with poor outcomes after ACLR. Additionally, the criteria that are used to determine a patient's readiness to return to the preinjury activity level are undefined which may also be associated with poor outcomes after ACLR. The clinical decision-making to clear patients' for safe and successful return to high physical activities should be based on a universal comprehensive set of objective criteria that ensure normal knee function and limb-to-limb symmetry. A battery of return to activity criteria (RTAC) that emphases normal knee function and limb-to-limb movement symmetry has been constituted to better ensure safe and successful return to preinjury activity level. Yet, only variables related to patients' demographics, concomitant injuries, and treatment measures have been used to predict return to preinjury activity levels after ACLR. However, the ability of RTAC variables that ensure normal knee function and limb movement symmetry to predict the return to participate in the same preinjury activity level after ACLR has not been investigated. In light of this background, the first aim of the present study was to compare functional knee performance-based and patient-reported measures of those who PASS and who FAIL on RTAC at 6 months (6-M) following ACLR with those at 12 months (12-M) and 24 months (24-M) following ACLR and to determine how performance-based and patient-reported measures change over time. Further to investigate whether RTAC variables at 6-M following ACLR predict return to the same preinjury activity level at 12 and 24 months following ACLR. The findings of this work revealed that patients who fail on RTAC 6-M after ACLR are more likely to demonstrate impaired knee function and limb-to-limb movement asymmetry at 12-M and 24-M after ACLR. Additionally, RTAC variables can predict the return to participate in the same preinjury activity level at 12-M and 24-M after ACLR. The combination of RTAC variables explain more than one-fourth to one-third of returning to participate in the same preinjury activity level 12-M and 24-M respectively after ACLR. For athletes choosing non-surgical management, the physical therapy recommendation is to administrate progressive strength training augmented with manual perturbation training. Manual perturbation training is a type of specialized neuromuscular training that includes purposeful manipulations of support surfaces by a therapist. While manual perturbation promotes dynamic knee stability, enhances dynamic knee function, mitigates abnormal movement pattern and normalizes the muscle co-contraction, perturbation training is not widely used as part of the ACL rehabilitation program in the United States. Further, the perturbation training requires extensive physical labor and one-on-one time from the treating therapist. The effect of administering perturbation training using mechanical device as part of the ACL rehabilitation program has not investigated. An automated "Reactive Agility System" device provides perturbation stimuli including multidirectional translations similar to those of manual perturbation training. Administrating the perturbation training using a mechanical device may facilitate the use of controlled and standardized training in a wide range of the rehabilitation clinics and allow administering controlled and standardized training. However, it is unknown whether administering perturbation training using mechanical device provides effects similar to manual perturbation training on knee mechanics, knee functional performance, and neuromuscular activation pattern in patients with ACL rupture. The second aim of this study was to measure whether the mechanical perturbation training provides an effect similar to that of manual perturbation training on gait mechanics, knee functional performance, muscle co-contraction, and neuromuscular activation pattern in athletes with an acute ACL rupture who are managed non-surgically. The findings of this work revealed that mechanical perturbation training provides effects similar to the manual perturbation training on knee kinematics and kinetics during walking and performance-based and patient-reported measures. Gait limb-to-limb asymmetries continue persist after the training regardless of the treatment group which may indicate that patients require participating in an extended rehabilitation program. Additionally, Perturbation training attempts to resolve the neuromuscular deficits and restore a balance in muscle activation and strength between knee flexors and extensors to enhance the dynamic stability of the knee joint. There are moderate to strong relationships between time duration of muscles' activities and the muscle co-contraction that may reflect neuromuscular adaptations to provide dynamic knee stability.

75 FR 65645 - Notice Reopening the Call for Nominations for the New Mexico Resource Advisory Councils

Federal Register 2010, 2011, 2012, 2013, 2014

2010-10-26

... INFORMATION CONTACT: Allison Sandoval, Bureau of Land Management, Correspondence, International, and Advisory... variety of factors, including training, experience, and knowledge of the geographical area of the RAC... Office will issue a press release simultaneously with this notice, providing additional information for...

Models for Conducting Institutional Research. New Directions for Community Colleges, Number 72.

ERIC Educational Resources Information Center

MacDougall, Peter, Ed.; Friedlander, Jack, Ed.

1990-01-01

Recent mandates from state and accrediting agencies are requiring community colleges to provide evidence of their success in such areas as basic skills and remediation, general education, major-field content, student development, transfer effectiveness, job training, job placement, and fiscal accountability. This volume, in addition to describing…

42 CFR 61.37 - Stipends, allowances, and benefits.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 1 2010-10-01 2010-10-01 false Stipends, allowances, and benefits. 61.37 Section..., INTERNSHIPS, TRAINING FELLOWSHIPS Service Fellowships § 61.37 Stipends, allowances, and benefits. (a) Stipends... employees of the Public Health Service. (c) Benefits. In addition to other benefits provided herein, service...

The Electronic Classroom: A Handbook for Education in the Electronic Environment.

ERIC Educational Resources Information Center

Boschmann, Erwin, Ed.

This book explores emerging technologies and their use in secondary and higher education and in private, corporate, and government training environments. In addition to providing specific classroom applications of technology, the book treats issues of research, technology assessment, legal, copyright, and privacy rights, ethical considerations,…

A Program for Optimizing Women's Leadership Skills (OWLS)

ERIC Educational Resources Information Center

Sandmeyer, Louise; And Others

This program provides counselors with a means for integrating the individual, with the organizational, aspects of leadership training. In addition to an extensive, annotated bibliography, this monograph consists of seven sections: (1) an historical perspective of women in leadership roles; (2) a review of the literature concerning women and…

Desktop Publishing: A Brave New World and Publishing from the Desktop.

ERIC Educational Resources Information Center

Lormand, Robert; Rowe, Jane J.

1988-01-01

The first of two articles presents basic selection criteria for desktop publishing software packages, including discussion of expectations, required equipment, training costs, publication size, desired software features, additional equipment needed, and quality control. The second provides a brief description of desktop publishing using the Apple…

Decreasing the Risk of Adopting New Interactive Instructional Delivery Technologies.

ERIC Educational Resources Information Center

Dennis, Verl E.

1993-01-01

Discusses new interactive training technologies; considers risks of adopting a new technology; and presents the conceptual framework of technology life cycle analysis that provides timing information for the adoption of a new technology that should be used in addition to cost-benefit analysis and technical analysis. (LRW)

On the road to becoming a responsible leader: A simulation-based training approach for final year medical students

PubMed Central

Schmidt-Huber, Marion; Netzel, Janine; Kiesewetter, Jan

2017-01-01

Background and objective: There is a need for young physicians to take a responsible role in clinical teams, comparable to a leadership role. However, today’s medical curricula barely consider the development of leadership competencies. Acquisition of leadership skills are currently a by-product of medical education, even though it seems to be a competency relevant for physicians’ success. Therefore, an innovative leadership training program for young physicians was developed and validated. Training conceptualisation were based upon findings of critical incidents interviews (N=19) with relevant personnel (e.g. experienced doctors/nurses, residents) and upon evidence-based leadership contents focusing on ethical leadership behaviors. Method: The training consists of four sessions (3-4 hours each) and provided evidence-based lectures of leadership theory and effective leader behaviors, interactive training elements and a simulation-based approach with professional role players focusing on interprofessional collaboration with care staff. Training evaluation was assessed twice after completion of the program (N=37). Assessments included items from validated and approved evaluation instruments regarding diverse learning outcomes (satisfaction/reaction, learning, self-efficacy, and application/transfer) and transfer indicators. Furthermore, training success predictors were assessed based on stepwise regression analysis. In addition, long-term trainings effects and behavioral changes were analysed. Results: Various learning outcomes are achieved (self-reported training satisfaction, usefulness of the content and learning effects) and results show substantial transfer effects of the training contents and a strengthened awareness for the leadership role (e.g. self-confidence, ideas dealing with work-related problems in a role as responsible physician). We identified competence of trainer, training of applied tools, awareness of job expectations, and the opportunity to learn from experiences of other participants as predictors of training success. Additionally, we found long-term training effects and participants reported an increase in specific competencies, relevant for effective interprofessional collaboration (active perspective-taking, communication, conflict management, personal competencies). Conclusion: The training of leadership competencies for young physicians seems feasible to develop constructive influence strategies for a successful interprofessional collaboration in early career stages. The simulation-based approach is beneficial for residents to practice leadership behaviour in realistic job situations. PMID:28890925

On the road to becoming a responsible leader: A simulation-based training approach for final year medical students.

PubMed

Schmidt-Huber, Marion; Netzel, Janine; Kiesewetter, Jan

2017-01-01

Background and objective: There is a need for young physicians to take a responsible role in clinical teams, comparable to a leadership role. However, today's medical curricula barely consider the development of leadership competencies. Acquisition of leadership skills are currently a by-product of medical education, even though it seems to be a competency relevant for physicians' success. Therefore, an innovative leadership training program for young physicians was developed and validated. Training conceptualisation were based upon findings of critical incidents interviews ( N =19) with relevant personnel (e.g. experienced doctors/nurses, residents) and upon evidence-based leadership contents focusing on ethical leadership behaviors. Method: The training consists of four sessions (3-4 hours each) and provided evidence-based lectures of leadership theory and effective leader behaviors, interactive training elements and a simulation-based approach with professional role players focusing on interprofessional collaboration with care staff. Training evaluation was assessed twice after completion of the program ( N =37). Assessments included items from validated and approved evaluation instruments regarding diverse learning outcomes (satisfaction/reaction, learning, self-efficacy, and application/transfer) and transfer indicators. Furthermore, training success predictors were assessed based on stepwise regression analysis. In addition, long-term trainings effects and behavioral changes were analysed. Results: Various learning outcomes are achieved (self-reported training satisfaction, usefulness of the content and learning effects) and results show substantial transfer effects of the training contents and a strengthened awareness for the leadership role (e.g. self-confidence, ideas dealing with work-related problems in a role as responsible physician). We identified competence of trainer, training of applied tools, awareness of job expectations, and the opportunity to learn from experiences of other participants as predictors of training success. Additionally, we found long-term training effects and participants reported an increase in specific competencies, relevant for effective interprofessional collaboration (active perspective-taking, communication, conflict management, personal competencies). Conclusion: The training of leadership competencies for young physicians seems feasible to develop constructive influence strategies for a successful interprofessional collaboration in early career stages. The simulation-based approach is beneficial for residents to practice leadership behaviour in realistic job situations.

Nurse practitioners and physician assistants: preparing new providers for hospital medicine at the mayo clinic.

PubMed

Spychalla, Megan T; Heathman, Joanne H; Pearson, Katherine A; Herber, Andrew J; Newman, James S

2014-01-01

Hospital medicine is a growing field with an increasing demand for additional healthcare providers, especially in the face of an aging population. Reductions in resident duty hours, coupled with a continued deficit of medical school graduates to appropriately meet the demand, require an additional workforce to counter the shortage. A major dilemma of incorporating nonphysician providers such as nurse practitioners and physician assistants (NPPAs) into a hospital medicine practice is their varying academic backgrounds and inpatient care experiences. Medical institutions seeking to add NPPAs to their hospital medicine practice need a structured orientation program and ongoing NPPA educational support. This article outlines an NPPA orientation and training program within the Division of Hospital Internal Medicine (HIM) at the Mayo Clinic in Rochester, MN. In addition to a practical orientation program that other institutions can model and implement, the division of HIM also developed supplemental learning modalities to maintain ongoing NPPA competencies and fill learning gaps, including a formal NPPA hospital medicine continuing medical education (CME) course, an NPPA simulation-based boot camp, and the first hospital-based NPPA grand rounds offering CME credit. Since the NPPA orientation and training program was implemented, NPPAs within the division of HIM have gained a reputation for possessing a strong clinical skill set coupled with a depth of knowledge in hospital medicine. The NPPA-physician model serves as an alternative care practice, and we believe that with the institution of modalities, including a structured orientation program, didactic support, hands-on learning, and professional growth opportunities, NPPAs are capable of fulfilling the gap created by provider shortages and resident duty hour restrictions. Additionally, the use of NPPAs in hospital medicine allows for patient care continuity that is otherwise missing with resident practice models.

The effect of combined resistance exercise training and vitamin D3 supplementation on musculoskeletal health and function in older adults: a systematic review and meta-analysis.

PubMed

Antoniak, Anneka Elizabeth; Greig, Carolyn A

2017-07-20

In older adults, there is a blunted responsiveness to resistance training and reduced muscle hypertrophy compared with younger adults. There is evidence that both exercise training and vitamin D supplementation may benefit musculoskeletal health in older adults, and it is plausible that in combination their effects may be additive. The aim of this systematic review was to evaluate the effectiveness of combined resistance exercise training and vitamin D 3 supplementation on musculoskeletal health in older adults. A comprehensive search of electronic databases, including Science Direct, Medline, PubMed, Google Scholar and Cochrane Central Register of Controlled Trials (Cochrane CENTRAL accessed by Wiley Science) was conducted. Eligible studies were randomised controlled trials including men and women (aged ≥65 years or mean age ≥65 years); enlisting resistance exercise training and vitamin D 3 supplementation; including outcomes of muscle strength, function, muscle power, body composition, serum vitamin D/calcium status or quality of life comparing results with a control group. The review was informed by a preregistered protocol (http://www.crd.york.ac.uk/PROSPERO/display_record.asp?ID=CRD42015020157). Seven studies including a total of 792 participants were identified. Studies were categorised into two groups; group 1 compared vitamin D 3 supplementation and exercise training versus exercise alone (describing the additive effect of vitamin D 3 supplementation when combined with resistance exercise training) and group 2 compared vitamin D 3 supplementation and exercise training versus vitamin D 3 supplementation alone (describing the additive effect of resistance exercise training when combined with vitamin D 3 supplementation).Meta-analyses for group 1 found muscle strength of the lower limb to be significantly improved within the intervention group (0.98, 95% CI 0.73 to 1.24, p<0.001); all other outcomes showed small but non-significant positive effects for the intervention group. The short physical performance battery (SPPB), timed up and go (TUG), muscle strength of the lower limb and femoral neck bone mineral density showed significantly greater improvements in the intervention group for group 2 comparisons. This review provides tentative support for the additive effect of resistance exercise and vitamin D 3 supplementation for the improvement of muscle strength in older adults. For other functional variables, such as SPPB and TUG, no additional benefit beyond exercise was shown. Further evidence is required to draw firm conclusions or make explicit recommendations regarding combined exercise and vitamin D 3 supplementation. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Should Dental Schools Invest in Training Predoctoral Students for Academic Careers? Two Viewpoints: Viewpoint 1: Dental Schools Should Add Academic Careers Training to Their Predoctoral Curricula to Enhance Faculty Recruitment and Viewpoint 2: Addition of Academic Careers Training for All Predoctoral Students Would Be Inefficient and Ineffective.

PubMed

Fung, Brent; Fatahzadeh, Mahnaz; Kirkwood, Keith L; Hicks, Jeffery; Timmons, Sherry R

2018-04-01

This Point/Counterpoint considers whether providing dental students with academic career training and teaching experiences during their predoctoral education would be valuable to recruit dental academicians. While training the next generation of dentists continues to be the primary focus for dental schools, the cultivation and recruitment of dental faculty members from the pool of dental students remain challenges. Viewpoint 1 supports the position that providing dental students with exposure to academic career opportunities has positive value in recruiting new dental faculty. The advantages of academic careers training as a required educational experience in dental schools and as a potential means to recruit dental students into the ranks of faculty are described in this viewpoint. In contrast, Viewpoint 2 contends that such career exposure has limited value and argues that, across the board, allocation of resources to support preparation for academic careers would have a poor cost-benefit return on investment. Adding a requirement for educational experiences for all students would overburden institutions, students, and faculty according to this viewpoint. The authors agree that research is needed to determine how and where to make predoctoral curricular changes that will have maximum impact on academic recruitment.

Training supervisors of primary health workers.

PubMed

Bennett, F J

1982-01-01

This article draws on experience gained working with an international agency that provides assistance to primary health care programs, and deals briefly with some of the issues involved in training of supervisors of primary health workers (PHWs). The job of supervising PHWs is best described by the word "support," which takes the form of technical guidance, assistance with problems and referrals, provision of supplies, continuing education, monitoring of activities, checking and analysis of records, and discussion and coordinaiton of health care management with the community. A list of the duties of a supervisor is provided, all of which are based on the ability to form a helping relationship. Training requires field work, team work, and multisectorial exposure, and probably the best way to gain some ideas of the PHWs role in the community is to participate in the training program of the PHW. Supervisors also need some knowledge and skills in community diagnosis, simple field epidemiology, and statistical determinations in addition to managerial skills and a broad outlook on community problems. In training supervisors, the emphasis should be as practical as possible, remembering that the reality for which most supervisors are needed is rural primary health care. The content of training is summarized and a list of items to monitor in supervisory visits is given. This training requires considerable thought as to content and method, as it must shape not only cognitive skills for a disciplinary-administrative role, but also communicative skills for a counseling-educational role.

The development of sustainable emergency care in ghana: physician, nursing and prehospital care training initiatives.

PubMed

Martel, John; Oteng, Rockefeller; Mould-Millman, Nee-Kofi; Bell, Sue Anne; Zakariah, Ahmed; Oduro, George; Kowalenko, Terry; Donkor, Peter

2014-10-01

Ghana's first Emergency Medicine residency and nursing training programs were initiated in 2009 and 2010, respectively, at Komfo Anokye Teaching Hospital in the city of Kumasi in association with Kwame Nkrumah University of Science and Technology and the Universities of Michigan and Utah. In addition, the National Ambulance Service was commissioned initially in 2004 and has developed to include both prehospital transport services in all regions of the country and Emergency Medical Technician training. Over a decade of domestic and international partnership has focused on making improvements in emergency care at a variety of institutional levels, culminating in the establishment of comprehensive emergency care training programs. We describe the history and status of novel postgraduate emergency physician, nurse, and prehospital provider training programs as well as the prospect of creating a board certification process and formal continuing education program for practicing emergency physicians. Significant strides have been made in the development of emergency care and training in Ghana over the last decade, resulting in the first group of Specialist-level emergency physicians as of late 2012, as well as development of accredited emergency nursing curricula and continued expansion of a national Emergency Medical Service. This work represents a significant move toward in-country development of sustainable, interdisciplinary, team-based emergency provider training programs designed to retain skilled health care workers in Ghana and may serve as a model for similar developing nations. Copyright © 2014 Elsevier Inc. All rights reserved.

Marine Science Training Program for Alaska Native Students

DTIC Science & Technology

1991-08-01

Seward Marine Center or Kasitsna Bay. In 1989 we decided that a more intensive internship with direct faculty involvement would be more effective ...at UAF provides orientation activities for prospective Native students from the states rural high schools. In addition RSS provides the Alaska Native...opportunity to explore the effects of science upon their daily lives will attract student to careers into oceanic and related sciences and further

Aeromedical Lessons Learned from the Space Shuttle Columbia Accident Investigation

NASA Technical Reports Server (NTRS)

Chandler, Mike

2011-01-01

This slide presentation provides an update on the Columbia accident response presented in 2005 with additional information that was not available at that time. It will provide information on the following topics: (1) medical response and Search and Rescue, (2) medico-legal issues associated with the accident, (3) the Spacecraft Crew Survival Integrated Investigation Team Report published in 2008, and (4) future NASA flight surgeon spacecraft accident response training.

Supporting cancer patients with work-related problems through an oncological occupational physician: a feasibility study.

PubMed

Zaman, A C G N M; Bruinvels, D J; de Boer, A G E M; Frings-Dresen, M H W

2017-09-01

To evaluate the feasibility of an oncological occupational physician (OOP) who is trained in oncological work-related problems, and in providing work-related support to cancer patients within the curative setting. We assessed facilitators and barriers that affect the activities of an OOP, and the satisfaction of the OOPs and patients with this new form of health care. Interviews were held with (1) OOPs (N = 13) to assess facilitators, barriers and their satisfaction with their ability to give supportive care and (2) cancer patients (N = 8) to assess their satisfaction concerning consulting an OOP. The main facilitators were positive feedback from health care providers and patients about the received care and support that the OOP had given, and the additional knowledge of the OOPs about cancer and work-related problems. Major barriers for being active as an OOP were lack of financial support for the OOP and the unfamiliarity of patients and health care providers with the specialised occupational physician. Both OOPs and the specialised knowledge and additional training of the OOPs facilitated providing support to cancer patients and survivors with work-related problems. Familiarity with the specialised occupational physician and financial support should be improved. © 2015 John Wiley & Sons Ltd.

Simulation-Based Training - Evaluation of the Course Concept "Laparoscopic Surgery Curriculum" by the Participants.

PubMed

Köckerling, Ferdinand; Pass, Michael; Brunner, Petra; Hafermalz, Matthias; Grund, Stefan; Sauer, Joerg; Lange, Volker; Schröder, Wolfgang

2016-01-01

The learning curve in minimally invasive surgery is much longer than in open surgery. This is thought to be due to the higher demands made on the surgeon's skills. Therefore, the question raised at the outset of training in laparoscopic surgery is how such skills can be acquired by undergoing training outside the bounds of clinical activities to try to shorten the learning curve. Simulation-based training courses are one such model. In 2011, the surgery societies of Germany adopted the "laparoscopic surgery curriculum" as a recommendation for the learning content of systematic training courses for laparoscopic surgery. The curricular structure provides for four 2-day training courses. These courses offer an interrelated content, with each course focusing additionally on specific topics of laparoscopic surgery based on live operations, lectures, and exercises carried out on bio simulators. Between 1st January, 2012 and 31st March, 2016, a total of 36 training courses were conducted at the Vivantes Endoscopic Training Center in accordance with the "laparoscopic surgery curriculum." The training courses were attended by a total of 741 young surgeons and were evaluated as good to very good during continuous evaluation by the participants. Training courses based on the "laparoscopic surgery curriculum" for acquiring skills in laparoscopy are taken up and positively evaluated by young surgeons.

The value of biomedical research training for veterinary anatomic and clinical pathologists.

PubMed

Sharkey, L C; Simpson, R M; Wellman, M L; Craig, L E; Birkebak, T A; Kock, N D; Miller, M A; Harris, R K; Munson, L

2012-07-01

Veterinary pathologists traditionally have been actively engaged in research as principal investigators and as collaborators. Pathologists frequently obtain advanced training in research; however, it appears that in the last 10 years there has been a reversal of a previous trend toward increasing numbers of pathologists obtaining PhD degrees. This has arisen despite an established shortage of veterinarians engaged in research. This article evaluates the benefits of research training for individual pathologists, including a wide spectrum of professional opportunities and additional skill development beyond that usually provided by diagnostic pathology training alone. Various training models are discussed, including combined and sequential diagnostic residency and research degree training as well as the nondegree research fellowship programs more commonly pursued in human medicine. Best-practice recommendations for program infrastructure, mentorship, time management, and a team approach to research and research training are advocated to facilitate the development of successful programs and to encourage a continued emphasis on integrated training for pathologists as both clinical diagnosticians and experimentalists. This article is intended to help prospective and active pathology trainees, their mentors, and educational administrators optimize opportunities to ensure the future vitality of veterinary pathologists, and their contributions, in basic and applied research.

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.

Effectiveness of a computerised working memory training in adolescents with mild to borderline intellectual disabilities.

PubMed

Van der Molen, M J; Van Luit, J E H; Van der Molen, M W; Klugkist, I; Jongmans, M J

2010-05-01

The goal of this study is to evaluate the effectiveness of a computerised working memory (WM) training on memory, response inhibition, fluid intelligence, scholastic abilities and the recall of stories in adolescents with mild to borderline intellectual disabilities attending special education. A total of 95 adolescents with mild to borderline intellectual disabilities were randomly assigned to either a training adaptive to each child's progress in WM, a non-adaptive WM training, or to a control group. Verbal short-term memory (STM) improved significantly from pre- to post-testing in the group who received the adaptive training compared with the control group. The beneficial effect on verbal STM was maintained at follow-up and other effects became clear at that time as well. Both the adaptive and non-adaptive WM training led to higher scores at follow-up than at post-intervention on visual STM, arithmetic and story recall compared with the control condition. In addition, the non-adaptive training group showed a significant increase in visuo-spatial WM capacity. The current study provides the first demonstration that WM can be effectively trained in adolescents with mild to borderline intellectual disabilities.

Effects of Non-Symbolic Approximate Number Practice on Symbolic Numerical Abilities in Pakistani Children.

PubMed

Khanum, Saeeda; Hanif, Rubina; Spelke, Elizabeth S; Berteletti, Ilaria; Hyde, Daniel C

2016-01-01

Current theories of numerical cognition posit that uniquely human symbolic number abilities connect to an early developing cognitive system for representing approximate numerical magnitudes, the approximate number system (ANS). In support of this proposal, recent laboratory-based training experiments with U.S. children show enhanced performance on symbolic addition after brief practice comparing or adding arrays of dots without counting: tasks that engage the ANS. Here we explore the nature and generality of this effect through two brief training experiments. In Experiment 1, elementary school children in Pakistan practiced either a non-symbolic numerical addition task or a line-length addition task with no numerical content, and then were tested on symbolic addition. After training, children in the numerical training group completed the symbolic addition test faster than children in the line length training group, suggesting a causal role of brief, non-symbolic numerical training on exact, symbolic addition. These findings replicate and extend the core findings of a recent U.S. laboratory-based study to non-Western children tested in a school setting, attesting to the robustness and generalizability of the observed training effects. Experiment 2 tested whether ANS training would also enhance the consistency of performance on a symbolic number line task. Over several analyses of the data there was some evidence that approximate number training enhanced symbolic number line placements relative to control conditions. Together, the findings suggest that engagement of the ANS through brief training procedures enhances children's immediate attention to number and engagement with symbolic number tasks.

Effects of Non-Symbolic Approximate Number Practice on Symbolic Numerical Abilities in Pakistani Children

PubMed Central

Khanum, Saeeda; Hanif, Rubina; Spelke, Elizabeth S.; Berteletti, Ilaria; Hyde, Daniel C.

2016-01-01

Current theories of numerical cognition posit that uniquely human symbolic number abilities connect to an early developing cognitive system for representing approximate numerical magnitudes, the approximate number system (ANS). In support of this proposal, recent laboratory-based training experiments with U.S. children show enhanced performance on symbolic addition after brief practice comparing or adding arrays of dots without counting: tasks that engage the ANS. Here we explore the nature and generality of this effect through two brief training experiments. In Experiment 1, elementary school children in Pakistan practiced either a non-symbolic numerical addition task or a line-length addition task with no numerical content, and then were tested on symbolic addition. After training, children in the numerical training group completed the symbolic addition test faster than children in the line length training group, suggesting a causal role of brief, non-symbolic numerical training on exact, symbolic addition. These findings replicate and extend the core findings of a recent U.S. laboratory-based study to non-Western children tested in a school setting, attesting to the robustness and generalizability of the observed training effects. Experiment 2 tested whether ANS training would also enhance the consistency of performance on a symbolic number line task. Over several analyses of the data there was some evidence that approximate number training enhanced symbolic number line placements relative to control conditions. Together, the findings suggest that engagement of the ANS through brief training procedures enhances children's immediate attention to number and engagement with symbolic number tasks. PMID:27764117

A new hat for librarians: providing REDCap support to establish the library as a central data hub

PubMed Central

Read, Kevin; LaPolla, Fred Willie Zametkin

2018-01-01

Background REDCap, an electronic data capture tool, supports good research data management, but many researchers lack familiarity with the tool. While a REDCap administrator provided technical support and a clinical data management support unit provided study design support, a service gap existed. Case Presentation Librarians with REDCap expertise sought to increase and improve usage through outreach, workshops, and consultations. In collaboration with a REDCap administrator and the director of the clinical data management support unit, the role of the library was established in providing REDCap training and consultations. REDCap trainings were offered to the medical center during the library’s quarterly data series, which served as a springboard for offering tailored REDCap support to researchers and research groups. Conclusions Providing REDCap support has proved to be an effective way to associate the library with data-related activities in an academic medical center and identify new opportunities for offering data services in the library. By offering REDCap services, the library established strong partnerships with the Information Technology Department, Clinical Data Support Department, and Compliance Office by filling in training gaps, while simultaneously referring users back to these departments when additional expertise was required. These new partnerships continue to grow and serve to position the library as a central data hub in the institution. PMID:29339942

Pilot project and evaluation of delivering diabetes work-based education using video conferencing.

PubMed

Maltinsky, W; Hall, S; Grant, L; Simpson, K; MacRury, S

2013-01-01

Diabetes is a chronic long-term disease with an increasing incidence. There is a need to increase access to effective care and to ensure such care is delivered as locally as possible. The geographical spread of NHS Highland Scotland presents additional challenges to ensuring a skilled workforce given education is normally work-based tuition and assessment. The aim of this pilot project was to deliver teleconferenced diabetes training to healthcare and allied healthcare professionals who provide basic level care for, and management of, people with diabetes and to evaluate this training. Work-based diabetes education was designed to be delivered by a diabetes educator through videoconferencing or face to face (F2F) for healthcare professionals in peripheral settings in the Scottish Highlands region over two half-days. The education covered theoretical and practical training in diabetes. The evaluation of the project was through post-course questionnaires and assessment instruments to capture views of the content and delivery mode, as well as student performance. Feedback from participants indicated that the educational content was relevant and that the use of videoconferencing (VC) could provide accessibility to training where distance, cost and other issues may make access difficult. Student performance on the assessment instruments did not differ between those who received the training through video conferencing and those who received the training through F2F delivery. Video conferencing can counteract the difficulties of accessing training for clinical peripherally based professionals. Training through VC did not compromise student acquisition of learning outcomes. Feedback indicates that VC can reduce the interactive nature of the learning and teaching experience.

ExtraTrain: a database of Extragenic regions and Transcriptional information in prokaryotic organisms

PubMed Central

Pareja, Eduardo; Pareja-Tobes, Pablo; Manrique, Marina; Pareja-Tobes, Eduardo; Bonal, Javier; Tobes, Raquel

2006-01-01

Background Transcriptional regulation processes are the principal mechanisms of adaptation in prokaryotes. In these processes, the regulatory proteins and the regulatory DNA signals located in extragenic regions are the key elements involved. As all extragenic spaces are putative regulatory regions, ExtraTrain covers all extragenic regions of available genomes and regulatory proteins from bacteria and archaea included in the UniProt database. Description ExtraTrain provides integrated and easily manageable information for 679816 extragenic regions and for the genes delimiting each of them. In addition ExtraTrain supplies a tool to explore extragenic regions, named Palinsight, oriented to detect and search palindromic patterns. This interactive visual tool is totally integrated in the database, allowing the search for regulatory signals in user defined sets of extragenic regions. The 26046 regulatory proteins included in ExtraTrain belong to the families AraC/XylS, ArsR, AsnC, Cold shock domain, CRP-FNR, DeoR, GntR, IclR, LacI, LuxR, LysR, MarR, MerR, NtrC/Fis, OmpR and TetR. The database follows the InterPro criteria to define these families. The information about regulators includes manually curated sets of references specifically associated to regulator entries. In order to achieve a sustainable and maintainable knowledge database ExtraTrain is a platform open to the contribution of knowledge by the scientific community providing a system for the incorporation of textual knowledge. Conclusion ExtraTrain is a new database for exploring Extragenic regions and Transcriptional information in bacteria and archaea. ExtraTrain database is available at . PMID:16539733

Training Malaysian Pharmacy Undergraduates with Knowledge and Skills on Smoking Cessation

PubMed Central

Brewster, Joan M.; Nik Mohamed, Mohamad Haniki

2015-01-01

Objective. To evaluate the feasibility of an online training module, Certified Smoking Cessation Service Provider (CSCSP), developed for practicing pharmacists to equip pharmacy students with knowledge necessary for smoking cessation counseling and to assess the changes in student knowledge and skills regarding smoking cessation following training. Design. Sixty third-year and 80 fourth-year pharmacy undergraduates (N=140) were given access to an online module, the main intervention in the study. Two linkable questionnaires were administered to assess students’ preintervention and postintervention knowledge. For the third-year students, an additional role-play training component was incorporated, and student skills were assessed during week 14 with an Objective Structured Clinical Examination (OSCE). Assessment. Preintervention and postintervention knowledge assessments were completed by 130 (92.8%) students. Sixty-six students scored above 50% for the knowledge component postintervention, compared to 13 at preintervention, demonstrating significant improvement (x2(1, N=130)=32, p=0.003). All third-year students completed the intervention, and 66.7% were able to counsel excellently for smoking cessation, scoring more than 80%. Conclusion. The CSCSP online module developed for practicing professionals was found suitable for equipping pharmacy undergraduates with knowledge on smoking cessation topics. The module, along with role-play training, also equipped students with knowledge and skills to provide smoking cessation counseling. PMID:26246620

Navigating the Path to a Biomedical Science Career

NASA Astrophysics Data System (ADS)

Zimmerman, Andrea McNeely

The number of biomedical PhD scientists being trained and graduated far exceeds the number of academic faculty positions and academic research jobs. If this trend is compelling biomedical PhD scientists to increasingly seek career paths outside of academia, then more should be known about their intentions, desires, training experiences, and career path navigation. Therefore, the purpose of this study was to understand the process through which biomedical PhD scientists are trained and supported for navigating future career paths. In addition, the study sought to determine whether career development support efforts and opportunities should be redesigned to account for the proportion of PhD scientists following non-academic career pathways. Guided by the social cognitive career theory (SCCT) framework this study sought to answer the following central research question: How does a southeastern tier 1 research university train and support its biomedical PhD scientists for navigating their career paths? Key findings are: Many factors influence PhD scientists' career sector preference and job search process, but the most influential were relationships with faculty, particularly the mentor advisor; Planned activities are a significant aspect of the training process and provide skills for career success; and Planned activities provided skills necessary for a career, but influential factors directed the career path navigated. Implications for practice and future research are discussed.

Diversity training for the community aged care workers: A conceptual framework for evaluation.

PubMed

Appannah, Arti; Meyer, Claudia; Ogrin, Rajna; McMillan, Sally; Barrett, Elizabeth; Browning, Colette

2017-08-01

Older Australians are an increasingly diverse population, with variable characteristics such as culture, sexual orientation, socioeconomic status, and physical capabilities potentially influencing their participation in healthcare. In response, community aged care workers may need to increase skills and uptake of knowledge into practice regarding diversity through appropriate training interventions. Diversity training (DT) programs have traditionally existed in the realm of business, with little research attention devoted to scientifically evaluating the outcomes of training directed at community aged care workers. A DT workshop has been developed for community aged care workers, and this paper focuses on the construction of a formative evaluative framework for the workshop. Key evaluation concepts and measures relating to DT have been identified in the literature and integrated into the framework, focusing on five categories: Training needs analysis; Reactions; Learning outcomes, Behavioural outcomes and Results The use of a mixed methods approach in the framework provides an additional strength, by evaluating long-term behavioural change and improvements in service delivery. As little is known about the effectiveness of DT programs for community aged care workers, the proposed framework will provide an empirical and consistent method of evaluation, to assess their impact on enhancing older people's experience of healthcare. Copyright © 2017 Elsevier Ltd. All rights reserved.

The medical mission and modern cultural competency training.

PubMed

Campbell, Alex; Sullivan, Maura; Sherman, Randy; Magee, William P

2011-01-01

Culture has increasingly appreciated clinical consequences on the patient-physician relationship, and governing bodies of medical education are widely expanding educational programs to train providers in culturally competent care. A recent study demonstrated the value an international surgical mission in modern surgical training, while fulfilling the mandate of educational growth through six core competencies. This report further examines the impact of international volunteerism on surgical residents, and demonstrates that such experiences are particularly suited to education in cultural competency. Twenty-one resident physicians who participated in the inaugural Operation Smile Regan Fellowship were surveyed one year after their experiences. One hundred percent strongly agreed that participation in an international surgical mission was a quality educational experience and 94.7% deemed the experience a valuable part of their residency training. In additional to education in each of the ACGME core competencies, results demonstrate valuable training in cultural competence. A properly structured and proctored experience for surgical residents in international volunteerism is an effective instruction tool in the modern competency-based residency curriculum. These endeavors provide a unique understanding of the global burden of surgical disease, a deeper appreciation for global public health issues, and increased cultural sensitivity. A surgical mission experience should be widely available to surgery residents. Copyright © 2010 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

Foundation doctors working at night: what training opportunities exist?

PubMed

Coomber, R; Smith, D; McGuinness, D; Shao, E; Soobrah, R; Frankel, A H

2014-07-01

Foundation Training is designed for doctors in their first two years of post-graduation. The number of foundation doctors (FD) in the UK working nights has reduced because of a perception that clinical supervision at night is unsatisfactory and that minimal training opportunities exist. We aimed to assess the value of night shifts to FDs and hypothesised that removing FDs from nights may be detrimental to training. Using a survey, we assessed the number of FDs working nights in London, FDs views on working nights and their supervision at night. We evaluated whether working at night, compared to daytime working provided opportunities to achieve foundation competencies. 83% (N = 2157/2593) of FDs completed the survey. Over 90% of FDs who worked nights felt that the experience they gained improved their ability to prioritise, make decisions and plan. FDs who worked nights reported higher scores for achieving competencies in history taking (2.67 vs. 2.51; p = 0.00), examination (2.72 vs. 2.59; p = 0.01) and resuscitation (2.27 vs. 1.96; p = 0.00). The majority (65%) felt adequately supervised. Our survey has demonstrated that FDs find working nights a valuable experience, providing important training opportunities, which are additional to those encountered during daytime working.

Training for vigilance: using predictive power to evaluate feedback effectiveness.

PubMed

Szalma, James L; Hancock, Peter A; Warm, Joel S; Dember, William N; Parsons, Kelley S

2006-01-01

We examined the effects of knowledge of results (KR) on vigilance accuracy and report the first use of positive and negative predictive power (PPP and NPP) to assess vigilance training effectiveness. Training individuals to detect infrequent signals among a plethora of nonsignals is critical to success in many failure-intolerant monitoring technologies. KR has been widely used for vigilance training, but the effect of the schedule of KR presentation on accuracy has been neglected. Previous research on training for vigilance has used signal detection metrics or hits and false alarms. In this study diagnosticity measures were applied to augment traditional analytic methods. We examined the effects of continuous KR and a partial-KR regimen versus a no-KR control on decision diagnosticity. Signal detection theory (SDT) analysis indicated that KR induced conservatism in responding but did not enhance sensitivity. However, KR in both forms equally enhanced PPP while selectively impairing NPP. There is a trade-off in the effectiveness of KR in reducing false alarms and misses. Together, SDT and PPP/NPP measures provide a more complete portrait of performance effects. PPP and NPP together provide another assessment technique for vigilance performance, and as additional diagnostic tools, these measures are potentially useful to the human factors community.

Outcomes from the GLEON fellowship program. Training graduate students in data driven network science.

NASA Astrophysics Data System (ADS)

Dugan, H.; Hanson, P. C.; Weathers, K. C.

2016-12-01

In the water sciences there is a massive need for graduate students who possess the analytical and technical skills to deal with large datasets and function in the new paradigm of open, collaborative -science. The Global Lake Ecological Observatory Network (GLEON) graduate fellowship program (GFP) was developed as an interdisciplinary training program to supplement the intensive disciplinary training of traditional graduate education. The primary goal of the GFP was to train a diverse cohort of graduate students in network science, open-web technologies, collaboration, and data analytics, and importantly to provide the opportunity to use these skills to conduct collaborative research resulting in publishable scientific products. The GFP is run as a series of three week-long workshops over two years that brings together a cohort of twelve students. In addition, fellows are expected to attend and contribute to at least one international GLEON all-hands' meeting. Here, we provide examples of training modules in the GFP (model building, data QA/QC, information management, bayesian modeling, open coding/version control, national data programs), as well as scientific outputs (manuscripts, software products, and new global datasets) produced by the fellows, as well as the process by which this team science was catalyzed. Data driven education that lets students apply learned skills to real research projects reinforces concepts, provides motivation, and can benefit their publication record. This program design is extendable to other institutions and networks.

Practices of pharmacies that compound extemporaneous formulations.

PubMed

Treadway, Angela K; Craddock, Deeatra; Leff, Richard

2007-07-01

A survey was conducted to characterize the standard of practice for extemporaneous pharmaceutical compounding within community and institutional pharmacies. Extemporaneous compounding practices vary among pharmacies. Because of this, the survey inquired specifically about a single pharmaceutical product (caffeine citrate 20 mg/mL) to minimize variability among respondents. Survey questions were written to identify compounding practice variations with (1) policies and procedures, (2) process validation, (3) personnel education, training, and evaluation, (4) expiration dating, (5) storage and handling of compounded prescriptions within the pharmacy, (6) labeling, (7) facilities and equipment, (8) end-product evaluation, (9) handling of sterile products outside of the pharmacy, (10) aseptic technique and product preparation, and (11) documentation. A total of 522 surveys were mailed; 117 completed surveys were returned and included in the analyses. Over half of the pharmacies surveyed were large institutional pharmacies with daily prescriptions exceeding 300. Almost 71% of pharmacies reported having policies and procedures for compounding and providing compounding training for staff. Almost one third of the pharmacies that responded did not have compounding policies and procedures and did not provide staff training. For those pharmacies that provided training, the methods used were diverse (e.g., lectures and videotapes, external certificate programs). Formulations used to compound caffeine appeared to be diverse as evidenced by the varied addition of inactive ingredients. A survey of compounding pharmacies found variability in overall compounding practices and training and in practices specifically related to compounding preparations of caffeine citrate.

Physical Health Care for People with Severe Mental Illness: the Attitudes, Practices, and Training Needs of Nurses in Three Asian Countries

PubMed Central

Badnapurkar, Ashish; Ma, Hin Yeung; Nelson, Deborah

2018-01-01

People with severe mental illness (SMI) have considerable unmet physical health needs and an increased risk of early mortality. This cross-sectional survey utilized the Physical Health Attitude Scale (PHASe) to examine the attitudes, practices, and training needs of nurses towards physical health care of people with SMI in three Asian countries (Hong Kong, Japan, Qatar). Cross-country differences were explored and linear regression was used to investigate if nurses’ attitudes and confidence were associated with their level of involvement in physical health care. A total of 481 questionnaires were returned. Hong Kong nurses were less involved in physical health care than those from Japan and Qatar. Nurses’ attitudes and confidence were significant predictors of their participation in managing physical health. Compared with western countries, more nurses in this study felt that mental illness was a barrier to improving physical health. Three-quarters reported that they needed additional training in promoting cardiometabolic health. The perceived need for additional training in physical health care was held by Mental Health Nurses (MHN) irrespective of their type of nursing registration and nationality. Nurse educators and service providers should reconsider the physical health care training requirements of nurses working in mental health settings in order to improve the physical health of people with SMI. PMID:29462859

Improving support for parents of children with hearing loss: provider training on use of targeted communication strategies.

PubMed

Muñoz, Karen; Nelson, Lauri; Blaiser, Kristina; Price, Tanner; Twohig, Michael

2015-02-01

When proper protocols are followed, children who are identified with a permanent hearing loss early in life have opportunities to develop language on par with their typical hearing peers. Young children with hearing loss are dependent on their parents to manage intervention during early years critical to their development, and parents' ability to effectively integrate recommendations in daily life is foundational for intervention success. Audiologists and early intervention professionals not only need to provide current evidence-based services, but also must address parents' emotional and learning needs related to their child's hearing loss. This study explored practice patterns related to education and support provided to parents of children with hearing loss and the influence of an in-service training on provider attitudes. This study used a prepost design with a self-report questionnaire to identify practice patterns related to communication skills and support used by providers when working with parents of children with hearing loss. A total of 45 participants (21 professionals and 24 graduate students) currently working with children completed the pretraining questionnaire, and 29 participants (13 professionals and 16 graduate students) completed the postquestionnaire. Data were collected using an online questionnaire before the training and 1 mo after training. Descriptive analyses were done to identify trends, and paired-samples t-tests were used to determine changes pretraining to posttraining. Findings revealed that professionals most frequently teach skills to mothers (91%) and infrequently teach skills to fathers (19%) and other caregivers (10%). Professionals reported frequently collaborating with other intervention providers (76%) and infrequently collaborating with primary care physicians (19%). One-third of the professionals reported addressing symptoms of depression and anxiety as an interfering factor with the ability to implement management recommendations. For providers who completed both the prequestionnaires and postquestionnaires, an increase in confidence was reported for several areas of communication; however, as expected, practices remained similar, and all of the practicing professionals and 94% of the graduate students indicated a desire for more training on how to be effective in supporting parents with implementing intervention recommendations. Providers do not necessarily use effective methods of communication, needed to adequately help parents, requiring additional focused training to change how providers interact with parents and how support is provided. American Academy of Audiology.

Walking training associated with virtual reality-based training increases walking speed of individuals with chronic stroke: systematic review with meta-analysis.

PubMed

Rodrigues-Baroni, Juliana M; Nascimento, Lucas R; Ada, Louise; Teixeira-Salmela, Luci F

2014-01-01

To systematically review the available evidence on the efficacy of walking training associated with virtual reality-based training in patients with stroke. The specific questions were: Is walking training associated with virtual reality-based training effective in increasing walking speed after stroke? Is this type of intervention more effective in increasing walking speed, than non-virtual reality-based walking interventions? A systematic review with meta-analysis of randomized clinical trials was conducted. Participants were adults with chronic stroke and the experimental intervention was walking training associated with virtual reality-based training to increase walking speed. The outcome data regarding walking speed were extracted from the eligible trials and were combined using a meta-analysis approach. Seven trials representing eight comparisons were included in this systematic review. Overall, the virtual reality-based training increased walking speed by 0.17 m/s (IC 95% 0.08 to 0.26), compared with placebo/nothing or non-walking interventions. In addition, the virtual reality-based training increased walking speed by 0.15 m/s (IC 95% 0.05 to 0.24), compared with non-virtual reality walking interventions. This review provided evidence that walking training associated with virtual reality-based training was effective in increasing walking speed after stroke, and resulted in better results than non-virtual reality interventions.

Walking training associated with virtual reality-based training increases walking speed of individuals with chronic stroke: systematic review with meta-analysis

PubMed Central

Rodrigues-Baroni, Juliana M.; Nascimento, Lucas R.; Ada, Louise; Teixeira-Salmela, Luci F.

2014-01-01

OBJECTIVE: To systematically review the available evidence on the efficacy of walking training associated with virtual reality-based training in patients with stroke. The specific questions were: Is walking training associated with virtual reality-based training effective in increasing walking speed after stroke? Is this type of intervention more effective in increasing walking speed, than non-virtual reality-based walking interventions? METHOD: A systematic review with meta-analysis of randomized clinical trials was conducted. Participants were adults with chronic stroke and the experimental intervention was walking training associated with virtual reality-based training to increase walking speed. The outcome data regarding walking speed were extracted from the eligible trials and were combined using a meta-analysis approach. RESULTS: Seven trials representing eight comparisons were included in this systematic review. Overall, the virtual reality-based training increased walking speed by 0.17 m/s (IC 95% 0.08 to 0.26), compared with placebo/nothing or non-walking interventions. In addition, the virtual reality-based training increased walking speed by 0.15 m/s (IC 95% 0.05 to 0.24), compared with non-virtual reality walking interventions. CONCLUSIONS: This review provided evidence that walking training associated with virtual reality-based training was effective in increasing walking speed after stroke, and resulted in better results than non-virtual reality interventions. PMID:25590442

Emergency Medical Services Perspectives on Identifying and Reporting Victims of Elder Abuse, Neglect, and Self-Neglect.

PubMed

Rosen, Tony; Lien, Cynthia; Stern, Michael E; Bloemen, Elizabeth M; Mysliwiec, Regina; McCarthy, Thomas J; Clark, Sunday; Mulcare, Mary R; Ribaudo, Daniel S; Lachs, Mark S; Pillemer, Karl; Flomenbaum, Neal E

2017-10-01

Emergency Medical Services (EMS) providers, who perform initial assessments of ill and injured patients, often in a patient's home, are uniquely positioned to identify potential victims of elder abuse, neglect, or self-neglect. Despite this, few organized programs exist to ensure that EMS concerns are communicated to or further investigated by other health care providers, social workers, or the authorities. To explore attitudes and self-reported practices of EMS providers surrounding identification and reporting of elder mistreatment. Five semi-structured focus groups with 27 EMS providers. Participants reported believing they frequently encountered and were able to identify potential elder mistreatment victims. Many reported infrequently discussing their concerns with other health care providers or social workers and not reporting them to the authorities due to barriers: 1) lack of EMS protocols or training specific to vulnerable elders; 2) challenges in communication with emergency department providers, including social workers, who are often unavailable or not receptive; 3) time limitations; and 4) lack of follow-up when EMS providers do report concerns. Many participants reported interest in adopting protocols to assist in elder protection. Additional strategies included photographically documenting the home environment, additional training, improved direct communication with social workers, a dedicated location on existing forms or new form to document concerns, a reporting hotline, a system to provide feedback to EMS, and community paramedicine. EMS providers frequently identify potential victims of elder abuse, neglect, and self-neglect, but significant barriers to reporting exist. Strategies to empower EMS providers and improve reporting were identified. Copyright © 2017 Elsevier Inc. All rights reserved.

Gamification and Multimedia for Medical Education: A Landscape Review.

PubMed

McCoy, Lise; Lewis, Joy H; Dalton, David

2016-01-01

Medical education is rapidly evolving. Students enter medical school with a high level of technological literacy and an expectation for instructional variety in the curriculum. In response, many medical schools now incorporate technology-enhanced active learning and multimedia education applications. Education games, medical mobile applications, and virtual patient simulations are together termed gamified training platforms. To review available literature for the benefits of using gamified training platforms for medical education (both preclinical and clinical) and training. Also, to identify platforms suitable for these purposes with links to multimedia content. Peer-reviewed literature, commercially published media, and grey literature were searched to compile an archive of recently published scientific evaluations of gamified training platforms for medical education. Specific educational games, mobile applications, and virtual simulations useful for preclinical and clinical training were identified and categorized. Available evidence was summarized as it related to potential educational advantages of the identified platforms for medical education. Overall, improved learning outcomes have been demonstrated with virtual patient simulations. Games have the potential to promote learning, increase engagement, allow for real-word application, and enhance collaboration. They can also provide opportunities for risk-free clinical decision making, distance training, learning analytics, and swift feedback. A total of 5 electronic games and 4 mobile applications were identified for preclinical training, and 5 electronic games, 10 mobile applications, and 12 virtual patient simulation tools were identified for clinical training. Nine additional gamified, virtual environment training tools not commercially available were also identified. Many published studies suggest possible benefits from using gamified media in medical curriculum. This is a rapidly growing field. More research is required to rigorously evaluate the specific educational benefits of these interventions. This archive of hyperlinked tools can be used as a resource for all levels of medical trainees, providers, and educators.

Training hospital providers in basic CPR skills in Botswana: acquisition, retention and impact of novel training techniques.

PubMed

Meaney, Peter A; Sutton, Robert M; Tsima, Billy; Steenhoff, Andrew P; Shilkofski, Nicole; Boulet, John R; Davis, Amanda; Kestler, Andrew M; Church, Kasey K; Niles, Dana E; Irving, Sharon Y; Mazhani, Loeto; Nadkarni, Vinay M

2012-12-01

Globally, one third of deaths each year are from cardiovascular diseases, yet no strong evidence supports any specific method of CPR instruction in a resource-limited setting. We hypothesized that both existing and novel CPR training programs significantly impact skills of hospital-based healthcare providers (HCP) in Botswana. HCP were prospectively randomized to 3 training groups: instructor led, limited instructor with manikin feedback, or self-directed learning. Data was collected prior to training, immediately after and at 3 and 6 months. Excellent CPR was prospectively defined as having at least 4 of 5 characteristics: depth, rate, release, no flow fraction, and no excessive ventilation. GEE was performed to account for within subject correlation. Of 214 HCP trained, 40% resuscitate ≥ 1/month, 28% had previous formal CPR training, and 65% required additional skills remediation to pass using AHA criteria. Excellent CPR skill acquisition was significant (infant: 32% vs. 71%, p<0.01; adult 28% vs. 48%, p<0.01). Infant CPR skill retention was significant at 3 (39% vs. 70%, p<0.01) and 6 months (38% vs. 67%, p<0.01), and adult CPR skills were retained to 3 months (34% vs. 51%, p=0.02). On multivariable analysis, low cognitive score and need for skill remediation, but not instruction method, impacted CPR skill performance. HCP in resource-limited settings resuscitate frequently, with little CPR training. Using existing training, HCP acquire and retain skills, yet often require remediation. Novel techniques with increased student: instructor ratio and feedback manikins were not different compared to traditional instruction. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Driving With Hemianopia VI: Peripheral Prisms and Perceptual-Motor Training Improve Detection in a Driving Simulator

PubMed Central

Houston, Kevin E.; Peli, Eli; Goldstein, Robert B.; Bowers, Alex R.

2018-01-01

Purpose Drivers with homonymous hemianopia (HH) were previously found to have impaired detection of blind-side hazards, yet in many jurisdictions they may obtain a license. We evaluated whether oblique 57Δ peripheral prisms (p-prisms) and perceptual-motor training improved blind-side detection rates. Methods Patients with HH (n = 11) wore p-prisms for 2 weeks and then received perceptual-motor training (six visits) detecting and touching stimuli in the prism-expanded vision. In a driving simulator, patients drove and pressed the horn upon detection of pedestrians who ran toward the roadway (26 from each side): (1) without p-prisms at baseline; (2) with p-prisms after 2 weeks acclimation but before training; (3) with p-prisms after training; and (4) 3 months later. Results P-prisms improved blind-side detection from 42% to 56%, which further improved after training to 72% (all P < 0.001). Blind-side timely responses (adequate time to have stopped) improved from 31% without to 44% with p-prisms (P < 0.001) and further improved with training to 55% (P = 0.02). At the 3-month follow-up, improvements from training were maintained for detection (65%; P = 0.02) but not timely responses (P = 0.725). There was wide between-subject variability in baseline detection performance and response to p-prisms. There were no negative effects of p-prisms on vehicle control or seeing-side performance. Conclusions P-prisms improved detection with no negative effects, and training may provide additional benefit. Translational Relevance In jurisdictions where people with HH are legally driving, these data aid in clinical decision making by providing evidence that p-prisms improve performance without negative effects. PMID:29359111

Two weeks of moderate-intensity continuous training, but not high-intensity interval training, increases insulin-stimulated intestinal glucose uptake

PubMed Central

Savolainen, Anna M.; Eskelinen, Jari-Joonas; Toivanen, Jussi; Ishizu, Tamiko; Yli-Karjanmaa, Minna; Virtanen, Kirsi A.; Parkkola, Riitta; Kapanen, Jukka; Grönroos, Tove J.; Haaparanta-Solin, Merja; Solin, Olof; Savisto, Nina; Ahotupa, Markku; Löyttyniemi, Eliisa; Knuuti, Juhani; Nuutila, Pirjo; Kalliokoski, Kari K.

2017-01-01

Similar to muscles, the intestine is also insulin resistant in obese subjects and subjects with impaired glucose tolerance. Exercise training improves muscle insulin sensitivity, but its effects on intestinal metabolism are not known. We studied the effects of high-intensity interval training (HIIT) and moderate-intensity continuous training (MICT) on intestinal glucose and free fatty acid uptake from circulation in humans. Twenty-eight healthy, middle-aged, sedentary men were randomized for 2 wk of HIIT or MICT. Intestinal insulin-stimulated glucose uptake and fasting free fatty acid uptake from circulation were measured using positron emission tomography and [18F]FDG and [18F]FTHA. In addition, effects of HIIT and MICT on intestinal GLUT2 and CD36 protein expression were studied in rats. Training improved aerobic capacity (P = 0.001) and whole body insulin sensitivity (P = 0.04), but not differently between HIIT and MICT. Insulin-stimulated glucose uptake increased only after the MICT in the colon (HIIT = 0%; MICT = 37%) (P = 0.02 for time × training) and tended to increase in the jejunum (HIIT = −4%; MICT = 13%) (P = 0.08 for time × training). Fasting free fatty acid uptake decreased in the duodenum in both groups (HIIT = −6%; MICT = −48%) (P = 0.001 time) and tended to decrease in the colon in the MICT group (HIIT = 0%; MICT = −38%) (P = 0.08 for time × training). In rats, both training groups had higher GLUT2 and CD36 expression compared with control animals. This study shows that already 2 wk of MICT enhances insulin-stimulated glucose uptake, while both training modes reduce fasting free fatty acid uptake in the intestine in healthy, middle-aged men, providing an additional mechanism by which exercise training can improve whole body metabolism. NEW & NOTEWORTHY This is the first study where the effects of exercise training on the intestinal substrate uptake have been investigated using the most advanced techniques available. We also show the importance of exercise intensity in inducing these changes. PMID:28183816

Adequacy of pathology resident training for employment: a survey report from the Future of Pathology Task Group.

PubMed

Kass, Mary E; Crawford, James M; Bennett, Betsy; Cox, Teresa M; Grimes, Margaret M; LiVolsi, Virginia; Fletcher, Christopher D M; Wilkinson, David S

2007-04-01

The recent change in accreditation requirements for anatomic pathology and clinical pathology residency training from 5 to 4 years and the rapid advances in technologies for pathology services have sparked a renewed debate over the adequacy of pathology residency training. In particular, perceived deficiencies in training have been declared from a variety of sources, both in the form of recent editorial opinions and from surveys of community hospital pathologist employers in 1998, 2003, and 2005 by Dr Richard Horowitz. To obtain more comprehensive data on the perceptions of strengths and weaknesses in pathology residency training. The College of American Pathologists conducted a survey of potential pathology employers (senior College of American Pathologists members, members designated as head of group, and members of the Association of Directors of Anatomic and Surgical Pathology). Also surveyed were recent graduates of pathology residency programs, who were identified as being junior members of the College of American Pathologists, were recent recipients of certification from the American Board of Pathology, or were contacted through their directors of pathology residency programs. There were 559 employer respondents, of whom 384 were responsible for hiring and/or supervising new pathologists. There were 247 recent graduates of pathology residency training programs who responded. From the employers' standpoint, the majority expressed overall satisfaction with recent graduates, but almost one third of employers indicated that new hires had a major deficiency in a critical area. Specific areas of deficiency were clinical laboratory management and judgment in ordering special stains and studies. In addition, one half of employers agreed that more guidance and support for newly trained pathologists is needed now than was required 10 years ago. Academic employers generally were more satisfied than private sector employers. Newly trained pathologists did not appear to be inappropriately overconfident in their abilities. In addition, their perceptions of those specific areas in which they are most and least prepared are very similar to the ratings provided by employers. On average, newly trained pathologists' ratings of their own preparedness are highest for specific aspects of general pathology and anatomic pathology, and lowest for specific aspects of clinical pathology and administration. In selecting new pathologists, employers perceived medical knowledge and interpersonal skills as the most important discriminating applicant characteristics. When new employees were asked why they thought they were offered their position, the discriminating qualifications cited most often were academic background and training, as well as completion of a fellowship and subspecialty training. It is our hope that the results of this survey can be used as input for further discussions and recommendations for training of pathology residents so as to further advance the ability of pathologists to provide quality patient care upon their graduation from training.

Care Coordination: Empowering Families, a Promising Practice to Facilitate Medical Home Use Among Children and Youth with Special Health Care Needs.

PubMed

Ufer, Lisa Gorman; Moore, Julie A; Hawkins, Kristen; Gembel, Gina; Entwistle, David N; Hoffman, David

2018-05-01

Introduction This paper describes the care coordination training program and results of an evaluation from its pilot in seven states. Despite the importance of practice-based care coordination, only 42.3% of children with special health care needs (CYSHCN) met all needed components of care coordination as defined by the Maternal Child Health Bureau. Recognizing that children with medically complex conditions often have lower rates of achieving care coordination within a medical home, the Region 4 Midwest Genetics Collaborative worked with families to develop a training to empower families in care coordination. The Care Coordination: Empowering Families(CCEF) training provides families with the knowledge, tools, and resources to engage with health, education and family support systems. This article gives an overview of the training and comprehensive evaluation. Methods Participants were family caregivers of children with genetic conditions and other special health care needs recruited in one of seven pilot states. Evaluation data were collected from 190 participants prior to and immediately following the training. An additional follow-up assessment one full year post training was completed by 80 participants (a response rate of 42%). Results Families who attended the training report being the primary source of care coordination for their children and 83.7% see their role in their child's healthcare changing as a result of the training. The findings suggest that peer support and communication with providers increased as a result of the training over the course of the study. The data suggest that the training impacted how the family interacts with the child's doctor, including initiating conversations to prepare their child for transition to adult health care. Further, families report system-level improvements 1 year later compared to the pre-training assessment. Discussion CCEF training is a promising practice for facilitating medical home use among CYSHCN.

Low-Active Male Adolescents: A Dose Response to High-Intensity Interval Training.

PubMed

Logan, Greig Robert Melrose; Harris, Nigel; Duncan, Scott; Plank, Lindsay D; Merien, Fabrice; Schofield, Grant

2016-03-01

High-intensity interval training (HIIT) is a potential alternative to traditionally recommended steady state exercise for providing health benefits in adolescents, yet its dose-response relationship in this cohort remains unclear, as does its translatability to real-world, nonclinical settings. The present study adopts a novel dose-response design to investigate the effects of undertaking 8 wk of HIIT on the cardiometabolic health of low-active male adolescents. Twenty-six male adolescents (age 16 ± 1 yr), identified as low active by nonparticipation in structured sport and physical education classes, were randomly assigned to one of five treatment groups. Corresponding with their group numbers (1-5), participants completed a number of HIIT "sets," which consisted of 4 repeated bouts of 20-s near-maximal exertion interspersed with 10-s passive recovery. Participants performed two HIIT sessions and one resistance training session each week for 8 wk. Baseline and follow-up health measures consisted of peak oxygen uptake (V˙O2peak) with an incremental ramp test to volitional exhaustion; body composition (including visceral fat mass, body fat, and lean tissue mass) with dual-energy x-ray absorptiometry; and lipid profile, glucose, insulin, and interleukin-6 from blood analysis. All health outcomes were analyzed as percentage changes, and data were modeled using a quadratic function to explore dose-response relationships. Significant improvements were observed for V˙O2peak (∼6%), body fat percentage (∼4%), visceral fat mass (∼10%), and waist circumference-to-height ratio (∼3%), but there was no clear effect of dose across groups. Low-active adolescent males performing a single HIIT set twice weekly, in addition to one resistance training session, gained meaningful improvements in fitness and body composition. Performing additional HIIT sets provided no additional improvements to those of the lowest dose in this study.

Audit of annual medical appraisal and revalidation activity across the UK Defence Medical Services 2013-2014.

PubMed

Morris, Louisa E; Withnall, Rdj

2017-02-01

To provide the first annual audit of Defence Medical Services (DMS) medical appraisal and revalidation activity. A questionnaire-based survey of appraisal and revalidation activity within the 2013-2014 appraisal year (1 April 2013 - 1 March 2014) across the Royal Navy (RN), Army, Royal Air Force (RAF) and Ministry of Defence (MOD) and Defence Postgraduate Medical Deanery (DPMD) Designated Bodies (DBs). Mandatory annual medical appraisal of all DMS doctors was introduced in 2002. The General Medical Council (GMC) introduced licences to practise in November 2011. Revalidation went live in December 2012. In the 2013-2014 appraisal year, there were 1379 DMS doctors. The Responsible Officers (ROs) of the RN, Army, RAF, MOD and Defence Postgraduate Medical Deanery (DPMD) provide appraisal and revalidation services for doctors within their DBs. In the 2013-2014 appraisal year, 82% of DMS doctors completed an annual appraisal. ROs provided positive revalidation recommendations for 90% of DMS doctors without the need for additional supporting information. Additional supporting evidence was required for 10% of DMS trained doctors, but ultimately 100% of DMS doctors due revalidation in the 2013-2014 appraisal year received a positive recommendation. To assist DMS compliance with GMC quality assurance requirements, HQ Surgeon General now maintains a central database of appraisal and revalidation data across the five DMS DBs. Appropriately targeted appraiser training and 'revalidation ready top-up' training should be provided to ensure the demand for military appraisers is met, and that DMS appraisers appropriately maintain their skills. MOD now maintains a central live database for ongoing appraisal and revalidation monitoring. 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/.

Curricular Approaches in Research Ethics Education: Reflecting on More and Less Effective Practices in Instructional Content.

PubMed

Torrence, Brett S; Watts, Logan L; Mulhearn, Tyler J; Turner, Megan R; Todd, E Michelle; Mumford, Michael D; Connelly, Shane

2017-01-01

Over the past decade, the effectiveness of ethics education programs has increased with regard to trainee outcomes, such as knowledge, awareness, and ethical decision making. However, despite the overall improvement in training effectiveness, considerable variability still exists across programs. One potential source of variability arises from the substantial range in instructional training content utilized across ethics training courses. The goal of the present effort was to clarify which approaches in ethics education result in positive training outcomes through the identification of instructional content themes. Through a qualitative review of ethics training courses, we identified key themes in instructional content curriculum associated with effective courses: domain-general, domain-specific, standard compliance, professionalism, and process-based. In addition, we identified key themes associated with less effective courses: mixed-specificity, narrow coverage, and idealized ethics. Descriptions and key characteristics of each theme along with example courses are provided. Implications of the content themes for ethics education are discussed.

Performance Enhancing Diets and the PRISE Protocol to Optimize Athletic Performance

PubMed Central

Arciero, Paul J.; Ward, Emery

2015-01-01

The training regimens of modern-day athletes have evolved from the sole emphasis on a single fitness component (e.g., endurance athlete or resistance/strength athlete) to an integrative, multimode approach encompassing all four of the major fitness components: resistance (R), interval sprints (I), stretching (S), and endurance (E) training. Athletes rarely, if ever, focus their training on only one mode of exercise but instead routinely engage in a multimode training program. In addition, timed-daily protein (P) intake has become a hallmark for all athletes. Recent studies, including from our laboratory, have validated the effectiveness of this multimode paradigm (RISE) and protein-feeding regimen, which we have collectively termed PRISE. Unfortunately, sports nutrition recommendations and guidelines have lagged behind the PRISE integrative nutrition and training model and therefore limit an athletes' ability to succeed. Thus, it is the purpose of this review to provide a clearly defined roadmap linking specific performance enhancing diets (PEDs) with each PRISE component to facilitate optimal nourishment and ultimately optimal athletic performance. PMID:25949823

Designing evaluation studies to optimally inform policy: what factors do policy-makers in China consider when making resource allocation decisions on healthcare worker training programmes?

PubMed

Wu, Shishi; Legido-Quigley, Helena; Spencer, Julia; Coker, Richard James; Khan, Mishal Sameer

2018-02-23

In light of the gap in evidence to inform future resource allocation decisions about healthcare provider (HCP) training in low- and middle-income countries (LMICs), and the considerable donor investments being made towards training interventions, evaluation studies that are optimally designed to inform local policy-makers are needed. The aim of our study is to understand what features of HCP training evaluation studies are important for decision-making by policy-makers in LMICs. We investigate the extent to which evaluations based on the widely used Kirkpatrick model - focusing on direct outcomes of training, namely reaction of trainees, learning, behaviour change and improvements in programmatic health indicators - align with policy-makers' evidence needs for resource allocation decisions. We use China as a case study where resource allocation decisions about potential scale-up (using domestic funding) are being made about an externally funded pilot HCP training programme. Qualitative data were collected from high-level officials involved in resource allocation at the national and provincial level in China through ten face-to-face, in-depth interviews and two focus group discussions consisting of ten participants each. Data were analysed manually using an interpretive thematic analysis approach. Our study indicates that Chinese officials not only consider information about the direct outcomes of a training programme, as captured in the Kirkpatrick model, but also need information on the resources required to implement the training, the wider or indirect impacts of training, and the sustainability and scalability to other settings within the country. In addition to considering findings presented in evaluation studies, we found that Chinese policy-makers pay close attention to whether the evaluations were robust and to the composition of the evaluation team. Our qualitative study indicates that training programme evaluations that focus narrowly on direct training outcomes may not provide sufficient information for policy-makers to make decisions on future training programmes. Based on our findings, we have developed an evidence-based framework, which incorporates but expands beyond the Kirkpatrick model, to provide conceptual and practical guidance that aids in the design of training programme evaluations better suited to meet the information needs of policy-makers and to inform policy decisions.

Simulation Modeling Requirements for Loss-of-Control Accident Prevention of Turboprop Transport Aircraft

NASA Technical Reports Server (NTRS)

Crider, Dennis; Foster, John V.

2012-01-01

In-flight loss of control remains the leading contributor to aviation accident fatalities, with stall upsets being the leading causal factor. The February 12, 2009. Colgan Air, Inc., Continental Express flight 3407 accident outside Buffalo, New York, brought this issue to the forefront of public consciousness and resulted in recommendations from the National Transportation Safety Board to conduct training that incorporates stalls that are fully developed and develop simulator standards to support such training. In 2010, Congress responded to this accident with Public Law 11-216 (Section 208), which mandates full stall training for Part 121 flight operations. Efforts are currently in progress to develop recommendations on implementation of stall training for airline pilots. The International Committee on Aviation Training in Extended Envelopes (ICATEE) is currently defining simulator fidelity standards that will be necessary for effective stall training. These recommendations will apply to all civil transport aircraft including straight-wing turboprop aircraft. Government-funded research over the previous decade provides a strong foundation for stall/post-stall simulation for swept-wing, conventional tail jets to respond to this mandate, but turboprops present additional and unique modeling challenges. First among these challenges is the effect of power, which can provide enhanced flow attachment behind the propellers. Furthermore, turboprops tend to operate for longer periods in an environment more susceptible to ice. As a result, there have been a significant number of turboprop accidents as a result of the early (lower angle of attack) stalls in icing. The vulnerability of turboprop configurations to icing has led to studies on ice accumulation and the resulting effects on flight behavior. Piloted simulations of these effects have highlighted the important training needs for recognition and mitigation of icing effects, including the reduction of stall margins. This paper addresses simulation modeling requirements that are unique to turboprop transport aircraft and highlights the growing need for aerodynamic models suitable for stall training for these configurations. A review of prominent accidents that involved aerodynamic stall is used to illustrate various modeling features unique to turboprop configurations and the impact of stall behavior on susceptibility to loss of control that has led to new training requirements. This is followed by an overview of stability and control behavior of straight-wing turboprops, the related aerodynamic characteristics, and a summary of recent experimental studies on icing effects. In addition, differences in flight dynamics behavior between swept-wing jets and straight-wing turboprop configurations are discussed to compare and contrast modeling requirements. Specific recommendations for aerodynamic models along with further research needs and data measurements are also provided. 1

Do U.S. research institutions meet or exceed federal mandates for instruction in responsible conduct of research? A national survey.

PubMed

Resnik, David B; Dinse, Gregg E

2012-09-01

To explore the extent to which U.S. research institutions are meeting or exceeding National Institutes of Health and National Science Foundation mandates to provide instruction in responsible conduct of research (RCR). In summer 2011, the authors sent an e-mail survey to officials responsible for overseeing RCR instructional programs at the 200 top-funded research institutions in the United States and Puerto Rico. They cross-classified the proportions exceeding federal mandates by the types of additional individuals required to receive training and by medical school presence/absence. Responses were received from 144 institutions (72%); all had an RCR program. Of these 144 institutions, 69 (47.9%) required only federally mandated individuals to take RCR training, whereas 75 (52.1%) required additional individuals to be trained as well. A greater proportion of institutions with medical schools (62.3%; 53/85) went beyond the federal mandates than did those without (37.3%; 22/59). Types of additional individuals required to receive training included all students in selected programs (23.6%; 34/144), all students participating in externally funded research (12.5%; 18/144), all graduate students (11.1%; 16/144), all faculty/staff participating in externally funded research (9.7%; 14/144), all postdoctoral students or fellows (8.3%; 12/144), all doctoral-level students (4.9%; 7/144), all faculty/staff involved in human subjects research (4.9%; 7/144), and all faculty/staff involved in animal research (2.1%; 3/144). More institutions with medical schools exceeded federal RCR training mandates than did those without. The authors encourage other institutions to expand their RCR requirements to promote research integrity.

The effect of financial incentives on top of behavioral support on quit rates in tobacco smoking employees: study protocol of a cluster-randomized trial.

PubMed

van den Brand, F A; Nagelhout, G E; Winkens, B; Evers, S M A A; Kotz, D; Chavannes, N H; van Schayck, C P

2016-10-06

Stimulating successful tobacco cessation among employees has multiple benefits. Employees who quit tobacco are healthier, more productive, less absent from work, and longer employable than employees who continue to use tobacco. Despite the evidence for these benefits of tobacco cessation, a successful method to stimulate employees to quit tobacco is lacking. The aim of this study is to evaluate whether adding a financial incentive to behavioral support (compared with no additional incentive) is effective and cost-effective in increasing abstinence rates in tobacco smoking employees participating in a smoking cessation group training. In this cluster-randomized trial employees in the intervention and control group both participate in a smoking cessation group training consisting of seven weekly counseling sessions of ninety minutes each. In addition to the training, employees in the intervention group receive a voucher as an incentive for being abstinent from smoking at the end of the training (€50), after three months (€50), after six months (€50), and after one year (€200). The control group does not receive any incentive. The primary outcome is carbon monoxide validated 12-month continuous abstinence from smoking (Russel's standard). Additionally, an economic evaluation is performed from a societal and an employer perspective. The present paper describes the methods and design of this cluster-randomized trial in detail. We hypothesize that the financial incentive for abstinence in the form of vouchers increases abstinence rates over and above the group training. The results of this study can provide important recommendations for enhancement of employee tobacco cessation. Dutch Trial Register: NTR5657 . First received 27-01-2016.

A randomised controlled trial of sensory awareness training and additional motor practice for learning scalpel skills in podiatry students.

PubMed

Causby, Ryan S; McDonnell, Michelle N; Reed, Lloyd; Hillier, Susan L

2016-12-05

The process of using a scalpel, like all other motor activities, is dependent upon the successful integration of afferent (sensory), cognitive and efferent (motor) processes. During learning of these skills, even if motor practice is carefully monitored there is still an inherent risk involved. It is also possible that this strategy could reinforce high levels of anxiety experienced by the student and affect student self-efficacy, causing detrimental effects on motor learning. An alternative training strategy could be through targeting sensory rather than motor processes. Second year podiatry students who were about to commence learning scalpel skills were recruited. Participants were randomly allocated into sensory awareness training (Sensory), additional motor practice (Motor) or usual teaching only (Control) groups. Participants were then evaluated on psychological measures (Intrinsic Motivation Inventory) and dexterity measures (Purdue Pegboard, Grooved Pegboard Test and a grip-lift task). A total of 44 participants were included in the study. There were no baseline differences or significant differences between the three groups over time on the Perceived Competence, Effort/ Importance or Pressure/ Tension, psychological measures. All groups showed a significant increase in Perceived Competence over time (F 1,41  = 13.796, p = 0.001). Only one variable for the grip-lift task (Preload Duration for the non-dominant hand) showed a significant difference over time between the groups (F 2,41  = 3.280, p = 0.038), specifically, Motor and Control groups. The use of sensory awareness training, or additional motor practice did not provide a more effective alternative compared with usual teaching. Further research may be warranted using more engaged training, provision of supervision and greater participant numbers. Australian New Zealand Clinical Trials Registry (ANZCTR): ACTRN12616001428459 . Registered 13 th October 2016. Registered Retrospectively.

Smartphones in orthopaedics.

PubMed

Al-Hadithy, Nawfal; Gikas, Panagiotis D; Al-Nammari, Shafic Said

2012-08-01

With the introduction of the European Working Time Directive, surgical trainees are facing limited training opportunities and doctors are required to maximise their training opportunities. Smartphone sales have been rapidly increasing over the last five years and can be used as a training tool for the orthopaedic trainee and surgeon. Common uses include applications (AO, eLogbook and PubMed), Ebooks, online Logbooks, Guidelines and surgical techniques. In addition, smartphones can be used to immediately complete work-based assessments, in the absence of computers, hopefully increasing completion rates and reliability. Some journals now provide podcasts and video tutorials which may be accessed on smartphones, which is useful for higher examinations. Smartphones can also be used in the clinical setting to take photographs of wounds. Smartphones are enjoying increased uptake and application in the workplace and we review their use for orthopaedic surgeons and trainees to allow them to make the most out of their training opportunities.

Medical Training Issues and Skill Mix for Exploration Missions

NASA Technical Reports Server (NTRS)

Janney, R. P.; Armstrong, C. W.; Stepaniak, P. C.; Billica, Roger (Technical Monitor)

2000-01-01

The approach for treating in-flight medical events during exploration-class missions must reflect the need for an autonomous crew, and cannot be compared to current space flight therapeutic protocols. An exploration mission exposes the crew to periods of galactic cosmic radiation, isolation, confinement, and microgravity deconditioning far exceeding the low-Earth orbital missions performed to date. In addition, exploration crews will not be able to return to Earth at the onset of a medical event and will need to control the situation in-flight. Medical consultations with Earth-based physicians will be delayed as much as 40 minutes, dictating the need for a highly-trained medical team on board. This presentation will address the mix of crew medical skills and the training required for crew health care providers for missions beyond low-Earth orbit. Both low- and high-risk options for medical skill mix and preflight training will be compared.

Accreditation of residency training in the US.

PubMed Central

Armbruster, J. S.

1996-01-01

In the US, accreditation and certification of residency training are functions of separate public sector agencies. Accrediting decisions are made directly by 26 Residency Review Committees, which represent the primary medical specialties and function under the authority of the Accreditation Council for Graduate Medical Education. The accrediting bodies may consider only educational issues and are prohibited by the government from controlling physician supply. Only the programme, not the institution in which it is conducted, is accredited. The US residency is a structured educational programme that is expected to provide comparable experience to all enrolled residents. Length of training may vary from two to six years depending on the specialty. Additional training may be obtained in subspecialty programmes, which are subsets of the primary specialty residencies and are also reviewed for accreditation. These have increased in significant number in recent years as subspecialisation has proliferated in the US. PMID:8935597

Integrating musculoskeletal sonography into rehabilitation: Therapists’ experiences with training and implementation

PubMed Central

Gray, Julie McLaughlin; Frank, Gelya; Roll, Shawn C.

2018-01-01

Musculoskeletal sonography is rapidly extending beyond radiology; however, best practices for successful integration into new practice contexts are unknown. This study explored non-physician experiences with the processes of training and integration of musculoskeletal sonography into rehabilitation. Qualitative data were captured through multiple sources and iterative thematic analysis was used to describe two occupational therapists’ experiences. The dominant emerging theme was competency, in three domains: technical, procedural and analytical. Additionally, three practice considerations were illuminated: (1) understanding imaging within the dynamics of rehabilitation, (2) navigating nuances of interprofessional care, and (3) implications for post-professional training. Findings indicate that sonography training for rehabilitation providers requires multi-level competency development and consideration of practice complexities. These data lay a foundation on which to explore and develop best practices for incorporating sonographic imaging into the clinic as a means for engaging clients as active participants in the rehabilitation process to improve health and rehabilitation outcomes. PMID:28830315

Assessing lesbian, gay, and bisexual affirmative training in couple and family therapy: establishing the validity of the Faculty Version of the Affirmative Training Inventory.

PubMed

McGeorge, Christi R; Carlson, Thomas S; Toomey, Russell B

2015-01-01

This study established the validity and factor structure of the Faculty Version of the Affirmative Training Inventory (ATI-F), which assesses faculty members' perceptions of the level of lesbian, gay, and bisexual (LGB) affirmative training that occurs in clinical programs. Additionally, this study examined the latent associations among the subscales of the ATI-F and three convergent validity items utilizing a sample of 117 faculty members from accredited family therapy programs. The findings provide empirical support for the relationship between including classroom content on LGB affirmative therapy and faculty members' beliefs about LGB individuals and relationships. Specifically, faculty members who report more positive beliefs about LGB clients appear to be more likely to include LGB affirmative therapy content in the courses they teach. © 2013 American Association for Marriage and Family Therapy.

World Workshop on Oral Medicine VI: an international validation study of clinical competencies for advanced training in oral medicine.

PubMed

Steele, John C; Clark, Hadleigh J; Hong, Catherine H L; Jurge, Sabine; Muthukrishnan, Arvind; Kerr, A Ross; Wray, David; Prescott-Clements, Linda; Felix, David H; Sollecito, Thomas P

2015-08-01

To explore international consensus for the validation of clinical competencies for advanced training in Oral Medicine. An electronic survey of clinical competencies was designed. The survey was sent to and completed by identified international stakeholders during a 10-week period. To be validated, an individual competency had to achieve 90% or greater consensus to keep it in its current format. Stakeholders from 31 countries responded. High consensus agreement was achieved with 93 of 101 (92%) competencies exceeding the benchmark for agreement. Only 8 warranted further attention and were reviewed by a focus group. No additional competencies were suggested. This is the first international validated study of clinical competencies for advanced training in Oral Medicine. These validated clinical competencies could provide a model for countries developing an advanced training curriculum for Oral Medicine and also inform review of existing curricula. Copyright © 2015 Elsevier Inc. All rights reserved.

An observational analysis of surgical team compliance with perioperative safety practices after crew resource management training.

PubMed

France, Daniel J; Leming-Lee, Susie; Jackson, Tom; Feistritzer, Nancye R; Higgins, Michael S

2008-04-01

Acknowledging the need to improve team communication and coordination among health care providers, health care administrators and improvement officers have been quick to endorse and invest in aviation crew resource management (CRM). Despite the increased interest in CRM there exists limited data on the effectiveness of CRM to change team behavior and performance in clinical settings. Direct observational analyses were performed on 30 surgical teams (15 neurosurgery cases and 15 cardiac cases) to evaluate surgical team compliance with integrated safety and CRM practices after extensive CRM training. Observed surgical teams were compliant with only 60% of the CRM and perioperative safety practices emphasized in the training program. The results highlight many of the challenges the health care industry faces in its efforts to adapt CRM from aviation to medicine. Additional research is needed to develop and test new team training methods and performance feedback mechanisms for clinical teams.

Evidence for Narrow Transfer after Short-Term Cognitive Training in Older Adults.

PubMed

Souders, Dustin J; Boot, Walter R; Blocker, Kenneth; Vitale, Thomas; Roque, Nelson A; Charness, Neil

2017-01-01

The degree to which "brain training" can improve general cognition, resulting in improved performance on tasks dissimilar from the trained tasks (transfer of training), is a controversial topic. Here, we tested the degree to which cognitive training, in the form of gamified training activities that have demonstrated some degree of success in the past, might result in broad transfer. Sixty older adults were randomly assigned to a gamified cognitive training intervention or to an active control condition that involved playing word and number puzzle games. Participants were provided with tablet computers and asked to engage in their assigned training for 30 45-min training sessions over the course of 1 month. Although intervention adherence was acceptable, little evidence for transfer was observed except for the performance of one task that most resembled the gamified cognitive training: There was a trend for greater improvement on a version of the corsi block tapping task for the cognitive training group relative to the control group. This task was very similar to one of the training games. Results suggest that participants were learning specific skills and strategies from game training that influenced their performance on a similar task. However, even this near-transfer effect was weak. Although the results were not positive with respect to broad transfer of training, longer duration studies with larger samples and the addition of a retention period are necessary before the benefit of this specific intervention can be ruled out.

34. VIEW OF SUBMARINE ESCAPE TRAINING TANK PRIOR TO ADDITION ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

34. VIEW OF SUBMARINE ESCAPE TRAINING TANK PRIOR TO ADDITION OF BLISTERS IN 1959, LOOKING SOUTHEAST - U.S. Naval Submarine Base, New London Submarine Escape Training Tank, Albacore & Darter Roads, Groton, New London County, CT

Online Training in Mind-Body Therapies: Different Doses, Long-term Outcomes.

PubMed

Kemper, Kathi J; Rao, Nisha; Gascon, Gregg; Mahan, John D

2017-10-01

There is a high rate of burnout among health professionals, driving diverse attempts to promote resilience and well-being to counter this trend. The purpose of this project was to assess the dose-response relationship between the number of hours of online mind-body skills training for health professionals and relevant outcomes a year later. Among 1438 registrants for online training (including up to 12 hours of training on mind-body practices) between December 2013 and November 2015, we analyzed responses from the first 10% who responded to an anonymous online survey between December 1, 2015 and February 1, 2016. Questions included the type and frequency of mind-body practice in the past 30 days and whether the online training had any impact on personal life or professional practice. Standardized measures were used to assess stress, mindfulness, confidence in providing compassionate care, and burnout. The 149 respondents represented a variety of ages and health professions; 55% completed one or more mind-body training modules an average of 14 months previously. Most (78%) engaged in one or more mind-body practices in the 30 days before the survey; 79% reported changes in self-care and 71% reported changes in the care of others as a result of participating. Increasing number of hours of training were significantly associated with practicing mind-body skills more frequently; increasing practice frequency was associated with less stress and burnout, which were associated with missing less work. Greater practice frequency was also associated with improvements in stress, mindfulness, and resilience, which were associated with increased confidence in providing compassionate care. Online training in mind-body therapies is associated with changes in self-reported behavior one year later; increasing doses of training are associated with more frequent practice which is associated with less stress, burnout, and missing work, and higher levels of mindfulness, resilience, and confidence in providing compassionate care. Additional studies are needed to compare mind-body skills training with other interventions designed to improve resilience and compassion while decreasing burnout in health professionals.

Is task-shifting a solution to the health workers' shortage in Northern Ghana?

PubMed

Okyere, Eunice; Mwanri, Lillian; Ward, Paul

2017-01-01

To explore the experiences and perceptions of health workers and implementers of task-shifting in rural health facilities in Upper East Region, Ghana. Data was collected through field interviews. A total of sixty eight (68) in-depth interviews were conducted with health workers' in primary health care facilities (health centres); Four in-depth interviews with key persons involved in staff management was conducted to understand how task-shifting is organised including its strengths and challenges. The health workers interview guide was designed with the aim of getting data on official tasks of health workers, additional tasks assigned to them, how they perceive these tasks, and the challenges associated with the practice of task-shifting. Task-shifting is a practice being used across the health facilities in the study area to help reduce the impact of insufficient health workers. Generally, health workers had a comprehensive training that supported the organisation of task-shifting. However, staff members' are sometimes engaged in tasks above their level of training and beyond their actual job descriptions. Adequate training is usually not provided before additional tasks are assigned to staff members. Whilst some health workers perceived the additional tasks they performed as an opportunity to learn new skills, others described these as stressful and overburdening. Task-shifting has the potential to contribute to addressing the insufficient health workforce, and thereby improving health delivery system where the procedures are well defined and staff members work in a coordinated and organised manner. The provision of adequate training and supervision for health workers is important in order to improve their expertise before additional tasks are assigned to them so that the quality of care would not be compromised.

Is task-shifting a solution to the health workers’ shortage in Northern Ghana?

PubMed Central

Okyere, Eunice; Mwanri, Lillian; Ward, Paul

2017-01-01

Objective To explore the experiences and perceptions of health workers and implementers of task-shifting in rural health facilities in Upper East Region, Ghana. Methods Data was collected through field interviews. A total of sixty eight (68) in-depth interviews were conducted with health workers’ in primary health care facilities (health centres); Four in-depth interviews with key persons involved in staff management was conducted to understand how task-shifting is organised including its strengths and challenges. The health workers interview guide was designed with the aim of getting data on official tasks of health workers, additional tasks assigned to them, how they perceive these tasks, and the challenges associated with the practice of task-shifting. Findings Task-shifting is a practice being used across the health facilities in the study area to help reduce the impact of insufficient health workers. Generally, health workers had a comprehensive training that supported the organisation of task-shifting. However, staff members’ are sometimes engaged in tasks above their level of training and beyond their actual job descriptions. Adequate training is usually not provided before additional tasks are assigned to staff members. Whilst some health workers perceived the additional tasks they performed as an opportunity to learn new skills, others described these as stressful and overburdening. Conclusion Task-shifting has the potential to contribute to addressing the insufficient health workforce, and thereby improving health delivery system where the procedures are well defined and staff members work in a coordinated and organised manner. The provision of adequate training and supervision for health workers is important in order to improve their expertise before additional tasks are assigned to them so that the quality of care would not be compromised. PMID:28358841

Improving the well-being of nursing leaders through healing touch training.

PubMed

Tang, Rong; Tegeler, Charles; Larrimore, Deborah; Cowgill, Sally; Kemper, Kathi J

2010-08-01

Chronic stress adversely affects performance. We evaluated the effect of Healing Touch training on subjective and objective measures of stress in nursing leaders in an academic health center. In this quasi-experimental single group pretest-post-test study, we recruited nursing leaders at an academic health center and provided 17.5 hours of Healing Touch training over 2 days. We measured subjective measures of stress using visual analog scales as well as heart rate variability 1-2 weeks before and 4 weeks after the training. Target enrollment was exceeded within 2 weeks; all participants were women and the mean age was 47 years. Of the 26 enrollees, 24 completed training, and 20 (77%) completed all pre- and post-training measures. There was significant improvement in self-reported stress, depression, anxiety, relaxation, well-being, and sleep. Heart rate variability changes were also significant for total power, high- and low-frequency power, and coherence, suggesting improved autonomic function consistent with greater well-being. Training nurse leaders in an academic health center in Healing Touch is associated with significant improvements in subjective and objective measures of stress. Additional studies are needed to compare the impact of this training versus stress management training on the nurses themselves and on the quality of care.

Strength training for children and adolescents.

PubMed

Faigenbaum, A D

2000-10-01

The potential benefits of youth strength training extend beyond an increase in muscular strength and may include favorable changes in selected health- and fitness-related measures. If appropriate training guidelines are followed, regular participation in a youth strength-training program has the potential to increase bone mineral density, improve motor performance skills, enhance sports performance, and better prepare our young athletes for the demands of practice and competition. Despite earlier concerns regarding the safety and efficacy of youth strength training, current public health objectives now aim to increase the number of boys and girls age 6 and older who regularly participate in physical activities that enhance and maintain muscular fitness. Parents, teachers, coaches, and healthcare providers should realize that youth strength training is a specialized method of conditioning that can offer enormous benefit but at the same time can result in serious injury if established guidelines are not followed. With qualified instruction, competent supervision, and an appropriate progression of the volume and intensity of training, children and adolescents cannot only learn advanced strength training exercises but can feel good about their performances, and have fun. Additional clinical trails involving children and adolescents are needed to further explore the acute and chronic effects of strength training on a variety of anatomical, physiological, and psychological parameters.

Wireless just-in-time training of mobile skilled support personnel

NASA Astrophysics Data System (ADS)

Bandera, Cesar; Marsico, Michael; Rosen, Mitchel; Schlegel, Barry

2006-05-01

Skilled Support Personnel (SSP) serve emergency response organizations during an emergency incident, and include laborers, operating engineers, carpenters, ironworkers, sanitation workers and utility workers. SSP called to an emergency incident rarely have recent detailed training on the chemical, biological, radiological, nuclear and/or explosives (CBRNE) agents or the personal protection equipment (PPE) relevant to the incident. This increases personal risk to the SSP and mission risk at the incident site. Training for SSP has been identified as a critical need by the National Institute for Environmental Health Sciences, Worker Education and Training Program. We present a system being developed to address this SSP training shortfall by exploiting a new training paradigm called just-in-time training (JITT) made possible by advances in distance learning and cellular telephony. In addition to the current conventional training at regularly scheduled instructional events, SSP called to an emergency incident will have secure access to short (<5 minutes) training modules specific to the incident and derived from the Occupational Safety and Health Administration (OSHA) Disaster Site Worker Course. To increase retention, each learning module incorporates audio, video, interactive simulations, graphics, animation, and assessment designed for the user interface of most current cell phones. Engineering challenges include compatibility with current cell phone technologies and wireless service providers, integration with the incident management system, and SCORM compliance.

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.

Veterans Health Administration's Disaster Emergency Medical Personnel System (DEMPS) Training Evaluation: Potential Implications for Disaster Health Care Volunteers.

PubMed

Schmitz, Susan; Radcliff, Tiffany A; Chu, Karen; Smith, Robert E; Dobalian, Aram

2018-02-20

The US Veterans Health Administration's Disaster Emergency Medical Personnel System (DEMPS) is a team of employee disaster response volunteers who provide clinical and non-clinical staffing assistance when local systems are overwhelmed. This study evaluated attitudes and recommendations of the DEMPS program to understand the impact of multi-modal training on volunteer perceptions. DEMPS volunteers completed an electronic survey in 2012 (n=2120). Three training modes were evaluated: online, field exercise, and face-to-face. Measures included: "Training Satisfaction," "Attitudes about Training," "Continued Engagement in DEMPS." Data were analyzed using χ2 and logistic regression. Open-ended questions were evaluated in a manner consistent with grounded theory methodology. Most respondents participated in DEMPS training (80%). Volunteers with multi-modal training who completed all 3 modes (14%) were significantly more likely to have positive attitudes about training, plan to continue as volunteers, and would recommend DEMPS to others (P-value<0.001). Some respondents requested additional interactive activities and suggested increased availability of training may improve volunteer engagement. A blended learning environment using multi-modal training methods, could enhance satisfaction and attitudes and possibly encourage continued engagement in DEMPS or similar programs. DEMPS training program modifications in 2015 expanded this blended learning approach through new interactive online learning opportunities. (Disaster Med Public Health Preparedness. 2018; page 1 of 8).

Advanced Software Development Workstation Project, phase 3

NASA Technical Reports Server (NTRS)

1991-01-01

ACCESS provides a generic capability to develop software information system applications which are explicitly intended to facilitate software reuse. In addition, it provides the capability to retrofit existing large applications with a user friendly front end for preparation of input streams in a way that will reduce required training time, improve the productivity even of experienced users, and increase accuracy. Current and past work shows that ACCESS will be scalable to much larger object bases.

A worldview of the professional experiences and training needs of pediatric psycho-oncologists

PubMed Central

Oppenheim, Daniel; Breyer, Joanna; Battles, Haven; Zadeh, Sima; Patenaude, Andrea Farkas

2012-01-01

BACKGROUND Thirty years after the origin of the field of psycho-oncology, limited data exist about the work practices of professionals providing psychosocial care to children with cancer and their families. METHOD A survey was designed to assess training, work environment, theoretical orientation, services provided, sub-specialty areas or areas of special interest, satisfactions, challenges and continuing education needs of pediatric psycho-oncologists. Members of national and international psycho-oncology organizations were invited to participate in the web-based survey. RESULTS 786 professionals from 63 countries responded. The sample consisted mostly of psychologists (41%), physicians (20%), and social workers (14%). Approximately half of the participants worked in a designated psycho-oncology unit. Psychologists and social workers provided the majority of psychosocial services. Individual sessions with parents were most common (42%), followed by sessions with children (41%), survivors (36%), families (31%) and siblings (25%). Therapies provided include CBT (50%), relaxation (43%), psychodynamic psychotherapy (27%), play therapy (26%), and imagery (23%). Two-thirds report having appropriate supervision; 37% conduct research; only half feel their salary is appropriate. Differences in therapeutic modalities were found by country. Clinicians desire training on clinical interventions, improving communication with medical staff, research and ethics. CONCLUSIONS An international cohort of clinicians providing pediatric psycho-oncology services perform a wide variety of tasks, use a range of therapeutic approaches and report considerable work satisfaction. Problem areas include professional inter-relations, inadequate supervision and needs for additional, specialized training. Opportunity exists for global collaboration in pediatric psycho-oncology research and practices to enhance clinical effectiveness and reduce professional isolation. PMID:22461180

Qualitative exploration of the views of healthy living champions from pharmacies in England.

PubMed

Rutter, Paul; Vryaparj, Gursharan

2015-02-01

In England, the 'Healthy Living Pharmacy (HLP)' initiative has been trialed; positive outcomes led to national roll-out across England to 20 pathfinder sites. A HLP provides health promotion/prevention services through a structured framework to meet local population need. Non-pharmacist staff receive additional training so that they can provide these services, and are known as Healthy Living Champions (HLCs). To explore HLCs views on their role and to identify any barriers or facilitators in performing the role. Fourteen semi-structured face-to-face interviews were conducted during February and March 2013 in NHS Dudley, and analysed using the principles of content analysis. Three themes emerged from the interviews; HLC job role; training; and public awareness. HLC staff showed high levels of motivation, a strong desire to help people and felt a sense of personal reward, resulting in increased levels of job satisfaction. Training had improved their confidence but they still had reservations in offering services such as alcohol intervention and weight management. All believed that public awareness was low despite advertising. HLCs were positive toward their new role and derived job satisfaction from helping people to improve their health, although on-going training and support was perceived as important.

Evidence on Private Sector Training. Background Paper No. 7b.

ERIC Educational Resources Information Center

Mangum, Stephen L.

Today's postindustrial or information age requires a different mix and a more advanced level of basic employability skills than those needed in the industrial age. As a result, the workplace is now demanding a higher entrance level of employability skills than the schools have previously been asked to provide. In addition, information technology…

Effects of cosmic rays on single event upsets

NASA Technical Reports Server (NTRS)

Lowe, Calvin W.; Oladipupo, Adebisi O.; Venable, Demetrius D.

1988-01-01

The efforts at establishing a research program in space radiation effects are discussed. The research program has served as the basis for training several graduate students in an area of research that is of importance to NASA. In addition, technical support was provided for the Single Event Facility Group at Brookhaven National Laboratory.

Grover Cleveland High School Project CAUSA 1984-1985. OEE Evaluation Report.

ERIC Educational Resources Information Center

New York City Board of Education, Brooklyn. Office of Educational Assessment.

This program, Project CAUSA, provided instruction in English as a second language (ESL), native language arts, and content-area courses, in addition to a career and vocational training program focused on office and computer skills, to a selected group of 141 Hispanic and Italian immigrant students of limited English proficiency (LEP). Students…

The Use of Information Based Evaluation in Evaluating the Diagnostic Teaching Center.

ERIC Educational Resources Information Center

Poteet, James A.

Information Based Evaluation (IBE) is identified as a design procedure for assessing a variety of projects, programs, and educational changes. IBE was used to evaluate a Comprehensive Diagnostic Teaching Center (DTC) which, in addition to providing teacher training and services to handicapped pupils, would bring together and focus all of the…

Who Cares for Kids? A Report on Child Care Providers.

ERIC Educational Resources Information Center

Benson, Carolyn

This study offers a profile of child care workers in family day care homes and child care centers, reporting general statistics and examining their wages, benefits, training, working conditions, and turnover rates. In addition, it looks at government regulation and licensing, employer-sponsored programs, child abuse, insurance rates, and federal…

Engineering, Scientific, and Related Occupations. Occupational Outlook Handbook Reprints. Bulletin 2450-3.

ERIC Educational Resources Information Center

Bureau of Labor Statistics, Washington, DC.

This document provides a description of engineering, scientific, and related occupations. Descriptions may include: (1) information on the nature of the work; (2) training required; (3) earnings; (4) job prospects, and (5) sources of additional information. Among the occupations described, the following job titles are included: Engineering,…