10 CFR 1046.16 - Training certification.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 10 Energy 4 2010-01-01 2010-01-01 false Training certification. 1046.16 Section 1046.16 Energy... Personnel § 1046.16 Training certification. DOE contractors shall employ as protective force personnel only individuals who have successfully completed all applicable training and qualification standards set forth in...

10 CFR 1046.16 - Training certification.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 10 Energy 4 2011-01-01 2011-01-01 false Training certification. 1046.16 Section 1046.16 Energy... Personnel § 1046.16 Training certification. DOE contractors shall employ as protective force personnel only individuals who have successfully completed all applicable training and qualification standards set forth in...

42 CFR 73.15 - Training.

Code of Federal Regulations, 2010 CFR

2010-10-01

... provide information and training on biosafety and security to each individual with access approval from... entity must provide information and training on biosafety and security to each individual not approved... provided under the OSHA Bloodborne Pathogen Standard set forth at 29 CFR 1910.1030. (b) Refresher training...

32 CFR 813.3 - Responsibilities.

Code of Federal Regulations, 2011 CFR

2011-07-01

..., bomb damage assessment, collateral intelligence, training, historical, public affairs, and other needs. (3) Sets combat training standards and develops programs for all Air Force COMCAM personnel (includes both formal classroom and field readiness training). (4) Coordinates and meets COMCAM needs in war...

Approximate Dynamic Programming and Aerial Refueling

DTIC Science & Technology

2007-06-01

by two Army Air Corps de Havilland DH -4Bs (9). While crude by modern standards, the passing of hoses be- tween planes is effectively the same approach...incorporating stochastic data sets. . . . . . . . . . . 106 55 Total Cost Stochastically Trained Simulations versus Deterministically Trained Simulations...incorporating stochastic data sets. 106 To create meaningful results when testing stochastic data, the data sets are av- eraged so that conclusions are not

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 9: Tool and Die, 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 document is intended to help education and training institutions deliver the Machine Tool Advanced Skills Technology (MAST) curriculum to a variety of individuals and organizations. MAST consists of industry-specific skill standards and model curricula for 15 occupational specialty areas within the U.S. machine tool and metals-related…

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 8: Sheet Metal & Composites, 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 document is intended to help education and training institutions deliver the Machine Tool Advanced Skills Technology (MAST) curriculum to a variety of individuals and organizations. MAST consists of industry-specific skill standards and model curricula for 15 occupational specialty areas within the U.S. machine tool and metals-related…

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 4: Manufacturing Engineering Technology, 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 document is intended to help education and training institutions deliver the Machine Tool Advanced Skills Technology (MAST) curriculum to a variety of individuals and organizations. MAST consists of industry-specific skill standards and model curricula for 15 occupational specialty areas within the U.S. machine tool and metals-related…

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 14: Automated Equipment Technician (CIM), 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 document is intended to help education and training institutions deliver the Machine Tool Advanced Skills Technology (MAST) curriculum to a variety of individuals and organizations. MAST consists of industry-specific skill standards and model curricula for 15 occupational specialty areas within the U.S. machine tool and metals-related…

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 10: Computer-Aided Drafting & Design, 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 document is intended to help education and training institutions deliver the Machine Tool Advanced Skills Technology (MAST) curriculum to a variety of individuals and organizations. MAST consists of industry-specific skill standards and model curricula for 15 occupational specialty areas within the U.S. machine tool and metals-related…

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 11: Computer-Aided Manufacturing & Advanced CNC, 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 document is intended to help education and training institutions deliver the Machine Tool Advanced Skills Technology (MAST) curriculum to a variety of individuals and organizations. MAST consists of industry-specific skill standards and model curricula for 15 occupational specialty areas within the U.S. machine tool and metals-related…

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 2: Career Development, General Education and Remediation, 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 document is intended to help education and training institutions deliver the Machine Tool Advanced Skills Technology (MAST) curriculum to a variety of individuals and organizations. MAST consists of industry-specific skill standards and model curricula for 15 occupational specialty areas within the U.S. machine tool and metals-related…

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 7: Industrial Maintenance Technology, 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 document is intended to help education and training institutions deliver the Machine Tool Advanced Skills Technology (MAST) curriculum to a variety of individuals and organizations. MAST consists of industry-specific skill standards and model curricula for 15 occupational specialty areas within the U.S. machine tool and metals-related…

20 CFR 619.4 - Data exchange standardization for the UI Benefits and Tax Systems.

Code of Federal Regulations, 2014 CFR

2014-04-01

... Benefits and Tax Systems. 619.4 Section 619.4 Employees' Benefits EMPLOYMENT AND TRAINING ADMINISTRATION... § 619.4 Data exchange standardization for the UI Benefits and Tax Systems. (a) XML is the data exchange standard for the real time ICON applications set out in § 619.2 and for the SIDES exchanges set out in...

Ethics and Accreditation in Addictions Counselor Training: Possible Field Placement Issues for CACREP-Accredited Addictions Counseling Programs

ERIC Educational Resources Information Center

Linton, Jeremy M.

2012-01-01

Professional counselors have long been practicing in alcohol and drug treatment settings. However, only recently has the counseling field offered formal recognition of addictions counseling as a specialization through the implementation of accreditation standards for addiction counseling training programs. With the passage of the 2009 standards,…

Use of WONCA global standards to evaluate family medicine postgraduate education for curriculum development and review in Nepal and Myanmar.

PubMed

Gibson, Christine; Ladak, Farah; Shrestha, Ashis; Yadav, Bharat; Thu, Kyaw; Aye, Tin

2016-09-01

Family medicine is an integral part of primary care within health systems. Globally, training programmes exhibit a great degree of variability in content and skill acquisition. While this may in part reflect the needs of a given setting, there exists standard criteria that all family medicine programmes should consider core activities. WONCA has provided an open-access list of standards that their expert community considers essential for family medicine (GP) post-graduate training. Evaluation of developing or existing training programmes using these standards can provide insight into the degree of variability, gaps within programmes and equally as important, gaps within recommendations. In collaboration with the host institution, two family medicine programmes in Nepal and Myanmar were evaluated based on WONCA global standards. The results of the evaluation demonstrated that such a process can allow for critical review of curriculum in various stages of development and evaluation. The implications of reviewing training programmes according to WONCA standards can lead to enhanced training world-wide and standardisation of training for post-graduate family medicine.

Sample Selection for Training Cascade Detectors.

PubMed

Vállez, Noelia; Deniz, Oscar; Bueno, Gloria

2015-01-01

Automatic detection systems usually require large and representative training datasets in order to obtain good detection and false positive rates. Training datasets are such that the positive set has few samples and/or the negative set should represent anything except the object of interest. In this respect, the negative set typically contains orders of magnitude more images than the positive set. However, imbalanced training databases lead to biased classifiers. In this paper, we focus our attention on a negative sample selection method to properly balance the training data for cascade detectors. The method is based on the selection of the most informative false positive samples generated in one stage to feed the next stage. The results show that the proposed cascade detector with sample selection obtains on average better partial AUC and smaller standard deviation than the other compared cascade detectors.

Emergency department-based interventions for women suffering domestic abuse: a critical literature review.

PubMed

Ansari, Sereena; Boyle, Adrian

2017-02-01

Domestic abuse represents a serious public health and human rights concern. Interventions to reduce the risk of abuse include staff training and standardized documentation improving detection and adherence to referral pathways. Interventional studies have been conducted in primary care, maternity and outpatient settings. Women disclosing abuse in emergency departments differ from women attending other healthcare settings, and it is unclear whether these interventions can be transferred to the emergency care setting. This review examines interventional studies to evaluate the effectiveness of emergency department-based interventions in reducing domestic abuse-related morbidity. Medline, EMBASE, CINAHL, PsycINFO and Cochrane Library were searched, according to prespecified selection criteria. Study quality was assessed using the Jadad scale. Of 273 search results, nine were eligible for review. Interventions involving staff training demonstrated benefits in subjective measures, such as staff knowledge regarding abuse, but no changes in clinical practice, based on detection and referral rates. When staff training was implemented in conjunction with supporting system changes - for example, standardized documentation for assessment and referral - clinically relevant improvements were noted. Interventions centred around staff training are insufficient to bring about improvements in the management and, thus, outcome of patients suffering abuse. Instead, system changes, such as standardized documentation and referral pathways, supported by training, may bring about beneficial changes. It remains uncertain whether surrogate outcomes employed by most studies translate to changes in abuse-related morbidity: the ultimate goal.

Pilot Evaluation of a Communication Skills Training Program for Psychiatry Residents Using Standardized Patient Assessment.

PubMed

Ditton-Phare, Philippa; Sandhu, Harsimrat; Kelly, Brian; Kissane, David; Loughland, Carmel

2016-10-01

Mental health clinicians can experience difficulties communicating diagnostic information to patients and their families/carers, especially about distressing psychiatric disorders such as schizophrenia. There is evidence for the effectiveness of communication skills training (CST) for improving diagnostic discussions, particularly in specialties such as oncology, but only limited evidence exists about CST for psychiatry. This study evaluated a CST program specifically developed for psychiatry residents called ComPsych that focuses on conveying diagnostic and prognostic information about schizophrenia. The ComPsych program consists of an introductory lecture, module booklets for trainees, and exemplary skills videos, followed by small group role-plays with simulated patients (SPs) led by a trained facilitator. A standardized patient assessment (SPA) was digitally recorded pre- and post-training with a SP using a standardized scenario in a time-limited (15 min) period. Recorded SPAs were independently rated using a validated coding system (ComSkil) to identify frequency of skills used in five skills categories (agenda setting, checking, questioning, information organization, and empathic communication). Thirty trainees (15 males and 15 females; median age = 32) undertaking their vocational specialty training in psychiatry participated in ComPsych training and pre- and post-ComPsych SPAs. Skills increased post-training for agenda setting (d = -0.82), while questioning skills (d = 0.56) decreased. There were no significant differences in any other skills grouping, although checking, information organization, and empathic communication skills tended to increase post-training. A dose effect was observed for agenda setting, with trainees who attended more CST sessions outperforming those attending fewer. Findings support the generalization and translation of ComPsych CST to psychiatry.

Minimum training criteria for police traffic accident reconstruction.

DOT National Transportation Integrated Search

1987-03-01

This report summarizes the development of a set of minimum training criteria for police accident reconstructionists. Prior to this effort, no nationally accepted standards or criteria were recognized for evaluating the qualifications of police engage...

The LET Procedure for Prosthetic Myocontrol: Towards Multi-DOF Control Using Single-DOF Activations.

PubMed

Nowak, Markus; Castellini, Claudio

2016-01-01

Simultaneous and proportional myocontrol of dexterous hand prostheses is to a large extent still an open problem. With the advent of commercially and clinically available multi-fingered hand prostheses there are now more independent degrees of freedom (DOFs) in prostheses than can be effectively controlled using surface electromyography (sEMG), the current standard human-machine interface for hand amputees. In particular, it is uncertain, whether several DOFs can be controlled simultaneously and proportionally by exclusively calibrating the intended activation of single DOFs. The problem is currently solved by training on all required combinations. However, as the number of available DOFs grows, this approach becomes overly long and poses a high cognitive burden on the subject. In this paper we present a novel approach to overcome this problem. Multi-DOF activations are artificially modelled from single-DOF ones using a simple linear combination of sEMG signals, which are then added to the training set. This procedure, which we named LET (Linearly Enhanced Training), provides an augmented data set to any machine-learning-based intent detection system. In two experiments involving intact subjects, one offline and one online, we trained a standard machine learning approach using the full data set containing single- and multi-DOF activations as well as using the LET-augmented data set in order to evaluate the performance of the LET procedure. The results indicate that the machine trained on the latter data set obtains worse results in the offline experiment compared to the full data set. However, the online implementation enables the user to perform multi-DOF tasks with almost the same precision as single-DOF tasks without the need of explicitly training multi-DOF activations. Moreover, the parameters involved in the system are statistically uniform across subjects.

National Crime Information Center Mandatory Minimum Standards Curriculum for Full Access Terminal Operators. Volume Two--NCIC "Hot" Files.

ERIC Educational Resources Information Center

Federal Bureau of Investigation, Washington, DC. National Crime Information Center.

This document is the second volume of a two-volume set of lesson plans that together make up a complete training package for full-service terminal operators. The lesson plans are designed to ensure that a state's National Crime Information Center (NCIC) training program meets Advisory Policy Board standards. (NCIC is a nationwide computerized…

Permissible Inferences from the Outcome of Training Studies in Cognitive Development Research. Technical Report No. 127.

ERIC Educational Resources Information Center

Brown, Ann L.; Campione, Joseph C.

In modal training studies, the comparative groups differ in the use of a particular cognitive process; training to overcome the deficiency is provided for the deficient group only, and their performance is then compared to the standard set by the untrained group. Improvements are necessary in the design of training studies, as are a…

Strategically Leapfrogging Education in Prehospital Trauma Management: Four-Tiered Training Protocols

PubMed Central

Abraham, Rohit; Vyas, Dinesh; Narayan, Mayur; Vyas, Arpita

2016-01-01

Trauma-related injury in fast developing countries are linked to 90% of international mortality rates, which can be greatly reduced by improvements in often non-existent or non-centralized emergency medical systems (EMS)—particularly in the pre-hospital care phase. Traditional trauma training protocols—such as Advanced Trauma Life Support (ATLS), International Trauma Life Support (ITLS), and Basic Life Support (BLS)—have failed to produce an effective pre-hospital ground force of medical first responders. To overcome these barriers, we propose a new four-tiered set of trauma training protocols: Massive Open Online Course (MOOC) Trauma Training, Acute Trauma Training (ATT), Broad Trauma Training (BTT), and Cardiac and Trauma Training (CTT). These standards are specifically differentiated to accommodate the educational and socioeconomic diversity found in fast developing settings, where each free course is taught in native, lay language while ensuring the education standards are maintained by fully incorporating high-fidelity simulation, video-recorded debriefing, and retraining. The innovative pedagogy of this trauma education program utilizes MOOC for global scalability and a “train-the-trainer” approach for exponential growth—both components help fast developing countries reach a critical mass of first responders needed for the base of an evolving EMS. PMID:27419222

Strategically Leapfrogging Education in Prehospital Trauma Management: Four-Tiered Training Protocols.

PubMed

Abraham, Rohit; Vyas, Dinesh; Narayan, Mayur; Vyas, Arpita

2015-12-01

Trauma-related injury in fast developing countries are linked to 90% of international mortality rates, which can be greatly reduced by improvements in often non-existent or non-centralized emergency medical systems (EMS)-particularly in the pre-hospital care phase. Traditional trauma training protocols-such as Advanced Trauma Life Support (ATLS), International Trauma Life Support (ITLS), and Basic Life Support (BLS)-have failed to produce an effective pre-hospital ground force of medical first responders. To overcome these barriers, we propose a new four-tiered set of trauma training protocols: Massive Open Online Course (MOOC) Trauma Training, Acute Trauma Training (ATT), Broad Trauma Training (BTT), and Cardiac and Trauma Training (CTT). These standards are specifically differentiated to accommodate the educational and socioeconomic diversity found in fast developing settings, where each free course is taught in native, lay language while ensuring the education standards are maintained by fully incorporating high-fidelity simulation, video-recorded debriefing, and retraining. The innovative pedagogy of this trauma education program utilizes MOOC for global scalability and a "train-the-trainer" approach for exponential growth-both components help fast developing countries reach a critical mass of first responders needed for the base of an evolving EMS.

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 1: Executive Summary, of a 15-Volume Set of Skills Standards and Curriculum Training Materials for the Precision Manufacturing Industry.

ERIC Educational Resources Information Center

Texas State Technical Coll., Waco.

The Machine Tool Advanced Skills Technology (MAST) consortium was formed to address the shortage of skilled workers for the machine tools and metals-related industries. Featuring six of the nation's leading advanced technology centers, the MAST consortium developed, tested, and disseminated industry-specific skill standards and model curricula for…

Principles to Consider in Defining New Directions in Internal Medicine Training and Certification

PubMed Central

Turner, Barbara J; Centor, Robert M; Rosenthal, Gary E

2006-01-01

SGIM endoreses seven principles related to current thinking about internal medicine training: 1) internal medicine requires a full three years of residency training before subspecialization; 2) internal medicine residency programs must dramatically increase support for training in the ambulatory setting and offer equivalent opportunities for training in both inpatient and outpatient medicine; 3) in settings where adequate support and time are devoted to ambulatory training, the third year of residency could offer an opportunity to develop further expertise or mastery in a specific type or setting of care; 4) further certification in specific specialties within internal medicine requires the completion of an approved fellowship program; 5) areas of mastery in internal medicine can be demonstrated through modified board certification and recertification examinations; 6) certification processes throughout internal medicine should focus increasingly on demonstration of clinical competence through adherence to validated standards of care within and across practice settings; and 7) regardless of the setting in which General Internists practice, we should unite to promote the critical role that this specialty serves in patient care. PMID:16637826

Factors Affecting Success of Training Companies

ERIC Educational Resources Information Center

Rogala, Piotr; Batko, Roman; Wawak, Slawomir

2017-01-01

This study aims to identify the key factors which influence the functioning quality and success of training companies. Based on an analysis of the requirements included in the quality management system standards for providers of education and training services, a set of twenty factors has been developed. This was followed by a survey for…

STACCATO: a novel solution to supernova photometric classification with biased training sets

NASA Astrophysics Data System (ADS)

Revsbech, E. A.; Trotta, R.; van Dyk, D. A.

2018-01-01

We present a new solution to the problem of classifying Type Ia supernovae from their light curves alone given a spectroscopically confirmed but biased training set, circumventing the need to obtain an observationally expensive unbiased training set. We use Gaussian processes (GPs) to model the supernovae's (SN's) light curves, and demonstrate that the choice of covariance function has only a small influence on the GPs ability to accurately classify SNe. We extend and improve the approach of Richards et al. - a diffusion map combined with a random forest classifier - to deal specifically with the case of biased training sets. We propose a novel method called Synthetically Augmented Light Curve Classification (STACCATO) that synthetically augments a biased training set by generating additional training data from the fitted GPs. Key to the success of the method is the partitioning of the observations into subgroups based on their propensity score of being included in the training set. Using simulated light curve data, we show that STACCATO increases performance, as measured by the area under the Receiver Operating Characteristic curve (AUC), from 0.93 to 0.96, close to the AUC of 0.977 obtained using the 'gold standard' of an unbiased training set and significantly improving on the previous best result of 0.88. STACCATO also increases the true positive rate for SNIa classification by up to a factor of 50 for high-redshift/low-brightness SNe.

32 CFR 2001.70 - General.

Code of Federal Regulations, 2010 CFR

2010-07-01

... ARCHIVES AND RECORDS ADMINISTRATION CLASSIFIED NATIONAL SECURITY INFORMATION Security Education and Training § 2001.70 General. (a) Purpose. This subpart sets standards for agency security education and... uniformity in the conduct of agency security education and training programs; and (3) Reduce instances of...

Helicopter simulator standards

NASA Technical Reports Server (NTRS)

Boothe, Edward M.

1992-01-01

The initial advisory circular was produced in 1984 (AC 120-XX). It was not finalized, however, because the FAR's for pilot certification did not recognize helicopter simulators and, therefore, permitted no credit for their use. That is being rectified, and, when the new rules are published, standards must be available for qualifying simulators. Because of the lack of a data base to support specification of these standards, the FAA must rely on the knowledge of experts in the simulator/training industry. A major aim of this workshop is to form a working group of these experts to produce a set of standards for helicopter training simulators.

Training a whole-book LSTM-based recognizer with an optimal training set

NASA Astrophysics Data System (ADS)

Soheili, Mohammad Reza; Yousefi, Mohammad Reza; Kabir, Ehsanollah; Stricker, Didier

2018-04-01

Despite the recent progress in OCR technologies, whole-book recognition, is still a challenging task, in particular in case of old and historical books, that the unknown font faces or low quality of paper and print contributes to the challenge. Therefore, pre-trained recognizers and generic methods do not usually perform up to required standards, and usually the performance degrades for larger scale recognition tasks, such as of a book. Such reportedly low error-rate methods turn out to require a great deal of manual correction. Generally, such methodologies do not make effective use of concepts such redundancy in whole-book recognition. In this work, we propose to train Long Short Term Memory (LSTM) networks on a minimal training set obtained from the book to be recognized. We show that clustering all the sub-words in the book, and using the sub-word cluster centers as the training set for the LSTM network, we can train models that outperform any identical network that is trained with randomly selected pages of the book. In our experiments, we also show that although the sub-word cluster centers are equivalent to about 8 pages of text for a 101- page book, a LSTM network trained on such a set performs competitively compared to an identical network that is trained on a set of 60 randomly selected pages of the book.

Classroom versus Computer-Based CPR Training: A Comparison of the Effectiveness of Two Instructional Methods

ERIC Educational Resources Information Center

Rehberg, Robb S.; Gazzillo Diaz, Linda; Middlemas, David A.

2009-01-01

Objective: The objective of this study was to determine whether computer-based CPR training is comparable to traditional classroom training. Design and Setting: This study was quantitative in design. Data was gathered from a standardized examination and skill performance evaluation which yielded numerical scores. Subjects: The subjects were 64…

Restructuring an undergraduate dental curriculum to global standards--a case study in an Indian dental school.

PubMed

Kadagad, P; Tekian, A; Pinto, P X; Jirge, V L

2012-05-01

Globalisation has affected all aspects of life and dentistry is no exception. In the context of today's dentist being a global citizen, undergraduate training in dentistry is set to ensure converging standards so that international recognition of dental qualifications can move forward. The decision of the Dental Council of India to expand the undergraduate dental program to five years provides an opportunity to be part of the endeavor of the Global Dental Congress to achieve converging standards which was initially for the European Union, and now spreading out globally. Economic emergence in Indian subcontinent has resulted in growing oral health care needs both in quality and quantity. To address this issue, the graduating dentist needs to be trained following a competency based curricular model. Access to Internet facilitated the goal of achieving converging standards of dental schools to be feasible because of the instant communication and capacity to share information about training strategies via technology across the globe. Upgrading the undergraduate training to global standards by dental schools in India could be a wise and strategic move both for attracting students to study in India, as well as retaining the graduates after their training. The following is a case study of an Indian dental school set to restructure the undergraduate curriculum to global standards using the 8 steps of Kotter's transformational change. Change in curriculum and the subsequent accreditation of the school in global platform not only attracts prospective students but also results in producing competent dentists. Dental education provided by the institution can result in quality assurance, benchmarking the assessment system to achieve international recognition. This paper highlights the need and importance of facilitation of international convergence with long term aspirations for mutual recognition of international degrees. © 2011 John Wiley & Sons A/S.

Academic requirements for Certificate of Completion of Training in surgical training: Consensus recommendations from the Association of Surgeons in Training/National Research Collaborative Consensus Group.

PubMed

Lee, Mathew J; Bhangu, A; Blencowe, Natalie S; Nepogodiev, D; Gokani, Vimal J; Harries, Rhiannon L; Akinfala, M; Ali, O; Allum, W; Bosanquet, D C; Boyce, K; Bradburn, M; Chapman, S J; Christopher, E; Coulter, I; Dean, B J F; Dickfos, M; El Boghdady, M; Elmasry, M; Fleming, S; Glasbey, J; Healy, C; Kasivisvanathan, V; Khan, K S; Kolias, A G; Lee, S M; Morton, D; O'Beirne, J; Sinclair, P; Sutton, P A

2016-11-01

Surgical trainees are expected to demonstrate academic achievement in order to obtain their certificate of completion of training (CCT). These standards are set by the Joint Committee on Surgical Training (JCST) and specialty advisory committees (SAC). The standards are not equivalent across all surgical specialties and recognise different achievements as evidence. They do not recognise changes in models of research and focus on outcomes rather than process. The Association of Surgeons in Training (ASiT) and National Research Collaborative (NRC) set out to develop progressive, consistent and flexible evidence set for academic requirements at CCT. A modified-Delphi approach was used. An expert group consisting of representatives from the ASiT and the NRC undertook iterative review of a document proposing changes to requirements. This was circulated amongst wider stakeholders. After ten iterations, an open meeting was held to discuss these proposals. Voting on statements was performed using a 5-point Likert Scale. Each statement was voted on twice, with ≥80% of votes in agreement meaning the statement was approved. The results of this vote were used to propose core and optional academic requirements for CCT. Online discussion concluded after ten rounds. At the consensus meeting, statements were voted on by 25 delegates from across surgical specialties and training-grades. The group strongly favoured acquisition of 'Good Clinical Practice' training and research methodology training as CCT requirements. The group agreed that higher degrees, publications in any author position (including collaborative authorship), recruiting patients to a study or multicentre audit and presentation at a national or international meeting could be used as evidence for the purpose of CCT. The group agreed on two essential 'core' requirements (GCP and methodology training) and two of a menu of four 'additional' requirements (publication with any authorship position, presentation, recruitment of patients to a multicentre study and completion of a higher degree), which should be completed in order to attain CCT. This approach has engaged stakeholders to produce a progressive set of academic requirements for CCT, which are applicable across surgical specialties. Flexibility in requirements whilst retaining a high standard of evidence is desirable. Copyright © 2016 IJS Publishing Group Ltd. Published by Elsevier Ltd. All rights reserved.

National Apprenticeship and Training Standards for the Sheet Metal Industry. Revised.

ERIC Educational Resources Information Center

Employment and Training Administration (DOL), Washington, DC. Bureau of Apprenticeship and Training.

These national standards are designed to aid contractors, labor, and joint committees in setting up, conducting, and improving apprenticeship programs for individuals seeking to become skilled in the sheet metal industry. Covered in the individual sections are the following topics: the provisions of the apprenticeship standards (definitions,…

How large a training set is needed to develop a classifier for microarray data?

PubMed

Dobbin, Kevin K; Zhao, Yingdong; Simon, Richard M

2008-01-01

A common goal of gene expression microarray studies is the development of a classifier that can be used to divide patients into groups with different prognoses, or with different expected responses to a therapy. These types of classifiers are developed on a training set, which is the set of samples used to train a classifier. The question of how many samples are needed in the training set to produce a good classifier from high-dimensional microarray data is challenging. We present a model-based approach to determining the sample size required to adequately train a classifier. It is shown that sample size can be determined from three quantities: standardized fold change, class prevalence, and number of genes or features on the arrays. Numerous examples and important experimental design issues are discussed. The method is adapted to address ex post facto determination of whether the size of a training set used to develop a classifier was adequate. An interactive web site for performing the sample size calculations is provided. We showed that sample size calculations for classifier development from high-dimensional microarray data are feasible, discussed numerous important considerations, and presented examples.

A Gold Standards Approach to Training Instructors to Evaluate Crew Performance

NASA Technical Reports Server (NTRS)

Baker, David P.; Dismukes, R. Key

2003-01-01

The Advanced Qualification Program requires that airlines evaluate crew performance in Line Oriented Simulation. For this evaluation to be meaningful, instructors must observe relevant crew behaviors and evaluate those behaviors consistently and accurately against standards established by the airline. The airline industry has largely settled on an approach in which instructors evaluate crew performance on a series of event sets, using standardized grade sheets on which behaviors specific to event set are listed. Typically, new instructors are given a class in which they learn to use the grade sheets and practice evaluating crew performance observed on videotapes. These classes emphasize reliability, providing detailed instruction and practice in scoring so that all instructors within a given class will give similar scores to similar performance. This approach has value but also has important limitations; (1) ratings within one class of new instructors may differ from those of other classes; (2) ratings may not be driven primarily by the specific behaviors on which the company wanted the crews to be scored; and (3) ratings may not be calibrated to company standards for level of performance skill required. In this paper we provide a method to extend the existing method of training instructors to address these three limitations. We call this method the "gold standards" approach because it uses ratings from the company's most experienced instructors as the basis for training rater accuracy. This approach ties the training to the specific behaviors on which the experienced instructors based their ratings.

Training in interprofessional collaboration: pedagogic innovation in family medicine units.

PubMed

Paré, Line; Maziade, Jean; Pelletier, Francine; Houle, Nathalie; Iloko-Fundi, Maximilien

2012-04-01

A number of agencies that accredit university health sciences programs recently added standards for the acquisition of knowledge and skills with respect to interprofessional collaboration. Within primary care settings there are no practical training programs that allow students from different disciplines to develop competencies in this area. The training program was developed within family medicine units affiliated with Université Laval in Quebec for family medicine residents and trainees from various disciplines to develop competencies in patient-centred, interprofessional collaborative practice in primary care. Based on adult learning theories, the program was divided into 3 phases--preparing family medicine unit professionals, training preceptors, and training the residents and trainees. The program's pedagogic strategies allowed participants to learn with, from, and about one another while preparing them to engage in contemporary primary care practices. A combination of quantitative and qualitative methods was used to evaluate the implementation process and the immediate results of the training program. The training program had a positive effect on both the clinical settings and the students. Preparation of clinical settings is an important issue that must be considered when planning practical interprofessional training.

14 CFR 142.11 - Application for issuance or amendment.

Code of Federal Regulations, 2012 CFR

2012-01-01

... flight simulator or flight training device, the make, model, and series of airplane or the set of... simulator and flight training device subject to qualification evaluation by the Administrator, the... Flight Standards District Office that has jurisdiction over the area in which the applicant's principal...

14 CFR 142.11 - Application for issuance or amendment.

Code of Federal Regulations, 2014 CFR

2014-01-01

... flight simulator or flight training device, the make, model, and series of airplane or the set of... simulator and flight training device subject to qualification evaluation by the Administrator, the... Flight Standards District Office that has jurisdiction over the area in which the applicant's principal...

14 CFR 142.11 - Application for issuance or amendment.

Code of Federal Regulations, 2013 CFR

2013-01-01

... flight simulator or flight training device, the make, model, and series of airplane or the set of... simulator and flight training device subject to qualification evaluation by the Administrator, the... Flight Standards District Office that has jurisdiction over the area in which the applicant's principal...

32 CFR 101.6 - Criteria for satisfactory performance.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 32 National Defense 1 2010-07-01 2010-07-01 false Criteria for satisfactory performance. 101.6..., MILITARY AND CIVILIAN PARTICIPATION IN RESERVE TRAINING PROGRAMS § 101.6 Criteria for satisfactory...) Shall require members to: (1) Meet the standards of satisfactory performance of training duty set forth...

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.

Survey and analysis of the current state of residency training in medical-school-affiliated hospitals in China

PubMed Central

2014-01-01

Background Since the global standards for postgraduate medical education (PGME) were published in January 2003, they have gained worldwide attention. The current state of residency training programs in medical-school-affiliated hospitals throughout China was assessed in this study. Methods Based on the internationally recognized global standards for PGME, residents undergoing residency training at that time and the relevant residency training instructors and management personnel from 15 medical-school-affiliated hospitals throughout China were recruited and surveyed regarding the current state of residency training programs. A total of 938 questionnaire surveys were distributed between June 30, 2006 and July 30, 2006; of 892 surveys collected, 841 were valid. Results For six items, the total proportions of “basically meets standards” and “completely meets standards” were <70% for the basic standards. These items were identified in the fields of “training settings and educational resources”, “evaluation of training process”, and “trainees”. In all fields other than “continuous updates”, the average scores of the western regions were significantly lower than those of the eastern regions for both the basic and target standards. Specifically, the average scores for the basic standards on as many as 25 of the 38 items in the nine fields were significantly lower in the western regions. There were significant differences in the basic standards scores on 13 of the 38 items among trainees, instructors, and managers. Conclusions The residency training programs have achieved satisfactory outcomes in the hospitals affiliated with various medical schools in China. However, overall, the programs remain inadequate in certain areas. For the governments, organizations, and institutions responsible for PGME, such global standards for PGME are a very useful self-assessment tool and can help identify problems, promote reform, and ultimately standardize PGME. PMID:24885865

42 CFR 410.144 - Quality standards for deemed entities.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 42 Public Health 2 2013-10-01 2013-10-01 false Quality standards for deemed entities. 410.144...-Management Training and Diabetes Outcome Measurements § 410.144 Quality standards for deemed entities. An organization approved and recognized by CMS may accredit an entity to meet one of the following sets of quality...

42 CFR 410.144 - Quality standards for deemed entities.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 42 Public Health 2 2012-10-01 2012-10-01 false Quality standards for deemed entities. 410.144...-Management Training and Diabetes Outcome Measurements § 410.144 Quality standards for deemed entities. An organization approved and recognized by CMS may accredit an entity to meet one of the following sets of quality...

42 CFR 410.144 - Quality standards for deemed entities.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 2 2010-10-01 2010-10-01 false Quality standards for deemed entities. 410.144...-Management Training and Diabetes Outcome Measurements § 410.144 Quality standards for deemed entities. An organization approved and recognized by CMS may accredit an entity to meet one of the following sets of quality...

42 CFR 410.144 - Quality standards for deemed entities.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 42 Public Health 2 2014-10-01 2014-10-01 false Quality standards for deemed entities. 410.144...-Management Training and Diabetes Outcome Measurements § 410.144 Quality standards for deemed entities. An organization approved and recognized by CMS may accredit an entity to meet one of the following sets of quality...

42 CFR 410.144 - Quality standards for deemed entities.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 2 2011-10-01 2011-10-01 false Quality standards for deemed entities. 410.144...-Management Training and Diabetes Outcome Measurements § 410.144 Quality standards for deemed entities. An organization approved and recognized by CMS may accredit an entity to meet one of the following sets of quality...

Comparison of Computational-Model and Experimental-Example Trained Neural Networks for Processing Speckled Fringe Patterns

NASA Technical Reports Server (NTRS)

Decker, A. J.; Fite, E. B.; Thorp, S. A.; Mehmed, O.

1998-01-01

The responses of artificial neural networks to experimental and model-generated inputs are compared for detection of damage in twisted fan blades using electronic holography. The training-set inputs, for this work, are experimentally generated characteristic patterns of the vibrating blades. The outputs are damage-flag indicators or second derivatives of the sensitivity-vector-projected displacement vectors from a finite element model. Artificial neural networks have been trained in the past with computational-model-generated training sets. This approach avoids the difficult inverse calculations traditionally used to compare interference fringes with the models. But the high modeling standards are hard to achieve, even with fan-blade finite-element models.

Comparison of Computational, Model and Experimental, Example Trained Neural Networks for Processing Speckled Fringe Patterns

NASA Technical Reports Server (NTRS)

Decker, A. J.; Fite, E. B.; Thorp, S. A.; Mehmed, O.

1998-01-01

The responses of artificial neural networks to experimental and model-generated inputs are compared for detection of damage in twisted fan blades using electronic holography. The training-set inputs, for this work, are experimentally generated characteristic patterns of the vibrating blades. The outputs are damage-flag indicators or second derivatives of the sensitivity-vector-projected displacement vectors from a finite element model. Artificial neural networks have been trained in the past with computational-model- generated training sets. This approach avoids the difficult inverse calculations traditionally used to compare interference fringes with the models. But the high modeling standards are hard to achieve, even with fan-blade finite-element models.

Photoelectric professional students in common universities cultivate way to explore under the background of professional certification

NASA Astrophysics Data System (ADS)

Sun, Yan-jun; Wang, Li; Leng, Yan-bing

2017-08-01

In view of the engineering education professional certification of specialty construction and the specific requirements of the training system, combining with our school optoelectronic information science and engineering characteristics, analysis of the optoelectronic information science and engineering in our school problems and challenges, to locate the specific professional training objectives. From the service oriented industry demand for talent ability, at the same time, according to the ministry of education professional norms of the development of the photoelectric teaching steering committee, and the professional development and the characteristics of target, to build a set to conform to the goal of cultivating the professional curriculum system. At the same time set up a from fundamental to professional practice teaching system, covers the course experiment, course design, case teaching, comprehensive training, such as graduation design practice. Which implements a whole ability training from the practice of foundation to high-end chain, embodies the training goal emphasize "outstanding practical skills, quality education is distinct culture characteristic. By further speed up the professional construction, professional certification standards to standardize our training process, improved the level of professional training, and improve the comprehensive quality of the graduates and talent of social competitiveness, fostered more professional talents for the country.

A game-based platform for crowd-sourcing biomedical image diagnosis and standardized remote training and education of diagnosticians

NASA Astrophysics Data System (ADS)

Feng, Steve; Woo, Minjae; Chandramouli, Krithika; Ozcan, Aydogan

2015-03-01

Over the past decade, crowd-sourcing complex image analysis tasks to a human crowd has emerged as an alternative to energy-inefficient and difficult-to-implement computational approaches. Following this trend, we have developed a mathematical framework for statistically combining human crowd-sourcing of biomedical image analysis and diagnosis through games. Using a web-based smart game (BioGames), we demonstrated this platform's effectiveness for telediagnosis of malaria from microscopic images of individual red blood cells (RBCs). After public release in early 2012 (http://biogames.ee.ucla.edu), more than 3000 gamers (experts and non-experts) used this BioGames platform to diagnose over 2800 distinct RBC images, marking them as positive (infected) or negative (non-infected). Furthermore, we asked expert diagnosticians to tag the same set of cells with labels of positive, negative, or questionable (insufficient information for a reliable diagnosis) and statistically combined their decisions to generate a gold standard malaria image library. Our framework utilized minimally trained gamers' diagnoses to generate a set of statistical labels with an accuracy that is within 98% of our gold standard image library, demonstrating the "wisdom of the crowd". Using the same image library, we have recently launched a web-based malaria training and educational game allowing diagnosticians to compare their performance with their peers. After diagnosing a set of ~500 cells per game, diagnosticians can compare their quantified scores against a leaderboard and view their misdiagnosed cells. Using this platform, we aim to expand our gold standard library with new RBC images and provide a quantified digital tool for measuring and improving diagnostician training globally.

Using athletic training clinical education standards in radiography.

PubMed

Giordano, Shelley; Harris, Katherine

2012-01-01

The selection of clinical education sites for radiography students is based on availability, access to radiographic examinations, and appropriate student-to-technologist ratio. Radiography program directors are not required to evaluate sites based on their educational validity (eg, the clinical instructor's knowledge of basic teaching and learning principles, how well the site communicates with the program, or the clinical instructor's involvement in professional organizations). The purpose of this study was to determine if a set of 12 clinical education standards used in athletic training would be applicable and beneficial to radiography program directors when selecting clinical sites for students. A survey concerning the applicability of the athletic training standards to radiography site selection was completed by 270 directors of radiography programs accredited by the Joint Review Committee on Education in Radiologic Technology. The survey results indicated the athletic training clinical education standards were considered applicable to the selection of clinical sites for radiography students and would be beneficial to radiography program directors when selecting sites.

Global Health: Pediatric Neurology.

PubMed

Bearden, David R; Ciccone, Ornella; Patel, Archana A

2018-04-01

Neurologic disorders contribute significantly to both morbidity and mortality among children in resource-limited settings, but there are a few succinct studies summarizing the epidemiology of neurologic disorders in these settings. A review of available literature was performed to identify data on the prevalence, etiology, outcomes, and treatment of neurologic disorders in children in resource-limited settings. The burden of neurologic disorders in children is high in resource-limited settings. Barriers to optimal care include lack of trained personnel, limited access to diagnostic technology, and limited availability of drugs used to treat common conditions. Several solutions have been suggested to deal with these challenges including increased collaborations to train neurologists willing to practice in resource-limited settings and increased training of physician extenders or community health workers. Further studies are necessary to improve our understanding of the epidemiology of neurologic disorders in resource-limited settings. Future epidemiologic studies should incorporate multiple countries in resource-limited settings and utilize standardized definitions and methodologies to enable comparison across regions. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Simulation improves procedural protocol adherence during central venous catheter placement: a randomized-controlled trial

PubMed Central

Peltan, Ithan D.; Shiga, Takashi; Gordon, James A.; Currier, Paul F.

2015-01-01

Background Simulation training may improve proficiency at and reduces complications from central venous catheter (CVC) placement, but the scope of simulation’s effect remains unclear. This randomized controlled trial evaluated the effects of a pragmatic CVC simulation program on procedural protocol adherence, technical skill, and patient outcomes. Methods Internal medicine interns were randomized to standard training for CVC insertion or standard training plus simulation-based mastery training. Standard training involved a lecture, a video-based online module, and instruction by the supervising physician during actual CVC insertions. Intervention-group subjects additionally underwent supervised training on a venous access simulator until they demonstrated procedural competence. Raters evaluated interns’ performance during internal jugular CVC placement on actual patients in the medical intensive care unit. Generalized estimating equations were used to account for outcome clustering within trainees. Results We observed 52 interns place 87 CVCs. Simulation-trained interns exhibited better adherence to prescribed procedural technique than interns who received only standard training (p=0.024). There were no significant differences detected in first-attempt or overall cannulation success rates, mean needle passes, global assessment scores or complication rates. Conclusions Simulation training added to standard training improved protocol adherence during CVC insertion by novice practitioners. This study may have been too small to detect meaningful differences in venous cannulation proficiency and other clinical outcomes, highlighting the difficulty of patient-centered simulation research in settings where poor outcomes are rare. For high-performing systems, where protocol deviations may provide an important proxy for rare procedural complications, simulation may improve CVC insertion quality and safety. PMID:26154250

Training in clinical forensic medicine in the UK--perceptions of current regulatory standards.

PubMed

Stark, Margaret M; Norfolk, Guy A

2011-08-01

As clinical forensic medicine (CFM) is not currently recognised as a speciality in the UK there are no nationally agreed mandatory standards for training forensic physicians in either general forensic (GFM) or sexual offence medicine (SOM). The General Medical Council (GMC), the medical regulator in the UK, has issued clear standards for training in all specialities recommending that "trainees must be supported to acquire the necessary skills and experience through induction, effective educational supervision, an appropriate workload and time to learn". In order to evaluate the current situation in the field of clinical forensic medicine, doctors who have recently (within the last two years) started working in the field "trainees" (n = 38), and trainers (n = 61) with responsibility for clinical and educational supervision of new trainees, were surveyed by questionnaire to gather their perceptions of how the relevant GMC standards are being met in initial on-the-job training. Telephone interviews were performed with eleven doctors working as clinical or medical directors to determine their views. It is clear that currently the quality of training in CFM is sub-standard and inconsistent and that the published standards, as to the minimum requirement for training that must be met by post-graduate medical and training providers at all levels, are not being met. The Faculty of Forensic and Legal Medicine (FFLM) needs to set explicit minimum standards which will comply with the regulator and work to pilot credentialing for forensic physicians. A number of recommendations are made for urgent FFLM development. Crown Copyright © 2011. Published by Elsevier Ltd. All rights reserved.

Effects of draught load exercise and training on calcium homeostasis in horses.

PubMed

Vervuert, I; Coenen, M; Zamhöfer, J

2005-01-01

This study was conducted to investigate the effects of draught load exercise on calcium (Ca) homeostasis in young horses. Five 2-year-old untrained Standardbred horses were studied in a 4-month training programme. All exercise workouts were performed on a treadmill at a 6% incline and with a constant draught load of 40 kg (0.44 kN). The training programme started with a standardized exercise test (SET 1; six incremental steps of 5 min duration each, first step 1.38 m/s, stepwise increase by 0.56 m/s). A training programme was then initiated which consisted of low-speed exercise sessions (LSE; constant velocity at 1.67 m/s for 60 min, 48 training sessions in total). After the 16th and 48th LSE sessions, SETs (SET 2: middle of training period, SET 3: finishing training period) were performed again under the identical test protocol of SET 1. Blood samples for blood lactate, plasma total Ca, blood ionized calcium (Ca(2+)), blood pH, plasma inorganic phosphorus (P(i)) and plasma intact parathyroid hormone (PTH) were collected before, during and after SETs, and before and after the first, 16th, 32nd and 48th LSE sessions. During SETs there was a decrease in ionized Ca(2+) and a rise in lactate, P(i) and intact PTH. The LSEs resulted in an increase in pH and P(i), whereas lactate, ionized Ca(2+), total Ca and intact PTH were not affected. No changes in Ca metabolism were detected in the course of training. Results of this study suggest that the type of exercise influences Ca homeostasis and intact PTH response, but that these effects are not influenced in the course of the training period.

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…

A summative, Objective, Structured, Clinical Examination in ENT used to assess postgraduate doctors after one year of ENT training, as part of the Diploma of Otorhinolaryngology, Head and Neck Surgery.

PubMed

Drake-Lee, A B; Skinner, D; Hawthorne, M; Clarke, R

2009-10-01

'High stakes' postgraduate medical examinations should conform to current educational standards. In the UK and Ireland, national assessments in surgery are devised and managed through the examination structure of the Royal Colleges of Surgeons. Their efforts are not reported in the medical education literature. In the current paper, we aim to clarify this process. To replace the clinical section of the Diploma of Otorhinolaryngology with an Objective, Structured, Clinical Examination, and to set the level of the assessment at one year of postgraduate training in the specialty. After 'blueprinting' against the whole curriculum, an Objective, Structured, Clinical Examination comprising 25 stations was divided into six clinical stations and 19 other stations exploring written case histories, instruments, test results, written communication skills and interpretation skills. The pass mark was set using a modified borderline method and other methods, and statistical analysis of the results was performed. The results of nine examinations between May 2004 and May 2008 are presented. The pass mark varied between 68 and 82 per cent. Internal consistency was good, with a Cronbach's alpha value of 0.99 for all examinations and split-half statistics varying from 0.96 to 0.99. Different standard settings gave similar pass marks. We have developed a summative, Objective, Structured, Clinical Examination for doctors training in otorhinolaryngology, reported herein. The objectives and standards of setting a high quality assessment were met.

[The standardization of medical care and the training of medical personnel].

PubMed

Korbut, V B; Tyts, V V; Boĭshenko, V A

1997-09-01

The medical specialist training at all levels (medical orderly, doctor's assistant, general practitioner, doctors) should be based on the medical care standards. Preliminary studies in the field of military medicine standards have demonstrated that the medical service of the Armed Forces of Russia needs medical resources' standards, structure and organization standards, technology standards. Military medical service resources' standards should reflect the requisitions for: all medical specialists' qualification, equipment and material for medical set-ups, field medical systems, drugs, etc. Standards for structures and organization should include requisitions for: command and control systems in military formations' and task forces' medical services and their information support; health-care and evacuation functions, sanitary control and anti-epidemic measures and personnel health protection. Technology standards development could improve and regulate the health care procedures in the process of evacuation. Standards' development will help to solve the problem of the data-base for the military medicine education system and medical research.

Nutriendo la Promesa: Materiales Para la Aplicacion de las Normas de Ejecucion del Programa Head Start. Guia Para la Utilizacion de los Materiales [y] Transparencias (Nurturing the Promise: Set of Training Materials on the Head Start Program Performance Standards. User's Guide [and] Set of Transparencies).

ERIC Educational Resources Information Center

Educational Services, Inc., Washington, DC.

Since 1975, the Head Start Program Performance Standards have defined the services that local programs are required to provide to enrolled children and families. With revisions effective in 1998, the Program Performance Standards translate the Head Start vision into quality practices implemented at the local level. This document is comprised of a…

[Development of standards for education and training in family and community medicine - contributions by WONCA IberoAmerica (CIMF)].

PubMed

Demarzo, Marcelo Marcos Piva; Marin, Anibal; Padula Anderson, Maria Inez; De Castro Filho, Eno Dias; Kidd, Michael

2011-02-01

The WONCA Education Working Party (WEP) is developing a set of standards for medical student education, postgraduate training in family medicine / general practice and continuing professional development for family doctors. At this point the contributions by WONCA world regions are very important, and for this reason the main objective of this report is to present the standards developed by the Iberoamerican WONCA Region (CIMF). To be comprehensive and effective, standards should reflect regional realities and so the contributions from CIMF may reinforce and strengthen the key initiative of WEP and the implementation of the standards throughout the world. Copyright © 2010 Elsevier España, S.L. All rights reserved.

Comprehensive simulation-enhanced training curriculum for an advanced minimally invasive procedure: a randomized controlled trial.

PubMed

Zevin, Boris; Dedy, Nicolas J; Bonrath, Esther M; Grantcharov, Teodor P

2017-05-01

There is no comprehensive simulation-enhanced training curriculum to address cognitive, psychomotor, and nontechnical skills for an advanced minimally invasive procedure. 1) To develop and provide evidence of validity for a comprehensive simulation-enhanced training (SET) curriculum for an advanced minimally invasive procedure; (2) to demonstrate transfer of acquired psychomotor skills from a simulation laboratory to live porcine model; and (3) to compare training outcomes of SET curriculum group and chief resident group. University. This prospective single-blinded, randomized, controlled trial allocated 20 intermediate-level surgery residents to receive either conventional training (control) or SET curriculum training (intervention). The SET curriculum consisted of cognitive, psychomotor, and nontechnical training modules. Psychomotor skills in a live anesthetized porcine model in the OR was the primary outcome. Knowledge of advanced minimally invasive and bariatric surgery and nontechnical skills in a simulated OR crisis scenario were the secondary outcomes. Residents in the SET curriculum group went on to perform a laparoscopic jejunojejunostomy in the OR. Cognitive, psychomotor, and nontechnical skills of SET curriculum group were also compared to a group of 12 chief surgery residents. SET curriculum group demonstrated superior psychomotor skills in a live porcine model (56 [47-62] versus 44 [38-53], P<.05) and superior nontechnical skills (41 [38-45] versus 31 [24-40], P<.01) compared with conventional training group. SET curriculum group and conventional training group demonstrated equivalent knowledge (14 [12-15] versus 13 [11-15], P = 0.47). SET curriculum group demonstrated equivalent psychomotor skills in the live porcine model and in the OR in a human patient (56 [47-62] versus 63 [61-68]; P = .21). SET curriculum group demonstrated inferior knowledge (13 [11-15] versus 16 [14-16]; P<.05), equivalent psychomotor skill (63 [61-68] versus 68 [62-74]; P = .50), and superior nontechnical skills (41 [38-45] versus 34 [27-35], P<.01) compared with chief resident group. Completion of the SET curriculum resulted in superior training outcomes, compared with conventional surgery training. Implementation of the SET curriculum can standardize training for an advanced minimally invasive procedure and can ensure that comprehensive proficiency milestones are met before exposure to patient care. Copyright © 2017 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.

Take-Home Training in Laparoscopy.

PubMed

Thinggaard, Ebbe

2017-04-01

When laparoscopy was first introduced, skills were primarily taught using the apprenticeship model. A limitation of this method when compared to open surgery, was that it requires more time to practise and more frequent learning opportunities in clinical practice. The unique set of skills required in laparoscopy highlighted the need for new training methods that reduce the need for supervision and do not put the patient at risk. Simulation training was developed to meet this need. The overall purpose of this thesis was to explore simulation-based laparoscopic training at home. The thesis consists of five papers: a review, a validation study, a study of methodology, a randomised controlled trial and a mixed-methods study. Our aims were to review the current knowledge on training off-site, to develop and explore validity for a training and assessment system, to investigate the effect of take-home training in a simulation-based laparoscopic training programme, and to explore the use of take-home training. The first paper in this thesis is a scoping review. The aim of the review was to explore the current knowledge on off-site laparoscopic skills training. We found that off-site training was feasible but that changes were required in order for it to become an effective method of training. Furthermore, the select-ed instructional design varied and training programmes were designed using a variety of educational theories. Based on our findings, we recommended that courses and training curricula should follow established education theories such as proficiency-based learning and deliberate practice. Principles of directed self-regulated learning could be used to improve off-site laparoscopic training programmes. In the second study, we set out to develop and explore validity evidence of the TABLT test. The TABLT test was developed for basic laparoscopic skills training in a cross-specialty curriculum. We found validity evidence to support the TABLT test as a summative test in a basic laparoscopic training programme. We also established a credible pass/fail level using the contrasting groups method. We concluded that the TABTL test could be used to assess novice laparoscopic trainees across different specialties and help trainees acquire basic laparoscopic competencies prior to supervised surgery. In the third study, we aimed to explore the consequences of the choice of standard setting method and whether there is a difference in terms of how high a score experienced and novice laparoscopic surgeons expect that novices should achieve during training. We used three different standard setting methods and found that pass/fail levels vary depending on the choice of standard setting method. We also asked experienced and novice laparoscopic surgeons how high a score they expected a novice laparoscopic surgeon should achieve on a test during training. We found a significant difference, with experienced surgeons setting a lower pass/fail level. We concluded that an established standard setting method supported by evidence should be used when setting a pass/fail level. In the first and second papers of this thesis, we found that off-site training is feasible and explored validity for the TABLT test. We used this knowledge in the fourth study to design a randomised controlled trial. The aim of the trial was to investigate the effect of take-home training in a simulation-based laparoscopic course. We hypothesised that training at home could help trainees plan their training according to their own schedule and thereby increase the effect of training. We found that participants had a distributed training pattern; they trained more frequently and in shorter sessions. We also found that participants were able to rate their own performance during unsupervised training and that selfrating was reliable. The fifth and final study of the thesis was a mixed-methods study that aimed to explore the use of take-home training. To meet this aim, we recruited participants from the intervention arm in our randomised controlled trial. All participants had access to the simulation centre and were given a port-able trainer to train on at home. Participants were asked to use a logbook during training. At the end of the course, they were invited to take part in focus group interviews and individual interviews. Based on data from logbooks, a descriptive statistical analysis was conducted and data from interviews were analysed using a content analysis. We found that participants took an individualised approach to training when training at home. They structured their training according to their needs and external requirements. We concluded that mandatory training requirements and testing help determine when and how much participants train. We also found that self-rating can guide unsupervised training by giving clear goals to be reached during training. From the papers included in the thesis, we found that the literature describes training at home as a feasible method of acquiring laparoscopic skills. Nonetheless, changes to current training programmes are needed in order to make this method effective. We then developed and explored validity evidence for the TABLT test. We also established a reasonable pass/fail level and went on to explore the immediate consequences of the pass/fail level. Using our knowledge from the review, we conducted a randomised controlled trial and a mixed-method study. Based on these studies we found that training at home allows for distributed learning, that self-rating guides unsupervised training, and that mandatory training requirements and testing strongly influence training patterns. Access to training, guidance during training, and mandatory training requirements will make take-home training not just feasible but also effective. Articles published in the Danish Medical Journal are “open access”. This means that the articles are distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits any non-commercial use, distribution, and reproduction in any medium, provided the original author(s) and source are credited.

Training propositional reasoning.

PubMed

Klauer, K C; Meiser, T; Naumer, B

2000-08-01

Two experiments compared the effects of four training conditions on propositional reasoning. A syntactic training demonstrated formal derivations, in an abstract semantic training the standard truth-table definitions of logical connectives were explained, and a domain-specific semantic training provided thematic contexts for the premises of the reasoning task. In a control training, an inductive reasoning task was practised. In line with the account by mental models, both kinds of semantic training were significantly more effective than the control and the syntactic training, whereas there were no significant differences between the control and the syntactic training, nor between the two kinds of semantic training. Experiment 2 replicated this pattern of effects using a different set of syntactic and domain-specific training conditions.

Setting the Standards; The Importance of the Language Audit.

ERIC Educational Resources Information Center

Greensmith, Catherine

It is proposed that business language training be based on results of a "language audit," designed to identify the skill levels required to carry out specific tasks, propose training solutions, and monitor progress. A British organization has established a framework for assessing five levels of language skill in this context. These standards…

nu-Anomica: A Fast Support Vector Based Novelty Detection Technique

NASA Technical Reports Server (NTRS)

Das, Santanu; Bhaduri, Kanishka; Oza, Nikunj C.; Srivastava, Ashok N.

2009-01-01

In this paper we propose nu-Anomica, a novel anomaly detection technique that can be trained on huge data sets with much reduced running time compared to the benchmark one-class Support Vector Machines algorithm. In -Anomica, the idea is to train the machine such that it can provide a close approximation to the exact decision plane using fewer training points and without losing much of the generalization performance of the classical approach. We have tested the proposed algorithm on a variety of continuous data sets under different conditions. We show that under all test conditions the developed procedure closely preserves the accuracy of standard one-class Support Vector Machines while reducing both the training time and the test time by 5 - 20 times.

Training in interprofessional collaboration

PubMed Central

Paré, Line; Maziade, Jean; Pelletier, Francine; Houle, Nathalie; Iloko-Fundi, Maximilien

2012-01-01

Abstract Problem addressed A number of agencies that accredit university health sciences programs recently added standards for the acquisition of knowledge and skills with respect to interprofessional collaboration. Within primary care settings there are no practical training programs that allow students from different disciplines to develop competencies in this area. Objective of the program The training program was developed within family medicine units affiliated with Université Laval in Quebec for family medicine residents and trainees from various disciplines to develop competencies in patient-centred, interprofessional collaborative practice in primary care. Program description Based on adult learning theories, the program was divided into 3 phases—preparing family medicine unit professionals, training preceptors, and training the residents and trainees. The program’s pedagogic strategies allowed participants to learn with, from, and about one another while preparing them to engage in contemporary primary care practices. A combination of quantitative and qualitative methods was used to evaluate the implementation process and the immediate results of the training program. Conclusion The training program had a positive effect on both the clinical settings and the students. Preparation of clinical settings is an important issue that must be considered when planning practical interprofessional training. PMID:22611607

Making the Case for Standards of Conduct in Clinical Training

ERIC Educational Resources Information Center

Homrich, Alicia M.; DeLorenzi, Leigh D.; Bloom, Zachary D.; Godbee, Brandi

2014-01-01

The authors examined a proposed set of standards for the personal and professional conduct of counseling trainees. Eighty-two counselor educators and supervisors from programs accredited by the Council for Accreditation of Counseling and Related Educational Programs ranked 55 behaviors divided across 3 categories (i.e., professional,…

Computer-enhanced laparoscopic training system (CELTS): bridging the gap.

PubMed

Stylopoulos, N; Cotin, S; Maithel, S K; Ottensmeye, M; Jackson, P G; Bardsley, R S; Neumann, P F; Rattner, D W; Dawson, S L

2004-05-01

There is a large and growing gap between the need for better surgical training methodologies and the systems currently available for such training. In an effort to bridge this gap and overcome the disadvantages of the training simulators now in use, we developed the Computer-Enhanced Laparoscopic Training System (CELTS). CELTS is a computer-based system capable of tracking the motion of laparoscopic instruments and providing feedback about performance in real time. CELTS consists of a mechanical interface, a customizable set of tasks, and an Internet-based software interface. The special cognitive and psychomotor skills a laparoscopic surgeon should master were explicitly defined and transformed into quantitative metrics based on kinematics analysis theory. A single global standardized and task-independent scoring system utilizing a z-score statistic was developed. Validation exercises were performed. The scoring system clearly revealed a gap between experts and trainees, irrespective of the task performed; none of the trainees obtained a score above the threshold that distinguishes the two groups. Moreover, CELTS provided educational feedback by identifying the key factors that contributed to the overall score. Among the defined metrics, depth perception, smoothness of motion, instrument orientation, and the outcome of the task are major indicators of performance and key parameters that distinguish experts from trainees. Time and path length alone, which are the most commonly used metrics in currently available systems, are not considered good indicators of performance. CELTS is a novel and standardized skills trainer that combines the advantages of computer simulation with the features of the traditional and popular training boxes. CELTS can easily be used with a wide array of tasks and ensures comparability across different training conditions. This report further shows that a set of appropriate and clinically relevant performance metrics can be defined and a standardized scoring system can be designed.

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

PubMed

Brookman-Frazee, Lauren; Stahmer, Aubyn C

2018-05-09

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

What the Logs Can Tell You: Mediation to Implement Feedback in Training

NASA Technical Reports Server (NTRS)

Maluf, David; Wiederhold, Gio; Abou-Khalil, Ali; Norvig, Peter (Technical Monitor)

2000-01-01

The problem addressed by Mediation to Implement Feedback in Training (MIFT) is to customize the feedback from training exercizes by exploiting knowledge about the training scenario, training objectives, and specific student/teacher needs. We achieve this by inserting an intelligent mediation layer into the information flow from observations collected during training exercises to the display and user interface. Knowledge about training objectives, scenarios, and tasks is maintained in the mediating layer. A designer constraint is that domain experts must be able to extend mediators by adding domain-specific knowledge that supports additional aggregations, abstractions, and views of the results of training exercises. The MIFT mediation concept is intended to be integrated with existing military training exercise management tools and reduce the cost of developing and maintaining separate feedback and evaluation tools for every training simulator and every set of customer needs. The MIFT Architecture is designed as a set of independently reusable components which interact with each other through standardized formalisms such as the Knowledge Interchange Format (KIF) and Knowledge Query and Manipulation Language (KQML).

Training and the Development of Curriculum Standards in On Farm Water Management: Pakistan, 1984-1985.

ERIC Educational Resources Information Center

Bergsma, Harold M.

The document describes the 18-month Phase I of the On Farm Management Project--supported by the World Bank and operated by Colorado State University and the Consortium for International Development--to design more systematic approaches to train people who will work in technical settings related to water management and irrigation channel…

Automatic Lung-RADS™ classification with a natural language processing system.

PubMed

Beyer, Sebastian E; McKee, Brady J; Regis, Shawn M; McKee, Andrea B; Flacke, Sebastian; El Saadawi, Gilan; Wald, Christoph

2017-09-01

Our aim was to train a natural language processing (NLP) algorithm to capture imaging characteristics of lung nodules reported in a structured CT report and suggest the applicable Lung-RADS™ (LR) category. Our study included structured, clinical reports of consecutive CT lung screening (CTLS) exams performed from 08/2014 to 08/2015 at an ACR accredited Lung Cancer Screening Center. All patients screened were at high-risk for lung cancer according to the NCCN Guidelines ® . All exams were interpreted by one of three radiologists credentialed to read CTLS exams using LR using a standard reporting template. Training and test sets consisted of consecutive exams. Lung screening exams were divided into two groups: three training sets (500, 120, and 383 reports each) and one final evaluation set (498 reports). NLP algorithm results were compared with the gold standard of LR category assigned by the radiologist. The sensitivity/specificity of the NLP algorithm to correctly assign LR categories for suspicious nodules (LR 4) and positive nodules (LR 3/4) were 74.1%/98.6% and 75.0%/98.8% respectively. The majority of mismatches occurred in cases where pulmonary findings were present not currently addressed by LR. Misclassifications also resulted from the failure to identify exams as follow-up and the failure to completely characterize part-solid nodules. In a sub-group analysis among structured reports with standardized language, the sensitivity and specificity to detect LR 4 nodules were 87.0% and 99.5%, respectively. An NLP system can accurately suggest the appropriate LR category from CTLS exam findings when standardized reporting is used.

Automatic Lung-RADS™ classification with a natural language processing system

PubMed Central

Beyer, Sebastian E.; Regis, Shawn M.; McKee, Andrea B.; Flacke, Sebastian; El Saadawi, Gilan; Wald, Christoph

2017-01-01

Background Our aim was to train a natural language processing (NLP) algorithm to capture imaging characteristics of lung nodules reported in a structured CT report and suggest the applicable Lung-RADS™ (LR) category. Methods Our study included structured, clinical reports of consecutive CT lung screening (CTLS) exams performed from 08/2014 to 08/2015 at an ACR accredited Lung Cancer Screening Center. All patients screened were at high-risk for lung cancer according to the NCCN Guidelines®. All exams were interpreted by one of three radiologists credentialed to read CTLS exams using LR using a standard reporting template. Training and test sets consisted of consecutive exams. Lung screening exams were divided into two groups: three training sets (500, 120, and 383 reports each) and one final evaluation set (498 reports). NLP algorithm results were compared with the gold standard of LR category assigned by the radiologist. Results The sensitivity/specificity of the NLP algorithm to correctly assign LR categories for suspicious nodules (LR 4) and positive nodules (LR 3/4) were 74.1%/98.6% and 75.0%/98.8% respectively. The majority of mismatches occurred in cases where pulmonary findings were present not currently addressed by LR. Misclassifications also resulted from the failure to identify exams as follow-up and the failure to completely characterize part-solid nodules. In a sub-group analysis among structured reports with standardized language, the sensitivity and specificity to detect LR 4 nodules were 87.0% and 99.5%, respectively. Conclusions An NLP system can accurately suggest the appropriate LR category from CTLS exam findings when standardized reporting is used. PMID:29221286

Manual cleaning of hospital mattresses: an observational study comparing high- and low-resource settings.

PubMed

Hopman, J; Hakizimana, B; Meintjes, W A J; Nillessen, M; de Both, E; Voss, A; Mehtar, S

2016-01-01

Hospital-associated infections (HAIs) are more frequently encountered in low- than in high-resource settings. There is a need to identify and implement feasible and sustainable approaches to strengthen HAI prevention in low-resource settings. To evaluate the biological contamination of routinely cleaned mattresses in both high- and low-resource settings. In this two-stage observational study, routine manual bed cleaning was evaluated at two university hospitals using adenosine triphosphate (ATP). Standardized training of cleaning personnel was achieved in both high- and low-resource settings. Qualitative analysis of the cleaning process was performed to identify predictors of cleaning outcome in low-resource settings. Mattresses in low-resource settings were highly contaminated prior to cleaning. Cleaning significantly reduced biological contamination of mattresses in low-resource settings (P < 0.0001). After training, the contamination observed after cleaning in both the high- and low-resource settings seemed comparable. Cleaning with appropriate type of cleaning materials reduced the contamination of mattresses adequately. Predictors for mattresses that remained contaminated in a low-resource setting included: type of product used, type of ward, training, and the level of contamination prior to cleaning. In low-resource settings mattresses were highly contaminated as noted by ATP levels. Routine manual cleaning by trained staff can be as effective in a low-resource setting as in a high-resource setting. We recommend a multi-modal cleaning strategy that consists of training of domestic services staff, availability of adequate time to clean beds between patients, and application of the correct type of cleaning products. Copyright © 2015 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

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.

Setting Standards for Medically-Based Running Analysis

PubMed Central

Vincent, Heather K.; Herman, Daniel C.; Lear-Barnes, Leslie; Barnes, Robert; Chen, Cong; Greenberg, Scott; Vincent, Kevin R.

2015-01-01

Setting standards for medically based running analyses is necessary to ensure that runners receive a high-quality service from practitioners. Medical and training history, physical and functional tests, and motion analysis of running at self-selected and faster speeds are key features of a comprehensive analysis. Self-reported history and movement symmetry are critical factors that require follow-up therapy or long-term management. Pain or injury is typically the result of a functional deficit above or below the site along the kinematic chain. PMID:25014394

An Intensive Continuing Education Initiative to Train Social Workers for Military Social Work Practice

ERIC Educational Resources Information Center

Smith-Osborne, Alexa

2015-01-01

Specific standards exist for social work practice with service members, military families, and veterans, whether in civilian or military practice settings. Based on these standards, a continuing education certificate for practitioners was designed with companion military social work coursework in the advanced graduate curriculum and field…

Training and Validation of Standardized Patients for Unannounced Assessment of Physicians' Management of Depression

ERIC Educational Resources Information Center

Shirazi, Mandana; Sadeghi, Majid; Emami, A.; Kashani, A. Sabouri; Parikh, Sagar; Alaeddini, F.; Arbabi, Mohammad; Wahlstrom, Rolf

2011-01-01

Objective: Standardized patients (SPs) have been developed to measure practitioner performance in actual practice settings, but results have not been fully validated for psychiatric disorders. This study describes the process of creating reliable and valid SPs for unannounced assessment of general-practitioners' management of depression disorders…

Positive School Leadership: How the Professional Standards for Educational Leaders Can Be Brought to Life

ERIC Educational Resources Information Center

Murphy, Joseph; Louis, Karen Seashore; Smylie, Mark

2017-01-01

In November 2015, the National Policy Board for Educational Administration--a coalition of nine professional associations--adopted the Professional Standards for Educational Leaders (PSEL), a set of guidelines for the training, certification, hiring, evaluation, and supervision of school principals and superintendents. While it draws heavily from…

Emergency Medical Technician-Ambulance: National Standard Curriculum. Instructor's Lesson Plans (Third Edition).

ERIC Educational Resources Information Center

National Highway Traffic Safety Administration (DOT), Washington, DC.

This set of instructor's lesson plans is one of three documents prepared for the Emergency Medical Technician (EMT) National Standard Curriculum. It contains detailed outlines of course content and guidance for teaching each course lesson. The training course contains 33 lessons covering all emergency medical techniques currently considered to be…

Implementing standard setting into the Conjoint MAFP/FRACGP Part 1 examination - Process and issues.

PubMed

Chan, S C; Mohd Amin, S; Lee, T W

2016-01-01

The College of General Practitioners of Malaysia and the Royal Australian College of General Practitioners held the first Conjoint Member of the College of General Practitioners (MCGP)/Fellow of Royal Australian College of General Practitioners (FRACGP) examination in 1982, later renamed the Conjoint MAFP/FRACGP examinations. The examination assesses competency for safe independent general practice and as family medicine specialists in Malaysia. Therefore, a defensible standard set pass mark is imperative to separate the competent from the incompetent. This paper discusses the process and issues encountered in implementing standard setting to the Conjoint Part 1 examination. Critical to success in standard setting were judges' understanding of the process of the modified Angoff method, defining the borderline candidate's characteristics and the composition of judges. These were overcome by repeated hands-on training, provision of detailed guidelines and careful selection of judges. In December 2013, 16 judges successfully standard set the Part 1 Conjoint examinations, with high inter-rater reliability: Cronbach's alpha coefficient 0.926 (Applied Knowledge Test), 0.921 (Key Feature Problems).

A Survey of Athletic Training Employers' Hiring Criteria

PubMed Central

Andrews, Lanna

2001-01-01

Objective: To identify athletic training employers' hiring criteria and to determine if the importance of individual hiring criteria vary by setting. Design and Setting: The Athletic Training Employer Needs Assessment Survey was mailed to athletic training employers advertising in the National Athletic Trainers' Association (NATA) placement vacancy notice between October 1996 and October 1998. Subjects: A total of 111 athletic training employers in NATA Districts 7, 8, and 10 were surveyed. Measurements: Employers rated the importance of hiring criteria on a 7-point Likert scale. Means and standard deviations were calculated for each criterion and compared these values to ascertain the importance of individual criteria. A principal component analysis was done to determine the underlying factors. Results: Hiring characteristics can be divided into 4 factors that include highly related criteria: (1) personal characteristics, (2) educational experience, (3) professional experience, and (4) work-related attributes. In addition, the hiring characteristics desired by employers varied among athletic training settings. Conclusions: When interviewing and presenting themselves for entry-level positions, athletic trainers should pay particular attention to the attributes within the 4 hiring criteria factors. Also, the desired hiring criteria of athletic training employers differed by setting. Applicants need to pay particular attention to these hiring criteria differences when constructing résumés, cover letters, and professional correspondence and when interviewing with prospective employers. PMID:12937484

Challenges in Developing Competency-based Training Curriculum for Food Safety Regulators in India

PubMed Central

Thippaiah, Anitha; Allagh, Komal Preet; Murthy, G. V.

2014-01-01

Context: The Food Safety and Standards Act have redefined the roles and responsibilities of food regulatory workforce and calls for highly skilled human resources as it involves complex management procedures. Aims: 1) Identify the competencies needed among the food regulatory workforce in India. 2) Develop a competency-based training curriculum for food safety regulators in the country. 3) Develop training materials for use to train the food regulatory workforce. Settings and Design: The Indian Institute of Public Health, Hyderabad, led the development of training curriculum on food safety with technical assistance from the Royal Society for Public Health, UK and the National Institute of Nutrition, India. The exercise was to facilitate the implementation of new Act by undertaking capacity building through a comprehensive training program. Materials and Methods: A competency-based training needs assessment was conducted before undertaking the development of the training materials. Results: The training program for Food Safety Officers was designed to comprise of five modules to include: Food science and technology, Food safety management systems, Food safety legislation, Enforcement of food safety regulations, and Administrative functions. Each module has a facilitator guide for the tutor and a handbook for the participant. Essentials of Food Hygiene-I (Basic level), II and III (Retail/ Catering/ Manufacturing) were primarily designed for training of food handlers and are part of essential reading for food safety regulators. Conclusion: The Food Safety and Standards Act calls for highly skilled human resources as it involves complex management procedures. Despite having developed a comprehensive competency-based training curriculum by joint efforts by the local, national, and international agencies, implementation remains a challenge in resource-limited setting. PMID:25136155

Competency based training in robotic surgery: benchmark scores for virtual reality robotic simulation.

PubMed

Raison, Nicholas; Ahmed, Kamran; Fossati, Nicola; Buffi, Nicolò; Mottrie, Alexandre; Dasgupta, Prokar; Van Der Poel, Henk

2017-05-01

To develop benchmark scores of competency for use within a competency based virtual reality (VR) robotic training curriculum. This longitudinal, observational study analysed results from nine European Association of Urology hands-on-training courses in VR simulation. In all, 223 participants ranging from novice to expert robotic surgeons completed 1565 exercises. Competency was set at 75% of the mean expert score. Benchmark scores for all general performance metrics generated by the simulator were calculated. Assessment exercises were selected by expert consensus and through learning-curve analysis. Three basic skill and two advanced skill exercises were identified. Benchmark scores based on expert performance offered viable targets for novice and intermediate trainees in robotic surgery. Novice participants met the competency standards for most basic skill exercises; however, advanced exercises were significantly more challenging. Intermediate participants performed better across the seven metrics but still did not achieve the benchmark standard in the more difficult exercises. Benchmark scores derived from expert performances offer relevant and challenging scores for trainees to achieve during VR simulation training. Objective feedback allows both participants and trainers to monitor educational progress and ensures that training remains effective. Furthermore, the well-defined goals set through benchmarking offer clear targets for trainees and enable training to move to a more efficient competency based curriculum. © 2016 The Authors BJU International © 2016 BJU International Published by John Wiley & Sons Ltd.

Patient Safety: Moving the Bar in Prison Health Care Standards

PubMed Central

Greifinger, Robert B.; Mellow, Jeff

2010-01-01

Improvements in community health care quality through error reduction have been slow to transfer to correctional settings. We convened a panel of correctional experts, which recommended 60 patient safety standards focusing on such issues as creating safety cultures at organizational, supervisory, and staff levels through changes to policy and training and by ensuring staff competency, reducing medication errors, encouraging the seamless transfer of information between and within practice settings, and developing mechanisms to detect errors or near misses and to shift the emphasis from blaming staff to fixing systems. To our knowledge, this is the first published set of standards focusing on patient safety in prisons, adapted from the emerging literature on quality improvement in the community. PMID:20864714

In silico prediction of nematic transition temperature for liquid crystals using quantitative structure-property relationship approaches.

PubMed

Fatemi, Mohammad Hossein; Ghorbanzad'e, Mehdi

2009-11-01

Quantitative structure-property relationship models for the prediction of the nematic transition temperature (T (N)) were developed by using multilinear regression analysis and a feedforward artificial neural network (ANN). A collection of 42 thermotropic liquid crystals was chosen as the data set. The data set was divided into three sets: for training, and an internal and external test set. Training and internal test sets were used for ANN model development, and the external test set was used for evaluation of the predictive power of the model. In order to build the models, a set of six descriptors were selected by the best multilinear regression procedure of the CODESSA program. These descriptors were: atomic charge weighted partial negatively charged surface area, relative negative charged surface area, polarity parameter/square distance, minimum most negative atomic partial charge, molecular volume, and the A component of moment of inertia, which encode geometrical and electronic characteristics of molecules. These descriptors were used as inputs to ANN. The optimized ANN model had 6:6:1 topology. The standard errors in the calculation of T (N) for the training, internal, and external test sets using the ANN model were 1.012, 4.910, and 4.070, respectively. To further evaluate the ANN model, a crossvalidation test was performed, which produced the statistic Q (2) = 0.9796 and standard deviation of 2.67 based on predicted residual sum of square. Also, the diversity test was performed to ensure the model's stability and prove its predictive capability. The obtained results reveal the suitability of ANN for the prediction of T (N) for liquid crystals using molecular structural descriptors.

Student-Faculty Perceptions of Multicultural Training in Accredited Marriage and Family Therapy Programs in Relation to Students' Self-Reported Competence

ERIC Educational Resources Information Center

Inman, Arpana G.; Meza, Marisol M.; Brown, Andrae L.; Hargrove, Byron K.

2004-01-01

Although the marriage and family therapy field's recent attention to multicultural issues is laudable, there appears to be little clarity on what constitutes an effective multicultural competence. The field continues to be challenged at different levels-training, practice, research, the setting of the standards and the work of the commission on…

Generalization of Skills through the Addition of Individualized Coaching: Development and Evaluation of a Social Skills Training Program in a Rural Setting

ERIC Educational Resources Information Center

Gottlieb, Jennifer D.; Pryzgoda, Jayde; Neal, Andrea; Schuldberg, David

2005-01-01

There has been recent interest in adding interventions that aid in skill generalization to standard social skills training programs for schizophrenia. Some of these adjunctive interventions are very comprehensive and clearly promising (e.g., IVAST; Liberman, Glynn, Blair, Ross, & Marder, 2002), but their overall cost-effectiveness and feasibility…

Translating Training in the NYU Caregiver Intervention in Australia: Maintaining Fidelity and Meeting Graduate Standards in an Online Continuing Professional Education Setting

ERIC Educational Resources Information Center

Scott, Theresa L.; Mittelman, Mary S.; Beattie, Elizabeth; Parker, Deborah; Neville, Christine

2015-01-01

The aim of this study was to develop an Internet-based self-directed training program for Australian healthcare workers to facilitate learning and competence in delivery of a proven intervention for caregivers of people with dementia: The New York University Caregiver Intervention (NYUCI). The NYUCI is a nonpharmacological, multicomponent…

A professional development model for medical laboratory scientists working in the microbiology laboratory.

PubMed

Amerson, Megan H; Pulido, Lila; Garza, Melinda N; Ali, Faheem A; Greenhill, Brandy; Einspahr, Christopher L; Yarsa, Joseph; Sood, Pramilla K; Hu, Peter C

2012-01-01

The University of Texas M.D. Anderson Cancer Center, Division of Pathology and Laboratory Medicine is committed to providing the best pathology and medicine through: state-of-the art techniques, progressive ground-breaking research, education and training for the clinical diagnosis and research of cancer and related diseases. After surveying the laboratory staff and other hospital professionals, the Department administrators and Human Resource generalists developed a professional development model for Microbiology to support laboratory skills, behavior, certification, and continual education within its staff. This model sets high standards for the laboratory professionals to allow the labs to work at their fullest potential; it provides organization to training technologists based on complete laboratory needs instead of training technologists in individual areas in which more training is required if the laboratory needs them to work in other areas. This model is a working example for all microbiology based laboratories who want to set high standards and want their staff to be acknowledged for demonstrated excellence and professional development in the laboratory. The PDM model is designed to focus on the needs of the laboratory as well as the laboratory professionals.

Comparison of the identification and ease of use of two alarm sound sets by critical and acute care nurses with little or no music training: a laboratory study.

PubMed

Atyeo, J; Sanderson, P M

2015-07-01

The melodic alarm sound set for medical electrical equipment that was recommended in the International Electrotechnical Commission's IEC 60601-1-8 standard has proven difficult for clinicians to learn and remember, especially clinicians with little prior formal music training. An alarm sound set proposed by Patterson and Edworthy in 1986 might improve performance for such participants. In this study, 31 critical and acute care nurses with less than one year of formal music training identified alarm sounds while they calculated drug dosages. Sixteen nurses used the IEC and 15 used the Patterson-Edworthy alarm sound set. The mean (SD) percentage of alarms correctly identified by nurses was 51.3 (25.6)% for the IEC alarm set and 72.1 (18.8)% for the Patterson-Edworthy alarms (p = 0.016). Nurses using the Patterson-Edworthy alarm sound set reported that it was easier to distinguish between alarm sounds than did nurses using the IEC alarm sound set (p = 0.015). Principles used to construct the Patterson-Edworthy alarm sounds should be adopted for future alarm sound sets. © 2015 The Association of Anaesthetists of Great Britain and Ireland.

Predicting ground contact events for a continuum of gait types: An application of targeted machine learning using principal component analysis.

PubMed

Osis, Sean T; Hettinga, Blayne A; Ferber, Reed

2016-05-01

An ongoing challenge in the application of gait analysis to clinical settings is the standardized detection of temporal events, with unobtrusive and cost-effective equipment, for a wide range of gait types. The purpose of the current study was to investigate a targeted machine learning approach for the prediction of timing for foot strike (or initial contact) and toe-off, using only kinematics for walking, forefoot running, and heel-toe running. Data were categorized by gait type and split into a training set (∼30%) and a validation set (∼70%). A principal component analysis was performed, and separate linear models were trained and validated for foot strike and toe-off, using ground reaction force data as a gold-standard for event timing. Results indicate the model predicted both foot strike and toe-off timing to within 20ms of the gold-standard for more than 95% of cases in walking and running gaits. The machine learning approach continues to provide robust timing predictions for clinical use, and may offer a flexible methodology to handle new events and gait types. Copyright © 2016 Elsevier B.V. All rights reserved.

Monitoring training response in young Friesian dressage horses using two different standardised exercise tests (SETs).

PubMed

de Bruijn, Cornelis Marinus; Houterman, Willem; Ploeg, Margreet; Ducro, Bart; Boshuizen, Berit; Goethals, Klaartje; Verdegaal, Elisabeth-Lidwien; Delesalle, Catherine

2017-02-14

Most Friesian horses reach their anaerobic threshold during a standardized exercise test (SET) which requires lower intensity exercise than daily routine training. to study strengths and weaknesses of an alternative SET-protocol. Two different SETs (SETA and SETB) were applied during a 2 month training period of 9 young Friesian dressage horses. SETB alternated short episodes of canter with trot and walk, lacking long episodes of cantering, as applied in SETA. Following parameters were monitored: blood lactic acid (BLA) after cantering, average heart rate (HR) in trot and maximum HR in canter. HR and BLA of SETA and SETB were analyzed using a paired two-sided T-test and Spearman Correlation-coefficient (p* < 0.05). BLA after cantering was significantly higher in SETA compared to SETB and maximum HR in canter was significantly higher in SETA compared to SETB. The majority of horses showed a significant training response based upon longitudinal follow-up of BLA. Horses with the lowest fitness at start, displayed the largest training response. BLA was significantly lower in week 8 compared to week 0, in both SETA and SETB. A significantly decreased BLA level after cantering was noticeable in week 6 in SETA, whereas in SETB only as of week 8. In SETA a very strong correlation for BLA and average HR at trot was found throughout the entire training period, not for canter. Young Friesian horses do reach their anaerobic threshold during a SET which requires lower intensity than daily routine training. Therefore close monitoring throughout training is warranted. Longitudinal follow up of BLA and not of HR is suitable to assess training response. In the current study, horses that started with the lowest fitness level, showed the largest training response. During training monitoring HR in trot rather than in canter is advised. SETB is best suited as a template for daily training in the aerobic window.

NeuroRecovery Network provides standardization of locomotor training for persons with incomplete spinal cord injury.

PubMed

Morrison, Sarah A; Forrest, Gail F; VanHiel, Leslie R; Davé, Michele; D'Urso, Denise

2012-09-01

To illustrate the continuity of care afforded by a standardized locomotor training program across a multisite network setting within the Christopher and Dana Reeve Foundation NeuroRecovery Network (NRN). Single patient case study. Two geographically different hospital-based outpatient facilities. This case highlights a 25-year-old man diagnosed with C4 motor incomplete spinal cord injury with American Spinal Injury Association Impairment Scale grade D. Standardized locomotor training program 5 sessions per week for 1.5 hours per session, for a total of 100 treatment sessions, with 40 sessions at 1 center and 60 at another. Ten-meter walk test and 6-minute walk test were assessed at admission and discharge across both facilities. For each of the 100 treatment sessions percent body weight support, average, and maximum treadmill speed were evaluated. Locomotor endurance, as measured by the 6-minute walk test, and overground gait speed showed consistent improvement from admission to discharge. Throughout training, the patient decreased the need for body weight support and was able to tolerate faster treadmill speeds. Data indicate that the patient continued to improve on both treatment parameters and walking function. Standardization across the NRN centers provided a mechanism for delivering consistent and reproducible locomotor training programs across 2 facilities without disrupting training or recovery progression. Copyright © 2012 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Ethical issues in health workforce development.

PubMed Central

Cash, Richard

2005-01-01

Increasing the numbers of health workers and improving their skills requires that countries confront a number of ethical dilemmas. The ethical considerations in answering five important questions on enabling health workers to deal appropriately with the circumstances in which they must work are described. These include the problems of the standards of training and practice required in countries with differing levels of socioeconomic development and different priority diseases; how a society can be assured that health practitioners are properly trained; how a health system can support its workers; diversion of health workers and training institutions; and the teaching of ethical principles to student health workers. The ethics of setting standards for the skills and care provided by traditional health-care practitioners are also discussed. PMID:15868019

Improving the performance of extreme learning machine for hyperspectral image classification

NASA Astrophysics Data System (ADS)

Li, Jiaojiao; Du, Qian; Li, Wei; Li, Yunsong

2015-05-01

Extreme learning machine (ELM) and kernel ELM (KELM) can offer comparable performance as the standard powerful classifier―support vector machine (SVM), but with much lower computational cost due to extremely simple training step. However, their performance may be sensitive to several parameters, such as the number of hidden neurons. An empirical linear relationship between the number of training samples and the number of hidden neurons is proposed. Such a relationship can be easily estimated with two small training sets and extended to large training sets so as to greatly reduce computational cost. Other parameters, such as the steepness parameter in the sigmodal activation function and regularization parameter in the KELM, are also investigated. The experimental results show that classification performance is sensitive to these parameters; fortunately, simple selections will result in suboptimal performance.

High-Throughput Classification of Radiographs Using Deep Convolutional Neural Networks.

PubMed

Rajkomar, Alvin; Lingam, Sneha; Taylor, Andrew G; Blum, Michael; Mongan, John

2017-02-01

The study aimed to determine if computer vision techniques rooted in deep learning can use a small set of radiographs to perform clinically relevant image classification with high fidelity. One thousand eight hundred eighty-five chest radiographs on 909 patients obtained between January 2013 and July 2015 at our institution were retrieved and anonymized. The source images were manually annotated as frontal or lateral and randomly divided into training, validation, and test sets. Training and validation sets were augmented to over 150,000 images using standard image manipulations. We then pre-trained a series of deep convolutional networks based on the open-source GoogLeNet with various transformations of the open-source ImageNet (non-radiology) images. These trained networks were then fine-tuned using the original and augmented radiology images. The model with highest validation accuracy was applied to our institutional test set and a publicly available set. Accuracy was assessed by using the Youden Index to set a binary cutoff for frontal or lateral classification. This retrospective study was IRB approved prior to initiation. A network pre-trained on 1.2 million greyscale ImageNet images and fine-tuned on augmented radiographs was chosen. The binary classification method correctly classified 100 % (95 % CI 99.73-100 %) of both our test set and the publicly available images. Classification was rapid, at 38 images per second. A deep convolutional neural network created using non-radiological images, and an augmented set of radiographs is effective in highly accurate classification of chest radiograph view type and is a feasible, rapid method for high-throughput annotation.

Pedagogical Competencies for Mother-Tongue Teacher Education

ERIC Educational Resources Information Center

Mata, Liliana

2014-01-01

This study aims to elaborate a framework for both the foundation and application of professional standards for mother-tongue teachers. The main issue with which this study is concerned constitutes the lack of a set of clear standards for the initial training of mother-tongue teachers. In terms of theory, that which has currently been analyzed in…

49 CFR 1103.3 - Persons not attorneys-at-law-qualifications and requirements for practice before the Board.

Code of Federal Regulations, 2011 CFR

2011-10-01

... burden of proof is on the applicant to establish that the formal education satisfies the standards set... standards. A non-attorney applicant for admission to practice must meet one of the following requirements... secondary education and must possess technical knowledge, training or experience in the field of...

Maritime English Vocabulary in Feature Films: "The Perfect Storm" (2000) and "Master and Commander" (2003)

ERIC Educational Resources Information Center

Jurkovic, Violeta

2016-01-01

The teaching content of Maritime English is dictated by the 1995 International Convention on Standards of Training, Certification, and Watchkeeping, as amended, which sets qualification standards for masters, officers, and officers of the watch on merchant ships, including a high proficiency level in maritime English. Feature films have an…

Are You Gainfully Employed? Setting Standards for For-Profit Degrees. Education Sector Reports

ERIC Educational Resources Information Center

Miller, Ben

2010-01-01

For-profit higher education institutions have grown by leaps and bounds in recent years, largely free of federal regulation. That freedom would be significantly curtailed if the gainful employment standard takes effect. Vocational training programs would be judged by the ratio of the debt that graduates assume relative to their current earnings…

Greater improvement in cardiorespiratory fitness using higher-intensity interval training in the standard cardiac rehabilitation setting.

PubMed

Keteyian, Steven J; Hibner, Brooks A; Bronsteen, Kyle; Kerrigan, Dennis; Aldred, Heather A; Reasons, Lisa M; Saval, Mathew A; Brawner, Clinton A; Schairer, John R; Thompson, Tracey M S; Hill, Jason; McCulloch, Derek; Ehrman, Jonathon K

2014-01-01

We tested the hypothesis that higher-intensity interval training (HIIT) could be deployed into a standard cardiac rehabilitation (CR) setting and would result in a greater increase in cardiorespiratory fitness (ie, peak oxygen uptake, (·)VO₂) versus moderate-intensity continuous training (MCT). Thirty-nine patients participating in a standard phase 2 CR program were randomized to HIIT or MCT; 15 patients and 13 patients in the HIIT and MCT groups, respectively, completed CR and baseline and followup cardiopulmonary exercise testing. No patients in either study group experienced an event that required hospitalization during or within 3 hours after exercise. The changes in resting heart rate and blood pressure at followup testing were similar for both HIIT and MCT. (·)VO₂ at ventilatory-derived anaerobic threshold increased more (P < .05) with HIIT (3.0 ± 2.8 mL·kg⁻¹·min⁻¹) versus MCT (0.7 ± 2.2 mL·kg⁻¹·min⁻¹). During followup testing, submaximal heart rate at the end of stage 2 of the exercise test was significantly lower within both the HIIT and MCT groups, with no difference noted between groups. Peak (·)VO₂ improved more after CR in patients in HIIT versus MCT (3.6 ± 3.1 mL·kg⁻¹·min⁻¹ vs 1.7 ± 1.7 mL·kg⁻¹·min⁻¹; P < .05). Among patients with stable coronary heart disease on evidence-based therapy, HIIT was successfully integrated into a standard CR setting and, when compared to MCT, resulted in greater improvement in peak exercise capacity and submaximal endurance.

Training set optimization and classifier performance in a top-down diabetic retinopathy screening system

NASA Astrophysics Data System (ADS)

Wigdahl, J.; Agurto, C.; Murray, V.; Barriga, S.; Soliz, P.

2013-03-01

Diabetic retinopathy (DR) affects more than 4.4 million Americans age 40 and over. Automatic screening for DR has shown to be an efficient and cost-effective way to lower the burden on the healthcare system, by triaging diabetic patients and ensuring timely care for those presenting with DR. Several supervised algorithms have been developed to detect pathologies related to DR, but little work has been done in determining the size of the training set that optimizes an algorithm's performance. In this paper we analyze the effect of the training sample size on the performance of a top-down DR screening algorithm for different types of statistical classifiers. Results are based on partial least squares (PLS), support vector machines (SVM), k-nearest neighbor (kNN), and Naïve Bayes classifiers. Our dataset consisted of digital retinal images collected from a total of 745 cases (595 controls, 150 with DR). We varied the number of normal controls in the training set, while keeping the number of DR samples constant, and repeated the procedure 10 times using randomized training sets to avoid bias. Results show increasing performance in terms of area under the ROC curve (AUC) when the number of DR subjects in the training set increased, with similar trends for each of the classifiers. Of these, PLS and k-NN had the highest average AUC. Lower standard deviation and a flattening of the AUC curve gives evidence that there is a limit to the learning ability of the classifiers and an optimal number of cases to train on.

Students' Perceptions on an Interprofessional Ward Round Training - A Qualitative Pilot Study.

PubMed

Nikendei, C; Huhn, D; Pittius, G; Trost, Y; Bugaj, T J; Koechel, A; Schultz, J-H

2016-01-01

Ward rounds are an essential activity for interprofessional teams in hospital settings and represent complex tasks requiring not only medical knowledge but also communication skills, clinical technical skills, patient management skills and team-work skills. The present study aimed to analyse final year students', nurses' as well as physiotherapists' views on a simulation-based interprofessional ward round training. In two successive passes a total number of 29 final year students, nursing students and physiotherapy students (16 in the first run, 13 in the second) volunteered to participate in two standardized patient ward round scenarios: (1) patient with myocardial infarction, and (2) patient with poorly controlled diabetes. Views on the interprofessional ward round training were assessed using focus groups. Focus group based feedback contained two main categories (A) ward round training benefits and (B) difficulties. Positive aspects enfolded course preparation, setting of the training, the involvement of the participants during training and the positive learning atmosphere. Difficulties were seen in the flawed atmosphere and realization of ward rounds in the daily clinical setting with respect to inter-professional aspects, and course benefit for the different professional groups. The presented inter-professional ward round training represents a well received and valuable model of interprofessional learning. Further research should assess its effectiveness, processes of interprofessional interplay and transfer into clinical practice.

The application of neural networks to the SSME startup transient

NASA Technical Reports Server (NTRS)

Meyer, Claudia M.; Maul, William A.

1991-01-01

Feedforward neural networks were used to model three parameters during the Space Shuttle Main Engine startup transient. The three parameters were the main combustion chamber pressure, a controlled parameter, the high pressure oxidizer turbine discharge temperature, a redlined parameter, and the high pressure fuel pump discharge pressure, a failure-indicating performance parameter. Network inputs consisted of time windows of data from engine measurements that correlated highly to the modeled parameter. A standard backpropagation algorithm was used to train the feedforward networks on two nominal firings. Each trained network was validated with four additional nominal firings. For all three parameters, the neural networks were able to accurately predict the data in the validation sets as well as the training set.

The new GRID Hamilton Rating Scale for Depression demonstrates excellent inter-rater reliability for inexperienced and experienced raters before and after training.

PubMed

Tabuse, Hideaki; Kalali, Amir; Azuma, Hideki; Ozaki, Norio; Iwata, Nakao; Naitoh, Hiroshi; Higuchi, Teruhiko; Kanba, Shigenobu; Shioe, Kunihiko; Akechi, Tatsuo; Furukawa, Toshi A

2007-09-30

The Hamilton Rating Scale for Depression (HAMD) is the de facto international gold standard for the assessment of depression. There are some criticisms, however, especially with regard to its inter-rater reliability, due to the lack of standardized questions or explicit scoring procedures. The GRID-HAMD was developed to provide standardized explicit scoring conventions and a structured interview guide for administration and scoring of the HAMD. We developed the Japanese version of the GRID-HAMD and examined its inter-rater reliability among experienced and inexperienced clinicians (n=70), how rater characteristics may affect it, and how training can improve it in the course of a model training program using videotaped interviews. The results showed that the inter-rater reliability of the GRID-HAMD total score was excellent to almost perfect and those of most individual items were also satisfactory to excellent, both with experienced and inexperienced raters, and both before and after the training. With its standardized definitions, questions and detailed scoring conventions, the GRID-HAMD appears to be the best achievable set of interview guides for the HAMD and can provide a solid tool for highly reliable assessment of depression severity.

Interoceptive conditioning in rats: effects of using a single training dose or a set of 5 different doses of nicotine.

PubMed

Pittenger, Steven T; Bevins, Rick A

2013-12-01

Interoceptive conditioning contributes to the tenacity of nicotine dependence. Previous research investigating nicotine as an interoceptive stimulus has typically employed administration of a single training dose of nicotine over an extended time. This approach has allowed for careful study of the nicotine stimulus. In humans, the nicotine stimulus is unlikely to be fixed across learning episodes. Thus, from a translational perspective, systematic variation of nicotine dose in training might better approximate interoceptive conditioning in humans. Notably, training with a class or set of discrete exteroceptive stimuli (e.g., different pictures of cars) produces interesting behavioral differences relative to training with a single stimulus. The present study sought to determine whether similar differences would occur if a set of nicotine stimuli were used in place of a single dose. To investigate this question, one group of male Sprague-Dawley rats was trained on a discriminated goal-tracking task with a set of nicotine doses (0.05, 0.125, 0.2, 0.275, and 0.35mg/kg). A second group received the standard protocol of training with a single nicotine dose (0.2mg/kg). On each nicotine session, there was intermittent access to liquid sucrose (26%) in a conditioning chamber. On intermixed saline sessions, sucrose was withheld. We examined acquisition, subsequent extinction, transfer of extinction, nicotine generalization, and mecamylamine blockade. Both groups reliably discriminated between nicotine and saline sessions, were sensitive to non-reinforcement, displayed transfer of extinction, demonstrated dose-dependent nicotine generalization, and responding was blocked by mecamylamine. There were no significant differences between the two groups. The unique nature of an interoceptive pharmacological stimulus and the challenges posed for studying the impact of training with a set of interoceptive stimuli are discussed. © 2013.

On the design of flight-deck procedures

DOT National Transportation Integrated Search

1994-06-01

In complex human-machine systems, operations, training, and standardization depend on an elaborate set of procedures which are specified and mandated by the operational management of the organization. These procedures indicate to the human operator (...

[Assessment of capacity for logisty, public education, and training in public health emergency management in China].

PubMed

Hu, Guo-qing; Rao, Ke-qin; Sun, Zhen-qiu; Yu, Ren-he

2008-10-01

To assess the capacity for logistics, public education, and training in managing public health emergency in China at present. Four provinces were selected using stratified sampling. All the municipalities of these 4 provinces were assessed using the 9th and 10th subscales (logistics, public education and training) of Preparedness and response capacity questionnaire for public health emergencies for provincial or municipal governments developed by the Center for Health Statistics and Information, Ministry of Health of China. Sixty of the 66 questionnaires (90.91%) were collected. Among the 60 investigated municipalities, 80% established a specific agency to take charge of emergency material storage, management and allocation, 65% developed standard for material storage, 35% developed standard of places for material storage, 25% built regulation for testing, maintaining, and updating the emergency materials regularly, 45% arranged budget for routine payment, 27% established standard of emergency fund, and 28% set up the procedure to initiate emergency fund. The average of standard score of subscale 9 was 43.33 (95% confidence interval, 35.65~51.01). 25% of the 60 municipalities conducted assessment for training in the past 2 years, 53% developed plan for emergency personnel training, 20% developed effectiveness assessment regulation of emergency personnel training, 80% assigned a specific agency to be responsible for public education, and 23% established regulation for public education. The average of standard score of subscale 10 was 47.43 (95% confidence interval, 40.69~54.17). Serious problems are found in logistics, public education, and training for public health emergency management in China. Measures should be taken immediately by the central and local government to improve these capacities.

Randomized controlled comparative study on effect of training to improve lower limb motor paralysis in convalescent patients with post-stroke hemiplegia

PubMed Central

Kawakami, Kenji; Miyasaka, Hiroyuki; Nonoyama, Sayaka; Hayashi, Kazuya; Tonogai, Yusuke; Tanino, Genichi; Wada, Yosuke; Narukawa, Akihisa; Okuyama, Yuko; Tomita, Yutaka; Sonoda, Shigeru

2015-01-01

[Purpose] The motor paralysis-improving effect on the hemiplegic lower limb was compared among mirror therapy, integrated volitional-control electrical stimulation, therapeutic electrical stimulation, repetitive facilitative exercises, and the standard training method in post-stroke hemiplegia patients. [Subjects and Methods] Eighty one stroke patients admitted to a convalescent rehabilitation ward were randomly allocated to the above 5 treatment groups. Each patient performed functional training of the paralytic lower limb for 20 minutes a day for 4 weeks, and changes in the lower limb function were investigated using the Stroke Impairment Assessment Set. [Results] The hip and knee joint functions did not significantly improve in the standard training control group, but significant improvements were observed after 4 weeks in the other intervention groups. Significant improvement was noted in the ankle joint function in all groups. [Conclusion] Although the results were influenced by spontaneous recovery and the standard training in the control group, the hip and knee joints were more markedly improved by the interventions in the other 4 groups of patients with moderate paralysis, compared to the control group. PMID:26504331

Training artificial neural networks directly on the concordance index for censored data using genetic algorithms.

PubMed

Kalderstam, Jonas; Edén, Patrik; Bendahl, Pär-Ola; Strand, Carina; Fernö, Mårten; Ohlsson, Mattias

2013-06-01

The concordance index (c-index) is the standard way of evaluating the performance of prognostic models in the presence of censored data. Constructing prognostic models using artificial neural networks (ANNs) is commonly done by training on error functions which are modified versions of the c-index. Our objective was to demonstrate the capability of training directly on the c-index and to evaluate our approach compared to the Cox proportional hazards model. We constructed a prognostic model using an ensemble of ANNs which were trained using a genetic algorithm. The individual networks were trained on a non-linear artificial data set divided into a training and test set both of size 2000, where 50% of the data was censored. The ANNs were also trained on a data set consisting of 4042 patients treated for breast cancer spread over five different medical studies, 2/3 used for training and 1/3 used as a test set. A Cox model was also constructed on the same data in both cases. The two models' c-indices on the test sets were then compared. The ranking performance of the models is additionally presented visually using modified scatter plots. Cross validation on the cancer training set did not indicate any non-linear effects between the covariates. An ensemble of 30 ANNs with one hidden neuron was therefore used. The ANN model had almost the same c-index score as the Cox model (c-index=0.70 and 0.71, respectively) on the cancer test set. Both models identified similarly sized low risk groups with at most 10% false positives, 49 for the ANN model and 60 for the Cox model, but repeated bootstrap runs indicate that the difference was not significant. A significant difference could however be seen when applied on the non-linear synthetic data set. In that case the ANN ensemble managed to achieve a c-index score of 0.90 whereas the Cox model failed to distinguish itself from the random case (c-index=0.49). We have found empirical evidence that ensembles of ANN models can be optimized directly on the c-index. Comparison with a Cox model indicates that near identical performance is achieved on a real cancer data set while on a non-linear data set the ANN model is clearly superior. Copyright © 2013 Elsevier B.V. All rights reserved.

Point-of-care ultrasonography by pediatric emergency physicians. Policy statement.

PubMed

Marin, Jennifer R; Lewiss, Resa E

2015-04-01

Point-of-care ultrasonography is increasingly being used to facilitate accurate and timely diagnoses and to guide procedures. It is important for pediatric emergency physicians caring for patients in the emergency department to receive adequate and continued point-of-care ultrasonography training for those indications used in their practice setting. Emergency departments should have credentialing and quality assurance programs. Pediatric emergency medicine fellowships should provide appropriate training to physician trainees. Hospitals should provide privileges to physicians who demonstrate competency in point-of-care ultrasonography. Ongoing research will provide the necessary measures to define the optimal training and competency assessment standards. Requirements for credentialing and hospital privileges will vary and will be specific to individual departments and hospitals. As more physicians are trained and more research is completed, there should be one national standard for credentialing and privileging in point-of-care ultrasonography for pediatric emergency physicians.

Medicines management: an interview study of nurses at a secure psychiatric hospital.

PubMed

Haw, Camilla; Stubbs, Jean; Dickens, Geoff

2015-02-01

To explore mental health nurses' knowledge, attitudes and clinical judgement concerning medicines management in an inpatient setting with a view to enhancing training. Medicines management is a key role of mental health nurses, but little research has been conducted into their training needs. An exploratory mixed-methods design was used involving individual interviews with participants to investigate their responses to hypothetical medicine administration scenarios. Interviews were held with a convenience sample of 50 Registered Nurses working in a specialist mental health hospital between November 2012-February 2013. Participants were presented with clinical vignettes describing eight scenarios they might encounter as part of their medicines management role and asked about how they would respond. Responses were assessed by two independent raters against ten quality standards underpinning the vignettes. The median number of responses that were judged to demonstrate adequate awareness of associated quality standards was 4 (range 1-7), indicating that many participants did not appear to be aware of, or compliant with, current UK medicines management guidance and local policy. Many would not report a 'near miss' or medicines administration error. There was a lack of awareness of guidance on verbal prescribing, consent to treatment rules and the administration of off-label/unlicensed drugs. Past year attendance on a medicines management course, time since registration and self-reported knowledge of national standards for medicines administration did not discriminate between total score on the 10 quality standards. The medicines management training needs of participants appeared not to be fully met by the existing learning sources. The use of vignettes to assess nurses' training needs requires evaluation in other settings. © 2014 John Wiley & Sons Ltd.

Effect of training on word-recognition performance in noise for young normal-hearing and older hearing-impaired listeners.

PubMed

Burk, Matthew H; Humes, Larry E; Amos, Nathan E; Strauser, Lauren E

2006-06-01

The objective of this study was to evaluate the effectiveness of a training program for hearing-impaired listeners to improve their speech-recognition performance within a background noise when listening to amplified speech. Both noise-masked young normal-hearing listeners, used to model the performance of elderly hearing-impaired listeners, and a group of elderly hearing-impaired listeners participated in the study. Of particular interest was whether training on an isolated word list presented by a standardized talker can generalize to everyday speech communication across novel talkers. Word-recognition performance was measured for both young normal-hearing (n = 16) and older hearing-impaired (n = 7) adults. Listeners were trained on a set of 75 monosyllabic words spoken by a single female talker over a 9- to 14-day period. Performance for the familiar (trained) talker was measured before and after training in both open-set and closed-set response conditions. Performance on the trained words of the familiar talker were then compared with those same words spoken by three novel talkers and to performance on a second set of untrained words presented by both the familiar and unfamiliar talkers. The hearing-impaired listeners returned 6 mo after their initial training to examine retention of the trained words as well as their ability to transfer any knowledge gained from word training to sentences containing both trained and untrained words. Both young normal-hearing and older hearing-impaired listeners performed significantly better on the word list in which they were trained versus a second untrained list presented by the same talker. Improvements on the untrained words were small but significant, indicating some generalization to novel words. The large increase in performance on the trained words, however, was maintained across novel talkers, pointing to the listener's greater focus on lexical memorization of the words rather than a focus on talker-specific acoustic characteristics. On return in 6 mo, listeners performed significantly better on the trained words relative to their initial baseline performance. Although the listeners performed significantly better on trained versus untrained words in isolation, once the trained words were embedded in sentences, no improvement in recognition over untrained words within the same sentences was shown. Older hearing-impaired listeners were able to significantly improve their word-recognition abilities through training with one talker and to the same degree as young normal-hearing listeners. The improved performance was maintained across talkers and across time. This might imply that training a listener using a standardized list and talker may still provide benefit when these same words are presented by novel talkers outside the clinic. However, training on isolated words was not sufficient to transfer to fluent speech for the specific sentence materials used within this study. Further investigation is needed regarding approaches to improve a hearing aid user's speech understanding in everyday communication situations.

A Criterion-Referenced Viewpoint on Standards/Cutscores in Language Testing.

ERIC Educational Resources Information Center

Davidson, Fred; Lynch, Brian K.

"Standard" is distinguished from "criterion" as it is used in criterion-referenced testing. The former is argued to refer to the real-world cutpoint at which a decision is made based on a test's result (e.g., exemption from a special training program). The latter is a skill or set of skills to which a test is referenced.…

The Use of Autonomic Modulation Device to Control Training Performance after High-Intensity Interval Training Program.

PubMed

Clemente-Suárez, Vicente Javier; Arroyo-Toledo, Juan Jaime

2018-01-25

The aim of the present research was to analyze the autonomic response in a group of trained swimmers before and after conducting a 4-week period of high-intensity interval training (HIT). Heart rate variability was analyzed in 14 swimmers (16.2 ± 2.6 years, 169.1 ± 10.2 cm and 61.3 ± 9.9 kg) in basal condition and during a HIT session before and after completing a training period. The HIT session that was evaluated consisted of: 16 × 25 m maximum speed, resting 30 s between sets. Participants combined aerobic training with tethered swimming and HIT sessions three times per week in a period of 4 weeks. Results showed a significantly decrease (p < 0.05) of the standard deviation of the NN intervals (SDNN), the standard deviation of differences between adjacent NN intervals (SDSD), the number of successive difference of intervals which differ by more than 50 ms (NN50), after the training period. Results showed a higher parasympathetic activation besides improvements in autonomic adaptation after HIT training period.

K-12 School Food Service Staff Training Interventions: A Review of the Literature.

PubMed

Stephens, Lacy; Byker Shanks, Carmen

2015-12-01

School food service professionals are vital to implementing national nutrition standards in school meal programs. Appropriate and effective training for these professionals may be one key to producing healthful meals that students are excited to eat and also meet United States Department of Agriculture (USDA) nutrient guidelines. A systematic literature review was conducted to understand the scope of interventions conducted with food service staff. PubMed, Web of Knowledge, and Science Direct databases were searched for articles detailing school food service training interventions in K-12 school settings within the United States. Of 2341 articles retrieved, 17 articles describing 14 food service training interventions met the inclusion criteria. While food service staff training was an important component of many comprehensive school health and school meal interventions, there were few studies that specifically addressed school food service staff trainings. Although some best practices can be concluded from the current literature, major gaps in knowledge about effective school food service training interventions and validated research tools remain. As new professional standards are mandated by the USDA, a more thorough evaluation and understanding of best practices is vital to maximize the effectiveness of food service staff training. © 2015, American School Health Association.

Training labels for hippocampal segmentation based on the EADC-ADNI harmonized hippocampal protocol.

PubMed

Boccardi, Marina; Bocchetta, Martina; Morency, Félix C; Collins, D Louis; Nishikawa, Masami; Ganzola, Rossana; Grothe, Michel J; Wolf, Dominik; Redolfi, Alberto; Pievani, Michela; Antelmi, Luigi; Fellgiebel, Andreas; Matsuda, Hiroshi; Teipel, Stefan; Duchesne, Simon; Jack, Clifford R; Frisoni, Giovanni B

2015-02-01

The European Alzheimer's Disease Consortium and Alzheimer's Disease Neuroimaging Initiative (ADNI) Harmonized Protocol (HarP) is a Delphi definition of manual hippocampal segmentation from magnetic resonance imaging (MRI) that can be used as the standard of truth to train new tracers, and to validate automated segmentation algorithms. Training requires large and representative data sets of segmented hippocampi. This work aims to produce a set of HarP labels for the proper training and certification of tracers and algorithms. Sixty-eight 1.5 T and 67 3 T volumetric structural ADNI scans from different subjects, balanced by age, medial temporal atrophy, and scanner manufacturer, were segmented by five qualified HarP tracers whose absolute interrater intraclass correlation coefficients were 0.953 and 0.975 (left and right). Labels were validated as HarP compliant through centralized quality check and correction. Hippocampal volumes (mm(3)) were as follows: controls: left = 3060 (standard deviation [SD], 502), right = 3120 (SD, 897); mild cognitive impairment (MCI): left = 2596 (SD, 447), right = 2686 (SD, 473); and Alzheimer's disease (AD): left = 2301 (SD, 492), right = 2445 (SD, 525). Volumes significantly correlated with atrophy severity at Scheltens' scale (Spearman's ρ = <-0.468, P = <.0005). Cerebrospinal fluid spaces (mm(3)) were as follows: controls: left = 23 (32), right = 25 (25); MCI: left = 15 (13), right = 22 (16); and AD: left = 11 (13), right = 20 (25). Five subjects (3.7%) presented with unusual anatomy. This work provides reference hippocampal labels for the training and certification of automated segmentation algorithms. The publicly released labels will allow the widespread implementation of the standard segmentation protocol. Copyright © 2015 The Alzheimer's Association. Published by Elsevier Inc. All rights reserved.

Auditory Learning Using a Portable Real-Time Vocoder: Preliminary Findings

PubMed Central

Pisoni, David B.

2015-01-01

Purpose Although traditional study of auditory training has been in controlled laboratory settings, interest has been increasing in more interactive options. The authors examine whether such interactive training can result in short-term perceptual learning, and the range of perceptual skills it impacts. Method Experiments 1 (N = 37) and 2 (N = 21) used pre- and posttest measures of speech and nonspeech recognition to find evidence of learning (within subject) and to compare the effects of 3 kinds of training (between subject) on the perceptual abilities of adults with normal hearing listening to simulations of cochlear implant processing. Subjects were given interactive, standard lab-based, or control training experience for 1 hr between the pre- and posttest tasks (unique sets across Experiments 1 & 2). Results Subjects receiving interactive training showed significant learning on sentence recognition in quiet task (Experiment 1), outperforming controls but not lab-trained subjects following training. Training groups did not differ significantly on any other task, even those directly involved in the interactive training experience. Conclusions Interactive training has the potential to produce learning in 1 domain (sentence recognition in quiet), but the particulars of the present training method (short duration, high complexity) may have limited benefits to this single criterion task. PMID:25674884

Strength Gains by Motor Imagery with Different Ratios of Physical to Mental Practice

PubMed Central

Reiser, Mathias; Büsch, Dirk; Munzert, Jörn

2011-01-01

The purpose of this training study was to determine the magnitude of strength gains following a high-intensity resistance training (i.e., improvement of neuromuscular coordination) that can be achieved by imagery of the respective muscle contraction imagined maximal isometric contraction (IMC training). Prior to the experimental intervention, subjects completed a 4-week standardized strength training program. 3 groups with different combinations of real maximum voluntary contraction (MVC) and mental (IMC) strength training (M75, M50, M25; numbers indicate percentages of mental trials) were compared to a MVC-only training group (M0) and a control condition without strength training (CO). Training sessions (altogether 12) consisted of four sets of two maximal 5-s isometric contractions with 10 s rest between sets of either MVC or IMC training. Task-specific effects of IMC training were tested in four strength exercises commonly used in practical settings (bench pressing, leg pressing, triceps extension, and calf raising). Maximum isometric voluntary contraction force (MVC) was measured before and after the experimental training intervention and again 1 week after cessation of the program. IMC groups (M25, M50, M75) showed slightly smaller increases in MVC (3.0% to 4.2%) than M0 (5.1%), but significantly stronger improvements than CO (−0.2%). Compared to further strength gains in M0 after 1 week (9.4% altogether), IMC groups showed no “delayed” improvement, but the attained training effects remained stable. It is concluded that high-intensity strength training sessions can be partly replaced by IMC training sessions without any considerable reduction of strength gains. PMID:21897826

Education in Disaster Management and Emergencies: Defining a New European Course.

PubMed

Khorram-Manesh, Amir; Ashkenazi, Michael; Djalali, Ahmadreza; Ingrassia, Pier Luigi; Friedl, Tom; von Armin, Gotz; Lupesco, Olivera; Kaptan, Kubilay; Arculeo, Chris; Hreckovski, Boris; Komadina, Radko; Fisher, Philipp; Voigt, Stefan; James, James; Gursky, Elin

2015-06-01

Unremitting natural disasters, deliberate threats, pandemics, and humanitarian suffering resulting from conflict situations necessitate swift and effective response paradigms. The European Union's (EU) increasing visibility as a disaster response enterprise suggests the need not only for financial contribution but also for instituting a coherent disaster response approach and management structure. The DITAC (Disaster Training Curriculum) project identified deficiencies in current responder training approaches and analyzed the characteristics and content required for a new, standardized European course in disaster management and emergencies. Over 35 experts from within and outside the EU representing various organizations and specialties involved in disaster management composed the DITAC Consortium. These experts were also organized into 5 specifically tasked working groups. Extensive literature reviews were conducted to identify requirements and deficiencies and to craft a new training concept based on research trends and lessons learned. A pilot course and program dissemination plan was also developed. The lack of standardization was repeatedly highlighted as a serious deficiency in current disaster training methods, along with gaps in the command, control, and communication levels. A blended and competency-based teaching approach using exercises combined with lectures was recommended to improve intercultural and interdisciplinary integration. The goal of a European disaster management course should be to standardize and enhance intercultural and inter-agency performance across the disaster management cycle. A set of minimal standards and evaluation metrics can be achieved through consensus, education, and training in different units. The core of the training initiative will be a unit that presents a realistic situation "scenario-based training."

Noise-enhanced convolutional neural networks.

PubMed

Audhkhasi, Kartik; Osoba, Osonde; Kosko, Bart

2016-06-01

Injecting carefully chosen noise can speed convergence in the backpropagation training of a convolutional neural network (CNN). The Noisy CNN algorithm speeds training on average because the backpropagation algorithm is a special case of the generalized expectation-maximization (EM) algorithm and because such carefully chosen noise always speeds up the EM algorithm on average. The CNN framework gives a practical way to learn and recognize images because backpropagation scales with training data. It has only linear time complexity in the number of training samples. The Noisy CNN algorithm finds a special separating hyperplane in the network's noise space. The hyperplane arises from the likelihood-based positivity condition that noise-boosts the EM algorithm. The hyperplane cuts through a uniform-noise hypercube or Gaussian ball in the noise space depending on the type of noise used. Noise chosen from above the hyperplane speeds training on average. Noise chosen from below slows it on average. The algorithm can inject noise anywhere in the multilayered network. Adding noise to the output neurons reduced the average per-iteration training-set cross entropy by 39% on a standard MNIST image test set of handwritten digits. It also reduced the average per-iteration training-set classification error by 47%. Adding noise to the hidden layers can also reduce these performance measures. The noise benefit is most pronounced for smaller data sets because the largest EM hill-climbing gains tend to occur in the first few iterations. This noise effect can assist random sampling from large data sets because it allows a smaller random sample to give the same or better performance than a noiseless sample gives. Copyright © 2015 Elsevier Ltd. All rights reserved.

Committee on Veterinary Medicine at the Society for Medical Education: Skills Labs in Veterinary Medicine - a brief overview.

PubMed

Dilly, Marc; Gruber, Christian

2016-01-01

Since 2012, skills labs have been set up to teach practical skills at veterinary training facilities in the German-speaking world. In addition to didactic considerations, ethical points of view in terms of animal protection form the basis of the increasing significance of skills labs in veterinary medicine. Not least because of the quality standards in veterinary medicine training which apply across Europe, the link between veterinary medicine training facilities is particularly significant when it comes to the setting up and development of skills labs. The Committee on Veterinary Medicine is therefore not only interested in exchange and cooperation within veterinary medicine, but also sees an opportunity for mutual gain in the link with the Society for Medical Education Committee "Practical Skills".

Effect of information literacy training course on information literacy skills of undergraduate students of Isfahan University of Medical Sciences based on ACRL standards.

PubMed

Karimi, Zohreh; Ashrafi-Rizi, Hasan; Papi, Ahmad; Shahrzadi, Leila; Hassanzadeh, Akbar

2015-01-01

Information literacy is the basis for lifelong learning. Information literacy skills, especially for student in an environment that is full of information from multiple technologies are being developed is equally important. Information literacy is a set of cognitive and practical skills and like any other science, proper training is needed, and standard-based education is definitely better and evaluation would be easier. This study aimed to determine the impact of information literacy training course on information literacy skills of Isfahan University of Medical Sciences students based on ACRL standard in 2012. The study method is semi-experience with two group design (with pre-test and post-test) and applied. The data collection toll was a questionnaire assessing student's information literacy that developed by Davarpanah and Siamak and validity was confirmed by professional librarians and reliability as measured by Cronbach's alpha, was 0.83. The sample consisted of 50 undergraduate students from Isfahan University of Medical Sciences that by random sampling method was perch in both case and control groups. Before and after the training (once a week), a questionnaire was distributed between the two groups. This training was held in a classroom equipped with computers with internet access and in addition to training using brochures and librarian presentation, interactive methods such as discussion and exercises were used. The data were analyzed using SPSS version 20 software and two level of descriptive (mean and SD) and inferential statistics (t-test and t-paired). The results showed that the students' information literacy scores before the training was lower than average, so that in the control group was 32.96 and in the case group was 33.24; while information literacy scores in the case group significantly increased after the training (46.68). Also, the effect of education, respectively had a greater impact on the ability to access information (the second standard), ethics and legal use of information (the third standard), effective use of information (the fourth standard), critically evaluate information and its sources (the fifth standard). This study showed that the training was effective on enhancing students' information literacy skills as the greatest impact was on increasing the ability to access information. Due to low mean score information literacy in the context of object recognition, there is a need for more training in this area.

Standards for education and training for interagency working in child protection in the UK: implications for nurses, midwives and health visitors.

PubMed

Long, Tony; Davis, Cathy; Johnson, Martin; Murphy, Michael; Race, David; Shardlow, Steven M

2006-01-01

This article presents a discussion of key issues for the education of nurses, midwives and health visitors following the completion of a Department of Health funded project, managed by the General Social Care Council and conducted jointly by two research centres; Salford Centre for Social Work Research and Salford Centre for Nursing, Midwifery and Collaborative Research. The work was initiated in response to Lord Laming's report on the circumstances leading to the death of Victoria Climbié. The project was conducted in relation to specified professions and occupational groups: doctors; health visitors; midwives; nurses; police; teachers, and social workers. It was undertaken in two stages. The first stage mapped existing material about standards in relation to education and training for interagency working. The second stage engaged in an extensive consultation exercise through which a model and a set of proposed standards for interagency education and training for interagency work were developed. The former is detailed fully in this report, while nine examples of standards are presented. The project final report was presented seven months after commencement.

The African Hospitalist Fellowship.

PubMed

Daniels, A D; Buys, H; Dunkley, R; Wilmshurst, J M

2017-10-31

The African Paediatric Fellowship Programme is rolling out a training course for newly qualified paediatricians to equip them with the leadership skills to function in complex general paediatric settings. The care of children in Africa carries its own unique demands, from the layering effects of multiple conditions through to establishing and sustaining services under severe resource constraints. This novel training concept aims to strengthen confidence and knowledge in areas that are not priorities during standard general paediatric training. The skills gained are considered of great relevance in assisting general paediatricians to achieve their full potential in their careers.

Comparing Pattern Recognition Feature Sets for Sorting Triples in the FIRST Database

NASA Astrophysics Data System (ADS)

Proctor, D. D.

2006-07-01

Pattern recognition techniques have been used with increasing success for coping with the tremendous amounts of data being generated by automated surveys. Usually this process involves construction of training sets, the typical examples of data with known classifications. Given a feature set, along with the training set, statistical methods can be employed to generate a classifier. The classifier is then applied to process the remaining data. Feature set selection, however, is still an issue. This paper presents techniques developed for accommodating data for which a substantive portion of the training set cannot be classified unambiguously, a typical case for low-resolution data. Significance tests on the sort-ordered, sample-size-normalized vote distribution of an ensemble of decision trees is introduced as a method of evaluating relative quality of feature sets. The technique is applied to comparing feature sets for sorting a particular radio galaxy morphology, bent-doubles, from the Faint Images of the Radio Sky at Twenty Centimeters (FIRST) database. Also examined are alternative functional forms for feature sets. Associated standard deviations provide the means to evaluate the effect of the number of folds, the number of classifiers per fold, and the sample size on the resulting classifications. The technique also may be applied to situations for which, although accurate classifications are available, the feature set is clearly inadequate, but is desired nonetheless to make the best of available information.

[Development of a computerized system using standard nursing language for creation of a nursing minimum data set].

PubMed

D'Agostino, Fabio; Vellone, Ercole; Tontini, Francesco; Zega, Maurizio; Alvaro, Rosaria

2012-01-01

The aim of a nursing data set is to provide useful information for assessing the level of care and the state of health of the population. Currently, both in Italy and in other countries, this data is incomplete due to the lack of a structured nursing documentation , making it indispensible to develop a Nursing Minimum Data Set (NMDS) using standard nursing language to evaluate care, costs and health requirements. The aim of the project described , is to create a computer system using standard nursing terms with a dedicated software which will aid the decision-making process and provide the relative documentation. This will make it possible to monitor nursing activity and costs and their impact on patients' health : adequate training and involvement of nursing staff will play a fundamental role.

The importance of setting and evaluating standards of telemedicine training.

PubMed

Brebner, E M; Brebner, J A; Ruddick-Bracken, H; Wootton, R; Ferguson, J

2003-01-01

The importance of appropriate training in the use of videoconferencing equipment for clinical purposes is often underestimated when telemedicine projects are established. We developed a user training programme which was delivered via videoconferencing to a group of 130 nurses. Training was delivered on a one-to-one basis. A questionnaire was developed to evaluate user satisfaction and the effectiveness of training. One hundred and two fully completed questionnaires were returned (a 79% response rate). High levels of satisfaction were obtained but the level of user competence reached 100% only when training was supported by a training manual and at least weekly practice. Before establishing a telemedicine service, the following steps appear to be important: identify the required training competencies; deliver a 'hands on' training programme based on the required training competencies; back up the training programme with an instruction booklet; ensure that trainees have at least weekly practice; measure the level of user competence.

Changes in skill and physical fitness following training in talent-identified volleyball players.

PubMed

Gabbett, Tim; Georgieff, Boris; Anderson, Steve; Cotton, Brad; Savovic, Darko; Nicholson, Lee

2006-02-01

This study investigated the effect of a skill-based training program on measurements of skill and physical fitness in talent-identified volleyball players. Twenty-six talented junior volleyball players (mean +/- SE age, 15.5 +/- 0.2 years) participated in an 8-week skill-based training program that included 3 skill-based court sessions per week. Skills sessions were designed to develop passing, setting, serving, spiking, and blocking technique and accuracy as well as game tactics and positioning skills. Coaches used a combination of technical and instructional coaching, coupled with skill-based games to facilitate learning. Subjects performed measurements of skill (passing, setting, serving, and spiking technique and accuracy), standard anthropometry (height, standing-reach height, body mass, and sum of 7 skinfolds), lower-body muscular power (vertical jump, spike jump), upper-body muscular power (overhead medicine-ball throw), speed (5- and 10-m sprint), agility (T-test), and maximal aerobic power (multistage fitness test) before and after training. Training induced significant (p < 0.05) improvements in spiking, setting, and passing accuracy and spiking and passing technique. Compared with pretraining, there were significant (p < 0.05) improvements in 5- and 10-m speed and agility. There were no significant differences between pretraining and posttraining for body mass, skinfold thickness, lower-body muscular power, upper-body muscular power, and maximal aerobic power. These findings demonstrate that skill-based volleyball training improves spiking, setting, and passing accuracy and spiking and passing technique, but has little effect on the physiological and anthropometric characteristics of players.

The 30th anniversary of the American Board of Allergy and Immunology: then and now.

PubMed

Des Prez, L; Reed, C E; Schwartz, L B; Yunginger, J W

2001-04-01

Thirty years ago the Allergy Subspecialty Boards of the American Board of Pediatrics (ABP) and the American Board of Internal Medicine (ABIM) merged to form the American Board of Allergy and Immunology (ABAI). The ABAI mission was to: establish qualifications and examine physician candidates for certification as specialists in allergy and immunology; serve the public, physicians, hospitals, and medical schools by providing the names of physicians certified by the Board; assist educational and professional organizations to improve the quality of care and availability of allergists to deliver such care, to establish and improve standards for the teaching of allergy and immunology, to establish standards for training programs, and to encourage development of increased opportunities for training of physicians interested in allergy and immunology. This mission statement has guided the activities of the Board ever since by providing a strong focus on the 2 major responsibilities: examining and certifying candidates in a fair objective way, and setting standards for the content and conduct of training programs.

Administrative Support Occupations Skill Standards.

ERIC Educational Resources Information Center

Professional Secretaries International, Kansas City, MO.

This document establishes a set of performance expectations based on current practices in administrative support occupations. It is designed to assist individuals, training providers, employers, management personnel, and professional organizations in matching knowledge, abilities, and interests to knowledge and skills required for success in…

Intercultural Action Learning within a Business Context.

ERIC Educational Resources Information Center

Sand, Gregory A.

1996-01-01

Describes an intercultural program adapted to international marketing requirements by GLOBALTEAM, a marketing consultancy. GLOBALTEAM aims to increase sales by introducing corporate managers and workers to merchandising principles and standards. Training stresses goal setting, appropriate change atmosphere, task-force organization, operational…

Innovative approach to teaching communication skills to nursing students.

PubMed

Zavertnik, Jean Ellen; Huff, Tanya A; Munro, Cindy L

2010-02-01

This study assessed the effectiveness of a learner-centered simulation intervention designed to improve the communication skills of preprofessional sophomore nursing students. An innovative teaching strategy in which communication skills are taught to nursing students by using trained actors who served as standardized family members in a clinical learning laboratory setting was evaluated using a two-group posttest design. In addition to current standard education, the intervention group received a formal training session presenting a framework for communication and a 60-minute practice session with the standardized family members. Four domains of communication-introduction, gathering of information, imparting information, and clarifying goals and expectations-were evaluated in the control and intervention groups in individual testing sessions with a standardized family member. The intervention group performed better than the control group in all four tested domains related to communication skills, and the difference was statistically significant in the domain of gathering information (p = 0.0257). Copyright 2010, SLACK Incorporated.

Interobserver agreement between primary graders and an expert grader in the Bristol and Weston diabetic retinopathy screening programme: a quality assurance audit.

PubMed

Patra, S; Gomm, E M W; Macipe, M; Bailey, C

2009-08-01

To assess the quality and accuracy of primary grading in the Bristol and Weston diabetic retinopathy screening programme and to set standards for future interobserver agreement reports. A prospective audit of 213 image sets from six fully trained primary graders in the Bristol and Weston diabetic retinopathy screening programme was carried out over a 4-week period. All the images graded by the primary graders were regraded by an expert grader blinded to the primary grading results and the identity of the primary grader. The interobserver agreement between primary graders and the blinded expert grader and the corresponding Kappa coefficient was determined for overall grading, referable, non-referable and ungradable disease. The audit standard was set at 80% for interobserver agreement with a Kappa coefficient of 0.7. The interobserver agreement bettered the audit standard of 80% in all the categories. The Kappa coefficient was substantial (0.7) for the overall grading results and ranged from moderate to substantial (0.59-0.65) for referable, non-referable and ungradable disease categories. The main recommendation of the audit was to provide refresher training for the primary graders with focus on ungradable disease. The audit demonstrated an acceptable level of quality and accuracy of primary grading in the Bristol and Weston diabetic retinopathy screening programme and provided a standard against which future interobserver agreement can be measured for quality assurance within a screening programme. Diabet. Med. 26, 820-823 (2009).

Teaching self-protection to children using television techniques.

PubMed Central

Poche, C; Yoder, P; Miltenberger, R

1988-01-01

This study compared the effectiveness of a videotape training program with other methods of teaching children self-protection to prevent child abduction. Subjects were kindergarten and first-grade students. Four experimental conditions were presented: videotape with behavior rehearsal, videotape only, a standard safety program, and no training. Acquisition of self-protective behaviors was measured at posttraining and follow-up by having confederate adults entice the children near their schools and homes. Results revealed that the videotape program with behavior rehearsal was highly effective in teaching children safe responses to potential abductors. The standard safety program was effective with fewer than half of the children. Three fourths of the children who received no training immediately agreed to go with the confederate suspects. The videotape program can be easily used with groups of young children in a classroom setting. PMID:3198545

Application of autogenic training for anxiety disorders: a clinical study in a psychiatric setting.

PubMed

Sakai, M

1997-03-01

The effects of autogenic training for anxiety disorders were investigated in a psychiatric setting of a medical school hospital and the predictors of this treatment outcome were identified. Fifty-five patients who meet the DSM-III-R criteria for anxiety disorders were treated individually with autogenic training by the author from October 1981 to October 1995. The medical records of the patients were investigated retrospectively. The results showed that the autogenic training was successful. Twenty-eight patients (51%) were cured, fourteen (25%) much improved, eight (15%) improved and five (9%) unchanged at the end of the treatment. Forty-two patients (76%) were assessed as having had successful treatment. Pretreatment variables, such as patient's clinical characteristics, did not provide a useful guide to the outcome. Four treatment variables did have a bearing on outcome. First, practicing the second standard autogenic training exercise was a satisfactory predictor of a better outcome. Second, practicing generalization training also was a useful predictor. Third, the application of other behavioral treatment techniques was found to be positively associated with outcome. Fourth, longer treatment periods were associated with a better outcome. These findings suggested that autogenic training could be of significant benefit for the treatment of anxiety disorders.

Mechanical Engineering Technology Curriculum.

ERIC Educational Resources Information Center

Georgia State Univ., Atlanta. Dept. of Vocational and Career Development.

This guide offers information and procedures necessary to train mechanical engineering technicians. Discussed first are the rationale and objectives of the curriculum. The occupational field of mechanical engineering technology is described. Next, a curriculum model is set forth that contains information on the standard mechanical engineering…

The effect of knee extensor open kinetic chain resistance training in the ACL-injured knee.

PubMed

Barcellona, Massimo G; Morrissey, Matthew C; Milligan, Peter; Clinton, Melissa; Amis, Andrew A

2015-11-01

To investigate the effect of different loads of knee extensor open kinetic chain resistance training on anterior knee laxity and function in the ACL-injured (ACLI) knee. Fifty-eight ACLI subjects were randomised to one of three (12-week duration) training groups. The STAND group trained according to a standardised rehabilitation protocol. Subjects in the LOW and HIGH group trained as did the STAND group but with the addition of seated knee extensor open kinetic chain resistance training at loads of 2 sets of 20 repetition maximum (RM) and 20 sets of 2RM, respectively. Anterior knee laxity and measurements of physical and subjective function were performed at baseline, 6 and 12 weeks. Thirty-six subjects were tested at both baseline and 12 weeks (STAND n = 13, LOW n = 11, HIGH n = 12). The LOW group demonstrated a reduction in 133 N anterior knee laxity between baseline and 12 weeks testing when compared to the HIGH and the STAND groups (p = 0.009). Specifically, the trained-untrained knee laxity decreased an average of approximately 5 mm in the LOW group while remaining the same in the other two groups. Twelve weeks of knee extensor open kinetic chain resistance training at loads of 2 sets of 20RM led to a reduction in anterior knee laxity in the ACLI knee. This reduction in laxity does not appear to offer any significant short-term functional advantages when compared to a standard rehabilitation protocol. These results indicate that knee laxity can be decreased with resistance training of the thigh muscles. Randomised controlled trial, Level II.

Motivation in vigilance - A test of the goal-setting hypothesis of the effectiveness of knowledge of results.

NASA Technical Reports Server (NTRS)

Warm, J. S.; Riechmann, S. W.; Grasha, A. F.; Seibel, B.

1973-01-01

This study tested the prediction, derived from the goal-setting hypothesis, that the facilitating effects of knowledge of results (KR) in a simple vigilance task should be related directly to the level of the performance standard used to regulate KR. Two groups of Ss received dichotomous KR in terms of whether Ss response times (RTs) to signal detections exceeded a high or low standard of performance. The aperiodic offset of a visual signal was the critical event for detection. The vigil was divided into a training phase followed by testing, during which KR was withdrawn. Knowledge of results enhanced performance in both phases. However, the two standards used to regulate feedback contributed little to these effects.

Does the addition of specific acupuncture to standard swallowing training improve outcomes in patients with dysphagia after stroke? a randomized controlled trial

PubMed Central

Xia, Wenguang; Zheng, Chanjuan; Zhu, Suiqiang; Tang, Zhouping

2015-01-01

Objective: To assess the effect of adding acupuncture to standard swallowing training for patients with dysphagia after stroke. Design: Single-blind randomized controlled trial. Setting: Inpatient and outpatient clinics. Subjects: A total of 124 patients with dysphagia after stroke were randomly divided into two groups: acupuncture and control. Interventions: The acupuncture group received standard swallowing training and acupuncture treatment. In comparison, the control group only received standard swallowing training. Participants in both groups received six days of therapy per week for a four-week period. Main measures: The primary outcome measures included the Standardized Swallowing Assessment and the Dysphagia Outcome Severity Scale. The secondary outcome measures included the Modified Barthel Index and Swallowing-Related Quality of Life, which were assessed before and after the four-week therapy period. Results: A total of 120 dysphagic subjects completed the study (60 in acupuncture group and 60 in control group). Significant differences existed in the Standardized Swallowing Assessment, Dysphagia Outcome Severity Scale, Modified Barthel Index, and Swallowing-Related Quality of Life scores of each group after the treatment (P < 0.01). After the four-week treatment, the Standardized Swallowing Assessment (mean difference − 2.9; 95% confidence interval (CI) – 5.0 to − 0.81; P < 0.01), Dysphagia Outcome Severity Scale (mean difference 2.3; 95% CI 0.7 to 1.2; P < 0.01), Modified Barthel Index (mean difference 17.2; 95% CI 2.6 to 9.3; P < 0.05) and Swallowing-Related Quality of Life scores (mean difference 31.4; 95% CI 3.2 to 11.4; P < 0.01) showed more significant improvement in the acupuncture group than the control group. Conclusions: Acupuncture combined with the standard swallowing training may be beneficial for dysphagic patients after stroke. PMID:25819076

E-Learning Quality Standards for Consumer Protection and Consumer Confidence: A Canadian Case Study in E-Learning Quality Assurance

ERIC Educational Resources Information Center

Barker, Kathryn Chang

2007-01-01

Emerging concerns about quality of e-learning products and services animated a project in Canada to create quality standards that derived primarily from the needs of consumer, that could be used to guide the development and choice of e-learning at all levels of education and training, and that could be implemented in a simple manner. A set of…

A novel resident-as-teacher training program to improve and evaluate obstetrics and gynecology resident teaching skills.

PubMed

Ricciotti, Hope A; Dodge, Laura E; Head, Julia; Atkins, K Meredith; Hacker, Michele R

2012-01-01

Residents play a significant role in teaching, but formal training, feedback, and evaluation are needed. Our aims were to assess resident teaching skills in the resident-as-teacher program, quantify correlations of faculty evaluations with resident self-evaluations, compare resident-as-teacher evaluations with clinical evaluations, and evaluate the resident-as-teacher program. The resident-as-teacher training program is a simulated, videotaped teaching encounter with a trained medical student and standardized teaching evaluation tool. Evaluations from the resident-as-teacher training program were compared to evaluations of resident teaching done by faculty, residents, and medical students from the clinical setting. Faculty evaluation of resident teaching skills in the resident-as-teacher program showed a mean total score of 4.5 ± 0.5 with statistically significant correlations between faculty assessment and resident self-evaluations (r = 0.47; p < 0.001). However, resident self-evaluation of teaching skill was lower than faculty evaluation (mean difference: 0.4; 95% CI 0.3-0.6). When compared to the clinical setting, resident-as-teacher evaluations were significantly correlated with faculty and resident evaluations, but not medical student evaluations. Evaluations from both the resident-as-teacher program and the clinical setting improved with duration of residency. The resident-as-teacher program provides a method to train, give feedback, and evaluate resident teaching.

Clinical neuropsychology practice and training in Canada.

PubMed

Janzen, Laura A; Guger, Sharon

2016-11-01

This invited paper provides information about professional neuropsychology issues in Canada and is part of a special issue addressing international perspectives on education, training, and practice in clinical neuropsychology. Information was gathered from literature searches and personal communication with other neuropsychologists in Canada. Canada has a rich neuropsychological history. Neuropsychologists typically have doctoral-level education including relevant coursework and supervised practical experience. Licensure requirements vary across the 10 provinces and there are regional differences in salary. While training at the graduate and internship level mirrors that of our American colleagues, completion of a two-year postdoctoral fellowship in neuropsychology is not required to obtain employment in many settings and there are few postdoctoral training programs in this country. The majority of neuropsychologists are employed in institutional settings (e.g. hospitals, universities, rehabilitation facilities), with a growing number entering private practice or other settings. There are challenges in providing neuropsychological services to the diverse Canadian population and a need for assessment measures and normative data in multiple languages. Canadian neuropsychologists face important challenges in defining ourselves as distinct from other professions and other psychologists, in maintaining funding for high-quality training and research, in establishing neuropsychology-specific training and practice standards at the provincial or national level, and ensuring the clinical care that we provide is efficient and effective in meeting the needs of our patient populations and consumers, both within and outside of the publically funded health care system.

British Association for the Study of Community Dentistry (BASCD) guidance on the statistical aspects of training and calibration of examiners for surveys of child dental health. A BASCD coordinated dental epidemiology programme quality standard.

PubMed

Pine, C M; Pitts, N B; Nugent, Z J

1997-03-01

The British Association for the Study of Community Dentistry (BASCD) is responsible for the coordination of locally based surveys of child dental health which permit local and national comparisons between health authorities and regions. These surveys began in 1985/86 in England and Wales, 1987/88 in Scotland and 1993/94 in Northern Ireland. BASCD has taken an increasing lead in setting quality standards in discussion with the NHS Epidemiology Coordinators of the Dental Epidemiology Programme. This paper comprises guidance on the statistical aspects of training and calibration of examiners for these surveys.

Mental Health Services in NCAA Division I Athletics: A Survey of Head ATCs.

PubMed

Sudano, Laura E; Miles, Christopher M

There is a growing awareness of the importance of mental health care in National Collegiate Athletic Association (NCAA) student-athletes; however, there is a lack of literature on mental health resources in collegiate settings. Identifying current practices can set the stage to improve the delivery of care. There is great variability in resources and current practices and no "standard of care" exists. Observational, quantitative. Level 5. One hundred twenty-seven (36% response rate) head athletic trainers at Division I NCAA member colleges completed a web-based survey. Questions assessed several aspects of mental health clinicians, perception of care coordination, and screening. Seventy-two percent of respondents noted that counseling took place in a counseling center, and 20.5% of respondents indicated that they had a mental health provider who worked in the athletic training room. Mental health clinician credentials included marriage and family therapist, psychologist, clinical social worker, and psychiatrist. The majority of athletic trainers (ATCs) noted that they are satisfied with the feedback from the mental health provider about the student-athletes' mental health (57.3%) and believe that they would be able to provide better care to student-athletes if mental health services occurred onsite in the training room (46.4%). Fewer than half (43%) indicated that they use screening instruments to assess for mental health disorders. There is wide variability on how mental health services are provided to NCAA Division 1 student-athletes. Some mental health care providers are located offsite, while some provide care in the training room setting. Also, there are inconsistencies in the use of standardized screening tools for mental health evaluation. There is no standard collaborative or integrated care delivery model for student-athletes. Opportunities exist for standardization through integrated care models and increased use of validated screening tools to deliver comprehensive care to student-athletes.

International Emergency Medical Teams Training Workshop Special Report.

PubMed

Albina, Anthony; Archer, Laura; Boivin, Marlène; Cranmer, Hilarie; Johnson, Kirsten; Krishnaraj, Gautham; Maneshi, Anali; Oddy, Lisa; Redwood-Campbell, Lynda; Russell, Rebecca

2018-04-26

The World Health Organization's (WHO; Geneva, Switzerland) Emergency Medical Team (EMT) Initiative created guidelines which define the basic procedures to be followed by personnel and teams, as well as the critical points to discuss before deploying a field hospital. However, to date, there is no formal standardized training program established for EMTs before deployment. Recognizing that the World Association of Disaster and Emergency Medicine (WADEM; Madison, Wisconsin USA) Congress brings together a diverse group of key stakeholders, a pre-Congress workshop was organized to seek out collective expertise and to identify key EMT training competencies for the future development of training programs and protocols. The future of EMT training should include standardization of curriculum and the recognition or accreditation of selected training programs. The outputs of this pre-WADEM Congress workshop provide an initial contribution to the EMT Training Working Group, as this group works on mapping training, competencies, and curriculum. Common EMT training themes that were identified as fundamental during the pre-Congress workshop include: the ability to adapt one's professional skills to low-resource settings; context-specific training, including the ability to serve the needs of the affected population in natural disasters; training together as a multi-disciplinary EMT prior to deployment; and the value of simulation in training. AlbinaA, ArcherL, BoivinM, CranmerH, JohnsonK, KrishnarajG, ManeshiA, OddyL, Redwood-CampbellL, RussellR. International Emergency Medical Teams training workshop special report.

Applying lessons from commercial aviation safety and operations to resuscitation.

PubMed

Ornato, Joseph P; Peberdy, Mary Ann

2014-02-01

Both commercial aviation and resuscitation are complex activities in which team members must respond to unexpected emergencies in a consistent, high quality manner. Lives are at stake in both activities and the two disciplines have similar leadership structures, standard setting processes, training methods, and operational tools. Commercial aviation crews operate with remarkable consistency and safety, while resuscitation team performance and outcomes are highly variable. This commentary provides the perspective of two physician-pilots showing how commercial aviation training, operations, and safety principles can be adapted to resuscitation team training and performance. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Employment training for disadvantaged or dependent populations.

PubMed

Stern, H

1982-01-01

The vocational rehabilitation process is viewed as having two dominant work-related components: the actual work-training experience and employability skills. The paper argues that both components are critical and must be integrated. The major role of the vocational rehabilitation agency is viewed as that of provider of employability (or job-seeking) skills programs. These programs consist of: (1) employability skills courses, (2) work performance demand standard setting, and (3) on-the-job rotational task schemes. Actual work skills can only be provided in the "real world" of work. Centralized work-training programs are viewed as creating inappropriate socialization and only moderately transferable skills.

Resuscitation training in small-group setting – gender matters

PubMed Central

2013-01-01

Background Within cardiopulmonary resuscitation external chest compressions (ECC) are of outstanding importance. Frequent training in Basic Life Support (BLS) may improve the performance, but the perfect method or environment is still a matter of research. The objective of this study was to evaluate whether practical performance and retention of skills in resuscitation training may be influenced by the gender composition in learning groups. Methods Participants were allocated to three groups for standardized BLS-training: Female group (F): only female participants; Male group (M): only male participants; Standard group (S): male and female participants. All groups were trained with the standardized 4-step-approach method. Assessment of participants’ performance was done before training (t1), after one week (t2) and eight months later (t3) on a manikin in the same cardiac arrest single-rescuer-scenario. Participants were 251 Laypersons (mean age 21; SD 4; range 18–42 years; females 63%) without previous medical knowledge. Endpoints: compression rate 90-110/min; mean compression depth 38–51 mm. Standardized questionnaires were used for the evaluation of attitude and learning environment. Results After one week group F performed significantly better with respect to the achievement of the correct mean compression depth (F: 63% vs. S: 43%; p = 0.02). Moreover, groups F and S were the only groups which were able to improve their performance concerning the mean compression rate (t1: 35%; t3: 52%; p = 0.04). Female participants felt more comfortable in the female–only environment. Conclusions Resuscitation training in gender-segregated groups has an effect on individual performance with superior ECC skills in the female-only learning groups. Female participants could improve their skills by a more suitable learning environment, while male participants in the standard group felt less distracted by their peers than male participants in the male-only group. PMID:23590998

Higher surgical training opportunities in the general hospital setting; getting the balance right.

PubMed

Robertson, I; Traynor, O; Khan, W; Waldron, R; Barry, K

2013-12-01

The general hospital can play an important role in training of higher surgical trainees (HSTs) in Ireland and abroad. Training opportunities in such a setting have not been closely analysed to date. The aim of this study was to quantify operative exposure for HSTs over a 5-year period in a single institution. Analysis of electronic training logbooks (over a 5-year period, 2007-2012) was performed for general surgery trainees on the higher surgical training programme in Ireland. The most commonly performed adult and paediatric procedures per trainee, per year were analysed. Standard general surgery operations such as herniae (average 58, range 32-86) and cholecystectomy (average 60, range 49-72) ranked highly in each logbook. The most frequently performed emergency operations were appendicectomy (average 45, range 33-53) and laparotomy for acute abdomen (average 48, range 10-79). Paediatric surgical experience included appendicectomy, circumcision, orchidopexy and hernia/hydrocoele repair. Overall, the procedure most commonly performed in the adult setting was endoscopy, with each trainee recording an average of 116 (range 98-132) oesophagogastroduodenoscopies and 284 (range 227-354) colonoscopies. General hospitals continue to play a major role in the training of higher surgical trainees. Analysis of the electronic logbooks over a 5-year period reveals the high volume of procedures available to trainees in a non-specialist centre. Such training opportunities are invaluable in the context of changing work practices and limited resources.

The National Resuscitation Council, Singapore, and 34 years of resuscitation training: 1983 to 2017.

PubMed

Anantharaman, Venkataraman

2017-07-01

Training in the modern form of cardiopulmonary resuscitation (CPR) started in Singapore in 1983. For the first 15 years, the expansion of training programmes was mainly owing to the interest of a few individuals. Public training in the skill was minimal. In an area of medical care where the greatest opportunity for benefit lies in employing core resuscitation skills in the prehospital environment, very little was being done to address such a need. In 1998, a group of physicians, working together with the Ministry of Health, set up the National Resuscitation Council (NRC). Over the years, the NRC has created national guidelines on resuscitation and reviewed them at five-yearly intervals. Provider training manuals are now available for most programmes. The NRC has set up an active accreditation system for monitoring and maintaining standards of life support training. This has led to a large increase in the number of training centres, as well as recognition and adoption of the council's guidelines in the country. The NRC has also actively promoted the use of bystander CPR through community-based programmes, resulting in a rise in the number of certified providers. Improving the chain of survival, through active community-based training programmes, will likely lead to more lives being saved from sudden cardiac arrest. Copyright: © Singapore Medical Association.

The National Resuscitation Council, Singapore, and 34 years of resuscitation training: 1983 to 2017

PubMed Central

Anantharaman, Venkataraman

2017-01-01

Training in the modern form of cardiopulmonary resuscitation (CPR) started in Singapore in 1983. For the first 15 years, the expansion of training programmes was mainly owing to the interest of a few individuals. Public training in the skill was minimal. In an area of medical care where the greatest opportunity for benefit lies in employing core resuscitation skills in the prehospital environment, very little was being done to address such a need. In 1998, a group of physicians, working together with the Ministry of Health, set up the National Resuscitation Council (NRC). Over the years, the NRC has created national guidelines on resuscitation and reviewed them at five-yearly intervals. Provider training manuals are now available for most programmes. The NRC has set up an active accreditation system for monitoring and maintaining standards of life support training. This has led to a large increase in the number of training centres, as well as recognition and adoption of the council’s guidelines in the country. The NRC has also actively promoted the use of bystander CPR through community-based programmes, resulting in a rise in the number of certified providers. Improving the chain of survival, through active community-based training programmes, will likely lead to more lives being saved from sudden cardiac arrest. PMID:28741008

Combining functional and structural tests improves the diagnostic accuracy of relevance vector machine classifiers

PubMed Central

Racette, Lyne; Chiou, Christine Y.; Hao, Jiucang; Bowd, Christopher; Goldbaum, Michael H.; Zangwill, Linda M.; Lee, Te-Won; Weinreb, Robert N.; Sample, Pamela A.

2009-01-01

Purpose To investigate whether combining optic disc topography and short-wavelength automated perimetry (SWAP) data improves the diagnostic accuracy of relevance vector machine (RVM) classifiers for detecting glaucomatous eyes compared to using each test alone. Methods One eye of 144 glaucoma patients and 68 healthy controls from the Diagnostic Innovations in Glaucoma Study were included. RVM were trained and tested with cross-validation on optimized (backward elimination) SWAP features (thresholds plus age; pattern deviation (PD); total deviation (TD)) and on Heidelberg Retina Tomograph II (HRT) optic disc topography features, independently and in combination. RVM performance was also compared to two HRT linear discriminant functions (LDF) and to SWAP mean deviation (MD) and pattern standard deviation (PSD). Classifier performance was measured by the area under the receiver operating characteristic curves (AUROCs) generated for each feature set and by the sensitivities at set specificities of 75%, 90% and 96%. Results RVM trained on combined HRT and SWAP thresholds plus age had significantly higher AUROC (0.93) than RVM trained on HRT (0.88) and SWAP (0.76) alone. AUROCs for the SWAP global indices (MD: 0.68; PSD: 0.72) offered no advantage over SWAP thresholds plus age, while the LDF AUROCs were significantly lower than RVM trained on the combined SWAP and HRT feature set and on HRT alone feature set. Conclusions Training RVM on combined optimized HRT and SWAP data improved diagnostic accuracy compared to training on SWAP and HRT parameters alone. Future research may identify other combinations of tests and classifiers that can also improve diagnostic accuracy. PMID:19528827

Clinical pathology accreditation: standards for the medical laboratory

PubMed Central

Burnett, D; Blair, C; Haeney, M R; Jeffcoate, S L; Scott, K W M; Williams, D L

2002-01-01

This article describes a new set of revised standards for the medical laboratory, which have been produced by Clinical Pathology Accreditation (UK) Ltd (CPA). The original standards have been in use since 1992 and it was recognised that extensive revision was required. A standards revision group was established by CPA and this group used several international standards as source references, so that the resulting new standards are compatible with the most recent international reference sources. The aim is to make the assessment of medical laboratories as objective as possible in the future. CPA plans to introduce these standards in the UK in 2003 following extensive consultation with professional bodies, piloting in selected laboratories, and training of assessors. PMID:12354795

Effect of information literacy training course on information literacy skills of undergraduate students of Isfahan University of Medical Sciences based on ACRL standards

PubMed Central

Karimi, Zohreh; Ashrafi-rizi, Hasan; Papi, Ahmad; Shahrzadi, Leila; Hassanzadeh, Akbar

2015-01-01

Background: Information literacy is the basis for lifelong learning. Information literacy skills, especially for student in an environment that is full of information from multiple technologies are being developed is equally important. Information literacy is a set of cognitive and practical skills and like any other science, proper training is needed, and standard-based education is definitely better and evaluation would be easier. This study aimed to determine the impact of information literacy training course on information literacy skills of Isfahan University of Medical Sciences students based on ACRL standard in 2012. Materials and Methods: The study method is semi-experience with two group design (with pre-test and post-test) and applied. The data collection toll was a questionnaire assessing student's information literacy that developed by Davarpanah and Siamak and validity was confirmed by professional librarians and reliability as measured by Cronbach's alpha, was 0.83. The sample consisted of 50 undergraduate students from Isfahan University of Medical Sciences that by random sampling method was perch in both case and control groups. Before and after the training (once a week), a questionnaire was distributed between the two groups. This training was held in a classroom equipped with computers with internet access and in addition to training using brochures and librarian presentation, interactive methods such as discussion and exercises were used. The data were analyzed using SPSS version 20 software and two level of descriptive (mean and SD) and inferential statistics (t-test and t-paired). Results: The results showed that the students’ information literacy scores before the training was lower than average, so that in the control group was 32.96 and in the case group was 33.24; while information literacy scores in the case group significantly increased after the training (46.68). Also, the effect of education, respectively had a greater impact on the ability to access information (the second standard), ethics and legal use of information (the third standard), effective use of information (the fourth standard), critically evaluate information and its sources (the fifth standard). Conclusion: This study showed that the training was effective on enhancing students’ information literacy skills as the greatest impact was on increasing the ability to access information. Due to low mean score information literacy in the context of object recognition, there is a need for more training in this area. PMID:27462618

An embedded system for face classification in infrared video using sparse representation

NASA Astrophysics Data System (ADS)

Saavedra M., Antonio; Pezoa, Jorge E.; Zarkesh-Ha, Payman; Figueroa, Miguel

2017-09-01

We propose a platform for robust face recognition in Infrared (IR) images using Compressive Sensing (CS). In line with CS theory, the classification problem is solved using a sparse representation framework, where test images are modeled by means of a linear combination of the training set. Because the training set constitutes an over-complete dictionary, we identify new images by finding their sparsest representation based on the training set, using standard l1-minimization algorithms. Unlike conventional face-recognition algorithms, we feature extraction is performed using random projections with a precomputed binary matrix, as proposed in the CS literature. This random sampling reduces the effects of noise and occlusions such as facial hair, eyeglasses, and disguises, which are notoriously challenging in IR images. Thus, the performance of our framework is robust to these noise and occlusion factors, achieving an average accuracy of approximately 90% when the UCHThermalFace database is used for training and testing purposes. We implemented our framework on a high-performance embedded digital system, where the computation of the sparse representation of IR images was performed by a dedicated hardware using a deeply pipelined architecture on an Field-Programmable Gate Array (FPGA).

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.

German MedicalTeachingNetwork (MDN) implementing national standards for teacher training.

PubMed

Lammerding-Koeppel, M; Ebert, T; Goerlitz, A; Karsten, G; Nounla, C; Schmidt, S; Stosch, C; Dieter, P

2016-01-01

An increasing demand for proof of professionalism in higher education strives for quality assurance (QA) and improvement in medical education. A wide range of teacher trainings is available to medical staff in Germany. Cross-institutional approval of individual certificates is usually a difficult and time consuming task for institutions. In case of non-acceptance it may hinder medical teachers in their professional mobility. The faculties of medicine aimed to develop a comprehensive national framework, to promote standards for formal faculty development programmes across institutions and to foster professionalization of medical teaching. Addressing the above challenges in a joint approach, the faculties set up the national MedicalTeacherNetwork (MDN). Great importance is attributed to work out nationally concerted standards for faculty development and an agreed-upon quality control process across Germany. Medical teachers benefit from these advantages due to portability of faculty development credentials from one faculty of medicine to another within the MDN system. The report outlines the process of setting up the MDN and the national faculty development programme in Germany. Success factors, strengths and limitations are discussed from an institutional, individual and general perspective. Faculties engaged in similar developments might be encouraged to transfer the MDN concept to their countries.

Challenges of pediatric residency training in Taiwan.

PubMed

Tsai, Tsuen-Chiuan; Harasym, Peter H

2006-01-01

A crisis in pediatric residency training today has raised serious concerns about the healthcare quality for children in Taiwan. The purpose of this study was to document the problems and to propose possible solutions for improvement. The problems include: 1) manpower shortage due to the difficulty of recruiting pediatric residents; 2) heavy workload that hinders learning; 3) lack of assessment and poor program planning; and 4) inadequate institutional and financial support. As a result, physicians' competencies are not guaranteed at the end of residency training, even with the pediatric board certification. Possible solutions may include: 1) conducting research on physician manpower statistics, work hours and environment; 2) establishing a Residency Program Review Committee and provision of standards for accreditation; 3) defining the competencies mandated as a general pediatrician and developing a set of measurable qualitative standards; 4) encouraging new programs with flexibility (e.g., primary care); and 5) pursuing adequate institutional and financial supports.

Tailoring a training based on the Mental Health Gap Action Programme (mhGAP) Intervention Guide (IG) to Tunisia: process and relevant adaptations.

PubMed

Spagnolo, Jessica; Champagne, François; Leduc, Nicole; Melki, Wahid; Guesmi, Imen; Bram, Nesrine; Guisset, Ann-Lise; Piat, Myra; Laporta, Marc; Charfi, Fatma

2018-01-01

In order to make mental health services more accessible, the Tunisian Ministry of Health, in collaboration with the School of Public Health at the University of Montreal, the World Health Organization office in Tunisia and the Montreal World Health Organization-Pan American Health Organization Collaborating Center for Research and Training in Mental Health, implemented a training programme based on the Mental Health Gap Action Programme (mhGAP) Intervention Guide (IG) (version 1.0) , developed by the World Health Organization. This article describes the phase prior to the implementation of the training, which was offered to general practitioners working in primary care settings in the Greater Tunis area of Tunisia. The phase prior to implementation consisted of adapting the standard mhGAP-IG (version 1.0) to the local primary healthcare context. This adaptation process, an essential step before piloting the training, involved discussions with stakeholder groups, as well as field observations. Through the adaptation process, we were able to make changes to the standard training format and material. In addition, the process helped uncover systemic barriers to effective mental health care. Targeting these barriers in addition to implementing a training programme may help reduce the mental health treatment gap, and promote implementation that is successful and sustainable.

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.

Do "Brain-Training" Programs Work?

PubMed

Simons, Daniel J; Boot, Walter R; Charness, Neil; Gathercole, Susan E; Chabris, Christopher F; Hambrick, David Z; Stine-Morrow, Elizabeth A L

2016-10-01

In 2014, two groups of scientists published open letters on the efficacy of brain-training interventions, or "brain games," for improving cognition. The first letter, a consensus statement from an international group of more than 70 scientists, claimed that brain games do not provide a scientifically grounded way to improve cognitive functioning or to stave off cognitive decline. Several months later, an international group of 133 scientists and practitioners countered that the literature is replete with demonstrations of the benefits of brain training for a wide variety of cognitive and everyday activities. How could two teams of scientists examine the same literature and come to conflicting "consensus" views about the effectiveness of brain training?In part, the disagreement might result from different standards used when evaluating the evidence. To date, the field has lacked a comprehensive review of the brain-training literature, one that examines both the quantity and the quality of the evidence according to a well-defined set of best practices. This article provides such a review, focusing exclusively on the use of cognitive tasks or games as a means to enhance performance on other tasks. We specify and justify a set of best practices for such brain-training interventions and then use those standards to evaluate all of the published peer-reviewed intervention studies cited on the websites of leading brain-training companies listed on Cognitive Training Data (www.cognitivetrainingdata.org), the site hosting the open letter from brain-training proponents. These citations presumably represent the evidence that best supports the claims of effectiveness.Based on this examination, we find extensive evidence that brain-training interventions improve performance on the trained tasks, less evidence that such interventions improve performance on closely related tasks, and little evidence that training enhances performance on distantly related tasks or that training improves everyday cognitive performance. We also find that many of the published intervention studies had major shortcomings in design or analysis that preclude definitive conclusions about the efficacy of training, and that none of the cited studies conformed to all of the best practices we identify as essential to drawing clear conclusions about the benefits of brain training for everyday activities. We conclude with detailed recommendations for scientists, funding agencies, and policymakers that, if adopted, would lead to better evidence regarding the efficacy of brain-training interventions. © The Author(s) 2016.

75 FR 8180 - Proposed Agency Information Collection Activities; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2010-02-23

... Emergency Preparedness. OMB Control Number: 2130-0545. Type of Request: Extension of a currently approved... passenger train emergency regulations set forth in 49 CFR Parts 223 and 239 which require railroads to meet minimum Federal standards for the preparation, adoption, and implementation of emergency preparedness...

Metamemory in the Aged.

ERIC Educational Resources Information Center

Murphy, Martin D.; And Others

1981-01-01

College-age and older adults predicted their memory spans and indicated readiness to recall sets of drawings. Differences were obtained in recall readiness. In Experiment two the recall of a chunking and rehearsal trained group of older adults was better than that of a control group given standard instructions. (Author)

Reduction of Classroom Noise Levels Using Group Contingencies

ERIC Educational Resources Information Center

Ring, Brandon M.; Sigurdsson, Sigurdur O.; Eubanks, Sean L.; Silverman, Kenneth

2014-01-01

The therapeutic workplace is an employment-based abstinence reinforcement intervention for unemployed drug users where trainees receive on-the-job employment skills training in a classroom setting. The study is an extension of prior therapeutic workplace research, which suggested that trainees frequently violated noise standards. Participants…

A novel Python program for implementation of quality control in the ELISA.

PubMed

Wetzel, Hanna N; Cohen, Cinder; Norman, Andrew B; Webster, Rose P

2017-09-01

The use of semi-quantitative assays such as the enzyme-linked immunosorbent assay (ELISA) requires stringent quality control of the data. However, such quality control is often lacking in academic settings due to unavailability of software and knowledge. Therefore, our aim was to develop methods to easily implement Levey-Jennings quality control methods. For this purpose, we created a program written in Python (a programming language with an open-source license) and tested it using a training set of ELISA standard curves quantifying the Fab fragment of an anti-cocaine monoclonal antibody in mouse blood. A colorimetric ELISA was developed using a goat anti-human anti-Fab capture method. Mouse blood samples spiked with the Fab fragment were tested against a standard curve of known concentrations of Fab fragment in buffer over a period of 133days stored at 4°C to assess stability of the Fab fragment and to generate a test dataset to assess the program. All standard curves were analyzed using our program to batch process the data and to generate Levey-Jennings control charts and statistics regarding the datasets. The program was able to identify values outside of two standard deviations, and this identification of outliers was consistent with the results of a two-way ANOVA. This program is freely available, which will help laboratories implement quality control methods, thus improving reproducibility within and between labs. We report here successful testing of the program with our training set and development of a method for quantification of the Fab fragment in mouse blood. Copyright © 2017 Elsevier B.V. All rights reserved.

Safety of strength training in premenopausal women: musculoskeletal injuries from a two-year randomized trial.

PubMed

Warren, Meghan; Schmitz, Kathryn H

2009-01-01

The health benefits of strength training must be weighed against risks, including injuries. A prior study observed 4.2 injuries that limited usual activities for a day per 1000 strength training sessions among men and women. The analysis herein explores the incidence rates of musculoskeletal injuries from strength training in women. Randomized controlled trial. SETTING; Free-living community. A total of 163 injury-free, overweight, sedentary, premenopausal women aged 25 to 44 years. Two years of strength training (n = 81) or standard care (n = 82). The intervention followed published guidelines (U.S. Department of Health and Human Services) with hypothesized injury prevention strategies. An injury survey was administered at years 1 and 2. Injury was defined as physical activity or strength training associated injuries that limited daily activities for 1 week or more. Denominators for rate calculation were accelerometer-measured physical activity and strength training attendance (strength training only). The between-group probability of injuries was assessed using generalized estimating equations. Injury incidence rates were higher in strength training compared with standard care. In strength training, the injury rates were 3.6 per 1000 strength training sessions (95% confidence interval: 2.5-4.8 per 1000) for physical activity-related injuries, and 2.6 per 1000 (95% confidence interval: 1.5-3.6 per 1000) for strength training-related injuries. Injury rates varied by definition and denominator. Strength training had lower injury rates than previously reported, providing preliminary support for the prevention strategies. The finding of strength training injuries underscores the need for balancing the benefits against the potential risks of this exercise modality.

Evaluation of Athletic Training Students' Clinical Proficiencies

PubMed Central

Walker, Stacy E; Weidner, Thomas G; Armstrong, Kirk J

2008-01-01

Context: Appropriate methods for evaluating clinical proficiencies are essential in ensuring entry-level competence. Objective: To investigate the common methods athletic training education programs use to evaluate student performance of clinical proficiencies. Design: Cross-sectional design. Setting: Public and private institutions nationwide. Patients or Other Participants: All program directors of athletic training education programs accredited by the Commission on Accreditation of Allied Health Education Programs as of January 2006 (n  =  337); 201 (59.6%) program directors responded. Data Collection and Analysis: The institutional survey consisted of 11 items regarding institutional and program demographics. The 14-item Methods of Clinical Proficiency Evaluation in Athletic Training survey consisted of respondents' demographic characteristics and Likert-scale items regarding clinical proficiency evaluation methods and barriers, educational content areas, and clinical experience settings. We used analyses of variance and independent t tests to assess differences among athletic training education program characteristics and the barriers, methods, content areas, and settings regarding clinical proficiency evaluation. Results: Of the 3 methods investigated, simulations (n  =  191, 95.0%) were the most prevalent method of clinical proficiency evaluation. An independent-samples t test revealed that more opportunities existed for real-time evaluations in the college or high school athletic training room (t189  =  2.866, P  =  .037) than in other settings. Orthopaedic clinical examination and diagnosis (4.37 ± 0.826) and therapeutic modalities (4.36 ± 0.738) content areas were scored the highest in sufficient opportunities for real-time clinical proficiency evaluations. An inadequate volume of injuries or conditions (3.99 ± 1.033) and injury/condition occurrence not coinciding with the clinical proficiency assessment timetable (4.06 ± 0.995) were barriers to real-time evaluation. One-way analyses of variance revealed no difference between athletic training education program characteristics and the opportunities for and barriers to real-time evaluations among the various clinical experience settings. Conclusions: No one primary barrier hindered real-time clinical proficiency evaluation. To determine athletic training students' clinical proficiency for entry-level employment, athletic training education programs must incorporate standardized patients or take a disciplined approach to using simulation for instruction and evaluation. PMID:18668172

Standard operating procedures for clinical research departments.

PubMed

Kee, Ashley Nichole

2011-01-01

A set of standard operating procedures (SOPs) provides a clinical research department with clear roles, responsibilities, and processes to ensure compliance, accuracy, and timeliness of data. SOPs also serve as a standardized training program for new employees. A practice may have an employee that can assist in the development of SOPs. There are also consultants that specialize in working with a practice to develop and write practice-specific SOPs. Making SOPs a priority will save a practice time and money in the long run and make the research practice more attractive to corporate study sponsors.

Relaxation training after stroke: potential to reduce anxiety.

PubMed

Kneebone, Ian; Walker-Samuel, Natalie; Swanston, Jennifer; Otto, Elisabeth

2014-01-01

To consider the feasibility of setting up a relaxation group to treat symptoms of post stroke anxiety in an in-patient post-acute setting; and to explore the effectiveness of relaxation training in reducing self-reported tension. A relaxation group protocol was developed in consultation with a multidisciplinary team and a user group. Over a period of 24 months, 55 stroke patients attended group autogenic relaxation training on a rehabilitation ward. Attendance ranged between one and eleven sessions. Self-reported tension was assessed pre and post relaxation training using the Tension Rating Circles (TRCs). The TRCs identified a significant reduction in self-reported tension from pre to post training, irrespective of the number of sessions attended; z = -3.656, p < 0.001, r = -0.67, for those who attended multiple sessions, z = -2.758, p < 0.01, r = -0.6 for those who attended a single session. The routine use of relaxation techniques in treating anxiety in patients undergoing post-stroke rehabilitation shows potential. Self-reported tension decreased after attendance at relaxation training. The TRCs proved acceptable to group members, but should be validated against standard anxiety measures. Further exploration of the application of relaxation techniques in clinical practice is desirable. Implications for Rehabilitation Anxiety is prevalent after stroke and likely affects rehabilitation outcomes. Relaxation training is a well proven treatment for anxiety in the non-stroke population. A significant within session reduction in tension, a hallmark symptom of anxiety, was evidenced via group relaxation training delivered in a post-acute, in-patient stroke unit setting. Relaxation training a shows promise as a treatment for anxiety after stroke.

Effective Bayesian Transfer Learning

DTIC Science & Technology

2010-03-01

reasonable value of k , defined by the task B training set size. Transfer Regret 1 Regret = 100 * G AB B No Transfer With Transfer AB...a. REPORT U b . ABSTRACT U c. THIS PAGE U 19b. TELEPHONE NUMBER (Include area code) N/A Standard Form 298 (Rev. 8-98) Prescribed...rule set given the prior and developed staged approximate inference strategy, in which data from observed tasks 1 to k are used to infer general rule

The Role of Plas y Brenin in the Development of Outdoor Activities.

ERIC Educational Resources Information Center

Nichols, Geoff

1995-01-01

Plas y Brenin, (British) National Mountain Centre, was evaluated through surveys of users of outdoor residential courses, nonusers from relevant sports, and experts. The center's most highly rated aspect was "setting standards for training," but some educators suggested that the center's concentration on technical expertise in sports…

Abbott Preschool: 10 Years Later

ERIC Educational Resources Information Center

Donovan, Laura Fasbach

2009-01-01

When New Jersey set out to level the educational playing field between the state's poorest and wealthiest school districts a decade ago, one of the mission's most important components was ensuring teacher quality met the same high standards regardless of zip code. Research shows, a teacher's own education and training in early childhood education…

Training L2 Learners to Use Facebook Appropriately and Effectively

ERIC Educational Resources Information Center

Prichard, Caleb

2013-01-01

Recognizing how essential communication technologies have become to language learners, the TESOL Technology Standards Task Force set three goals for learners (Healey et al., 2011): 1) demonstrating skills in technology for a multilingual world, 2) using technology appropriately and ethically, and 3) using and evaluating technology for language…

Competencies for Online Teaching. ERIC Digest.

ERIC Educational Resources Information Center

Spector, J. Michael; de la Teja, Ileana

Competence refers to a state of being well qualified to perform an activity, task, or job function. According to the International Board of Standards for Training, Performance and Instruction (IBSTPI), a competency involves a related set of knowledge, skills, and attitudes that enables a person to effectively perform the activities of a given…

Education Requirements for Natural Resource Based Outdoor Recreation Professionals.

ERIC Educational Resources Information Center

Elsner, Gary; And Others

The Office of Personnel Management should designate a new professional series for hiring individuals in outdoor recreational management. A new professional series would help set a standard for professionals with training in both resource management and the social sciences. Recommended educational requirements for the series include: (1) natural…

The facilitative effects of incidental teaching on preposition use by autistic children.

PubMed Central

McGee, G G; Krantz, P J; McClannahan, L E

1985-01-01

In a comparison of incidental teaching and traditional training procedures, three language-delayed autistic children were taught expressive use of prepositions to describe the location of preferred edibles and toys. Traditional highly structured training and incidental teaching procedures were used in a classroom setting, and generalization was assessed during free-play sessions. Results clearly indicate that incidental teaching promoted greater generalization and more spontaneous use of prepositions. These findings have important implications for language programming and teacher training, suggesting that incidental teaching should be included as a standard component of language development curricula for autistic and other developmentally delayed children. PMID:3997695

Active Learning to Overcome Sample Selection Bias: Application to Photometric Variable Star Classification

NASA Astrophysics Data System (ADS)

Richards, Joseph W.; Starr, Dan L.; Brink, Henrik; Miller, Adam A.; Bloom, Joshua S.; Butler, Nathaniel R.; James, J. Berian; Long, James P.; Rice, John

2012-01-01

Despite the great promise of machine-learning algorithms to classify and predict astrophysical parameters for the vast numbers of astrophysical sources and transients observed in large-scale surveys, the peculiarities of the training data often manifest as strongly biased predictions on the data of interest. Typically, training sets are derived from historical surveys of brighter, more nearby objects than those from more extensive, deeper surveys (testing data). This sample selection bias can cause catastrophic errors in predictions on the testing data because (1) standard assumptions for machine-learned model selection procedures break down and (2) dense regions of testing space might be completely devoid of training data. We explore possible remedies to sample selection bias, including importance weighting, co-training, and active learning (AL). We argue that AL—where the data whose inclusion in the training set would most improve predictions on the testing set are queried for manual follow-up—is an effective approach and is appropriate for many astronomical applications. For a variable star classification problem on a well-studied set of stars from Hipparcos and Optical Gravitational Lensing Experiment, AL is the optimal method in terms of error rate on the testing data, beating the off-the-shelf classifier by 3.4% and the other proposed methods by at least 3.0%. To aid with manual labeling of variable stars, we developed a Web interface which allows for easy light curve visualization and querying of external databases. Finally, we apply AL to classify variable stars in the All Sky Automated Survey, finding dramatic improvement in our agreement with the ASAS Catalog of Variable Stars, from 65.5% to 79.5%, and a significant increase in the classifier's average confidence for the testing set, from 14.6% to 42.9%, after a few AL iterations.

Method for Automatic Selection of Parameters in Normal Tissue Complication Probability Modeling.

PubMed

Christophides, Damianos; Appelt, Ane L; Gusnanto, Arief; Lilley, John; Sebag-Montefiore, David

2018-07-01

To present a fully automatic method to generate multiparameter normal tissue complication probability (NTCP) models and compare its results with those of a published model, using the same patient cohort. Data were analyzed from 345 rectal cancer patients treated with external radiation therapy to predict the risk of patients developing grade 1 or ≥2 cystitis. In total, 23 clinical factors were included in the analysis as candidate predictors of cystitis. Principal component analysis was used to decompose the bladder dose-volume histogram into 8 principal components, explaining more than 95% of the variance. The data set of clinical factors and principal components was divided into training (70%) and test (30%) data sets, with the training data set used by the algorithm to compute an NTCP model. The first step of the algorithm was to obtain a bootstrap sample, followed by multicollinearity reduction using the variance inflation factor and genetic algorithm optimization to determine an ordinal logistic regression model that minimizes the Bayesian information criterion. The process was repeated 100 times, and the model with the minimum Bayesian information criterion was recorded on each iteration. The most frequent model was selected as the final "automatically generated model" (AGM). The published model and AGM were fitted on the training data sets, and the risk of cystitis was calculated. The 2 models had no significant differences in predictive performance, both for the training and test data sets (P value > .05) and found similar clinical and dosimetric factors as predictors. Both models exhibited good explanatory performance on the training data set (P values > .44), which was reduced on the test data sets (P values < .05). The predictive value of the AGM is equivalent to that of the expert-derived published model. It demonstrates potential in saving time, tackling problems with a large number of parameters, and standardizing variable selection in NTCP modeling. Crown Copyright © 2018. Published by Elsevier Inc. All rights reserved.

Training set expansion: an approach to improving the reconstruction of biological networks from limited and uneven reliable interactions

PubMed Central

Yip, Kevin Y.; Gerstein, Mark

2009-01-01

Motivation: An important problem in systems biology is reconstructing complete networks of interactions between biological objects by extrapolating from a few known interactions as examples. While there are many computational techniques proposed for this network reconstruction task, their accuracy is consistently limited by the small number of high-confidence examples, and the uneven distribution of these examples across the potential interaction space, with some objects having many known interactions and others few. Results: To address this issue, we propose two computational methods based on the concept of training set expansion. They work particularly effectively in conjunction with kernel approaches, which are a popular class of approaches for fusing together many disparate types of features. Both our methods are based on semi-supervised learning and involve augmenting the limited number of gold-standard training instances with carefully chosen and highly confident auxiliary examples. The first method, prediction propagation, propagates highly confident predictions of one local model to another as the auxiliary examples, thus learning from information-rich regions of the training network to help predict the information-poor regions. The second method, kernel initialization, takes the most similar and most dissimilar objects of each object in a global kernel as the auxiliary examples. Using several sets of experimentally verified protein–protein interactions from yeast, we show that training set expansion gives a measurable performance gain over a number of representative, state-of-the-art network reconstruction methods, and it can correctly identify some interactions that are ranked low by other methods due to the lack of training examples of the involved proteins. Contact: mark.gerstein@yale.edu Availability: The datasets and additional materials can be found at http://networks.gersteinlab.org/tse. PMID:19015141

Resolving Transition Metal Chemical Space: Feature Selection for Machine Learning and Structure-Property Relationships.

PubMed

Janet, Jon Paul; Kulik, Heather J

2017-11-22

Machine learning (ML) of quantum mechanical properties shows promise for accelerating chemical discovery. For transition metal chemistry where accurate calculations are computationally costly and available training data sets are small, the molecular representation becomes a critical ingredient in ML model predictive accuracy. We introduce a series of revised autocorrelation functions (RACs) that encode relationships of the heuristic atomic properties (e.g., size, connectivity, and electronegativity) on a molecular graph. We alter the starting point, scope, and nature of the quantities evaluated in standard ACs to make these RACs amenable to inorganic chemistry. On an organic molecule set, we first demonstrate superior standard AC performance to other presently available topological descriptors for ML model training, with mean unsigned errors (MUEs) for atomization energies on set-aside test molecules as low as 6 kcal/mol. For inorganic chemistry, our RACs yield 1 kcal/mol ML MUEs on set-aside test molecules in spin-state splitting in comparison to 15-20× higher errors for feature sets that encode whole-molecule structural information. Systematic feature selection methods including univariate filtering, recursive feature elimination, and direct optimization (e.g., random forest and LASSO) are compared. Random-forest- or LASSO-selected subsets 4-5× smaller than the full RAC set produce sub- to 1 kcal/mol spin-splitting MUEs, with good transferability to metal-ligand bond length prediction (0.004-5 Å MUE) and redox potential on a smaller data set (0.2-0.3 eV MUE). Evaluation of feature selection results across property sets reveals the relative importance of local, electronic descriptors (e.g., electronegativity, atomic number) in spin-splitting and distal, steric effects in redox potential and bond lengths.

Programmatic assessment of a university-based implant training program using patient-reported outcomes.

PubMed

Al-Sabbagh, Mohanad; Jenkins, Diane W; de Leeuw, Reny; Nihill, Patricia; Robinson, Fonda G; Thomas, Mark V

2014-11-01

The University of Kentucky College of Dentistry (UKCD) established an implant training program that provides training in the use of a single implant system, evidence-based diagnostic and treatment protocols (standardized work practices), and a total quality management system (Implant Quality Assurance Program). The aim of this study was to assess the programmatic effectiveness of the UKCD implant training program by reporting the success and survival of implants placed, using patient-reported outcomes and comparing them to previously established benchmarks. A total of 415 patients (963 implants) were interviewed, approximately 50 percent of all qualified patients. The implant survival rate was 97 percent, and 88 percent of the implants were considered successful (as determined by patient-centric criteria). These outcomes were consistent with the program's previously established benchmarks of 90 percent. These results suggest that work standardization (in the form of specific treatment protocols) and the use of a formal, incremental learning system can result in positive patient outcomes. Clinical outcomes should be monitored in academic dental settings as part of clinical process improvement, and these outcomes can provide a means of assessing the effectiveness of the training program.

Effects of natural childbirth preparation versus standard antenatal education on epidural rates, experience of childbirth and parental stress in mothers and fathers: a randomised controlled multicentre trial

PubMed Central

Bergström, M; Kieler, H; Waldenström, U

2009-01-01

Objective To examine the effects of antenatal education focussing on natural childbirth preparation with psychoprophylactic training versus standard antenatal education on the use of epidural analgesia, experience of childbirth and parental stress in first-time mothers and fathers. Design Randomised controlled multicentre trial. Setting Fifteen antenatal clinics in Sweden between January 2006 and May 2007. Sample A total of 1087 nulliparous women and 1064 of their partners. Methods Natural group: Antenatal education focussing on natural childbirth preparation with training in breathing and relaxation techniques (psychoprophylaxis). Standard care group: Standard antenatal education focussing on both childbirth and parenthood, without psychoprophylactic training. Both groups: Four 2-hour sessions in groups of 12 participants during third trimester of pregnancy and one follow-up after delivery. Main outcome measures Epidural analgesia during labour, experience of childbirth as measured by the Wijma Delivery Experience Questionnaire (B), and parental stress measured by the Swedish Parenthood Stress Questionnaire. Results The epidural rate was 52% in both groups. There were no statistically significant differences in the experience of childbirth or parental stress between the randomised groups, either in women or men. Seventy percent of the women in the Natural group reported having used psychoprophylaxis during labour. A minority in the Standard care group (37%) had also used this method, but subgroup analysis where these women were excluded did not change the principal findings. Conclusion Natural childbirth preparation including training in breathing and relaxation did not decrease the use of epidural analgesia during labour, nor did it improve the birth experience or affect parental stress in early parenthood in nulliparous women and men, compared with a standard form of antenatal education. PMID:19538406

Voxel classification based airway tree segmentation

NASA Astrophysics Data System (ADS)

Lo, Pechin; de Bruijne, Marleen

2008-03-01

This paper presents a voxel classification based method for segmenting the human airway tree in volumetric computed tomography (CT) images. In contrast to standard methods that use only voxel intensities, our method uses a more complex appearance model based on a set of local image appearance features and Kth nearest neighbor (KNN) classification. The optimal set of features for classification is selected automatically from a large set of features describing the local image structure at several scales. The use of multiple features enables the appearance model to differentiate between airway tree voxels and other voxels of similar intensities in the lung, thus making the segmentation robust to pathologies such as emphysema. The classifier is trained on imperfect segmentations that can easily be obtained using region growing with a manual threshold selection. Experiments show that the proposed method results in a more robust segmentation that can grow into the smaller airway branches without leaking into emphysematous areas, and is able to segment many branches that are not present in the training set.

REVEAL: Reconstruction, Enhancement, Visualization, and Ergonomic Assessment for Laparoscopy

DTIC Science & Technology

2008-08-01

measurable disparity shift. Such an endoscope can be used to generate a stereoscopic view for a surgeon, as with the DaVinci robot in use today...training or surgery. We are working on the user interface issues of incorporating this measurement capability into the standard set of tools during...scope use, and in structuring a set of tasks around the use of through-the-scope measurement in order to determine how this tool can affect efficiency

Training clinicians treating HIV to diagnose cytomegalovirus retinitis

PubMed Central

Tun, NiNi; Maningding, Ernest; Heiden, Matthew; Rose-Nussbaumer, Jennifer; Chan, Khin Nyein; Khizniak, Tamara; Yakubenko, Alexandra; Lewallen, Susan; Keenan, Jeremy D; Saranchuk, Peter

2014-01-01

Abstract Problem Acquired immunodeficiency syndrome (AIDS)-related cytomegalovirus (CMV) retinitis continues to be a neglected source of blindness in resource-poor settings. The main issue is lack of capacity to diagnose CMV retinitis in the clinical setting where patients receive care and all other opportunistic infections are diagnosed. Approach We developed and implemented a four-day workshop to train clinicians working in human immunodeficiency virus (HIV) clinics how to perform binocular indirect ophthalmoscopy and diagnose CMV retinitis. Workshops comprised both classroom didactic instruction and direct clinical eye examinations in patients with advanced AIDS. Between 2007 and 2013, 14 workshops were conducted in China, Myanmar and the Russian Federation. Local setting Workshops were held with local clinicians at HIV clinics supported by nongovernmental organizations, public-sector municipal hospitals and provincial infectious disease referral hospitals. Each setting had limited or no access to locally- trained ophthalmologists, and an HIV-infected population with advanced disease. Relevant changes Clinicians learnt how to do binocular indirect ophthalmoscopy and to diagnose CMV retinitis. One year after the workshop, 32/38 trainees in Myanmar did systematic eye examination for early diagnosis of CMV retinitis as standard care for at-risk patients. In China and the Russian Federation, the success rates were lower, with 10/15 and 3/5 trainees, respectively, providing follow-up data. Lessons learnt Skills necessary for screening and diagnosis of CMV retinitis can be taught in a four-day task-oriented training workshop. Successful implementation depends on institutional support, ongoing training and technical support. The next challenge is to scale up this approach in other countries. PMID:25552774

Co-complex protein membership evaluation using Maximum Entropy on GO ontology and InterPro annotation.

PubMed

Armean, Irina M; Lilley, Kathryn S; Trotter, Matthew W B; Pilkington, Nicholas C V; Holden, Sean B

2018-06-01

Protein-protein interactions (PPI) play a crucial role in our understanding of protein function and biological processes. The standardization and recording of experimental findings is increasingly stored in ontologies, with the Gene Ontology (GO) being one of the most successful projects. Several PPI evaluation algorithms have been based on the application of probabilistic frameworks or machine learning algorithms to GO properties. Here, we introduce a new training set design and machine learning based approach that combines dependent heterogeneous protein annotations from the entire ontology to evaluate putative co-complex protein interactions determined by empirical studies. PPI annotations are built combinatorically using corresponding GO terms and InterPro annotation. We use a S.cerevisiae high-confidence complex dataset as a positive training set. A series of classifiers based on Maximum Entropy and support vector machines (SVMs), each with a composite counterpart algorithm, are trained on a series of training sets. These achieve a high performance area under the ROC curve of ≤0.97, outperforming go2ppi-a previously established prediction tool for protein-protein interactions (PPI) based on Gene Ontology (GO) annotations. https://github.com/ima23/maxent-ppi. sbh11@cl.cam.ac.uk. Supplementary data are available at Bioinformatics online.

Challenges in Developing Competency-based Training Curriculum for Food Safety Regulators in India.

PubMed

Thippaiah, Anitha; Allagh, Komal Preet; Murthy, G V

2014-07-01

The Food Safety and Standards Act have redefined the roles and responsibilities of food regulatory workforce and calls for highly skilled human resources as it involves complex management procedures. 1) Identify the competencies needed among the food regulatory workforce in India. 2) Develop a competency-based training curriculum for food safety regulators in the country. 3) Develop training materials for use to train the food regulatory workforce. The Indian Institute of Public Health, Hyderabad, led the development of training curriculum on food safety with technical assistance from the Royal Society for Public Health, UK and the National Institute of Nutrition, India. The exercise was to facilitate the implementation of new Act by undertaking capacity building through a comprehensive training program. A competency-based training needs assessment was conducted before undertaking the development of the training materials. THE TRAINING PROGRAM FOR FOOD SAFETY OFFICERS WAS DESIGNED TO COMPRISE OF FIVE MODULES TO INCLUDE: Food science and technology, Food safety management systems, Food safety legislation, Enforcement of food safety regulations, and Administrative functions. Each module has a facilitator guide for the tutor and a handbook for the participant. Essentials of Food Hygiene-I (Basic level), II and III (Retail/ Catering/ Manufacturing) were primarily designed for training of food handlers and are part of essential reading for food safety regulators. The Food Safety and Standards Act calls for highly skilled human resources as it involves complex management procedures. Despite having developed a comprehensive competency-based training curriculum by joint efforts by the local, national, and international agencies, implementation remains a challenge in resource-limited setting.

Developing proper mealtime behaviors of the institutionalized retarded.

PubMed

O'brien, F; Azrin, N H

1972-01-01

The institutionalized mentally retarded display a variety of unsanitary, disruptive, and improper table manners. A program was developed that included (1) acquisition-training of a high standard of proper table manners and (2) maintenance procedures to provide continued motivation to maintain proper mealtime behaviors and decrease improper skills. Twelve retardates received acquisition training, individually, by a combination of verbal instruction, imitation, and manual guidance. The students then ate in their group dining arrangement where the staff supervisor provided continuing approval for proper manners and verbal correction and timeout for improper manners. The results were: (1) the trained retardates showed significant improvement, whereas those untrained did not; (2) the trained retardates ate as well in the institution as non-retarded customers did in a public restaurant; (3) proper eating was maintained in the group dining setting; (4) timeout was rarely needed; (5) the program was easily administered by regular staff in a regular dining setting. The rapidity, feasibility, and effectiveness of the program suggests the program as a solution to improper mealtime behaviors by the institutionalized mentally retarded.

Illinois Early Learning Project Tip Sheets: Parenting and Family Life.

ERIC Educational Resources Information Center

2003

The Illinois Early Learning Project (IEL) is funded by the Illinois State Board of Education to provide information resources on early learning and training related to implementing the Illinois Early Learning Standards for parents and for early childhood personnel in all settings. The IEL tip sheets offer suggestions to parents and early childhood…

The Quartz Analog Watch: A Wonder Machine.

ERIC Educational Resources Information Center

Crane, H. Richard, Ed.

1993-01-01

Summarizes how a quartz watch works. Discusses the quartz crystal, its form, and how its frequency is set to a standard; the integrated circuit chip that drives the crystal in vibration, scales its frequency down, and forms pulses that turn the motor; and the motor that drives the gear train that turns the hands. (ZWH)

38 CFR 63.15 - Duties of, and standards applicable to, non-VA community-based providers.

Code of Federal Regulations, 2013 CFR

2013-07-01

...) Adequate meals must be provided in a setting that encourages social interaction; nutritious snacks between... group therapy, social skills training, self-help group meetings or peer counseling. (2) Professional... environment that promotes a lifestyle free of substance abuse. (2) The environment must be conducive to social...

38 CFR 63.15 - Duties of, and standards applicable to, non-VA community-based providers.

Code of Federal Regulations, 2014 CFR

2014-07-01

...) Adequate meals must be provided in a setting that encourages social interaction; nutritious snacks between... group therapy, social skills training, self-help group meetings or peer counseling. (2) Professional... environment that promotes a lifestyle free of substance abuse. (2) The environment must be conducive to social...

38 CFR 63.15 - Duties of, and standards applicable to, non-VA community-based providers.

Code of Federal Regulations, 2012 CFR

2012-07-01

...) Adequate meals must be provided in a setting that encourages social interaction; nutritious snacks between... group therapy, social skills training, self-help group meetings or peer counseling. (2) Professional... environment that promotes a lifestyle free of substance abuse. (2) The environment must be conducive to social...

Illinois Early Learning Project Tip Sheets: Physical Development and Health.

ERIC Educational Resources Information Center

2003

The Illinois Early Learning Project (IEL) is funded by the Illinois State Board of Education to provide information resources on early learning and training related to implementing the Illinois Early Learning Standards for parents and for early childhood personnel in all settings. The IEL tip sheets offer suggestions to parents and early childhood…

Comparing self-guided learning and educator-guided learning formats for simulation-based clinical training.

PubMed

Brydges, Ryan; Carnahan, Heather; Rose, Don; Dubrowski, Adam

2010-08-01

In this paper, we tested the over-arching hypothesis that progressive self-guided learning offers equivalent learning benefit vs. proficiency-based training while limiting the need to set proficiency standards. We have shown that self-guided learning is enhanced when students learn on simulators that progressively increase in fidelity during practice. Proficiency-based training, a current gold-standard training approach, requires achievement of a criterion score before students advance to the next learning level. Baccalaureate nursing students (n = 15/group) practised intravenous catheterization using simulators that differed in fidelity (i.e. students' perceived realism). Data were collected in 2008. Proficiency-based students advanced from low- to mid- to high-fidelity after achieving a proficiency criterion at each level. Progressive students self-guided their progression from low- to mid- to high-fidelity. Yoked control students followed an experimenter-defined progressive practice schedule. Open-ended students moved freely between the simulators. One week after practice, blinded experts evaluated students' skill transfer on a standardized patient simulation. Group differences were examined using analyses of variance. Proficiency-based students scored highest on the high-fidelity post-test (effect size = 1.22). An interaction effect showed that the Progressive and Open-ended groups maintained their performance from post-test to transfer test, whereas the Proficiency-based and Yoked control groups experienced a significant decrease (P < 0.05). Surprisingly, most Open-ended students (73%) chose the progressive practice schedule. Progressive training and proficiency-based training resulted in equivalent transfer test performance, suggesting that progressive students effectively self-guided when to transition between simulators. Students' preference for the progressive practice schedule indicates that educators should consider this sequence for simulation-based training.

Oncology education in Canadian undergraduate and postgraduate medical programs: a survey of educators and learners

PubMed Central

Tam, V.C.; Berry, S.; Hsu, T.; North, S.; Neville, A.; Chan, K.; Verma, S.

2014-01-01

Background The oncology education framework currently in use in Canadian medical training programs is unknown, and the needs of learners have not been fully assessed to determine whether they are adequately prepared to manage patients with cancer. Methods To assess the oncology education framework currently in use at Canadian medical schools and residency training programs for family (fm) and internal medicine (im), and to evaluate opinions about the content and utility of standard oncology education objectives, a Web survey was designed and sent to educators and learners. The survey recipients included undergraduate medical education curriculum committee members (umeccms), directors of fm and im programs, oncologists, medical students, and fm and im residents. Results Survey responses were received from 677 educators and learners. Oncology education was felt to be inadequate in their respective programs by 58% of umeccms, 57% of fm program directors, and 50% of im program directors. For learners, oncology education was thought to be inadequate by 67% of medical students, 86% of fm residents, and 63% of im residents. When comparing teaching of medical subspecialty–related diseases, all groups agreed that their trainees were least prepared to manage patients with cancer. A standard set of oncology objectives was thought to be possibly or definitely useful for undergraduate learners by 59% of respondents overall and by 61% of postgraduate learners. Conclusions Oncology education in Canadian undergraduate and postgraduate fm and im training programs are currently thought to be inadequate by a majority of educators and learners. Developing a standard set of oncology objectives might address the needs of learners. PMID:24523624

Wearable Technology for Global Surgical Teleproctoring.

PubMed

Datta, Néha; MacQueen, Ian T; Schroeder, Alexander D; Wilson, Jessica J; Espinoza, Juan C; Wagner, Justin P; Filipi, Charles J; Chen, David C

2015-01-01

In underserved communities around the world, inguinal hernias represent a significant burden of surgically-treatable disease. With traditional models of international surgical assistance limited to mission trips, a standardized framework to strengthen local healthcare systems is lacking. We established a surgical education model using web-based tools and wearable technology to allow for long-term proctoring and assessment in a resource-poor setting. This is a feasibility study examining wearable technology and web-based performance rating tools for long-term proctoring in an international setting. Using the Lichtenstein inguinal hernia repair as the index surgical procedure, local surgeons in Paraguay and Brazil were trained in person by visiting international expert trainers using a formal, standardized teaching protocol. Surgeries were captured in real-time using Google Glass and transmitted wirelessly to an online video stream, permitting real-time observation and proctoring by mentoring surgeon experts in remote locations around the world. A system for ongoing remote evaluation and support by experienced surgeons was established using the Lichtenstein-specific Operative Performance Rating Scale. Data were collected from 4 sequential training operations for surgeons trained in both Paraguay and Brazil. With continuous internet connectivity, live streaming of the surgeries was successful. The Operative Performance Rating Scale was immediately used after each operation. Both surgeons demonstrated proficiency at the completion of the fourth case. A sustainable model for surgical training and proctoring to empower local surgeons in resource-poor locations and "train trainers" is feasible with wearable technology and web-based communication. Capacity building by maximizing use of local resources and expertise offers a long-term solution to reducing the global burden of surgically-treatable disease. Copyright © 2015 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Using statistical and machine learning to help institutions detect suspicious access to electronic health records.

PubMed

Boxwala, Aziz A; Kim, Jihoon; Grillo, Janice M; Ohno-Machado, Lucila

2011-01-01

To determine whether statistical and machine-learning methods, when applied to electronic health record (EHR) access data, could help identify suspicious (ie, potentially inappropriate) access to EHRs. From EHR access logs and other organizational data collected over a 2-month period, the authors extracted 26 features likely to be useful in detecting suspicious accesses. Selected events were marked as either suspicious or appropriate by privacy officers, and served as the gold standard set for model evaluation. The authors trained logistic regression (LR) and support vector machine (SVM) models on 10-fold cross-validation sets of 1291 labeled events. The authors evaluated the sensitivity of final models on an external set of 58 events that were identified as truly inappropriate and investigated independently from this study using standard operating procedures. The area under the receiver operating characteristic curve of the models on the whole data set of 1291 events was 0.91 for LR, and 0.95 for SVM. The sensitivity of the baseline model on this set was 0.8. When the final models were evaluated on the set of 58 investigated events, all of which were determined as truly inappropriate, the sensitivity was 0 for the baseline method, 0.76 for LR, and 0.79 for SVM. The LR and SVM models may not generalize because of interinstitutional differences in organizational structures, applications, and workflows. Nevertheless, our approach for constructing the models using statistical and machine-learning techniques can be generalized. An important limitation is the relatively small sample used for the training set due to the effort required for its construction. The results suggest that statistical and machine-learning methods can play an important role in helping privacy officers detect suspicious accesses to EHRs.

Using statistical and machine learning to help institutions detect suspicious access to electronic health records

PubMed Central

Kim, Jihoon; Grillo, Janice M; Ohno-Machado, Lucila

2011-01-01

Objective To determine whether statistical and machine-learning methods, when applied to electronic health record (EHR) access data, could help identify suspicious (ie, potentially inappropriate) access to EHRs. Methods From EHR access logs and other organizational data collected over a 2-month period, the authors extracted 26 features likely to be useful in detecting suspicious accesses. Selected events were marked as either suspicious or appropriate by privacy officers, and served as the gold standard set for model evaluation. The authors trained logistic regression (LR) and support vector machine (SVM) models on 10-fold cross-validation sets of 1291 labeled events. The authors evaluated the sensitivity of final models on an external set of 58 events that were identified as truly inappropriate and investigated independently from this study using standard operating procedures. Results The area under the receiver operating characteristic curve of the models on the whole data set of 1291 events was 0.91 for LR, and 0.95 for SVM. The sensitivity of the baseline model on this set was 0.8. When the final models were evaluated on the set of 58 investigated events, all of which were determined as truly inappropriate, the sensitivity was 0 for the baseline method, 0.76 for LR, and 0.79 for SVM. Limitations The LR and SVM models may not generalize because of interinstitutional differences in organizational structures, applications, and workflows. Nevertheless, our approach for constructing the models using statistical and machine-learning techniques can be generalized. An important limitation is the relatively small sample used for the training set due to the effort required for its construction. Conclusion The results suggest that statistical and machine-learning methods can play an important role in helping privacy officers detect suspicious accesses to EHRs. PMID:21672912

Validation of a Detailed Scoring Checklist for Use During Advanced Cardiac Life Support Certification

PubMed Central

McEvoy, Matthew D.; Smalley, Jeremy C.; Nietert, Paul J.; Field, Larry C.; Furse, Cory M.; Blenko, John W.; Cobb, Benjamin G.; Walters, Jenna L.; Pendarvis, Allen; Dalal, Nishita S.; Schaefer, John J.

2012-01-01

Introduction Defining valid, reliable, defensible, and generalizable standards for the evaluation of learner performance is a key issue in assessing both baseline competence and mastery in medical education. However, prior to setting these standards of performance, the reliability of the scores yielding from a grading tool must be assessed. Accordingly, the purpose of this study was to assess the reliability of scores generated from a set of grading checklists used by non-expert raters during simulations of American Heart Association (AHA) MegaCodes. Methods The reliability of scores generated from a detailed set of checklists, when used by four non-expert raters, was tested by grading team leader performance in eight MegaCode scenarios. Videos of the scenarios were reviewed and rated by trained faculty facilitators and by a group of non-expert raters. The videos were reviewed “continuously” and “with pauses.” Two content experts served as the reference standard for grading, and four non-expert raters were used to test the reliability of the checklists. Results Our results demonstrate that non-expert raters are able to produce reliable grades when using the checklists under consideration, demonstrating excellent intra-rater reliability and agreement with a reference standard. The results also demonstrate that non-expert raters can be trained in the proper use of the checklist in a short amount of time, with no discernible learning curve thereafter. Finally, our results show that a single trained rater can achieve reliable scores of team leader performance during AHA MegaCodes when using our checklist in continuous mode, as measures of agreement in total scoring were very strong (Lin’s Concordance Correlation Coefficient = 0.96; Intraclass Correlation Coefficient = 0.97). Discussion We have shown that our checklists can yield reliable scores, are appropriate for use by non-expert raters, and are able to be employed during continuous assessment of team leader performance during the review of a simulated MegaCode. This checklist may be more appropriate for use by Advanced Cardiac Life Support (ACLS) instructors during MegaCode assessments than current tools provided by the AHA. PMID:22863996

Robust Machine Learning-Based Correction on Automatic Segmentation of the Cerebellum and Brainstem.

PubMed

Wang, Jun Yi; Ngo, Michael M; Hessl, David; Hagerman, Randi J; Rivera, Susan M

2016-01-01

Automated segmentation is a useful method for studying large brain structures such as the cerebellum and brainstem. However, automated segmentation may lead to inaccuracy and/or undesirable boundary. The goal of the present study was to investigate whether SegAdapter, a machine learning-based method, is useful for automatically correcting large segmentation errors and disagreement in anatomical definition. We further assessed the robustness of the method in handling size of training set, differences in head coil usage, and amount of brain atrophy. High resolution T1-weighted images were acquired from 30 healthy controls scanned with either an 8-channel or 32-channel head coil. Ten patients, who suffered from brain atrophy because of fragile X-associated tremor/ataxia syndrome, were scanned using the 32-channel head coil. The initial segmentations of the cerebellum and brainstem were generated automatically using Freesurfer. Subsequently, Freesurfer's segmentations were both manually corrected to serve as the gold standard and automatically corrected by SegAdapter. Using only 5 scans in the training set, spatial overlap with manual segmentation in Dice coefficient improved significantly from 0.956 (for Freesurfer segmentation) to 0.978 (for SegAdapter-corrected segmentation) for the cerebellum and from 0.821 to 0.954 for the brainstem. Reducing the training set size to 2 scans only decreased the Dice coefficient ≤0.002 for the cerebellum and ≤ 0.005 for the brainstem compared to the use of training set size of 5 scans in corrective learning. The method was also robust in handling differences between the training set and the test set in head coil usage and the amount of brain atrophy, which reduced spatial overlap only by <0.01. These results suggest that the combination of automated segmentation and corrective learning provides a valuable method for accurate and efficient segmentation of the cerebellum and brainstem, particularly in large-scale neuroimaging studies, and potentially for segmenting other neural regions as well.

Robust Machine Learning-Based Correction on Automatic Segmentation of the Cerebellum and Brainstem

PubMed Central

Wang, Jun Yi; Ngo, Michael M.; Hessl, David; Hagerman, Randi J.; Rivera, Susan M.

2016-01-01

Automated segmentation is a useful method for studying large brain structures such as the cerebellum and brainstem. However, automated segmentation may lead to inaccuracy and/or undesirable boundary. The goal of the present study was to investigate whether SegAdapter, a machine learning-based method, is useful for automatically correcting large segmentation errors and disagreement in anatomical definition. We further assessed the robustness of the method in handling size of training set, differences in head coil usage, and amount of brain atrophy. High resolution T1-weighted images were acquired from 30 healthy controls scanned with either an 8-channel or 32-channel head coil. Ten patients, who suffered from brain atrophy because of fragile X-associated tremor/ataxia syndrome, were scanned using the 32-channel head coil. The initial segmentations of the cerebellum and brainstem were generated automatically using Freesurfer. Subsequently, Freesurfer’s segmentations were both manually corrected to serve as the gold standard and automatically corrected by SegAdapter. Using only 5 scans in the training set, spatial overlap with manual segmentation in Dice coefficient improved significantly from 0.956 (for Freesurfer segmentation) to 0.978 (for SegAdapter-corrected segmentation) for the cerebellum and from 0.821 to 0.954 for the brainstem. Reducing the training set size to 2 scans only decreased the Dice coefficient ≤0.002 for the cerebellum and ≤ 0.005 for the brainstem compared to the use of training set size of 5 scans in corrective learning. The method was also robust in handling differences between the training set and the test set in head coil usage and the amount of brain atrophy, which reduced spatial overlap only by <0.01. These results suggest that the combination of automated segmentation and corrective learning provides a valuable method for accurate and efficient segmentation of the cerebellum and brainstem, particularly in large-scale neuroimaging studies, and potentially for segmenting other neural regions as well. PMID:27213683

Combined Annual Report to Congress on Standardization of Equipment with NATO Members and Cooperative Research and Development Projects with Allied Countries

DTIC Science & Technology

1990-06-01

Contamination Marking Set This set is designed for marking areas contaminated with nuclear, biological and chemical (NBC) agents. It consists of a metal ...program, formerly the Heavy Forces Modernization (HFM) program. In March 1990, the Army Systems Acquisition Review Council (ASARC) reviewed the ASM...AUTOKO) prior to initial fielding of MSE in Europe this year, interoperability training was conducted at Grafenwoehr , Germany, from 30 January to 1

Prototype Training Materials for Acceptance Criteria of Maintenance ASAP Events Occurring Within Social Context

NASA Technical Reports Server (NTRS)

Taylor, J. C.

2004-01-01

The aviation maintenance community is at a crossroads with respect to implementing the Aviation Safety Action Program (ASAP). While there is considerable interest, several key issues have emerged that cast doubt on how to assure a successful implementation, including buy-in from all levels of the company and training for key participants. There are two objectives for the present report. The first is to provide an examination of limits (or more properly, examples) of the degree of acceptability of more problematic events for risk-based decisions within the current ASAP guidelines. The second objective is to apply these limits of community standards to a set of further refined ASAP training scenarios.

Follow up of Stress Management Groups in Family Practice

PubMed Central

Herbert, Carol P.; Gutman, Gloria M.

1983-01-01

Ninety-six registrants (70 females, 26 males, mean age 36.4) were trained in seven standard autogenic training groups for management of stress-related disorders by a family physician in a community health centre. Comparisons were made before and after six training weeks, using the State-Trait Anxiety Inventory and a questionnaire about physical and psychological symptoms, drug, tobacco and alcohol use. As in a previous study, state and trait anxiety scores and symptoms related to stress were decreased in a majority of subjects. Effects were maintained in a subgroup followed for 12 months. Problems of data collection over time in clinical settings and of establishing the impact of health education measures are discussed. PMID:21283343

Approaching bathymetry estimation from high resolution multispectral satellite images using a neuro-fuzzy technique

NASA Astrophysics Data System (ADS)

Corucci, Linda; Masini, Andrea; Cococcioni, Marco

2011-01-01

This paper addresses bathymetry estimation from high resolution multispectral satellite images by proposing an accurate supervised method, based on a neuro-fuzzy approach. The method is applied to two Quickbird images of the same area, acquired in different years and meteorological conditions, and is validated using truth data. Performance is studied in different realistic situations of in situ data availability. The method allows to achieve a mean standard deviation of 36.7 cm for estimated water depths in the range [-18, -1] m. When only data collected along a closed path are used as a training set, a mean STD of 45 cm is obtained. The effect of both meteorological conditions and training set size reduction on the overall performance is also investigated.

Training clinicians treating HIV to diagnose cytomegalovirus retinitis.

PubMed

Heiden, David; Tun, NiNi; Maningding, Ernest; Heiden, Matthew; Rose-Nussbaumer, Jennifer; Chan, Khin Nyein; Khizniak, Tamara; Yakubenko, Alexandra; Lewallen, Susan; Keenan, Jeremy D; Saranchuk, Peter

2014-12-01

Acquired immunodeficiency syndrome (AIDS)-related cytomegalovirus (CMV) retinitis continues to be a neglected source of blindness in resource-poor settings. The main issue is lack of capacity to diagnose CMV retinitis in the clinical setting where patients receive care and all other opportunistic infections are diagnosed. We developed and implemented a four-day workshop to train clinicians working in human immunodeficiency virus (HIV) clinics how to perform binocular indirect ophthalmoscopy and diagnose CMV retinitis. Workshops comprised both classroom didactic instruction and direct clinical eye examinations in patients with advanced AIDS. Between 2007 and 2013, 14 workshops were conducted in China, Myanmar and the Russian Federation. Workshops were held with local clinicians at HIV clinics supported by nongovernmental organizations, public-sector municipal hospitals and provincial infectious disease referral hospitals. Each setting had limited or no access to locally- trained ophthalmologists, and an HIV-infected population with advanced disease. Clinicians learnt how to do binocular indirect ophthalmoscopy and to diagnose CMV retinitis. One year after the workshop, 32/38 trainees in Myanmar did systematic eye examination for early diagnosis of CMV retinitis as standard care for at-risk patients. In China and the Russian Federation, the success rates were lower, with 10/15 and 3/5 trainees, respectively, providing follow-up data. Skills necessary for screening and diagnosis of CMV retinitis can be taught in a four-day task-oriented training workshop. Successful implementation depends on institutional support, ongoing training and technical support. The next challenge is to scale up this approach in other countries.

Feasibility of task-specific brain-machine interface training for upper-extremity paralysis in patients with chronic hemiparetic stroke.

PubMed

Nishimoto, Atsuko; Kawakami, Michiyuki; Fujiwara, Toshiyuki; Hiramoto, Miho; Honaga, Kaoru; Abe, Kaoru; Mizuno, Katsuhiro; Ushiba, Junichi; Liu, Meigen

2018-01-10

Brain-machine interface training was developed for upper-extremity rehabilitation for patients with severe hemiparesis. Its clinical application, however, has been limited because of its lack of feasibility in real-world rehabilitation settings. We developed a new compact task-specific brain-machine interface system that enables task-specific training, including reach-and-grasp tasks, and studied its clinical feasibility and effectiveness for upper-extremity motor paralysis in patients with stroke. Prospective beforeâ€"after study. Twenty-six patients with severe chronic hemiparetic stroke. Participants were trained with the brain-machine interface system to pick up and release pegs during 40-min sessions and 40 min of standard occupational therapy per day for 10 days. Fugl-Meyer upper-extremity motor (FMA) and Motor Activity Log-14 amount of use (MAL-AOU) scores were assessed before and after the intervention. To test its feasibility, 4 occupational therapists who operated the system for the first time assessed it with the Quebec User Evaluation of Satisfaction with assistive Technology (QUEST) 2.0. FMA and MAL-AOU scores improved significantly after brain-machine interface training, with the effect sizes being medium and large, respectively (p<0.01, d=0.55; p<0.01, d=0.88). QUEST effectiveness and safety scores showed feasibility and satisfaction in the clinical setting. Our newly developed compact brain-machine interface system is feasible for use in real-world clinical settings.

Application of Artificial Neural Network to Optical Fluid Analyzer

NASA Astrophysics Data System (ADS)

Kimura, Makoto; Nishida, Katsuhiko

1994-04-01

A three-layer artificial neural network has been applied to the presentation of optical fluid analyzer (OFA) raw data, and the accuracy of oil fraction determination has been significantly improved compared to previous approaches. To apply the artificial neural network approach to solving a problem, the first step is training to determine the appropriate weight set for calculating the target values. This involves using a series of data sets (each comprising a set of input values and an associated set of output values that the artificial neural network is required to determine) to tune artificial neural network weighting parameters so that the output of the neural network to the given set of input values is as close as possible to the required output. The physical model used to generate the series of learning data sets was the effective flow stream model, developed for OFA data presentation. The effectiveness of the training was verified by reprocessing the same input data as were used to determine the weighting parameters and then by comparing the results of the artificial neural network to the expected output values. The standard deviation of the expected and obtained values was approximately 10% (two sigma).

Training US health care professionals on human trafficking: where do we go from here?

PubMed Central

Powell, Clydette; Dickins, Kirsten; Stoklosa, Hanni

2017-01-01

ABSTRACT Some 21 million adults and children are labor-trafficked or sex-trafficked through force, fraud, or coercion. In recognition of the interface between trafficking victims and the healthcare setting, over the last 10 years there has been a notable increase in training of health care professionals (HCPs) on human trafficking (HT) and its health implications. Many organizations have developed curricula and offered training in various clinical settings. However, methods and content of this education on trafficking vary widely, and there is little evaluation of the impact of the training. The goal of this study was to assess the gaps and strengths in HT education of HCPs in the US. This mixed-method study had two components. The first component consisted of structured interviews with experts in human trafficking HCP education. The second portion of the study involved an analysis of data from HCP calls to the National Human Trafficking Resource Center (NHTRC). The interviews captured trainer-specific data on types of HT training, duration and frequency, key content areas, presence of evaluation approaches and indicators, as well as an assessment of barriers and strengths in HT training for HCP. NHTRC call database analysis demonstrated increasing trends since 2008 in calls by HCPs. Overall findings revealed the need for standardization of HT training content to assure correct information, trauma-informed and patient-centered care, and consistent messaging for HCPs. Evaluation metrics for HT training need to be developed to demonstrate behavior change and impact on service delivery and patient-centered outcomes for HT victims, according to our proposed adapted Kirkpatrick’s Pyramid model. HT training and evaluation would benefit from an agency or institution at the national level to provide consistency and standardization of HT training content as well as to guide a process that would develop metrics for evaluation and the building of an evidence base. Abbreviations: AAP: American Academy of Pediatrics; ACF: Administration for Children and Families; CME: Continuing medical education; ED: Emergency department; HCP: Health care professional; HEAL: Health, Education, Advocacy, and Linkage; HHS: United States Department of Health and Human Services; HT: Human trafficking; IOM: United States Institute of Medicine; MH: Mental health; NHTRC: National Human Trafficking Resource Center; SOAR: Stop, Observe, Ask, and Respond to Health and Wellness Training PMID:28178913

Training US health care professionals on human trafficking: where do we go from here?

PubMed

Powell, Clydette; Dickins, Kirsten; Stoklosa, Hanni

2017-01-01

Some 21 million adults and children are labor-trafficked or sex-trafficked through force, fraud, or coercion. In recognition of the interface between trafficking victims and the healthcare setting, over the last 10 years there has been a notable increase in training of health care professionals (HCPs) on human trafficking (HT) and its health implications. Many organizations have developed curricula and offered training in various clinical settings. However, methods and content of this education on trafficking vary widely, and there is little evaluation of the impact of the training. The goal of this study was to assess the gaps and strengths in HT education of HCPs in the US. This mixed-method study had two components. The first component consisted of structured interviews with experts in human trafficking HCP education. The second portion of the study involved an analysis of data from HCP calls to the National Human Trafficking Resource Center (NHTRC). The interviews captured trainer-specific data on types of HT training, duration and frequency, key content areas, presence of evaluation approaches and indicators, as well as an assessment of barriers and strengths in HT training for HCP. NHTRC call database analysis demonstrated increasing trends since 2008 in calls by HCPs. Overall findings revealed the need for standardization of HT training content to assure correct information, trauma-informed and patient-centered care, and consistent messaging for HCPs. Evaluation metrics for HT training need to be developed to demonstrate behavior change and impact on service delivery and patient-centered outcomes for HT victims, according to our proposed adapted Kirkpatrick's Pyramid model. HT training and evaluation would benefit from an agency or institution at the national level to provide consistency and standardization of HT training content as well as to guide a process that would develop metrics for evaluation and the building of an evidence base. AAP: American Academy of Pediatrics; ACF: Administration for Children and Families; CME: Continuing medical education; ED: Emergency department; HCP: Health care professional; HEAL: Health, Education, Advocacy, and Linkage; HHS: United States Department of Health and Human Services; HT: Human trafficking; IOM: United States Institute of Medicine; MH: Mental health; NHTRC: National Human Trafficking Resource Center; SOAR: Stop, Observe, Ask, and Respond to Health and Wellness Training.

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.

Toward Defining, Measuring, and Evaluating LGBT Cultural Competence for Psychologists

PubMed Central

Boroughs, Michael S.; Andres Bedoya, C.; O'Cleirigh, Conall; Safren, Steven A.

2015-01-01

A central part of providing evidence-based practice is appropriate cultural competence to facilitate psychological assessment and intervention with diverse clients. At a minimum, cultural competence with lesbian, gay, bisexual, and transgender (LGBT) people involves adequate scientific and supervised practical training, with increasing depth and complexity across training levels. In order to further this goal, we offer 28 recommendations of minimum standards moving toward ideal training for LGBT-specific cultural competence. We review and synthesize the relevant literature to achieve and assess competence across the various levels of training (doctoral, internship, post-doctoral, and beyond) in order to guide the field towards best practices. These recommendations are aligned with educational and practice guidelines set forth by the field and informed by other allied professions in order to provide a roadmap for programs, faculty, and trainees in improving the training of psychologists to work with LGBT individuals. PMID:26279609

Training set selection for the prediction of essential genes.

PubMed

Cheng, Jian; Xu, Zhao; Wu, Wenwu; Zhao, Li; Li, Xiangchen; Liu, Yanlin; Tao, Shiheng

2014-01-01

Various computational models have been developed to transfer annotations of gene essentiality between organisms. However, despite the increasing number of microorganisms with well-characterized sets of essential genes, selection of appropriate training sets for predicting the essential genes of poorly-studied or newly sequenced organisms remains challenging. In this study, a machine learning approach was applied reciprocally to predict the essential genes in 21 microorganisms. Results showed that training set selection greatly influenced predictive accuracy. We determined four criteria for training set selection: (1) essential genes in the selected training set should be reliable; (2) the growth conditions in which essential genes are defined should be consistent in training and prediction sets; (3) species used as training set should be closely related to the target organism; and (4) organisms used as training and prediction sets should exhibit similar phenotypes or lifestyles. We then analyzed the performance of an incomplete training set and an integrated training set with multiple organisms. We found that the size of the training set should be at least 10% of the total genes to yield accurate predictions. Additionally, the integrated training sets exhibited remarkable increase in stability and accuracy compared with single sets. Finally, we compared the performance of the integrated training sets with the four criteria and with random selection. The results revealed that a rational selection of training sets based on our criteria yields better performance than random selection. Thus, our results provide empirical guidance on training set selection for the identification of essential genes on a genome-wide scale.

Experience of Testing Practice-Oriented Educational Model of Pedagogical Master's Program

ERIC Educational Resources Information Center

Shukshina, Tatjana I.; Buyanova, Irina B.; Gorshenina, Svetlana N.; Neyasova, Irina A.

2016-01-01

The recent changes in the Russian educational regulations have predetermined the search for new conceptual approaches and ways to improve the content and arrangement of pedagogical staff training. More attention is paid to the implementation of the professional standard of a teacher intended to set the etalon of a graduate of a pedagogical higher…

Systematic Approach to the Goalsetting of Higher Education in the Field of Tourism and Hospitality

ERIC Educational Resources Information Center

Romanova, Galina; Maznichenko, Marina; Neskoromnyh, Nataliya

2016-01-01

The article deals with key problems and contradictions of training of university graduates for the tourism and hospitality industry in Russia, primarily associated with the setting of educational goals. The article formulates the discussion points related to the updating of the existing educational standards for the enlarged "Service and…

The Administration of Sponsored Programs. Handbook for Developing and Managing Research Activities and Other Projects.

ERIC Educational Resources Information Center

Beasley, Kenneth L.; And Others

Designed as a standard reference and training resource for administrators and project managers, this handbook discusses how to plan, organize, and manage sponsored projects in any organizational setting. It provides detailed, how-to-do-it information and many resources for: negotiating grants, awards, and contracts; organizing a sponsored projects…

Educating and Training the Future Adolescent Health Workforce.

PubMed

Kokotailo, Patricia K; Baltag, Valentina; Sawyer, Susan M

2018-05-01

Unprecedented attention is now focused on adolescents with growing appreciation of their disease burden and of the opportunities of investing in adolescent health. New investments are required to build the technical capacity for policy, programming, research, and clinical care across the world, especially in resource-poor settings where most adolescents live. Strategies to educate and train the future workforce are needed. Competency-based education and training is the standard of education in preservice (undergraduate and postgraduate) health education and medical specialty training. Yet competency is difficult to quantify and standardize, as are the processes that underpin competency-based education and training. The primary objective of this review was to identify how quality education in adolescent health and medicine is determined. This information was used to inform the development of a conceptual framework for institutions teaching adolescent health, which can be used to assess the quality of teaching and learning and to monitor the implementation of these adolescent health competencies. Specific teaching modalities and assessment tools that have been used to teach adolescent health are described to exemplify how an educational program can be delivered and assessed. This framework is a step toward the development of a more adolescent-competent health workforce. Copyright © 2017 The Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Continuous chest compression cardiopulmonary resuscitation training promotes rescuer self-confidence and increased secondary training: A hospital-based randomized controlled trial

PubMed Central

Blewer, Audrey L.; Leary, Marion; Esposito, Emily C.; Gonzalez, Mariana; Riegel, Barbara; Bobrow, Bentley J.; Abella, Benjamin S.

2013-01-01

Objective Recent work suggests that delivery of continuous chest compression cardiopulmonary resuscitation is an acceptable layperson resuscitation strategy, although little is known about layperson preferences for cardiopulmonary resuscitation training in continuous chest compression cardiopulmonary resuscitation. We hypothesized that continuous chest compression cardiopulmonary resuscitation education would lead to greater trainee confidence and would encourage wider dissemination of cardiopulmonary resuscitation skills compared to standard cardiopulmonary resuscitation training (30 compressions: two breaths). Design Prospective, multicenter cohort study. Setting Three academic medical center inpatient wards. Subjects Adult family members or friends (≥18 yrs old) of inpatients admitted with cardiac-related diagnoses. Interventions In a multicenter randomized trial, family members of hospitalized patients were trained via the educational method of video self-instruction. Subjects were randomized to continuous chest compression cardiopulmonary resuscitation or standard cardiopulmonary resuscitation educational modes. Measurements Cardiopulmonary resuscitation performance data were collected using a cardiopulmonary resuscitation skill-reporting manikin. Trainee perspectives and secondary training rates were assessed through mixed qualitative and quantitative survey instruments. Main Results Chest compression performance was similar in both groups. The trainees in the continuous chest compression cardiopulmonary resuscitation group were significantly more likely to express a desire to share their training kit with others (152 of 207 [73%] vs. 133 of 199 [67%], p = .03). Subjects were contacted 1 month after initial enrollment to assess actual sharing, or “secondary training.” Kits were shared with 2.0 ± 3.4 additional family members in the continuous chest compression cardiopulmonary resuscitation group vs. 1.2 ± 2.2 in the standard cardiopulmonary resuscitation group (p = .03). As a secondary result, trainees in the continuous chest compression cardiopulmonary resuscitation group were more likely to rate themselves “very comfortable” with the idea of using cardiopulmonary resuscitation skills in actual events than the standard cardiopulmonary resuscitation trainees (71 of 207 [34%] vs. 57 of 199 [28%], p = .08). Conclusions Continuous chest compression cardiopulmonary resuscitation education resulted in a statistically significant increase in secondary training. This work suggests that implementation of video self-instruction training programs using continuous chest compression cardiopulmonary resuscitation may confer broader dissemination of life-saving skills and may promote rescuer comfort with newly acquired cardiopulmonary resuscitation knowledge. Clinical Trial Registration URL: http://clinicaltrials.gov. Unique identifier: NCT01260441. PMID:22080629

Automatic sleep stage classification using two facial electrodes.

PubMed

Virkkala, Jussi; Velin, Riitta; Himanen, Sari-Leena; Värri, Alpo; Müller, Kiti; Hasan, Joel

2008-01-01

Standard sleep stage classification is based on visual analysis of central EEG, EOG and EMG signals. Automatic analysis with a reduced number of sensors has been studied as an easy alternative to the standard. In this study, a single-channel electro-oculography (EOG) algorithm was developed for separation of wakefulness, SREM, light sleep (S1, S2) and slow wave sleep (S3, S4). The algorithm was developed and tested with 296 subjects. Additional validation was performed on 16 subjects using a low weight single-channel Alive Monitor. In the validation study, subjects attached the disposable EOG electrodes themselves at home. In separating the four stages total agreement (and Cohen's Kappa) in the training data set was 74% (0.59), in the testing data set 73% (0.59) and in the validation data set 74% (0.59). Self-applicable electro-oculography with only two facial electrodes was found to provide reasonable sleep stage information.

Improving clustering with metabolic pathway data.

PubMed

Milone, Diego H; Stegmayer, Georgina; López, Mariana; Kamenetzky, Laura; Carrari, Fernando

2014-04-10

It is a common practice in bioinformatics to validate each group returned by a clustering algorithm through manual analysis, according to a-priori biological knowledge. This procedure helps finding functionally related patterns to propose hypotheses for their behavior and the biological processes involved. Therefore, this knowledge is used only as a second step, after data are just clustered according to their expression patterns. Thus, it could be very useful to be able to improve the clustering of biological data by incorporating prior knowledge into the cluster formation itself, in order to enhance the biological value of the clusters. A novel training algorithm for clustering is presented, which evaluates the biological internal connections of the data points while the clusters are being formed. Within this training algorithm, the calculation of distances among data points and neurons centroids includes a new term based on information from well-known metabolic pathways. The standard self-organizing map (SOM) training versus the biologically-inspired SOM (bSOM) training were tested with two real data sets of transcripts and metabolites from Solanum lycopersicum and Arabidopsis thaliana species. Classical data mining validation measures were used to evaluate the clustering solutions obtained by both algorithms. Moreover, a new measure that takes into account the biological connectivity of the clusters was applied. The results of bSOM show important improvements in the convergence and performance for the proposed clustering method in comparison to standard SOM training, in particular, from the application point of view. Analyses of the clusters obtained with bSOM indicate that including biological information during training can certainly increase the biological value of the clusters found with the proposed method. It is worth to highlight that this fact has effectively improved the results, which can simplify their further analysis.The algorithm is available as a web-demo at http://fich.unl.edu.ar/sinc/web-demo/bsom-lite/. The source code and the data sets supporting the results of this article are available at http://sourceforge.net/projects/sourcesinc/files/bsom.

Effectiveness of the 'Who's Challenging Who' support staff training intervention to improve attitudes and empathy towards adults with intellectual disability and challenging behaviours: study protocol for a cluster randomised controlled trial.

PubMed

Randell, Elizabeth; Hastings, Richard P; McNamara, Rachel; Knight, Roseanna; Gillespie, David; Taylor, Zachary

2017-10-05

Findings suggest approximately one in six people with intellectual disability engage in 'challenging behaviours', which include aggression towards others/property and self-injurious actions. In residential settings, actions of staff members can make challenging behaviours more likely to occur, or make these behaviours worse. In particular, negative attitudes from members of staff and lack of understanding about the reasons for challenging behaviour are contributory factors. 'Who's Challenging Who?' (WCW) training is designed to emphasise the role of staff in residential settings as a challenge also to people with intellectual disability. The course is delivered jointly by a trainer with intellectual disability who has been labelled as having challenging behaviour, along with a trainer without intellectual disability. This is a cluster randomised two-arm trial of WCW training versus a waiting list control. Overall, 118 residential settings will be recruited and randomised on a 1:1 ratio. Within each setting, two members of staff will be invited to take part in the trial. Participants will complete assessments at baseline and at 6 and 20 weeks. WCW is a half day initial training course with some follow-on coaching to ensure implementation. The primary outcome is changes in staff empathy towards people with challenging behaviour. Secondary outcomes at the staff level include confidence, attitudes and work-related well-being. Secondary outcomes at the residential setting level include recorded incidents of aggressive challenging behaviour, and use of any restrictive practices. If the results of the cluster randomised trial are positive, we will disseminate the findings widely and make all training manuals and materials freely available for anyone in intellectual disability services (and beyond) to use. Our training approach may have wider implications in other areas of social care. It may also provide a generally applicable model for how to train people with intellectual disability to act as co-trainers in intellectual disability social care settings. People with intellectual disability and challenging behaviour have already been involved centrally with the design, development and pilot evaluation of WCW and will also be fully involved throughout this trial. Registered on the International Standard Randomised Controlled Trial Number registry on 8th December 2015: ISRCTN53763600 .

Applying an innovative educational program for the education of today's engineers

NASA Astrophysics Data System (ADS)

Kans, M.

2012-05-01

Engineers require a broad spectrum of knowledge and skills: basic skills in mathematics and physics, skills and competencies within the major subject area as well as more general knowledge about business and enterprise contexts, society regulations and understanding of the future professions' characteristics. In addition, social, intercultural, analytical and managing competencies are desired. The CDIO educational program was initiated as a means to come closer to practice and to assure the training of engineering skills that are required of today's engineers. CDIO is short for Conceive-Design-Implement-Operate and describes the full life cycle understanding of a system or asset that engineering students should reach during education. The CDIO initiative is formulated in a program consisting of two important documents: the CDIO standards and the CDIO syllabus. The standards describe a holistic approach on education, from knowledge and skills to be trained, how to train and assess them, to how to develop the teaching staff and the work places for enabling the goals. The specific knowledge and skills to be achieved are accounted for in the syllabus. In this paper we share our more than 15 years of experiences in problem and project based learning from the perspective of the CDIO standards. For each standard, examples of how to set up the education and overcome challenges connected to the standard are given. The paper concludes with recommendations to others wishing to work toward problem and real-life based education without compromising the requirements of a scientific approach.

A Model-independent Photometric Redshift Estimator for Type Ia Supernovae

NASA Astrophysics Data System (ADS)

Wang, Yun

2007-01-01

The use of Type Ia supernovae (SNe Ia) as cosmological standard candles is fundamental in modern observational cosmology. In this Letter, we derive a simple empirical photometric redshift estimator for SNe Ia using a training set of SNe Ia with multiband (griz) light curves and spectroscopic redshifts obtained by the Supernova Legacy Survey (SNLS). This estimator is analytical and model-independent it does not use spectral templates. We use all the available SNe Ia from SNLS with near-maximum photometry in griz (a total of 40 SNe Ia) to train and test our photometric redshift estimator. The difference between the estimated redshifts zphot and the spectroscopic redshifts zspec, (zphot-zspec)/(1+zspec), has rms dispersions of 0.031 for 20 SNe Ia used in the training set, and 0.050 for 20 SNe Ia not used in the training set. The dispersion is of the same order of magnitude as the flux uncertainties at peak brightness for the SNe Ia. There are no outliers. This photometric redshift estimator should significantly enhance the ability of observers to accurately target high-redshift SNe Ia for spectroscopy in ongoing surveys. It will also dramatically boost the cosmological impact of very large future supernova surveys, such as those planned for the Advanced Liquid-mirror Probe for Astrophysics, Cosmology, and Asteroids (ALPACA) and the Large Synoptic Survey Telescope (LSST).

Intervention Techniques Used With Autism Spectrum Disorder by Speech-Language Pathologists in the United States and Taiwan: A Descriptive Analysis of Practice in Clinical Settings.

PubMed

Hsieh, Ming-Yeh; Lynch, Georgina; Madison, Charles

2018-04-27

This study examined intervention techniques used with children with autism spectrum disorder (ASD) by speech-language pathologists (SLPs) in the United States and Taiwan working in clinic/hospital settings. The research questions addressed intervention techniques used with children with ASD, intervention techniques used with different age groups (under and above 8 years old), and training received before using the intervention techniques. The survey was distributed through the American Speech-Language-Hearing Association to selected SLPs across the United States. In Taiwan, the survey (Chinese version) was distributed through the Taiwan Speech-Language Pathologist Union, 2018, to certified SLPs. Results revealed that SLPs in the United States and Taiwan used 4 common intervention techniques: Social Skill Training, Augmentative and Alternative Communication, Picture Exchange Communication System, and Social Stories. Taiwanese SLPs reported SLP preparation program training across these common intervention strategies. In the United States, SLPs reported training via SLP preparation programs, peer therapists, and self-taught. Most SLPs reported using established or emerging evidence-based practices as defined by the National Professional Development Center (2014) and the National Standards Report (2015). Future research should address comparison of SLP preparation programs to examine the impact of preprofessional training on use of evidence-based practices to treat ASD.

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.

Community-based first aid: a program report on the intersection of community-based participatory research and first aid education in a remote Canadian Aboriginal community.

PubMed

VanderBurgh, D; Jamieson, R; Beardy, J; Ritchie, S D; Orkin, A

2014-01-01

Community-based first aid training is the collaborative development of locally relevant emergency response training. The Sachigo Lake Wilderness Emergency Response Education Initiative was developed, delivered, and evaluated through two intensive 5-day first aid courses. Sachigo Lake First Nation is a remote Aboriginal community of 450 people in northern Ontario, Canada, with no local paramedical services. These courses were developed in collaboration with the community, with a goal of building community capacity to respond to medical emergencies. Most first aid training programs rely on standardized curriculum developed for urban and rural contexts with established emergency response systems. Delivering effective community-based first aid training in a remote Aboriginal community required specific adaptations to conventional first aid educational content and pedagogy. Three key lessons emerged during this program that used collaborative principles to adapt conventional first aid concepts and curriculum: (1) standardized approaches may not be relevant nor appropriate; (2) relationships between course participants and the people they help are relevant and important; (3) curriculum must be attentive to existing informal and formal emergency response systems. These lessons may be instructive for the development of other programs in similar settings.

Nuclear materials control and accountability (NMC and A) auditors in the 90's

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

Barham, M.A.; Abbott, R.R.

1991-01-01

The increase in emphasis on the adequacy of the NMC and A internal control systems requires that management define what type of training and experience is needed by NMC and A Internal Audit Program. At Martin Marietta Energy Systems, inc. (the prime contractor for the Department of Energy at Oak Ridge, Tenn.), the Central NMC and A Manager has developed a comprehensive set of NMC and A Internal Audit policies that defines performance standards, methods of conducting audits, mechanisms for ensuring appropriate independence for NMC and A auditors, structure for standardized audit reports and working papers, and a section thatmore » addresses the development of training plans for individual NMC and A auditors. The training requirements reflect the unique combination of skills necessary to be an effective NMC and A Internal Auditor- a combination of the operational auditing skills of a Certified Internal Auditor, the accounting auditing capabilities of a Certified Public Accountant, and the specific technical knowledge base associated with nuclear materials. This paper presents a mechanism for identifying an individual training program for NMC and A auditors that considers the above requirements and the individual's long-range career goals.« less

Inpatient care of mentally ill people in prison: results of a year's programme of semistructured inspections

PubMed Central

Reed, John L; Lyne, Maggi

2000-01-01

Objective To investigate the facilities for inpatient care of mentally disordered people in prison. Design Semistructured inspections conducted by doctor and nurse. Expected standards were based on healthcare quality standards published by the Prison Service or the NHS. Setting 13 prisons with inpatient beds in England and Wales subject to the prison inspectorate's routine inspection programme during 1997-8. Main outcomes measures Appraisals of quality of care against published standards. Results The 13 prisons had 348 beds, 20% of all beds in prisons. Inpatient units had between 3 and 75 beds. No doctor in charge of inpatients had completed specialist psychiatric training. 24% of nursing staff had mental health training; 32% were non-nursing trained healthcare officers. Only one prison had occupational therapy input; two had input from a clinical psychologist. Most patients were unlocked for about 3.5 hours a day and none for more than nine hours a day. Four prisons provided statistics on the use of seclusion. The average length of an episode of seclusion was 50 hours. Conclusion The quality of services for mentally ill prisoners fell far below the standards in the NHS. Patients' lives were unacceptably restricted and therapy limited. The present policy dividing inpatient care of mentally disordered prisoners between the prison service and the NHS needs reconsideration. PMID:10764360

The use of psychometrists in clinical neuropsychology: history, current status, and future directions.

PubMed

Malek-Ahmadi, Michael; Erickson, Tom; Puente, Antonio E; Pliskin, Neil; Rock, Rachel

2012-01-01

In recent years, the National Academy of Neuropsychology and other professional neuropsychological organizations have published a number of articles and position papers regarding the use, education, and training of psychometrists ("technicians"). Although these documents provide guidelines for the suggested qualifications and training procedures of psychometrists, none make any mention of the need for a standardized credentialing process, which is commonly required of technicians in similar fields, especially in medical settings. Given the recent changes in current procedural Terminology codes used to bill for neuropsychological services and the interpretation of legislation disallowing the use of psychometrists in New York, the need for a standard credential for psychometrists is apparent. This article will review the history and current use of psychometrists in clinical neuropsychology and highlight the need and rationale for the credentialing of psychometrists.

A Matlab Program for Textural Classification Using Neural Networks

NASA Astrophysics Data System (ADS)

Leite, E. P.; de Souza, C.

2008-12-01

A new MATLAB code that provides tools to perform classification of textural images for applications in the Geosciences is presented. The program, here coined TEXTNN, comprises the computation of variogram maps in the frequency domain for specific lag distances in the neighborhood of a pixel. The result is then converted back to spatial domain, where directional or ominidirectional semivariograms are extracted. Feature vectors are built with textural information composed of the semivariance values at these lag distances and, moreover, with histogram measures of mean, standard deviation and weighted fill-ratio. This procedure is applied to a selected group of pixels or to all pixels in an image using a moving window. A feed- forward back-propagation Neural Network can then be designed and trained on feature vectors of predefined classes (training set). The training phase minimizes the mean-squared error on the training set. Additionally, at each iteration, the mean-squared error for every validation is assessed and a test set is evaluated. The program also calculates contingency matrices, global accuracy and kappa coefficient for the three data sets, allowing a quantitative appraisal of the predictive power of the Neural Network models. The interpreter is able to select the best model obtained from a k-fold cross-validation or to use a unique split-sample data set for classification of all pixels in a given textural image. The code is opened to the geoscientific community and is very flexible, allowing the experienced user to modify it as necessary. The performance of the algorithms and the end-user program were tested using synthetic images, orbital SAR (RADARSAT) imagery for oil seepage detection, and airborne, multi-polarimetric SAR imagery for geologic mapping. The overall results proved very promising.

Obtaining greater value from health care: the roles of the U.S. government.

PubMed

Schoenbaum, Stephen C; Audet, Anne-Marie J; Davis, Karen

2003-01-01

The problems of quality and cost in the U.S. health care system are unlikely to be solved without strong leadership from the federal government, which can mobilize action to set national priorities for quality; develop and promulgate standards for care; and stimulate implementation of performance measures and standards for providers. All of these functions would best be carried out by a new federal agency. Furthermore, the federal government should design payment policies based on the performance standards, invest in needed information technology, and invest in research related to improving care and in training professionals to support nationwide quality improvement.

Suborbital Safety Technical Committee- Summary of Proposed Standards & Guidelines

NASA Astrophysics Data System (ADS)

Quinn, Andy; Atencia Yepez, Amaya; Klicker, Michael; Howard, Diane; Verstraeten, Joram; Other Suborbital Safety TC Members

2013-09-01

There are currently no international safety standards and guidelines to assist designers, operators and authorities in the suborbital domain. There is a launch licensing regime in the United States (US) to assist the forerunners of the suborbital domain however this does not provide a safety approval for the vehicle against set standards or does not have an acceptable level of safety to achieve in terms of design or operation. In Europe a certification framework may be implemented however this (or any regulatory framework) is not in place as yet. This paper summarises the 5 tasks thus far completed by the International Association for the Advancement of Space Safety (IAASS) Suborbital Safety Technical Committee (SS TC) in terms of deriving standards and guidelines for the suborbital domain. The SS TC comprises members from the suborbital industry (US and European vehicle designers), safety experts, legal experts, medical/training experts, prospective spaceport operators and members from the US and European authorities (though these members cannot directly steer the standards and guidelines - they can merely review them for interest and comment on non-policy aspects). The SS TC has been divided into three working groups (WG): Regulatory WG, Technical WG and Operations WG. The 5 tasks that are summarised in this paper include: Regulatory WG - (Task 1) Clarify and promote regulatory framework for suborbital flights (including discussions on Space Law 'v' Air Law for suborbital domain); Technical WG - (Task 1) Defining & Alignment (globally) of Safety Criteria for Suborbital domain using industry best practices, (Task 2) Software/complex hardware certification for suborbital flights; Operations WG - (Task 1) Flight Crew and Spaceflight Participant Medical and Training Standards & Guidelines for suborbital flight, (Task 2) Spaceport Safety Management System. This paper also details the next set of standards and guidelines that will be derived by the SS TC. The paper concludes that these and future IAASS suborbital safety standards and guidelines are needed now and should beconsidered by the industry players before the first commercial flights expected late 2013/early 2014.

Can shoulder range of movement be measured accurately using the Microsoft Kinect sensor plus Medical Interactive Recovery Assistant (MIRA) software?

PubMed

Wilson, James D; Khan-Perez, Jennifer; Marley, Dominic; Buttress, Susan; Walton, Michael; Li, Baihua; Roy, Bibhas

2017-12-01

This study compared the accuracy of measuring shoulder range of movement (ROM) with a simple laptop-sensor combination vs. trained observers (shoulder physiotherapists and shoulder surgeons) using motion capture (MoCap) laboratory equipment as the gold standard. The Microsoft Kinect sensor (Microsoft Corp., Redmond, WA, USA) tracks 3-dimensional human motion. Ordinarily used with an Xbox (Microsoft Corp.) video game console, Medical Interactive Recovery Assistant (MIRA) software (MIRA Rehab Ltd., London, UK) allows this small sensor to measure shoulder movement with a standard computer. Shoulder movements of 49 healthy volunteers were simultaneously measured by trained observers, MoCap, and the MIRA device. Internal rotation was assessed with the shoulder abducted 90° and external rotation with the shoulder adducted. Visual estimation and MIRA measurements were compared with gold standard MoCap measurements for agreement using Bland-Altman methods. There were 1670 measurements analyzed. The MIRA evaluations of all 4 cardinal shoulder movements were significantly more precise, with narrower limits of agreement, than the measurements of trained observers. MIRA achieved ±11° (95% confidence interval [CI], 8.7°-12.6°) for forward flexion vs. ±16° (95% CI, 14.6°-17.6°) by trained observers. For abduction, MIRA showed ±11° (95% CI, 8.7°-12.8°) against ±15° (95% CI, 13.4°-16.2°) for trained observers. MIRA attained ±10° (95% CI, 8.1°-11.9°) during external rotation measurement, whereas trained observers only reached ±21° (95% CI, 18.7°-22.6°). For internal rotation, MIRA achieved ±9° (95% CI, 7.2°-10.4°), which was again better than TOs at ±18° (95% CI, 16.0°-19.3°). A laptop combined with a Microsoft Kinect sensor and the MIRA software can measure shoulder movements with acceptable levels of accuracy. This technology, which can be easily set up, may also allow precise shoulder ROM measurement outside the clinic setting. Copyright © 2017 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

Convolutional neural networks based on augmented training samples for synthetic aperture radar target recognition

NASA Astrophysics Data System (ADS)

Yan, Yue

2018-03-01

A synthetic aperture radar (SAR) automatic target recognition (ATR) method based on the convolutional neural networks (CNN) trained by augmented training samples is proposed. To enhance the robustness of CNN to various extended operating conditions (EOCs), the original training images are used to generate the noisy samples at different signal-to-noise ratios (SNRs), multiresolution representations, and partially occluded images. Then, the generated images together with the original ones are used to train a designed CNN for target recognition. The augmented training samples can contrapuntally improve the robustness of the trained CNN to the covered EOCs, i.e., the noise corruption, resolution variance, and partial occlusion. Moreover, the significantly larger training set effectively enhances the representation capability for other conditions, e.g., the standard operating condition (SOC), as well as the stability of the network. Therefore, better performance can be achieved by the proposed method for SAR ATR. For experimental evaluation, extensive experiments are conducted on the Moving and Stationary Target Acquisition and Recognition dataset under SOC and several typical EOCs.

A neural network approach for image reconstruction in electron magnetic resonance tomography.

PubMed

Durairaj, D Christopher; Krishna, Murali C; Murugesan, Ramachandran

2007-10-01

An object-oriented, artificial neural network (ANN) based, application system for reconstruction of two-dimensional spatial images in electron magnetic resonance (EMR) tomography is presented. The standard back propagation algorithm is utilized to train a three-layer sigmoidal feed-forward, supervised, ANN to perform the image reconstruction. The network learns the relationship between the 'ideal' images that are reconstructed using filtered back projection (FBP) technique and the corresponding projection data (sinograms). The input layer of the network is provided with a training set that contains projection data from various phantoms as well as in vivo objects, acquired from an EMR imager. Twenty five different network configurations are investigated to test the ability of the generalization of the network. The trained ANN then reconstructs two-dimensional temporal spatial images that present the distribution of free radicals in biological systems. Image reconstruction by the trained neural network shows better time complexity than the conventional iterative reconstruction algorithms such as multiplicative algebraic reconstruction technique (MART). The network is further explored for image reconstruction from 'noisy' EMR data and the results show better performance than the FBP method. The network is also tested for its ability to reconstruct from limited-angle EMR data set.

Parkinson's patients' executive profile and goals they set for improvement: Why is cognitive rehabilitation not common practice?

PubMed

Vlagsma, T T; Koerts, J; Fasotti, L; Tucha, O; van Laar, T; Dijkstra, H; Spikman, J M

2016-01-01

Impairments in executive functions (EF) are the core cognitive impairment in patients with Parkinson's disease (PD). Surprisingly, cognitive rehabilitation is not routinely offered to patients with PD. However, in patients with acquired brain injury (ABI), cognitive rehabilitation, in particular strategic executive training, is common practice and has been shown to be effective. In this study, we determined whether PD patients have different needs and aims with regard to strategic executive training than ABI patients, and whether possible differences might be a reason for not offering this kind of cognitive rehabilitation programme to patients with PD. Patients' needs and aims were operationalised by individually set goals, which were classified into domains of EF and daily life. In addition, patients with PD and ABI were compared on their cognitive, in particular EF, profile. Overall, PD patients' goals and cognitive profile were similar to those of patients with ABI. Therefore, based on the findings of this study, there is no reason to assume that strategic executive training cannot be part of standard therapy in PD. However, when strategic executive training is applied in clinical practice, disease-specific characteristics need to be taken into account.

Effectiveness of training on de-escalation of violence and management of aggressive behavior faced by health care providers in a public sector hospital of Karachi

PubMed Central

Baig, Lubna; Tanzil, Sana; Shaikh, Shiraz; Hashmi, Ibrahim; Khan, Muhammad Arslan; Polkowski, Maciej

2018-01-01

Background & Objective: Considering high burden of violence against healthcare workers in Pakistan APPNA Institute of Public Health developed a training to prevent reactive violence among healthcare providers. The purpose of this training was to equip healthcare providers with skills essential to control aggressive behaviors and prevent verbal and non-verbal violence in workplace settings. This study assesses the effectiveness of training in prevention, de-escalation and management of violence in healthcare settings. Methods: A quasi-experimental study was conducted in October, 2016 using mixed method concurrent embedded design. The study assessed effectiveness of de-escalation trainings among health care providers working in emergency and gynecology and obstetrics departments of two teaching hospitals in Karachi. Quantitative assessment was done through structured interviews and qualitative through Focus Group Discussions. Healthcare providers` confidence in coping with patient aggression was also measured using a standard validated tool”. Results: The overall self-perceived mean score of Confidence in Coping with Patient Aggression Instrument “(CCPAI)” scale was significantly higher in intervention group (Mean= 27.49, SD=3.53) as compared to control group (Mean= 23.92, SD=4.52) (p<0.001). No statistically significant difference was observed between intervention and control groups with regard to frequency of violence faced by HCPs post training and major perpetrators of violence.. Conclusion: De-escalation of violence training was effective in improving confidence of healthcare providers in coping with patient aggression. PMID:29805396

Radiation dose management in thoracic CT: an international survey.

PubMed

Molinari, Francesco; Tack, Denis M; Boiselle, Philip; Ngo, Long; Mueller-Mang, Christina; Litmanovich, Diana; Bankier, Alexander A

2013-01-01

We aimed to examine current practice patterns of international thoracic radiologists regarding radiation dose management in adult thoracic computed tomography (CT) examinations. An electronic questionnaire was sent to 800 members of five thoracic radiology societies in North America, Europe, Asia, and Latin America addressing radiation dose training and education, standard kVp and mAs settings for thoracic CT, dose reduction practices, clinical scenarios, and demographics. Of the 800 radiologists, 146 responded to our survey. Nearly half (66/146, 45% [95% confidence interval, 37%-53%]) had no formal training in dose reduction, with "self-study of the literature" being the most common form of training (54/146, 37% [29%-45%]). One hundred and seventeen (80% [74%-87%]) had automatic exposure control, and 76 (65% [56%-74%]) used it in all patients. Notably, most respondents (89% [84%-94%]) used a 120 to 125 kVp standard setting, whereas none used 140 kVp. The most common average dose-length-product (DLP) value was 150 to 249 mGy.cm (75/146, 51% [43%-59%]), and 59% (51%-67%) delivered less than 250 mGy.cm in a 70 kg patient. There was a tendency towards higher DLP values with multidetector-row CT. Age, gender, and pregnancy were associated more with dose reduction than weight and clinical indication. Efforts for reducing patient radiation dose are highly prevalent among thoracic radiologists. Areas for improvement include reduction of default tube current settings, reduction of anatomical scan coverage, greater use of automatic exposure control, and eventually, reduction of current reference dose values. Our study emphasizes the need for international guidelines to foster greater conformity in dose reduction by thoracic radiologists.

Improving Warfarin Management Within the Medical Home: A Health-System Approach.

PubMed

Rose, Anne E; Robinson, Erin N; Premo, Joan A; Hauschild, Lori J; Trapskin, Philip J; McBride, Ann M

2017-03-01

Anticoagulation clinics have been considered the optimal strategy for warfarin management with demonstrated improved patient outcomes through increased time in therapeutic international normalized ratio (INR) range, decreased critical INR values, and decreased anticoagulation-related adverse events. However, not all health systems are able to support a specialized anticoagulation clinic or may see patient volume exceed available anticoagulation clinic resources. The purpose of this study was to utilize an anticoagulation clinic model to standardize warfarin management in a primary care clinic setting. A warfarin management program was developed that included standardized patient assessment, protocolized warfarin-dosing algorithm, and electronic documentation and reporting tools. Primary care clinics were targeted for training and implementation of this program. The warfarin management program was applied to over 2000 patients and implemented at 39 clinic sites. A total of 160 nurses and 15 pharmacists were trained on the program. Documentation of warfarin dose and date of the next INR increased from 70% to 90% (P <.0001), documentation occurring within 24 hours of the INR result increased from 75% to 87% (P <.0001), and monitoring the INR at least every 4 weeks increased from 71% to 83% (P <.0001) per patient encounter. Time in therapeutic INR range improved from 65% to 75%. Incorporating a standardized approach to warfarin management in the primary care setting significantly improves warfarin-related documentation and time in therapeutic INR range. Copyright © 2016 Elsevier Inc. All rights reserved.

Detection of flow limitation in obstructive sleep apnea with an artificial neural network.

PubMed

Norman, Robert G; Rapoport, David M; Ayappa, Indu

2007-09-01

During sleep, the development of a plateau on the inspiratory airflow/time contour provides a non-invasive indicator of airway collapsibility. Humans recognize this abnormal contour easily, and this study replicates this with an artificial neural network (ANN) using a normalized shape. Five 10 min segments were selected from each of 18 sleep records (respiratory airflow measured with a nasal cannula) with varying degrees of sleep disordered breathing. Each breath was visually scored for shape, and breaths split randomly into a training and test set. Equally spaced, peak amplitude normalized flow values (representing breath shape) formed the only input to a back propagation ANN. Following training, breath-by-breath agreement of the ANN with the manual classification was tabulated for the training and test sets separately. Agreement of the ANN was 89% in the training set and 70.6% in the test set. When the categories of 'probably normal' and 'normal', and 'probably flow limited' and 'flow limited' were combined, the agreement increased to 92.7% and 89.4% respectively, similar to the intra- and inter-rater agreements obtained by a visual classification of these breaths. On a naive dataset, the agreement of the ANN to visual classification was 57.7% overall and 82.4% when the categories were collapsed. A neural network based only on the shape of inspiratory airflow succeeded in classifying breaths as to the presence/absence of flow limitation. This approach could be used to provide a standardized, reproducible and automated means of detecting elevated upper airway resistance.

Objective assessment in residency-based training for transoral robotic surgery.

PubMed

Curry, Martin; Malpani, Anand; Li, Ryan; Tantillo, Thomas; Jog, Amod; Blanco, Ray; Ha, Patrick K; Califano, Joseph; Kumar, Rajesh; Richmon, Jeremy

2012-10-01

To develop a robotic surgery training regimen integrating objective skill assessment for otolaryngology and head and neck surgery trainees consisting of training modules of increasing complexity leading up to procedure-specific training. In particular, we investigated applications of such a training approach for surgical extirpation of oropharyngeal tumors via a transoral approach using the da Vinci robotic system. Prospective blinded data collection and objective evaluation (Objective Structured Assessment of Technical Skills [OSATS]) of three distinct phases using the da Vinci robotic surgical system in an academic university medical engineering/computer science laboratory setting. Between September 2010 and July 2011, eight otolaryngology-head and neck surgery residents and four staff experts from an academic hospital participated in three distinct phases of robotic surgery training involving 1) robotic platform operational skills, 2) set up of the patient side system, and 3) a complete ex vivo surgical extirpation of an oropharyngeal tumor located in the base of tongue. Trainees performed multiple (four) approximately equally spaced training sessions in each stage of the training. In addition to trainees, baseline performance data were obtained for the experts. Each surgical stage was documented with motion and event data captured from the application programming interfaces of the da Vinci system, as well as separate video cameras as appropriate. All data were assessed using automated skill measures of task efficiency and correlated with structured assessment (OSATS and similar Likert scale) from three experts to assess expert and trainee differences and compute automated and expert assessed learning curves. Our data show that such training results in an improved didactic robotic knowledge base and improved clinical efficiency with respect to the set up and console manipulation. Experts (e.g., average OSATS, 25; standard deviation [SD], 3.1; module 1, suturing) and trainees (average OSATS, 15.9; SD, 3.9; week 1) are well separated at the beginning of the training, and the separation reduces significantly (expert average OSATS, 27.6; SD, 2.7; trainee average OSATS, 24.2; SD, 6.8; module 3) at the conclusion of the training. Learning curves in each of the three stages show diminishing differences between the experts and trainees, which is also consistent with expert assessment. Subjective assessment by experts verified the clinical utility of the module 3 surgical environment, and a survey of trainees consistently rated the curriculum as very useful in progression to human operating room assistance. Structured curricular robotic surgery training with objective assessment promises to reduce the overhead for mentors, allow detailed assessment of human-machine interface skills, and create customized training models for individualized training. This preliminary study verifies the utility of such training in improving human-machine operations skills (module 1), and operating room and surgical skills (modules 2 and 3). In contrast to current coarse measures of total operating time and subjective assessment of error for short mass training sessions, these methods may allow individual tasks to be removed from the trainee regimen when skill levels are within the standard deviation of the experts for these tasks, which can greatly enhance overall efficiency of the training regimen and allow time for additional and more complex training to be incorporated in the same time frame. Copyright © 2012 The American Laryngological, Rhinological, and Otological Society, Inc.

Patient Education on Oral Anticoagulation.

PubMed

Hawes, Emily M

2018-04-20

Given the potential harm associated with anticoagulant use, patient education is often provided as a standard of care and emphasized across healthcare settings. Effective anticoagulation education involves face-to-face interaction with a trained professional who ensures that the patient understands the risks involved, the precautions that should be taken, and the need for regular monitoring. The teaching should be tailored to each patient, accompanied with written resources and utilize the teach-back method. It can be incorporated in a variety of pharmacy practice settings, including in ambulatory care clinics, hospitals, and community pharmacies.

QSAR models for thiophene and imidazopyridine derivatives inhibitors of the Polo-Like Kinase 1.

PubMed

Comelli, Nieves C; Duchowicz, Pablo R; Castro, Eduardo A

2014-10-01

The inhibitory activity of 103 thiophene and 33 imidazopyridine derivatives against Polo-Like Kinase 1 (PLK1) expressed as pIC50 (-logIC50) was predicted by QSAR modeling. Multivariate linear regression (MLR) was employed to model the relationship between 0D and 3D molecular descriptors and biological activities of molecules using the replacement method (MR) as variable selection tool. The 136 compounds were separated into several training and test sets. Two splitting approaches, distribution of biological data and structural diversity, and the statistical experimental design procedure D-optimal distance were applied to the dataset. The significance of the training set models was confirmed by statistically higher values of the internal leave one out cross-validated coefficient of determination (Q2) and external predictive coefficient of determination for the test set (Rtest2). The model developed from a training set, obtained with the D-optimal distance protocol and using 3D descriptor space along with activity values, separated chemical features that allowed to distinguish high and low pIC50 values reasonably well. Then, we verified that such model was sufficient to reliably and accurately predict the activity of external diverse structures. The model robustness was properly characterized by means of standard procedures and their applicability domain (AD) was analyzed by leverage method. Copyright © 2014 Elsevier B.V. All rights reserved.

Antepartum fetal heart rate feature extraction and classification using empirical mode decomposition and support vector machine

PubMed Central

2011-01-01

Background Cardiotocography (CTG) is the most widely used tool for fetal surveillance. The visual analysis of fetal heart rate (FHR) traces largely depends on the expertise and experience of the clinician involved. Several approaches have been proposed for the effective interpretation of FHR. In this paper, a new approach for FHR feature extraction based on empirical mode decomposition (EMD) is proposed, which was used along with support vector machine (SVM) for the classification of FHR recordings as 'normal' or 'at risk'. Methods The FHR were recorded from 15 subjects at a sampling rate of 4 Hz and a dataset consisting of 90 randomly selected records of 20 minutes duration was formed from these. All records were labelled as 'normal' or 'at risk' by two experienced obstetricians. A training set was formed by 60 records, the remaining 30 left as the testing set. The standard deviations of the EMD components are input as features to a support vector machine (SVM) to classify FHR samples. Results For the training set, a five-fold cross validation test resulted in an accuracy of 86% whereas the overall geometric mean of sensitivity and specificity was 94.8%. The Kappa value for the training set was .923. Application of the proposed method to the testing set (30 records) resulted in a geometric mean of 81.5%. The Kappa value for the testing set was .684. Conclusions Based on the overall performance of the system it can be stated that the proposed methodology is a promising new approach for the feature extraction and classification of FHR signals. PMID:21244712

Project 2000-3 Leading Edge Enterprise: Insights into Employment and Training Practices. Working Paper.

ERIC Educational Resources Information Center

Long, Michael; Fischer, John

Leading-edge firms (LEFs)--at the forefront of their industry in terms of growth or market share--may influence skill development through diffusion of technology, products, or practices and use of market power to set standards or change customer businesses. Study of LEFs can identify the type and mix of skills needed in the industry. LEFs are…

Develop Training Standards for Undergraduate Students with Major Public Administration at King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia

ERIC Educational Resources Information Center

Al-Sehiemy, Zainab Abdul-Rahman; Gheith, Nervana Abdul-Rahman

2015-01-01

Recently, public administration graduates are exposed to new set of challenges because of globalization, virtual world and using modern technology as a base of all today's dealings. It imposes PAD at faculty of economic and administration faculty to prepare its students to confront these changes in organizations in the community. Therefore, the…

Problems Court: The Role of the Reading Educator in the Training of Elementary School Principals.

ERIC Educational Resources Information Center

Kurth, Ruth Justine

The lack of interest in the development of competent principals who can serve as instructional leaders of reading programs is apparent in three areas: (1) lack of clearly defined research on the role of the principal in the reading program (2) lack of involvement of reading professionals in setting standards for evaluating, certifying, and…

Error estimation of deformable image registration of pulmonary CT scans using convolutional neural networks.

PubMed

Eppenhof, Koen A J; Pluim, Josien P W

2018-04-01

Error estimation in nonlinear medical image registration is a nontrivial problem that is important for validation of registration methods. We propose a supervised method for estimation of registration errors in nonlinear registration of three-dimensional (3-D) images. The method is based on a 3-D convolutional neural network that learns to estimate registration errors from a pair of image patches. By applying the network to patches centered around every voxel, we construct registration error maps. The network is trained using a set of representative images that have been synthetically transformed to construct a set of image pairs with known deformations. The method is evaluated on deformable registrations of inhale-exhale pairs of thoracic CT scans. Using ground truth target registration errors on manually annotated landmarks, we evaluate the method's ability to estimate local registration errors. Estimation of full domain error maps is evaluated using a gold standard approach. The two evaluation approaches show that we can train the network to robustly estimate registration errors in a predetermined range, with subvoxel accuracy. We achieved a root-mean-square deviation of 0.51 mm from gold standard registration errors and of 0.66 mm from ground truth landmark registration errors.

Boosting productivity: a framework for professional/amateur collaborative teamwork

NASA Astrophysics Data System (ADS)

Al-Shedhani, Saleh S.

2002-11-01

As technology advances, remote operation of telescopes has paved the way for joint observational projects between Astronomy clubs. Equipped with a small telescope, a standard CCD, and a networked computer, the observatory can be set up to carry out several photometric studies. However, most club members lack the basic training and background required for such tasks. A collaborative network between professionals and amateurs is proposed to utilize professional know-how and amateurs' readiness for continuous observations. Working as a team, various long-term observational projects can be carried out using small telescopes. Professionals can play an important role in raising the standards of astronomy clubs via specialized training programs for members on how to use the available technology to search/observe certain events (e.g. supernovae, comets, etc.). Professionals in return can accumulate a research-relevant database and can set up an early notification scheme based on comparative analyses of the recently-added images in an online archive. Here we present a framework for the above collaborative teamwork that uses web-based communication tools to establish remote/robotic operation of the telescope, and an online archive and discussion forum, to maximize the interactions between professionals and amateurs and to boost the productivity of small telescope observatories.

Decaying relevance of clinical data towards future decisions in data-driven inpatient clinical order sets.

PubMed

Chen, Jonathan H; Alagappan, Muthuraman; Goldstein, Mary K; Asch, Steven M; Altman, Russ B

2017-06-01

Determine how varying longitudinal historical training data can impact prediction of future clinical decisions. Estimate the "decay rate" of clinical data source relevance. We trained a clinical order recommender system, analogous to Netflix or Amazon's "Customers who bought A also bought B..." product recommenders, based on a tertiary academic hospital's structured electronic health record data. We used this system to predict future (2013) admission orders based on different subsets of historical training data (2009 through 2012), relative to existing human-authored order sets. Predicting future (2013) inpatient orders is more accurate with models trained on just one month of recent (2012) data than with 12 months of older (2009) data (ROC AUC 0.91 vs. 0.88, precision 27% vs. 22%, recall 52% vs. 43%, all P<10 -10 ). Algorithmically learned models from even the older (2009) data was still more effective than existing human-authored order sets (ROC AUC 0.81, precision 16% recall 35%). Training with more longitudinal data (2009-2012) was no better than using only the most recent (2012) data, unless applying a decaying weighting scheme with a "half-life" of data relevance about 4 months. Clinical practice patterns (automatically) learned from electronic health record data can vary substantially across years. Gold standards for clinical decision support are elusive moving targets, reinforcing the need for automated methods that can adapt to evolving information. Prioritizing small amounts of recent data is more effective than using larger amounts of older data towards future clinical predictions. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.

Pilot study of a novel tool for input-free automated identification of transition zone prostate tumors using T2- and diffusion-weighted signal and textural features.

PubMed

Stember, Joseph N; Deng, Fang-Ming; Taneja, Samir S; Rosenkrantz, Andrew B

2014-08-01

To present results of a pilot study to develop software that identifies regions suspicious for prostate transition zone (TZ) tumor, free of user input. Eight patients with TZ tumors were used to develop the model by training a Naïve Bayes classifier to detect tumors based on selection of most accurate predictors among various signal and textural features on T2-weighted imaging (T2WI) and apparent diffusion coefficient (ADC) maps. Features tested as inputs were: average signal, signal standard deviation, energy, contrast, correlation, homogeneity and entropy (all defined on T2WI); and average ADC. A forward selection scheme was used on the remaining 20% of training set supervoxels to identify important inputs. The trained model was tested on a different set of ten patients, half with TZ tumors. In training cases, the software tiled the TZ with 4 × 4-voxel "supervoxels," 80% of which were used to train the classifier. Each of 100 iterations selected T2WI energy and average ADC, which therefore were deemed the optimal model input. The two-feature model was applied blindly to the separate set of test patients, again without operator input of suspicious foci. The software correctly predicted presence or absence of TZ tumor in all test patients. Furthermore, locations of predicted tumors corresponded spatially with locations of biopsies that had confirmed their presence. Preliminary findings suggest that this tool has potential to accurately predict TZ tumor presence and location, without operator input. © 2013 Wiley Periodicals, Inc.

Protocol - realist and meta-narrative evidence synthesis: Evolving Standards (RAMESES)

PubMed Central

2011-01-01

Background There is growing interest in theory-driven, qualitative and mixed-method approaches to systematic review as an alternative to (or to extend and supplement) conventional Cochrane-style reviews. These approaches offer the potential to expand the knowledge base in policy-relevant areas - for example by explaining the success, failure or mixed fortunes of complex interventions. However, the quality of such reviews can be difficult to assess. This study aims to produce methodological guidance, publication standards and training resources for those seeking to use the realist and/or meta-narrative approach to systematic review. Methods/design We will: [a] collate and summarise existing literature on the principles of good practice in realist and meta-narrative systematic review; [b] consider the extent to which these principles have been followed by published and in-progress reviews, thereby identifying how rigour may be lost and how existing methods could be improved; [c] using an online Delphi method with an interdisciplinary panel of experts from academia and policy, produce a draft set of methodological steps and publication standards; [d] produce training materials with learning outcomes linked to these steps; [e] pilot these standards and training materials prospectively on real reviews-in-progress, capturing methodological and other challenges as they arise; [f] synthesise expert input, evidence review and real-time problem analysis into more definitive guidance and standards; [g] disseminate outputs to audiences in academia and policy. The outputs of the study will be threefold: 1. Quality standards and methodological guidance for realist and meta-narrative reviews for use by researchers, research sponsors, students and supervisors 2. A 'RAMESES' (Realist and Meta-review Evidence Synthesis: Evolving Standards) statement (comparable to CONSORT or PRISMA) of publication standards for such reviews, published in an open-access academic journal. 3. A training module for researchers, including learning outcomes, outline course materials and assessment criteria. Discussion Realist and meta-narrative review are relatively new approaches to systematic review whose overall place in the secondary research toolkit is not yet fully established. As with all secondary research methods, guidance on quality assurance and uniform reporting is an important step towards improving quality and consistency of studies. PMID:21843376

Ultrasound-Guided Regional Anesthesia Simulation Training: A Systematic Review.

PubMed

Chen, Xiao Xu; Trivedi, Vatsal; AlSaflan, AbdulHadi A; Todd, Suzanne Clare; Tricco, Andrea C; McCartney, Colin J L; Boet, Sylvain

Ultrasound-guided regional anesthesia (UGRA) has become the criterion standard of regional anesthesia practice. Ultrasound-guided regional anesthesia teaching programs often use simulation, and guidelines have been published to help guide URGA education. This systematic review aimed to examine the effectiveness of simulation-based education for the acquisition and maintenance of competence in UGRA. Studies identified in MEDLINE, EMBASE, CINAHL, Cochrane Central Register of Controlled Trials, and ERIC were included if they assessed simulation-based UGRA teaching with outcomes measured at Kirkpatrick level 2 (knowledge and skills), 3 (transfer of learning to the workplace), or 4 (patient outcomes). Two authors independently reviewed all identified references for eligibility, abstracted data, and appraised quality. After screening 176 citations and 45 full-text articles, 12 studies were included. Simulation-enhanced training improved knowledge acquisition (Kirkpatrick level 2) when compared with nonsimulation training. Seven studies measuring skill acquisition (Kirkpatrick level 2) found that simulation-enhanced UGRA training was significantly more effective than alternative teaching methods or no intervention. One study measuring transfer of learning into the clinical setting (Kirkpatrick level 3) found no difference between simulation-enhanced UGRA training and non-simulation-based training. However, this study was discontinued early because of technical challenges. Two studies examined patient outcomes (Kirkpatrick level 4), and one of these found that simulation-based UGRA training improved patient outcomes compared with didactic teaching. Ultrasound-guided regional anesthesia knowledge and skills significantly improved with simulation training. The acquired UGRA skills may be transferred to the clinical setting; however, further studies are required to confirm these changes translate to improved patient outcomes.

Probabilistic Open Set Recognition

NASA Astrophysics Data System (ADS)

Jain, Lalit Prithviraj

Real-world tasks in computer vision, pattern recognition and machine learning often touch upon the open set recognition problem: multi-class recognition with incomplete knowledge of the world and many unknown inputs. An obvious way to approach such problems is to develop a recognition system that thresholds probabilities to reject unknown classes. Traditional rejection techniques are not about the unknown; they are about the uncertain boundary and rejection around that boundary. Thus traditional techniques only represent the "known unknowns". However, a proper open set recognition algorithm is needed to reduce the risk from the "unknown unknowns". This dissertation examines this concept and finds existing probabilistic multi-class recognition approaches are ineffective for true open set recognition. We hypothesize the cause is due to weak adhoc assumptions combined with closed-world assumptions made by existing calibration techniques. Intuitively, if we could accurately model just the positive data for any known class without overfitting, we could reject the large set of unknown classes even under this assumption of incomplete class knowledge. For this, we formulate the problem as one of modeling positive training data by invoking statistical extreme value theory (EVT) near the decision boundary of positive data with respect to negative data. We provide a new algorithm called the PI-SVM for estimating the unnormalized posterior probability of class inclusion. This dissertation also introduces a new open set recognition model called Compact Abating Probability (CAP), where the probability of class membership decreases in value (abates) as points move from known data toward open space. We show that CAP models improve open set recognition for multiple algorithms. Leveraging the CAP formulation, we go on to describe the novel Weibull-calibrated SVM (W-SVM) algorithm, which combines the useful properties of statistical EVT for score calibration with one-class and binary support vector machines. Building from the success of statistical EVT based recognition methods such as PI-SVM and W-SVM on the open set problem, we present a new general supervised learning algorithm for multi-class classification and multi-class open set recognition called the Extreme Value Local Basis (EVLB). The design of this algorithm is motivated by the observation that extrema from known negative class distributions are the closest negative points to any positive sample during training, and thus should be used to define the parameters of a probabilistic decision model. In the EVLB, the kernel distribution for each positive training sample is estimated via an EVT distribution fit over the distances to the separating hyperplane between positive training sample and closest negative samples, with a subset of the overall positive training data retained to form a probabilistic decision boundary. Using this subset as a frame of reference, the probability of a sample at test time decreases as it moves away from the positive class. Possessing this property, the EVLB is well-suited to open set recognition problems where samples from unknown or novel classes are encountered at test. Our experimental evaluation shows that the EVLB provides a substantial improvement in scalability compared to standard radial basis function kernel machines, as well as P I-SVM and W-SVM, with improved accuracy in many cases. We evaluate our algorithm on open set variations of the standard visual learning benchmarks, as well as with an open subset of classes from Caltech 256 and ImageNet. Our experiments show that PI-SVM, WSVM and EVLB provide significant advances over the previous state-of-the-art solutions for the same tasks.

Mass detection in digital breast tomosynthesis: Deep convolutional neural network with transfer learning from mammography.

PubMed

Samala, Ravi K; Chan, Heang-Ping; Hadjiiski, Lubomir; Helvie, Mark A; Wei, Jun; Cha, Kenny

2016-12-01

Develop a computer-aided detection (CAD) system for masses in digital breast tomosynthesis (DBT) volume using a deep convolutional neural network (DCNN) with transfer learning from mammograms. A data set containing 2282 digitized film and digital mammograms and 324 DBT volumes were collected with IRB approval. The mass of interest on the images was marked by an experienced breast radiologist as reference standard. The data set was partitioned into a training set (2282 mammograms with 2461 masses and 230 DBT views with 228 masses) and an independent test set (94 DBT views with 89 masses). For DCNN training, the region of interest (ROI) containing the mass (true positive) was extracted from each image. False positive (FP) ROIs were identified at prescreening by their previously developed CAD systems. After data augmentation, a total of 45 072 mammographic ROIs and 37 450 DBT ROIs were obtained. Data normalization and reduction of non-uniformity in the ROIs across heterogeneous data was achieved using a background correction method applied to each ROI. A DCNN with four convolutional layers and three fully connected (FC) layers was first trained on the mammography data. Jittering and dropout techniques were used to reduce overfitting. After training with the mammographic ROIs, all weights in the first three convolutional layers were frozen, and only the last convolution layer and the FC layers were randomly initialized again and trained using the DBT training ROIs. The authors compared the performances of two CAD systems for mass detection in DBT: one used the DCNN-based approach and the other used their previously developed feature-based approach for FP reduction. The prescreening stage was identical in both systems, passing the same set of mass candidates to the FP reduction stage. For the feature-based CAD system, 3D clustering and active contour method was used for segmentation; morphological, gray level, and texture features were extracted and merged with a linear discriminant classifier to score the detected masses. For the DCNN-based CAD system, ROIs from five consecutive slices centered at each candidate were passed through the trained DCNN and a mass likelihood score was generated. The performances of the CAD systems were evaluated using free-response ROC curves and the performance difference was analyzed using a non-parametric method. Before transfer learning, the DCNN trained only on mammograms with an AUC of 0.99 classified DBT masses with an AUC of 0.81 in the DBT training set. After transfer learning with DBT, the AUC improved to 0.90. For breast-based CAD detection in the test set, the sensitivity for the feature-based and the DCNN-based CAD systems was 83% and 91%, respectively, at 1 FP/DBT volume. The difference between the performances for the two systems was statistically significant (p-value < 0.05). The image patterns learned from the mammograms were transferred to the mass detection on DBT slices through the DCNN. This study demonstrated that large data sets collected from mammography are useful for developing new CAD systems for DBT, alleviating the problem and effort of collecting entirely new large data sets for the new modality.

Effect of handoff skills training for students during the medicine clerkship: a quasi-randomized study.

PubMed

Reyes, Juan A; Greenberg, Larrie; Amdur, Richard; Gehring, James; Lesky, Linda G

2016-03-01

Continuity is critical for safe patient care and its absence is associated with adverse outcomes. Continuity requires handoffs between physicians, but most published studies of educational interventions to improve handoffs have focused primarily on residents, despite interns expected to being proficient. The AAMC core entrustable activities for graduating medical students includes handoffs as a milestone, but no controlled studies with students have assessed the impact of training in handoff skills. The purpose of this study was to assess the impact of an educational intervention to improve third-year medical student handoff skills, the durability of learned skills into the fourth year, and the transfer of skills from the simulated setting to the clinical environment. Trained evaluators used standardized patient cases and an observation tool to assess verbal handoff skills immediately post intervention and during the student's fourth-year acting internship. Students were also observed doing real time sign-outs during their acting internship. Evaluators assessed untrained control students using a standardized case and performing a real-time sign-out. Intervention students mean score demonstrated improvement in handoff skills immediately after the workshop (2.6-3.8; p < 0.0001) that persisted into their fourth year acting internship when compared to baseline performance (3.9-3.5; p = 0.06) and to untrained control students (3.5 vs. 2.5; p < 0.001, d = 1.2). Intervention students evaluated in the clinical setting also scored higher than control students when assessed doing real-time handoffs (3.8 vs. 3.3; p = 0.032, d = 0.71). These findings should be useful to others considering introducing handoff teaching in the undergraduate medical curriculum in preparation for post-graduate medical training. Trial Registration Number NCT02217241.

Training the emotional brain: improving affective control through emotional working memory training.

PubMed

Schweizer, Susanne; Grahn, Jessica; Hampshire, Adam; Mobbs, Dean; Dalgleish, Tim

2013-03-20

Affective cognitive control capacity (e.g., the ability to regulate emotions or manipulate emotional material in the service of task goals) is associated with professional and interpersonal success. Impoverished affective control, by contrast, characterizes many neuropsychiatric disorders. Insights from neuroscience indicate that affective cognitive control relies on the same frontoparietal neural circuitry as working memory (WM) tasks, which suggests that systematic WM training, performed in an emotional context, has the potential to augment affective control. Here we show, using behavioral and fMRI measures, that 20 d of training on a novel emotional WM protocol successfully enhanced the efficiency of this frontoparietal demand network. Critically, compared with placebo training, emotional WM training also accrued transfer benefits to a "gold standard" measure of affective cognitive control-emotion regulation. These emotion regulation gains were associated with greater activity in the targeted frontoparietal demand network along with other brain regions implicated in affective control, notably the subgenual anterior cingulate cortex. The results have important implications for the utility of WM training in clinical, prevention, and occupational settings.

Developing hospital accreditation standards in Uganda.

PubMed

Galukande, Moses; Katamba, Achilles; Nakasujja, Noeline; Baingana, Rhona; Bateganya, Moses; Hagopian, Amy; Tavrow, Paula; Barnhart, Scott; Luboga, Sam

2016-07-01

Whereas accreditation is widely used as a tool to improve quality of healthcare in the developed world, it is a concept not well adapted in most developing countries for a host of reasons, including insufficient incentives, insufficient training and a shortage of human and material resources. The purpose of this paper is to describe refining use and outcomes of a self-assessment hospital accreditation tool developed for a resource-limited context. We invited 60 stakeholders to review a set of standards (from which a self-assessment tool was developed), and subsequently refined them to include 485 standards in 7 domains. We then invited 60 hospitals to test them. A study team traveled to each of the 40 hospitals that agreed to participate providing training and debrief the self-assessment. The study was completed in 8 weeks. Hospital self-assessments revealed hospitals were remarkably open to frank rating of their performance and willing to rank all 485 measures. Good performance was measured in outreach programs, availability of some types of equipment and running water, 24-h staff calls systems, clinical guidelines and waste segregation. Poor performance was measured in care for the vulnerable, staff living quarters, physician performance reviews, patient satisfaction surveys and sterilizing equipment. We have demonstrated the feasibility of a self-assessment approach to hospital standards in low-income country setting. This low-cost approach may be used as a good precursor to establishing a national accreditation body, as indicated by the Ministry's efforts to take the next steps. Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.

An artificial neural network prediction model of congenital heart disease based on risk factors: A hospital-based case-control study.

PubMed

Li, Huixia; Luo, Miyang; Zheng, Jianfei; Luo, Jiayou; Zeng, Rong; Feng, Na; Du, Qiyun; Fang, Junqun

2017-02-01

An artificial neural network (ANN) model was developed to predict the risks of congenital heart disease (CHD) in pregnant women.This hospital-based case-control study involved 119 CHD cases and 239 controls all recruited from birth defect surveillance hospitals in Hunan Province between July 2013 and June 2014. All subjects were interviewed face-to-face to fill in a questionnaire that covered 36 CHD-related variables. The 358 subjects were randomly divided into a training set and a testing set at the ratio of 85:15. The training set was used to identify the significant predictors of CHD by univariate logistic regression analyses and develop a standard feed-forward back-propagation neural network (BPNN) model for the prediction of CHD. The testing set was used to test and evaluate the performance of the ANN model. Univariate logistic regression analyses were performed on SPSS 18.0. The ANN models were developed on Matlab 7.1.The univariate logistic regression identified 15 predictors that were significantly associated with CHD, including education level (odds ratio  = 0.55), gravidity (1.95), parity (2.01), history of abnormal reproduction (2.49), family history of CHD (5.23), maternal chronic disease (4.19), maternal upper respiratory tract infection (2.08), environmental pollution around maternal dwelling place (3.63), maternal exposure to occupational hazards (3.53), maternal mental stress (2.48), paternal chronic disease (4.87), paternal exposure to occupational hazards (2.51), intake of vegetable/fruit (0.45), intake of fish/shrimp/meat/egg (0.59), and intake of milk/soymilk (0.55). After many trials, we selected a 3-layer BPNN model with 15, 12, and 1 neuron in the input, hidden, and output layers, respectively, as the best prediction model. The prediction model has accuracies of 0.91 and 0.86 on the training and testing sets, respectively. The sensitivity, specificity, and Yuden Index on the testing set (training set) are 0.78 (0.83), 0.90 (0.95), and 0.68 (0.78), respectively. The areas under the receiver operating curve on the testing and training sets are 0.87 and 0.97, respectively.This study suggests that the BPNN model could be used to predict the risk of CHD in individuals. This model should be further improved by large-sample-size research.

Novel, customizable scoring functions, parameterized using N-PLS, for structure-based drug discovery.

PubMed

Catana, Cornel; Stouten, Pieter F W

2007-01-01

The ability to accurately predict biological affinity on the basis of in silico docking to a protein target remains a challenging goal in the CADD arena. Typically, "standard" scoring functions have been employed that use the calculated docking result and a set of empirical parameters to calculate a predicted binding affinity. To improve on this, we are exploring novel strategies for rapidly developing and tuning "customized" scoring functions tailored to a specific need. In the present work, three such customized scoring functions were developed using a set of 129 high-resolution protein-ligand crystal structures with measured Ki values. The functions were parametrized using N-PLS (N-way partial least squares), a multivariate technique well-known in the 3D quantitative structure-activity relationship field. A modest correlation between observed and calculated pKi values using a standard scoring function (r2 = 0.5) could be improved to 0.8 when a customized scoring function was applied. To mimic a more realistic scenario, a second scoring function was developed, not based on crystal structures but exclusively on several binding poses generated with the Flo+ docking program. Finally, a validation study was conducted by generating a third scoring function with 99 randomly selected complexes from the 129 as a training set and predicting pKi values for a test set that comprised the remaining 30 complexes. Training and test set r2 values were 0.77 and 0.78, respectively. These results indicate that, even without direct structural information, predictive customized scoring functions can be developed using N-PLS, and this approach holds significant potential as a general procedure for predicting binding affinity on the basis of in silico docking.

Signal processing for the detection of explosive residues on varying substrates using laser-induced breakdown spectroscopy

NASA Astrophysics Data System (ADS)

Morton, Kenneth D., Jr.; Torrione, Peter A.; Collins, Leslie

2011-05-01

Laser induced breakdown spectroscopy (LIBS) can provide rapid, minimally destructive, chemical analysis of substances with the benefit of little to no sample preparation. Therefore, LIBS is a viable technology for the detection of substances of interest in near real-time fielded remote sensing scenarios. Of particular interest to military and security operations is the detection of explosive residues on various surfaces. It has been demonstrated that LIBS is capable of detecting such residues, however, the surface or substrate on which the residue is present can alter the observed spectra. Standard chemometric techniques such as principal components analysis and partial least squares discriminant analysis have previously been applied to explosive residue detection, however, the classification techniques developed on such data perform best against residue/substrate pairs that were included in model training but do not perform well when the residue/substrate pairs are not in the training set. Specifically residues in the training set may not be correctly detected if they are presented on a previously unseen substrate. In this work, we explicitly model LIBS spectra resulting from the residue and substrate to attempt to separate the response from each of the two components. This separation process is performed jointly with classifier design to ensure that the classifier that is developed is able to detect residues of interest without being confused by variations in the substrates. We demonstrate that the proposed classification algorithm provides improved robustness to variations in substrate compared to standard chemometric techniques for residue detection.

Online self-administered training for post-traumatic stress disorder treatment providers: design and methods for a randomized, prospective intervention study

PubMed Central

2012-01-01

This paper presents the rationale and methods for a randomized controlled evaluation of web-based training in motivational interviewing, goal setting, and behavioral task assignment. Web-based training may be a practical and cost-effective way to address the need for large-scale mental health training in evidence-based practice; however, there is a dearth of well-controlled outcome studies of these approaches. For the current trial, 168 mental health providers treating post-traumatic stress disorder (PTSD) were assigned to web-based training plus supervision, web-based training, or training-as-usual (control). A novel standardized patient (SP) assessment was developed and implemented for objective measurement of changes in clinical skills, while on-line self-report measures were used for assessing changes in knowledge, perceived self-efficacy, and practice related to cognitive behavioral therapy (CBT) techniques. Eligible participants were all actively involved in mental health treatment of veterans with PTSD. Study methodology illustrates ways of developing training content, recruiting participants, and assessing knowledge, perceived self-efficacy, and competency-based outcomes, and demonstrates the feasibility of conducting prospective studies of training efficacy or effectiveness in large healthcare systems. PMID:22583520

In vivo porcine training model for cranial neurosurgery.

PubMed

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

2015-01-01

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

Beyond Fine Tuning: Adding capacity to leverage few labels

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

Hodas, Nathan O.; Shaffer, Kyle J.; Yankov, Artem

2017-12-09

In this paper we present a technique to train neural network models on small amounts of data. Current methods for training neural networks on small amounts of rich data typically rely on strategies such as fine-tuning a pre-trained neural networks or the use of domain-specific hand-engineered features. Here we take the approach of treating network layers, or entire networks, as modules and combine pre-trained modules with untrained modules, to learn the shift in distributions between data sets. The central impact of using a modular approach comes from adding new representations to a network, as opposed to replacing representations via fine-tuning.more » Using this technique, we are able surpass results using standard fine-tuning transfer learning approaches, and we are also able to significantly increase performance over such approaches when using smaller amounts of data.« less

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

PubMed

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

2016-09-01

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

Existing and Future Educational Needs in Graduate and Postgraduate Education.

PubMed

Eardley, Ian; Reisman, Yacov; Goldstein, Sue; Kramer, Andrew; Dean, John; Coleman, Eli

2017-04-01

This review was designed to make recommendations on future educational needs, principles of curricular development, and how the International Society for Sexual Medicine (ISSM) should address the need to enhance and promote human sexuality education around the world. To explore the ways in which graduate and postgraduate medical education in human sexuality has evolved and is currently delivered. We reviewed existing literature concerning sexuality education, curriculum development, learning strategies, educational formats, evaluation of programs, evaluation of students, and faculty development. We reviewed literature relating to four main areas: (i) the current status of the international regulation of training in sexual medicine; (ii) the current delivery of education and training in sexual medicine; (iii) resident and postgraduate education in sexual medicine surgery; and (iv) education and training for allied health professionals. The main findings in these four areas are as follows. Sexual medicine has grown considerably as a specialty during the past 20 years, with many drivers being identified. However, the regulatory aspects of training, assessment, and certification are currently in the early stages of development and are in many ways lagging behind the scientific and clinical knowledge in the field. However, there are examples of the development of curricula with accompanying assessments that have attempted to set standards of education and training that might underlie the delivery of high-quality care to patients in sexual medicine. The development of competence assessment has been applied to surgical training in sexual medicine, and there is increasing interest in simulation as a means of enhancing technical skills training. Although the focus of curriculum development has largely been the medical profession, there is early interest in the development of standards for training and education of allied health professionals. Organizations of professionals in sexual health, such as the ISSM, have an opportunity, and indeed a responsibility, to provide and disseminate learning opportunities, curricula, and standards of training for doctors and allied health professionals in sexual medicine. Eardley I, Reisman Y, Goldstein S, et al. Existing and Future Educational Needs in Graduate and Postgraduate Education. J Sex Med 2017;14:475-485. Copyright © 2016 International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.

Validating hierarchical verbal autopsy expert algorithms in a large data set with known causes of death.

PubMed

Kalter, Henry D; Perin, Jamie; Black, Robert E

2016-06-01

Physician assessment historically has been the most common method of analyzing verbal autopsy (VA) data. Recently, the World Health Organization endorsed two automated methods, Tariff 2.0 and InterVA-4, which promise greater objectivity and lower cost. A disadvantage of the Tariff method is that it requires a training data set from a prior validation study, while InterVA relies on clinically specified conditional probabilities. We undertook to validate the hierarchical expert algorithm analysis of VA data, an automated, intuitive, deterministic method that does not require a training data set. Using Population Health Metrics Research Consortium study hospital source data, we compared the primary causes of 1629 neonatal and 1456 1-59 month-old child deaths from VA expert algorithms arranged in a hierarchy to their reference standard causes. The expert algorithms were held constant, while five prior and one new "compromise" neonatal hierarchy, and three former child hierarchies were tested. For each comparison, the reference standard data were resampled 1000 times within the range of cause-specific mortality fractions (CSMF) for one of three approximated community scenarios in the 2013 WHO global causes of death, plus one random mortality cause proportions scenario. We utilized CSMF accuracy to assess overall population-level validity, and the absolute difference between VA and reference standard CSMFs to examine particular causes. Chance-corrected concordance (CCC) and Cohen's kappa were used to evaluate individual-level cause assignment. Overall CSMF accuracy for the best-performing expert algorithm hierarchy was 0.80 (range 0.57-0.96) for neonatal deaths and 0.76 (0.50-0.97) for child deaths. Performance for particular causes of death varied, with fairly flat estimated CSMF over a range of reference values for several causes. Performance at the individual diagnosis level was also less favorable than that for overall CSMF (neonatal: best CCC = 0.23, range 0.16-0.33; best kappa = 0.29, 0.23-0.35; child: best CCC = 0.40, 0.19-0.45; best kappa = 0.29, 0.07-0.35). Expert algorithms in a hierarchy offer an accessible, automated method for assigning VA causes of death. Overall population-level accuracy is similar to that of more complex machine learning methods, but without need for a training data set from a prior validation study.

3D-quantitative structure-activity relationship studies on benzothiadiazepine hydroxamates as inhibitors of tumor necrosis factor-alpha converting enzyme.

PubMed

Murumkar, Prashant R; Giridhar, Rajani; Yadav, Mange Ram

2008-04-01

A set of 29 benzothiadiazepine hydroxamates having selective tumor necrosis factor-alpha converting enzyme inhibitory activity were used to compare the quality and predictive power of 3D-quantitative structure-activity relationship, comparative molecular field analysis, and comparative molecular similarity indices models for the atom-based, centroid/atom-based, data-based, and docked conformer-based alignment. Removal of two outliers from the initial training set of molecules improved the predictivity of models. Among the 3D-quantitative structure-activity relationship models developed using the above four alignments, the database alignment provided the optimal predictive comparative molecular field analysis model for the training set with cross-validated r(2) (q(2)) = 0.510, non-cross-validated r(2) = 0.972, standard error of estimates (s) = 0.098, and F = 215.44 and the optimal comparative molecular similarity indices model with cross-validated r(2) (q(2)) = 0.556, non-cross-validated r(2) = 0.946, standard error of estimates (s) = 0.163, and F = 99.785. These models also showed the best test set prediction for six compounds with predictive r(2) values of 0.460 and 0.535, respectively. The contour maps obtained from 3D-quantitative structure-activity relationship studies were appraised for activity trends for the molecules analyzed. The comparative molecular similarity indices models exhibited good external predictivity as compared with that of comparative molecular field analysis models. The data generated from the present study helped us to further design and report some novel and potent tumor necrosis factor-alpha converting enzyme inhibitors.

Slow Versus Fast Robot-Assisted Locomotor Training After Severe Stroke: A Randomized Controlled Trial.

PubMed

Rodrigues, Thais Amanda; Goroso, Daniel Gustavo; Westgate, Philip M; Carrico, Cheryl; Batistella, Linamara R; Sawaki, Lumy

2017-10-01

Robot-assisted locomotor training on a bodyweight-supported treadmill is a rehabilitation intervention that compels repetitive practice of gait movements. Standard treadmill speed may elicit rhythmic movements generated primarily by spinal circuits. Slower-than-standard treadmill speed may elicit discrete movements, which are more complex than rhythmic movements and involve cortical areas. Compare effects of fast (i.e., rhythmic) versus slow (i.e., discrete) robot-assisted locomotor training on a bodyweight-supported treadmill in subjects with chronic, severe gait deficit after stroke. Subjects (N = 18) were randomized to receive 30 sessions (5 d/wk) of either fast or slow robot-assisted locomotor training on a bodyweight-supported treadmill in an inpatient setting. Functional ambulation category, time up and go, 6-min walk test, 10-m walk test, Berg Balance Scale, and Fugl-Meyer Assessment were administered at baseline and postintervention. The slow group had statistically significant improvement on functional ambulation category (first quartile-third quartile, P = 0.004), 6-min walk test (95% confidence interval [CI] = 1.8 to 49.0, P = 0.040), Berg Balance Scale (95% CI = 7.4 to 14.8, P < 0.0001), time up and go (95% CI = -79.1 to 5.0, P < 0.0030), and Fugl-Meyer Assessment (95% CI = 24.1 to 45.1, P < 0.0001). The fast group had statistically significant improvement on Berg Balance Scale (95% CI = 1.5 to 10.5, P = 0.02). In initial stages of robot-assisted locomotor training on a bodyweight-supported treadmill after severe stroke, slow training targeting discrete movement may yield greater benefit than fast training.

Feasibility of a focused ultrasound training programme for medical undergraduate students.

PubMed

Wong, Ivan; Jayatilleke, Thilina; Kendall, Richard; Atkinson, Paul

2011-03-01

Although ultrasound is a core skill for many clinical specialties, UK medical schools are not currently required to teach this skill. The College of Emergency Medicine (CEM) has championed the use of ultrasound to answer focused clinical questions in emergency settings. We have designed and piloted an ultrasound training course for undergraduate medical students addressing one important indication: ultrasound assessment of the abdominal aorta. Fourteen clinical students, who had no prior experience of using ultrasound, received focused ultrasound training in the form of didactic instruction, a short bedside practical workshop and self-directed learning over a 20-day period. At the end of this period, the students were assessed by a structured viva and an observed structured clinical examination (OSCE) used for accreditation by the CEM. The primary endpoint was the number of students who passed the assessment. The secondary endpoint was the accuracy of the students' anatomical measurements. Thirteen of the 14 (93%) students completed the training and assessment. Eight of the 13 (62%) students passed both the viva and OSCE, and were deemed to have achieved the CEM standard. The measurements by the competent students were not statistically different from those of experienced practitioners. We have shown for the first time that it is feasible to train inexperienced undergraduate students to scan the abdominal aorta to a professional standard using a focused training course. It is time for the medical education community to address whether focused ultrasound training should accompany traditional clinical skills, such as using a stethoscope, in UK medical school curricula. © Blackwell Publishing Ltd 2011.

Detection of Cheating by Decimation Algorithm

NASA Astrophysics Data System (ADS)

Yamanaka, Shogo; Ohzeki, Masayuki; Decelle, Aurélien

2015-02-01

We expand the item response theory to study the case of "cheating students" for a set of exams, trying to detect them by applying a greedy algorithm of inference. This extended model is closely related to the Boltzmann machine learning. In this paper we aim to infer the correct biases and interactions of our model by considering a relatively small number of sets of training data. Nevertheless, the greedy algorithm that we employed in the present study exhibits good performance with a few number of training data. The key point is the sparseness of the interactions in our problem in the context of the Boltzmann machine learning: the existence of cheating students is expected to be very rare (possibly even in real world). We compare a standard approach to infer the sparse interactions in the Boltzmann machine learning to our greedy algorithm and we find the latter to be superior in several aspects.

Determinants of Antibiotic Consumption - Development of a Model using Partial Least Squares Regression based on Data from India.

PubMed

Tamhankar, Ashok J; Karnik, Shreyasee S; Stålsby Lundborg, Cecilia

2018-04-23

Antibiotic resistance, a consequence of antibiotic use, is a threat to health, with severe consequences for resource constrained settings. If determinants for human antibiotic use in India, a lower middle income country, with one of the highest antibiotic consumption in the world could be understood, interventions could be developed, having implications for similar settings. Year wise data for India, for potential determinants and antibiotic consumption, was sourced from publicly available databases for the years 2000-2010. Data was analyzed using Partial Least Squares regression and correlation between determinants and antibiotic consumption was evaluated, formulating 'Predictors' and 'Prediction models'. The 'prediction model' with the statistically most significant predictors (root mean square errors of prediction for train set-377.0 and test set-297.0) formulated from a combination of Health infrastructure + Surface transport infrastructure (HISTI), predicted antibiotic consumption within 95% confidence interval and estimated an antibiotic consumption of 11.6 standard units/person (14.37 billion standard units totally; standard units = number of doses sold in the country; a dose being a pill, capsule, or ampoule) for India for 2014. The HISTI model may become useful in predicting antibiotic consumption for countries/regions having circumstances and data similar to India, but without resources to measure actual data of antibiotic consumption.

Limited Effects of Set Shifting Training in Healthy Older Adults

PubMed Central

Grönholm-Nyman, Petra; Soveri, Anna; Rinne, Juha O.; Ek, Emilia; Nyholm, Alexandra; Stigsdotter Neely, Anna; Laine, Matti

2017-01-01

Our ability to flexibly shift between tasks or task sets declines in older age. As this decline may have adverse effects on everyday life of elderly people, it is of interest to study whether set shifting ability can be trained, and if training effects generalize to other cognitive tasks. Here, we report a randomized controlled trial where healthy older adults trained set shifting with three different set shifting tasks. The training group (n = 17) performed adaptive set shifting training for 5 weeks with three training sessions a week (45 min/session), while the active control group (n = 16) played three different computer games for the same period. Both groups underwent extensive pre- and post-testing and a 1-year follow-up. Compared to the controls, the training group showed significant improvements on the trained tasks. Evidence for near transfer in the training group was very limited, as it was seen only on overall accuracy on an untrained computerized set shifting task. No far transfer to other cognitive functions was observed. One year later, the training group was still better on the trained tasks but the single near transfer effect had vanished. The results suggest that computerized set shifting training in the elderly shows long-lasting effects on the trained tasks but very little benefit in terms of generalization. PMID:28386226

Technical tips and advancements in pediatric minimally invasive surgical training on porcine based simulations.

PubMed

Narayanan, Sarath Kumar; Cohen, Ralph Clinton; Shun, Albert

2014-06-01

Minimal access techniques have transformed the way pediatric surgery is practiced. Due to various constraints, surgical residency programs have not been able to tutor adequate training skills in the routine setting. The advent of new technology and methods in minimally invasive surgery (MIS), has similarly contributed to the need for systematic skills' training in a safe, simulated environment. To enable the training of the proper technique among pediatric surgery trainees, we have advanced a porcine non-survival model for endoscopic surgery. The technical advancements over the past 3 years and a subjective validation of the porcine model from 114 participating trainees using a standard questionnaire and a 5-point Likert scale have been described here. Mean attitude scores and analysis of variance (ANOVA) were used for statistical analysis of the data. Almost all trainees agreed or strongly agreed that the animal-based model was appropriate (98.35%) and also acknowledged that such workshops provided adequate practical experience before attempting on human subjects (96.6%). Mean attitude score for respondents was 19.08 (SD 3.4, range 4-20). Attitude scores showed no statistical association with years of experience or the level of seniority, indicating a positive attitude among all groups of respondents. Structured porcine-based MIS training should be an integral part of skill acquisition for pediatric surgery trainees and the experience gained can be transferred into clinical practice. We advocate that laparoscopic training should begin in a controlled workshop setting before procedures are attempted on human patients.

Constellation Training Facility Support

NASA Technical Reports Server (NTRS)

Flores, Jose M.

2008-01-01

The National Aeronautics and Space Administration is developing the next set of vehicles that will take men back to the moon under the Constellation Program. The Constellation Training Facility (CxTF) is a project in development that will be used to train astronauts, instructors, and flight controllers on the operation of Constellation Program vehicles. It will also be used for procedure verification and validation of flight software and console tools. The CxTF will have simulations for the Crew Exploration Vehicle (CEV), Crew Module (CM), CEV Service Module (SM), Launch Abort System (LAS), Spacecraft Adapter (SA), Crew Launch Vehicle (CLV), Pressurized Cargo Variant CM, Pressurized Cargo Variant SM, Cargo Launch Vehicle, Earth Departure Stage (EDS), and the Lunar Surface Access Module (LSAM). The Facility will consist of part-task and full-task trainers, each with a specific set of mission training capabilities. Part task trainers will be used for focused training on a single vehicle system or set of related systems. Full task trainers will be used for training on complete vehicles and all of its subsystems. Support was provided in both software development and project planning areas of the CxTF project. Simulation software was developed for the hydraulic system of the Thrust Vector Control (TVC) of the ARES I launch vehicle. The TVC system is in charge of the actuation of the nozzle gimbals for navigation control of the upper stage of the ARES I rocket. Also, software was developed using C standards to send and receive data to and from hand controllers to be used in CxTF cockpit simulations. The hand controllers provided movement in all six rotational and translational axes. Under Project Planning & Control, support was provided to the development and maintenance of integrated schedules for both the Constellation Training Facility and Missions Operations Facilities Division. These schedules maintain communication between projects in different levels. The CxTF support provided is one that requires continuous maintenance since the project is still on initial development phases.

Setting the Theater: US Sustainment Operations in the Pacific during World War II

DTIC Science & Technology

2016-05-26

effectively in a modern context during the 1940s would depend on its strategic deployment mobility, manpower mobilization and training, raw...properly resourced. The United States was (and still is) rich with resources, scientific capabilities, and manpower . The timing and synchronization of...equipment that could be rapidly transported and assembled; specifications for standardized barracks, warehouses , aircraft hangars, ammunition magazines

Competency in managing cardiac arrest: A scenario-based evaluation of dental students.

PubMed

Breuer, Georg; Knipfer, Christian; Huber, Tobias; Huettl, Stephan; Shams, Nima; Knipfer, Kristin; Neukam, Friedrich Wilhelm; Schuettler, Juergen; Stelzle, Florian

2016-01-01

Advanced Cardiovascular Life Support (ACLS) in life-threatening situations is perceived as a basic skill for dental professionals. However, medical emergency training in dental schools is often not standardized. The dental students' knowledge transfer to an ACLS setting thus remains questionable. The aim of the study was to evaluate dental pre-doctorate students' practical competence in ACLS in a standardized manner to enable the curriculum to be adapted to meet their particular needs. Thirty dental students (age 25.47 ± 1.81; 16 male/14 female) in their last year of dental studies were randomly assigned to 15 teams. Students' ability to successfully manage ACLS was assessed by a scenario-based approach (training module: Laerdal® ALS Skillmaster). Competence was assessed by means of (a) an observation chart, (b) video analysis and (c) training module analysis (Laerdal HeartSim®4000; Version 1.4). The evaluation was conducted by a trained anesthesiologist with regard to the 2010 guidelines of the European Resuscitation Council (ERC). Only five teams (33.3%) checked for all three vital functions (response, breathing and circulation). All teams initiated cardiopulmonary resuscitation (CPR). Only 54.12% of the compressions performed during CPR were sufficient. Four teams stopped the CPR after initiation. In total, 93% of the teams used the equipment for bag-valve-mask ventilation and 53.3% used the AED (Automated external defibrillator). ACLS training on a regular basis is necessary and, consistent with a close link between dentistry and medicine, should be a standardized part of the medical emergency curriculum for dental students with a specific focus on the deficiencies revealed in this study.

Influence of gravity compensation training on synergistic movement patterns of the upper extremity after stroke, a pilot study

PubMed Central

2012-01-01

Background The majority of stroke patients have to cope with impaired arm function. Gravity compensation of the arm instantaneously affects abnormal synergistic movement patterns. The goal of the present study is to examine whether gravity compensated training improves unsupported arm function. Methods Seven chronic stroke patients received 18 half-hour sessions of gravity compensated reach training, in a period of six weeks. During training a motivating computer game was played. Before and after training arm function was assessed with the Fugl-Meyer assessment and a standardized, unsupported circle drawing task. Synergistic movement patterns were identified based on concurrent changes in shoulder elevation and elbow flexion/extension angles. Results Median increase of Fugl-Meyer scores was 3 points after training. The training led to significantly increased work area of the hemiparetic arm, as indicated by the normalized circle area. Roundness of the drawn circles and the occurrence of synergistic movement patterns remained similar after the training. Conclusions A decreased strength of involuntary coupling might contribute to the increased arm function after training. More research is needed to study working mechanisms involved in post stroke rehabilitation training. The used training setup is simple and affordable and is therefore suitable to use in clinical settings. PMID:22824488

Establishing evidence-based training in cognitive behavioral therapy: A review of current empirical findings and theoretical guidance.

PubMed

Rakovshik, Sarah G; McManus, Freda

2010-07-01

Cognitive behavior therapy's (CBT) demonstrated efficacy has prompted calls for its increased dissemination to routine clinical practice settings. For the widespread dissemination of CBT to be successful in achieving effects similar to the original efficacy trials, there must also be effective dissemination of CBT training practices. However, as yet, CBT training is not evidence-based. This review examines what can be learned from existing research into the efficacy and effectiveness of CBT training. Due to the paucity of research specifically investigating CBT training, CBT effectiveness and dissemination studies are also examined to glean information about potentially effective training practices. In order to draw conclusions about effective training practices, comparisons are drawn between studies according to the clinical outcomes that they achieved. Training approaches are compared according to dose and active training elements, and theoretical models of learning are applied to interpret the findings. The limitations of the existing literature are discussed, as well as recommendations for improving training research to meet the standards evident in treatment trials (e.g., random allocation, control conditions, self-report and blind assessment, and adherence monitoring). Finally, the process of developing efficacious CBT treatment protocols is offered as a template for developing evidence-based CBT training protocols. 2010 Elsevier Ltd. All rights reserved.

Failure of Working Memory Training to Enhance Cognition or Intelligence

PubMed Central

Thompson, Todd W.; Waskom, Michael L.; Garel, Keri-Lee A.; Cardenas-Iniguez, Carlos; Reynolds, Gretchen O.; Winter, Rebecca; Chang, Patricia; Pollard, Kiersten; Lala, Nupur; Alvarez, George A.; Gabrieli, John D. E.

2013-01-01

Fluid intelligence is important for successful functioning in the modern world, but much evidence suggests that fluid intelligence is largely immutable after childhood. Recently, however, researchers have reported gains in fluid intelligence after multiple sessions of adaptive working memory training in adults. The current study attempted to replicate and expand those results by administering a broad assessment of cognitive abilities and personality traits to young adults who underwent 20 sessions of an adaptive dual n-back working memory training program and comparing their post-training performance on those tests to a matched set of young adults who underwent 20 sessions of an adaptive attentional tracking program. Pre- and post-training measurements of fluid intelligence, standardized intelligence tests, speed of processing, reading skills, and other tests of working memory were assessed. Both training groups exhibited substantial and specific improvements on the trained tasks that persisted for at least 6 months post-training, but no transfer of improvement was observed to any of the non-trained measurements when compared to a third untrained group serving as a passive control. These findings fail to support the idea that adaptive working memory training in healthy young adults enhances working memory capacity in non-trained tasks, fluid intelligence, or other measures of cognitive abilities. PMID:23717453

Setting Performance Standards for Technical and Nontechnical Competence in General Surgery.

PubMed

Szasz, Peter; Bonrath, Esther M; Louridas, Marisa; Fecso, Andras B; Howe, Brett; Fehr, Adam; Ott, Michael; Mack, Lloyd A; Harris, Kenneth A; Grantcharov, Teodor P

2017-07-01

The objectives of this study were to (1) create a technical and nontechnical performance standard for the laparoscopic cholecystectomy, (2) assess the classification accuracy and (3) credibility of these standards, (4) determine a trainees' ability to meet both standards concurrently, and (5) delineate factors that predict standard acquisition. Scores on performance assessments are difficult to interpret in the absence of established standards. Trained raters observed General Surgery residents performing laparoscopic cholecystectomies using the Objective Structured Assessment of Technical Skill (OSATS) and the Objective Structured Assessment of Non-Technical Skills (OSANTS) instruments, while as also providing a global competent/noncompetent decision for each performance. The global decision was used to divide the trainees into 2 contrasting groups and the OSATS or OSANTS scores were graphed per group to determine the performance standard. Parametric statistics were used to determine classification accuracy and concurrent standard acquisition, receiver operator characteristic (ROC) curves were used to delineate predictive factors. Thirty-six trainees were observed 101 times. The technical standard was an OSATS of 21.04/35.00 and the nontechnical standard an OSANTS of 22.49/35.00. Applying these standards, competent/noncompetent trainees could be discriminated in 94% of technical and 95% of nontechnical performances (P < 0.001). A 21% discordance between technically and nontechnically competent trainees was identified (P < 0.001). ROC analysis demonstrated case experience and trainee level were both able to predict achieving the standards with an area under the curve (AUC) between 0.83 and 0.96 (P < 0.001). The present study presents defensible standards for technical and nontechnical performance. Such standards are imperative to implementing summative assessments into surgical training.

Ballroom dancing as physical activity for patients with cancer: a systematic review and report of a pilot project.

PubMed

Rudolph, Ivonne; Schmidt, Thorsten; Wozniak, Tobias; Kubin, Thomas; Ruetters, Dana; Huebner, Jutta

2018-04-01

Physical activity has positive effects on cancer patients. Dancing addresses diverse bio-psycho-social aspects. Our aim was to assess the evidence on ballroom dancing and to develop the setting for a pilot project. We performed a systematic review, extracted the data and designed a pilot training based on standard curricula. We included cancer patients during or after therapy. Training duration was 90 min with one regular pause and individual pauses as needed. We retrieved two systematic reviews and six controlled studies. Types of dancing varied. Only one study used ballroom dancing. Dance training might improve well-being, physical fitness, fatigue and coping during and after therapy. Yet, evidence is scarce and data to derive the effect size are lacking; 27 patients and their partners took part in the pilot training. Patients and partners needed more time to learn the steps than is planned in regular ballroom classes. Participants were very satisfied with the adaptation of the training to their physical strength and estimated the training in a sheltered group. No side effects occurred. In spite of a high rate of participants reporting fatigue, 90 min of physical activity with only a few minutes of rest were manageable for all participants. Ballroom dancing may offer benefits for patients with respect to quality of life. Cancer patients prefer sheltered training setting and curricula of regular ballroom classes must be adapted for cancer patients. Strict curricula might reduce motivation and adherence and exclude patients with lower or variable fitness.

Alignment and Brakes Mechanic. Apprenticeship Training Standards = Mecanicien regleur d'avant-train et reparateur de freins. Normes de formation en apprentissage.

ERIC Educational Resources Information Center

Ontario Ministry of Skills Development, Toronto.

These training standards for alignment and brakes mechanics are intended to be used by apprentice/trainees, instructors, and companies in Ontario, Canada, as a blueprint for training or as a prerequisite for accreditation/certification. The training standards identify skills required for this occupation and its related training program. They are…

A Methodologic Approach for Normalizing Angular Work and Velocity During Isotonic and Isokinetic Eccentric Training

PubMed Central

Guilhem, Gaël; Cornu, Christophe; Guével, Arnaud

2012-01-01

Context: Resistance exercise training commonly is performed against a constant external load (isotonic) or at a constant velocity (isokinetic). Researchers comparing the effectiveness of isotonic and isokinetic resistance-training protocols need to equalize the mechanical stimulus (work and velocity) applied. Objective: To examine whether the standardization protocol could be adjusted and applied to an eccentric training program. Design: Controlled laboratory study. Setting: Controlled research laboratory. Patients or Other Participants: Twenty-one sport science male students (age = 20.6 ± 1.5 years, height = 178.0 ± 4.0 cm, mass = 74.5 ± 9.1 kg). Intervention(s): Participants performed 9 weeks of isotonic (n = 11) or isokinetic (n = 10) eccentric training of knee extensors that was designed so they would perform the same amount of angular work at the same mean angular velocity. Main Outcome Measure(s): Angular work and angular velocity. Results: The isotonic and isokinetic groups performed the same total amount of work (−185.2 ± 6.5 kJ and −184.4 ± 8.6 kJ, respectively) at the same angular velocity (21 ± 1°/s and 22°/s, respectively) with the same number of repetitions (8.0 and 8.0, respectively). Bland-Altman analysis showed that work (bias = 2.4%) and angular velocity (bias = 0.2%) were equalized over 9 weeks between the modes of training. Conclusions: The procedure developed allows angular work and velocity to be standardized over 9 weeks of isotonic and isokinetic eccentric training of the knee extensors. This method could be useful in future studies in which researchers compare neuromuscular adaptations induced by each type of training mode with respect to rehabilitating patients after musculoskeletal injury. PMID:22488276

2016 Updated American Society of Clinical Oncology/Oncology Nursing Society Chemotherapy Administration Safety Standards, Including Standards for Pediatric Oncology.

PubMed

Neuss, Michael N; Gilmore, Terry R; Belderson, Kristin M; Billett, Amy L; Conti-Kalchik, Tara; Harvey, Brittany E; Hendricks, Carolyn; LeFebvre, Kristine B; Mangu, Pamela B; McNiff, Kristen; Olsen, MiKaela; Schulmeister, Lisa; Von Gehr, Ann; Polovich, Martha

2016-12-01

Purpose To update the ASCO/Oncology Nursing Society (ONS) Chemotherapy Administration Safety Standards and to highlight standards for pediatric oncology. Methods The ASCO/ONS Chemotherapy Administration Safety Standards were first published in 2009 and updated in 2011 to include inpatient settings. A subsequent 2013 revision expanded the standards to include the safe administration and management of oral chemotherapy. A joint ASCO/ONS workshop with stakeholder participation, including that of the Association of Pediatric Hematology Oncology Nurses and American Society of Pediatric Hematology/Oncology, was held on May 12, 2015, to review the 2013 standards. An extensive literature search was subsequently conducted, and public comments on the revised draft standards were solicited. Results The updated 2016 standards presented here include clarification and expansion of existing standards to include pediatric oncology and to introduce new standards: most notably, two-person verification of chemotherapy preparation processes, administration of vinca alkaloids via minibags in facilities in which intrathecal medications are administered, and labeling of medications dispensed from the health care setting to be taken by the patient at home. The standards were reordered and renumbered to align with the sequential processes of chemotherapy prescription, preparation, and administration. Several standards were separated into their respective components for clarity and to facilitate measurement of adherence to a standard. Conclusion As oncology practice has changed, so have chemotherapy administration safety standards. Advances in technology, cancer treatment, and education and training have prompted the need for periodic review and revision of the standards. Additional information is available at http://www.asco.org/chemo-standards .

Backward Planning a Craniomaxillofacial Trauma Curriculum for the Surgical Workforce in Low-Resource Settings.

PubMed

Shaye, David A; Tollefson, Travis; Shah, Irfan; Krishnan, Gopal; Matic, Damir; Figari, Marcelo; Lim, Thiam Chye; Aniruth, Sunil; Schubert, Warren

2018-06-06

Trauma is a significant contributor to global disease, and low-income countries disproportionately shoulder this burden. Education and training are critical components in the effort to address the surgical workforce shortage. Educators can tailor training to a diverse background of health professionals in low-resource settings using competency-based curricula. We present a process for the development of a competency-based curriculum for low-resource settings in the context of craniomaxillofacial (CMF) trauma education. CMF trauma surgeons representing 7 low-, middle-, and high-income countries conducted a standardized educational curriculum development program. Patient problems related to facial injuries were identified and ranked from highest to lowest morbidity. Higher morbidity problems were categorized into 4 modules with agreed upon competencies. Methods of delivery (lectures, case discussions, and practical exercises) were selected to optimize learning of each competency. A facial injuries educational curriculum (1.5 days event) was tailored to health professionals with diverse training backgrounds who care for CMF trauma patients in low-resource settings. A backward planned, competency-based curriculum was organized into four modules titled: acute (emergent), eye (periorbital injuries and sight preserving measures), mouth (dental injuries and fracture care), and soft tissue injury treatments. Four courses have been completed with pre- and post-course assessments completed. Surgeons and educators from a diverse geographic background found the backward planning curriculum development method effective in creating a competency-based facial injuries (trauma) course for health professionals in low-resource settings, where contextual aspects of shortages of surgical capacity, equipment, and emergency transportation must be considered.

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.

An Examination of Cultural Competence Training in US Medical Education Guided by the Tool for Assessing Cultural Competence Training

PubMed Central

Jernigan, Valarie Blue Bird; Hearod, Jordan B.; Tran, Kim; Norris, Keith C.; Buchwald, Dedra

2015-01-01

In the United States, medical students must demonstrate a standard level of “cultural competence,” upon graduation. Cultural competence is most often defined as a set of congruent behaviors, attitudes, and policies that come together in a system, organization, or among professionals that enables effective work in cross-cultural situations. The Association of American Medical Colleges developed the Tool for Assessing Cultural Competence Training (TACCT) to assist schools in developing and evaluating cultural competence curricula to meet these requirements. This review uses the TACCT as a guideline to describe and assess pedagogical approaches to cultural competence training in US medical education and identify content gaps and opportunities for curriculum improvement. A total of 18 programs are assessed. Findings support previous research that cultural competence training can improve the knowledge, attitudes, and skills of medical trainees. However, wide variation in the conceptualization, implementation, and evaluation of cultural competence training programs exists, leading to differences in training quality and outcomes. More research is needed to establish optimal approaches to implementing and evaluating cultural competence training that incorporate cultural humility, the social determinants of health, and broader structural competency within the medical system. PMID:27818848

An Examination of Cultural Competence Training in US Medical Education Guided by the Tool for Assessing Cultural Competence Training.

PubMed

Jernigan, Valarie Blue Bird; Hearod, Jordan B; Tran, Kim; Norris, Keith C; Buchwald, Dedra

2016-01-01

In the United States, medical students must demonstrate a standard level of "cultural competence," upon graduation. Cultural competence is most often defined as a set of congruent behaviors, attitudes, and policies that come together in a system, organization, or among professionals that enables effective work in cross-cultural situations. The Association of American Medical Colleges developed the Tool for Assessing Cultural Competence Training (TACCT) to assist schools in developing and evaluating cultural competence curricula to meet these requirements. This review uses the TACCT as a guideline to describe and assess pedagogical approaches to cultural competence training in US medical education and identify content gaps and opportunities for curriculum improvement. A total of 18 programs are assessed. Findings support previous research that cultural competence training can improve the knowledge, attitudes, and skills of medical trainees. However, wide variation in the conceptualization, implementation, and evaluation of cultural competence training programs exists, leading to differences in training quality and outcomes. More research is needed to establish optimal approaches to implementing and evaluating cultural competence training that incorporate cultural humility, the social determinants of health, and broader structural competency within the medical system.

The effects of using high-fidelity simulators and standardized patients on the thorax, lung, and cardiac examination skills of undergraduate nursing students.

PubMed

Tuzer, Hilal; Dinc, Leyla; Elcin, Melih

2016-10-01

Existing research literature indicates that the use of various simulation techniques in the training of physical examination skills develops students' cognitive and psychomotor abilities in a realistic learning environment while improving patient safety. The study aimed to compare the effects of the use of a high-fidelity simulator and standardized patients on the knowledge and skills of students conducting thorax-lungs and cardiac examinations, and to explore the students' views and learning experiences. A mixed-method explanatory sequential design. The study was conducted in the Simulation Laboratory of a Nursing School, the Training Center at the Faculty of Medicine, and in the inpatient clinics of the Education and Research Hospital. Fifty-two fourth-year nursing students. Students were randomly assigned to Group I and Group II. The students in Group 1 attended the thorax-lungs and cardiac examination training using a high-fidelity simulator, while the students in Group 2 using standardized patients. After the training sessions, all students practiced their skills on real patients in the clinical setting under the supervision of the investigator. Knowledge and performance scores of all students increased following the simulation activities; however, the students that worked with standardized patients achieved significantly higher knowledge scores than those that worked with the high-fidelity simulator; however, there was no significant difference in performance scores between the groups. The mean performance scores of students on real patients were significantly higher compared to the post-simulation assessment scores (p<0.001). Results of this study revealed that use of standardized patients was more effective than the use of a high-fidelity simulator in increasing the knowledge scores of students on thorax-lungs and cardiac examinations; however, practice on real patients increased performance scores of all students without any significant difference in two groups. Copyright © 2016 Elsevier Ltd. All rights reserved.

Effects of Goal Setting on Performance and Job Satisfaction

ERIC Educational Resources Information Center

Ivancevich, John M.

1976-01-01

Studied the effect of goal-setting training on the performance and job satisfaction of sales personnel. One group was trained in participative goal setting; one group was trained in assigned goal setting; and one group received no training. Both trained groups showed temporary improvements in performance and job satisfaction. For availability see…

General Machinist. Apprenticeship Training Standards = Machiniste. Normes de formation en apprentissage.

ERIC Educational Resources Information Center

Ontario Ministry of Skills Development, Toronto.

These training standards for general machinists are intended to be used by apprentice/trainees, instructors, and companies in Ontario, Canada, as a blueprint for training or as a prerequisite for accreditation/certification. The training standards identify skills required for this occupation and its related training program. They are designed…

Mould Maker. Apprenticeship Training Standards = Confection de moules. Normes de formation en apprentissage.

ERIC Educational Resources Information Center

Ontario Ministry of Skills Development, Toronto.

These training standards for mold makers are intended to be used by apprentice/trainees, instructors, and companies in Ontario, Canada, as a blueprint for training or as a prerequisite for accreditation/certification. The training standards identify skills required for this occupation and its related training program. They are designed…

Motorcycle Mechanic. Apprenticeship Training Standards = Mecanicien de motocyclette. Normes de formation en apprentissage.

ERIC Educational Resources Information Center

Ontario Ministry of Skills Development, Toronto.

These training standards for motorcycle mechanics are intended to be used by apprentice/trainees, instructors, and companies in Ontario, Canada, as a blueprint for training or as a prerequisite for accreditation/certification. The training standards identify skills required for this occupation and its related training program. They are designed…

The 30-15 Intermittent Fitness Test versus the Yo-Yo Intermittent Recovery Test Level 1: relationship and sensitivity to training.

PubMed

Buchheit, Martin; Rabbani, Alireza

2014-05-01

The aim of the current study was to examine the relationship between performance of the Yo-Yo Intermittent Recovery Test Level 1 (Yo-YoIR1) and the 30-15 Intermittent Fitness Test (30-15IFT) and to compare the sensitivity of both tests to training. Fourteen young soccer players performed both tests before and after an 8-wk training intervention, which included 6 sessions/wk: 2 resistance training sessions, 2 high-intensity interval training sessions after technical training (4 sets of 3:30 min of generic running and small-sided games [4v4] during the first and second 4-wk periods, respectively [90-95% maximal HR], interspersed with 3 min at 60-70% maximal HR), and 2 tactical-only training sessions. There was a large correlation between 30-15IFT and Yo-YoIR1 (r = .75, 90% confidence limits [CL] 0.57;0.86). While within-test percentage changes suggested a greater sensitivity to training for the Yo-YoIR1 (+35%, 90%CL 24;45) than for the 30-15IFT (+7%; 4;10), these changes were similarly rated as almost certain (with chances for greater/similar/lower values after training of 100/0/0 for both tests) and moderate, ie, standardized difference, ES = +1.2 90%CL (0.9;1.5) for Yo-YoIR1 and ES = +1.1 (0.7;1.5) for 30-15IFT. The difference in the change between the 2 tests was clearly trivial (0/100/0, ES = -0.1, 90%CL -0.1;-0.1). Both tests might evaluate slightly different physical capacities, but their sensitivity to training is almost certainly similar. These results also highlight the importance of using standardized differences instead of percentage changes in performance to assess the actual training effect of an intervention.

Improving practice in community-based settings: a randomized trial of supervision - study protocol.

PubMed

Dorsey, Shannon; Pullmann, Michael D; Deblinger, Esther; Berliner, Lucy; Kerns, Suzanne E; Thompson, Kelly; Unützer, Jürgen; Weisz, John R; Garland, Ann F

2013-08-10

Evidence-based treatments for child mental health problems are not consistently available in public mental health settings. Expanding availability requires workforce training. However, research has demonstrated that training alone is not sufficient for changing provider behavior, suggesting that ongoing intervention-specific supervision or consultation is required. Supervision is notably under-investigated, particularly as provided in public mental health. The degree to which supervision in this setting includes 'gold standard' supervision elements from efficacy trials (e.g., session review, model fidelity, outcome monitoring, skill-building) is unknown. The current federally-funded investigation leverages the Washington State Trauma-focused Cognitive Behavioral Therapy Initiative to describe usual supervision practices and test the impact of systematic implementation of gold standard supervision strategies on treatment fidelity and clinical outcomes. The study has two phases. We will conduct an initial descriptive study (Phase I) of supervision practices within public mental health in Washington State followed by a randomized controlled trial of gold standard supervision strategies (Phase II), with randomization at the clinician level (i.e., supervisors provide both conditions). Study participants will be 35 supervisors and 130 clinicians in community mental health centers. We will enroll one child per clinician in Phase I (N = 130) and three children per clinician in Phase II (N = 390). We use a multi-level mixed within- and between-subjects longitudinal design. Audio recordings of supervision and therapy sessions will be collected and coded throughout both phases. Child outcome data will be collected at the beginning of treatment and at three and six months into treatment. This study will provide insight into how supervisors can optimally support clinicians delivering evidence-based treatments. Phase I will provide descriptive information, currently unavailable in the literature, about commonly used supervision strategies in community mental health. The Phase II randomized controlled trial of gold standard supervision strategies is, to our knowledge, the first experimental study of gold standard supervision strategies in community mental health and will yield needed information about how to leverage supervision to improve clinician fidelity and client outcomes. ClinicalTrials.gov NCT01800266.

A new dose of maximal-intensity interval training in hypoxia to improve body composition and hemoglobin and hematocrit levels: a pilot study.

PubMed

Camacho-Cardenosa, Marta; Camacho-Cardenosa, Alba; Martínez Guardado, Ismael; Marcos-Serrano, Marta; Timon, Rafael; Olcina, Guillermo

2017-01-01

This pilot study had the aim to determine the effects of a new dose of maximal-intensity interval training in hypoxia in active adults. Twenty-four university student volunteers were randomly assigned to three groups: hypoxia group, normoxia group or control group. The eight training sessions consisted of 2 sets of 5 repeated sprints of 10 seconds with a recovery of 20 seconds between sprints and a recovery period of 10 minutes between sets. Body composition was measured following standard procedures. A blood sample was taken for an immediate hematocrit (HCT) and hemoglobin (Hb) concentration assessment. An all-out 3-ute test was performed to evaluate ventilation parameters and power. HCT and Hb were significantly higher for the hypoxia group in Post- and Det- (P=0.01; P=0.03). Fat mass percentage was significantly lower for the hypoxia group in both assessments (P=0.05; P=0.05). The hypoxia group underwent a significant increase in mean power after the recovery period. A new dose of 8 sessions of maximal-intensity interval training in hypoxia is enough to decrease the percentage of fat mass and to improve HCT and Hb parameters and mean muscle power in healthy and active adults.

Artificial Neural Network Approach in Laboratory Test Reporting:  Learning Algorithms.

PubMed

Demirci, Ferhat; Akan, Pinar; Kume, Tuncay; Sisman, Ali Riza; Erbayraktar, Zubeyde; Sevinc, Suleyman

2016-08-01

In the field of laboratory medicine, minimizing errors and establishing standardization is only possible by predefined processes. The aim of this study was to build an experimental decision algorithm model open to improvement that would efficiently and rapidly evaluate the results of biochemical tests with critical values by evaluating multiple factors concurrently. The experimental model was built by Weka software (Weka, Waikato, New Zealand) based on the artificial neural network method. Data were received from Dokuz Eylül University Central Laboratory. "Training sets" were developed for our experimental model to teach the evaluation criteria. After training the system, "test sets" developed for different conditions were used to statistically assess the validity of the model. After developing the decision algorithm with three iterations of training, no result was verified that was refused by the laboratory specialist. The sensitivity of the model was 91% and specificity was 100%. The estimated κ score was 0.950. This is the first study based on an artificial neural network to build an experimental assessment and decision algorithm model. By integrating our trained algorithm model into a laboratory information system, it may be possible to reduce employees' workload without compromising patient safety. © American Society for Clinical Pathology, 2016. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Changing the formula of residents' work hours in internal medicine: moving from "years in training" to "hours in training".

PubMed

Mansi, Ishak A

2011-03-01

In a recent report, the Institute of Medicine recommended more restrictions on residents' working hours. Several problems exist with a system that places a weekly limit on resident duty hours: (1) it assumes the presence of a linear relationship between hours of work and patient safety; (2) it fails to consider differences in intensity among programs; and (3) it does not address increases in the scientific content of medicine, and it places the burden of enforcing the duty hour limits on the Accreditation Council for Graduate Medical Education. An innovative method of calculating credit hours for graduate medical education would shift the focus from "years of residency" to "hours of residency." For example, internal medicine residents would be requested to spend 8640 hours of total training hours (assuming 60 hours per week for 48 weeks annually) instead of the traditional 3 years. This method of counting training hours is used by other professions, such as the Intern Development Program of the National Council of Architectural Registration Boards. The proposed approach would allow residents and program directors to pace training based on individual capabilities. Standards for resident education should include the average number of patients treated in each setting (inpatient or outpatient). A possible set of "multipliers" based on these parameters, and possibly others such as resident evaluation, is devised to calculate the "final adjusted accredited hours" that count toward graduation. Substituting "years of training" with "hours of training" may resolve many of the concerns with the current residency education model, as well as adapt to the demands of residents' personal lives. It also may allow residents to pace their training according to their capabilities and learning styles, and contribute to reflective learning and better quality education.

Effectiveness of suicide prevention gatekeeper-training for university administrative staff in Japan.

PubMed

Hashimoto, Naoki; Suzuki, Yuriko; Kato, Takahiro A; Fujisawa, Daisuke; Sato, Ryoko; Aoyama-Uehara, Kumi; Fukasawa, Maiko; Asakura, Satoshi; Kusumi, Ichiro; Otsuka, Kotaro

2016-01-01

Suicide is a leading cause of death among Japanese college and university students. Gatekeeper-training programs have been shown to improve detection and referral of individuals who are at risk of suicide by training non-mental-health professional persons. However, no studies have investigated the effectiveness of such programs in university settings in Japan. The aim of this study was to investigate the effectiveness of the gatekeeper-training program for administrative staff in Japanese universities. We developed a 2.5-h gatekeeper-training program based on the Mental Health First Aid program, which was originally developed for the general public. Seventy-six administrative staff at Hokkaido University participated in the program. Competence and confidence in managing suicide intervention, behavioral intention as a gatekeeper and attitude while handling suicidal students were measured by a self-reported questionnaire before, immediately after and a month after the program. We found a significant improvement in competence in the management of suicidal students. We also found improvements in confidence in management of suicidal students and behavioral intention as a gatekeeper after training, though questionnaires for those secondary outcomes were not validated. These improvements continued for a month. About 95% of the participants rated the program as useful or very useful and one-third of the participants had one or more chances to utilize their skills within a month. The current results suggest the positive effects of the training program in university settings in Japan. Future evaluation that includes comparison with standard didactic trainings and an assessment of long-term effectiveness are warranted. © 2015 The Authors. Psychiatry and Clinical Neurosciences © 2015 Japanese Society of Psychiatry and Neurology.

Convolutional neural networks for an automatic classification of prostate tissue slides with high-grade Gleason score

NASA Astrophysics Data System (ADS)

Jiménez del Toro, Oscar; Atzori, Manfredo; Otálora, Sebastian; Andersson, Mats; Eurén, Kristian; Hedlund, Martin; Rönnquist, Peter; Müller, Henning

2017-03-01

The Gleason grading system was developed for assessing prostate histopathology slides. It is correlated to the outcome and incidence of relapse in prostate cancer. Although this grading is part of a standard protocol performed by pathologists, visual inspection of whole slide images (WSIs) has an inherent subjectivity when evaluated by different pathologists. Computer aided pathology has been proposed to generate an objective and reproducible assessment that can help pathologists in their evaluation of new tissue samples. Deep convolutional neural networks are a promising approach for the automatic classification of histopathology images and can hierarchically learn subtle visual features from the data. However, a large number of manual annotations from pathologists are commonly required to obtain sufficient statistical generalization when training new models that can evaluate the daily generated large amounts of pathology data. A fully automatic approach that detects prostatectomy WSIs with high-grade Gleason score is proposed. We evaluate the performance of various deep learning architectures training them with patches extracted from automatically generated regions-of-interest rather than from manually segmented ones. Relevant parameters for training the deep learning model such as size and number of patches as well as the inclusion or not of data augmentation are compared between the tested deep learning architectures. 235 prostate tissue WSIs with their pathology report from the publicly available TCGA data set were used. An accuracy of 78% was obtained in a balanced set of 46 unseen test images with different Gleason grades in a 2-class decision: high vs. low Gleason grade. Grades 7-8, which represent the boundary decision of the proposed task, were particularly well classified. The method is scalable to larger data sets with straightforward re-training of the model to include data from multiple sources, scanners and acquisition techniques. Automatically generated heatmaps for theWSIs could be useful for improving the selection of patches when training networks for big data sets and to guide the visual inspection of these images.

The Advocacy Portfolio: A Standardized Tool for Documenting Physician Advocacy.

PubMed

Nerlinger, Abby L; Shah, Anita N; Beck, Andrew F; Beers, Lee S; Wong, Shale L; Chamberlain, Lisa J; Keller, David

2018-01-02

Recent changes in health care delivery systems and in medical training have primed academia for a paradigm shift, with strengthened support for an expanded definition of scholarship. Physicians who consider advocacy to be relevant to their scholarly endeavors need a standardized format to display activities and measure the value of health outcomes to which their work can be attributed. Similar to the Educator Portfolio, the authors here propose the Advocacy Portfolio (AP) to document a scholarly approach to advocacy.Despite common challenges faced in the arguments for both education and advocacy to be viewed as scholarship, the authors highlight inherent differences between the two fields. Based on prior literature, the authors propose a broad yet comprehensive set of domains to categorize advocacy activities, including advocacy engagement, knowledge dissemination, community outreach, advocacy teaching/mentoring, and advocacy leadership/administration. Documenting quality, quantity, and a scholarly approach to advocacy within each domain is the first of many steps to establish congruence between advocacy and scholarship for physicians utilizing the AP format.This standardized format can be applied in a variety of settings, from medical training to academic promotion. Such documentation will encourage institutional buy-in by aligning measured outcomes with institutional missions. The AP will also provide physician advocates with a method to display the impact of advocacy projects on health outcomes for patients and populations. Future challenges to broad application include establishing institutional support and developing consensus regarding criteria by which to evaluate the contributions of advocacy activities to scholarship.

Decaying Relevance of Clinical Data Towards Future Decisions in Data-Driven Inpatient Clinical Order Sets

PubMed Central

Chen, Jonathan H; Alagappan, Muthuraman; Goldstein, Mary K; Asch, Steven M; Altman, Russ B

2017-01-01

Objective Determine how varying longitudinal historical training data can impact prediction of future clinical decisions. Estimate the “decay rate” of clinical data source relevance. Materials and Methods We trained a clinical order recommender system, analogous to Netflix or Amazon’s “Customers who bought A also bought B…” product recommenders, based on a tertiary academic hospital’s structured electronic health record data. We used this system to predict future (2013) admission orders based on different subsets of historical training data (2009 through 2012), relative to existing human-authored order sets. Results Predicting future (2013) inpatient orders is more accurate with models trained on just one month of recent (2012) data than with 12 months of older (2009) data (ROC AUC 0.91 vs. 0.88, precision 27% vs. 22%, recall 52% vs. 43%, all P<10−10). Algorithmically learned models from even the older (2009) data was still more effective than existing human-authored order sets (ROC AUC 0.81, precision 16% recall 35%). Training with more longitudinal data (2009–2012) was no better than using only the most recent (2012) data, unless applying a decaying weighting scheme with a “half-life” of data relevance about 4 months. Discussion Clinical practice patterns (automatically) learned from electronic health record data can vary substantially across years. Gold standards for clinical decision support are elusive moving targets, reinforcing the need for automated methods that can adapt to evolving information. Conclusions and Relevance Prioritizing small amounts of recent data is more effective than using larger amounts of older data towards future clinical predictions. PMID:28495350

Neural net applied to anthropological material: a methodical study on the human nasal skeleton.

PubMed

Prescher, Andreas; Meyers, Anne; Gerf von Keyserlingk, Diedrich

2005-07-01

A new information processing method, an artificial neural net, was applied to characterise the variability of anthropological features of the human nasal skeleton. The aim was to find different types of nasal skeletons. A neural net with 15*15 nodes was trained by 17 standard anthropological parameters taken from 184 skulls of the Aachen collection. The trained neural net delivers its classification in a two-dimensional map. Different types of noses were locally separated within the map. Rare and frequent types may be distinguished after one passage of the complete collection through the net. Statistical descriptive analysis, hierarchical cluster analysis, and discriminant analysis were applied to the same data set. These parallel applications allowed comparison of the new approach to the more traditional ones. In general the classification by the neural net is in correspondence with cluster analysis and discriminant analysis. However, it goes beyond these classifications because of the possibility of differentiating the types in multi-dimensional dependencies. Furthermore, places in the map are kept blank for intermediate forms, which may be theoretically expected, but were not included in the training set. In conclusion, the application of a neural network is a suitable method for investigating large collections of biological material. The gained classification may be helpful in anatomy and anthropology as well as in forensic medicine. It may be used to characterise the peculiarity of a whole set as well as to find particular cases within the set.

A machine learning approach for classification of anatomical coverage in CT

NASA Astrophysics Data System (ADS)

Wang, Xiaoyong; Lo, Pechin; Ramakrishna, Bharath; Goldin, Johnathan; Brown, Matthew

2016-03-01

Automatic classification of anatomical coverage of medical images is critical for big data mining and as a pre-processing step to automatically trigger specific computer aided diagnosis systems. The traditional way to identify scans through DICOM headers has various limitations due to manual entry of series descriptions and non-standardized naming conventions. In this study, we present a machine learning approach where multiple binary classifiers were used to classify different anatomical coverages of CT scans. A one-vs-rest strategy was applied. For a given training set, a template scan was selected from the positive samples and all other scans were registered to it. Each registered scan was then evenly split into k × k × k non-overlapping blocks and for each block the mean intensity was computed. This resulted in a 1 × k3 feature vector for each scan. The feature vectors were then used to train a SVM based classifier. In this feasibility study, four classifiers were built to identify anatomic coverages of brain, chest, abdomen-pelvis, and chest-abdomen-pelvis CT scans. Each classifier was trained and tested using a set of 300 scans from different subjects, composed of 150 positive samples and 150 negative samples. Area under the ROC curve (AUC) of the testing set was measured to evaluate the performance in a two-fold cross validation setting. Our results showed good classification performance with an average AUC of 0.96.

Learning Outcome Measurement in Nurse Participants After Disaster Training.

PubMed

Farra, Sharon L; Smith, Sherrill; Bashaw, Marie A

2016-10-01

The National Disaster Health Consortium is an interprofessional disaster training program. Using the Hierarchical Learning Framework of Competency Sets in Disaster Medicine and Public Health, this program educates nurses and other professionals to provide competent care and leadership within the interprofessional team. This study examined outcomes of this training. Training consisted of a combination of online and on-site training. Learning outcomes were measured by using the Emergency Preparedness Information Questionnaire (EPIQ) pre/post training and participant performance during live functional exercises with the use of rubrics based on Homeland Security Exercise and Evaluation principles. A total of 64 participants completed the EPIQ before and after training. The mean EPIQ pre-training score of 154 and mean post-training score of 81 (reverse-scored) was found to be statistically significant by paired t-test (P<0.001). Performance was evaluated in the areas of triage, re-triage, surge response, and sheltering. Greater than 90% of the exercise criteria were either met or partially met. Participants successfully achieved overall objectives in all scenarios. Disaster response requires nurses and other providers to function in interprofessional teams. Educational projects, like the National Disaster Health Consortium program, offer the potential to address the need for a standardized, interprofessional disaster training curriculum to promote positive outcomes. (Disaster Med Public Health Preparedness. 2016;page 1 of 6).

Brain structural changes following adaptive cognitive training assessed by Tensor-Based Morphometry (TBM)

PubMed Central

Colom, Roberto; Hua, Xue; Martínez, Kenia; Burgaleta, Miguel; Román, Francisco J.; Gunter, Jeffrey L.; Carmona, Susanna; Jaeggi, Susanne M.; Thompson, Paul M.

2016-01-01

Tensor-Based Morphometry (TBM) allows the automatic mapping of brain changes across time building 3D deformation maps. This technique has been applied for tracking brain degeneration in Alzheimer's and other neurodegenerative diseases with high sensitivity and reliability. Here we applied TBM to quantify changes in brain structure after completing a challenging adaptive cognitive training program based on the n-back task. Twenty-six young women completed twenty-four training sessions across twelve weeks and they showed, on average, large cognitive improvements. High-resolution MRI scans were obtained before and after training. The computed longitudinal deformation maps were analyzed for answering three questions: (a) Are there differential brain structural changes in the training group as compared with a matched control group? (b) Are these changes related to performance differences in the training program? (c) Are standardized changes in a set of psychological factors (fluid and crystallized intelligence, working memory, and attention control) measured before and after training, related to structural changes in the brain? Results showed (a) greater structural changes for the training group in the temporal lobe, (b) a negative correlation between these changes and performance across training sessions (the greater the structural change, the lower the cognitive performance improvements), and (c) negligible effects regarding the psychological factors measured before and after training. PMID:27477628

FEELnc: a tool for long non-coding RNA annotation and its application to the dog transcriptome.

PubMed

Wucher, Valentin; Legeai, Fabrice; Hédan, Benoît; Rizk, Guillaume; Lagoutte, Lætitia; Leeb, Tosso; Jagannathan, Vidhya; Cadieu, Edouard; David, Audrey; Lohi, Hannes; Cirera, Susanna; Fredholm, Merete; Botherel, Nadine; Leegwater, Peter A J; Le Béguec, Céline; Fieten, Hille; Johnson, Jeremy; Alföldi, Jessica; André, Catherine; Lindblad-Toh, Kerstin; Hitte, Christophe; Derrien, Thomas

2017-05-05

Whole transcriptome sequencing (RNA-seq) has become a standard for cataloguing and monitoring RNA populations. One of the main bottlenecks, however, is to correctly identify the different classes of RNAs among the plethora of reconstructed transcripts, particularly those that will be translated (mRNAs) from the class of long non-coding RNAs (lncRNAs). Here, we present FEELnc (FlExible Extraction of LncRNAs), an alignment-free program that accurately annotates lncRNAs based on a Random Forest model trained with general features such as multi k-mer frequencies and relaxed open reading frames. Benchmarking versus five state-of-the-art tools shows that FEELnc achieves similar or better classification performance on GENCODE and NONCODE data sets. The program also provides specific modules that enable the user to fine-tune classification accuracy, to formalize the annotation of lncRNA classes and to identify lncRNAs even in the absence of a training set of non-coding RNAs. We used FEELnc on a real data set comprising 20 canine RNA-seq samples produced by the European LUPA consortium to substantially expand the canine genome annotation to include 10 374 novel lncRNAs and 58 640 mRNA transcripts. FEELnc moves beyond conventional coding potential classifiers by providing a standardized and complete solution for annotating lncRNAs and is freely available at https://github.com/tderrien/FEELnc. © The Author(s) 2017. Published by Oxford University Press on behalf of Nucleic Acids Research.

Tool and Die Maker. Apprenticeship Training Standards = Outillage-ajustage. Normes de formation en apprentissage.

ERIC Educational Resources Information Center

Ontario Ministry of Skills Development, Toronto.

These training standards for tool and die makers are intended to be used by apprentice/trainees, instructors, and companies in Ontario, Canada, as a blueprint for training or as a prerequisite for accreditation/certification. The training standards identify skills required for this occupation and its related training program. They are designed…

Transmission Mechanic. Apprenticeship Training Standards = Mecanicien de boites de vitesses. Normes de formation en apprentissage.

ERIC Educational Resources Information Center

Ontario Ministry of Skills Development, Toronto.

These training standards for transmission mechanics are intended to be used by apprentice/trainees, instructors, and companies in Ontario, Canada, as a blueprint for training or as a prerequisite for accreditation/certification. The training standards identify skills required for this occupation and its related training program. They are designed…

Farm Equipment Mechanic. Apprenticeship Training Standards = Mecanicien de machines agricoles. Normes de formation en apprentissage.

ERIC Educational Resources Information Center

Ontario Ministry of Skills Development, Toronto.

These training standards for farm equipment mechanics are intended to be used by apprentice/trainees, instructors, and companies in Ontario, Canada, as a blueprint for training or as a prerequisite for accreditation/certification. The training standards identify skills required for this occupation and its related training program. They are…

Motor Vehicle Mechanic. Apprenticeship Training Standards = Mecanicien d'automobiles. Normes de formation en apprentissage.

ERIC Educational Resources Information Center

Ontario Ministry of Skills Development, Toronto.

These training standards for motor vehicle mechanics are intended to be used by apprentice/trainees, instructors, and companies in Ontario, Canada, as a blueprint for training or as a prerequisite for accreditation/certification. The training standards identify skills required for this occupation and its related training program. They are designed…

Marine Engine Mechanic. Apprenticeship Training Standards = Mecanicien de bateaux a moteur. Normes de formation en apprentissage.

ERIC Educational Resources Information Center

Ontario Ministry of Skills Development, Toronto.

These training standards for marine engine mechanics are intended to be used by apprentice/trainees, instructors, and companies in Ontario, Canada, as a blueprint for training or as a prerequisite for accreditation/certification. The training standards identify skills required for this occupation and its related training program. They are designed…

Heavy Duty Equipment Mechanic. Apprenticeship Training Standards = Mecanicien d'equipement lourd. Normes de formation en apprentissage.

ERIC Educational Resources Information Center

Ontario Ministry of Skills Development, Toronto.

These training standards for heavy duty equipment mechanics are intended to be used by apprentice/trainees, instructors, and companies in Ontario, Canada, as a blueprint for training or as a prerequisite for accreditation/certification. The training standards identify skills required for this occupation and its related training program. They are…

[Evaluation of a training system for middle ear surgery with optoelectric detection].

PubMed

Strauss, G; Bahrami, N; Pössneck, A; Strauss, M; Dietz, A; Korb, W; Lüth, T; Haase, R; Moeckel, H; Grunert, R

2009-10-01

This work presents a new training concept for surgery of the temporal bone. It is based on a model of gypsum plastic with optoelectric detection of risk structures. A prototypical evaluation is given. The training models are based on high-resolution computed tomographic data of a human skull. The resulting data set was printed by a three-dimensional (3D) printer. A 3D phantom is created from gypsum powder and a bonding agent. Risks structures are the facial nerve, semicircular canal, cochlea, ossicular chain, sigmoid sinus, dura, and internal carotid artery. An electrically conductive metal (Wood's metal) and a fiber-optic cable were used as detection materials for the risk structures. For evaluating the training system, a study was done with eight inexperienced and eight experienced ear surgeons. They were asked to perform temporal bone surgery using two identical training models (group A). In group B, the same surgeons underwent surgical training with human cadavers. In the case of injuries, the number, point in time, degree (facial nerve), and injured structure were documented during the training on the model. In addition, the total time needed was noted. The training systems could be used in all cases. Evaluation of the anatomic accuracy of the models showed results that were between 49.5% and 90% agreement with the anatomic origin. Error detection was evaluated with values between 79% and 100% agreement with the perception of an experienced surgeon. The operating setting was estimated to be better than the previous"gold standard." The possibility of completely replacing the previous training method, which uses cadavers, with the examined training model was affirmed. This study shows that the examined system fulfills the conditions for a new training concept for temporal bone surgery. The system connects the preliminary work with printed and sintered models with the possibilities of microsystem engineering. In addition, the model's digital database permits a complete virtual representation of the model with appropriate further applications ("look behind the wall," virtual endoscopy).

An inventory of undiscovered Canadian mineral resources

NASA Technical Reports Server (NTRS)

Labovitz, M. L.; Griffiths, J. C.

1982-01-01

Unit regional value (URV) and unit regional weight are area standardized measures of the expected value and quantity, respectively, of the mineral resources of a region. Estimation and manipulation of the URV statistic is the basis of an approach to mineral resource evaluation. Estimates of the kind and value of exploitable mineral resources yet to be discovered in the provinces of Canada are used as an illustration of the procedure. The URV statistic is set within a previously developed model wherein geology, as measured by point counting geologic maps, is related to the historical record of mineral resource production of well-developed regions of the world, such as the 50 states of the U.S.A.; these may be considered the training set. The Canadian provinces are related to this training set using geological information obtained in the same way from geologic maps of the provinces. The desired predictions of yet to be discovered mineral resources in the Canadian provinces arise as a consequence. The implicit assumption is that regions of similar geology, if equally well developed, will produce similar weights and values of mineral resources.

Assessing and minimizing contamination in time of flight based validation data

NASA Astrophysics Data System (ADS)

Lennox, Kristin P.; Rosenfield, Paul; Blair, Brenton; Kaplan, Alan; Ruz, Jaime; Glenn, Andrew; Wurtz, Ronald

2017-10-01

Time of flight experiments are the gold standard method for generating labeled training and testing data for the neutron/gamma pulse shape discrimination problem. As the popularity of supervised classification methods increases in this field, there will also be increasing reliance on time of flight data for algorithm development and evaluation. However, time of flight experiments are subject to various sources of contamination that lead to neutron and gamma pulses being mislabeled. Such labeling errors have a detrimental effect on classification algorithm training and testing, and should therefore be minimized. This paper presents a method for identifying minimally contaminated data sets from time of flight experiments and estimating the residual contamination rate. This method leverages statistical models describing neutron and gamma travel time distributions and is easily implemented using existing statistical software. The method produces a set of optimal intervals that balance the trade-off between interval size and nuisance particle contamination, and its use is demonstrated on a time of flight data set for Cf-252. The particular properties of the optimal intervals for the demonstration data are explored in detail.

Mass detection in digital breast tomosynthesis: Deep convolutional neural network with transfer learning from mammography

PubMed Central

Chan, Heang-Ping; Hadjiiski, Lubomir; Helvie, Mark A.; Wei, Jun; Cha, Kenny

2016-01-01

Purpose: Develop a computer-aided detection (CAD) system for masses in digital breast tomosynthesis (DBT) volume using a deep convolutional neural network (DCNN) with transfer learning from mammograms. Methods: A data set containing 2282 digitized film and digital mammograms and 324 DBT volumes were collected with IRB approval. The mass of interest on the images was marked by an experienced breast radiologist as reference standard. The data set was partitioned into a training set (2282 mammograms with 2461 masses and 230 DBT views with 228 masses) and an independent test set (94 DBT views with 89 masses). For DCNN training, the region of interest (ROI) containing the mass (true positive) was extracted from each image. False positive (FP) ROIs were identified at prescreening by their previously developed CAD systems. After data augmentation, a total of 45 072 mammographic ROIs and 37 450 DBT ROIs were obtained. Data normalization and reduction of non-uniformity in the ROIs across heterogeneous data was achieved using a background correction method applied to each ROI. A DCNN with four convolutional layers and three fully connected (FC) layers was first trained on the mammography data. Jittering and dropout techniques were used to reduce overfitting. After training with the mammographic ROIs, all weights in the first three convolutional layers were frozen, and only the last convolution layer and the FC layers were randomly initialized again and trained using the DBT training ROIs. The authors compared the performances of two CAD systems for mass detection in DBT: one used the DCNN-based approach and the other used their previously developed feature-based approach for FP reduction. The prescreening stage was identical in both systems, passing the same set of mass candidates to the FP reduction stage. For the feature-based CAD system, 3D clustering and active contour method was used for segmentation; morphological, gray level, and texture features were extracted and merged with a linear discriminant classifier to score the detected masses. For the DCNN-based CAD system, ROIs from five consecutive slices centered at each candidate were passed through the trained DCNN and a mass likelihood score was generated. The performances of the CAD systems were evaluated using free-response ROC curves and the performance difference was analyzed using a non-parametric method. Results: Before transfer learning, the DCNN trained only on mammograms with an AUC of 0.99 classified DBT masses with an AUC of 0.81 in the DBT training set. After transfer learning with DBT, the AUC improved to 0.90. For breast-based CAD detection in the test set, the sensitivity for the feature-based and the DCNN-based CAD systems was 83% and 91%, respectively, at 1 FP/DBT volume. The difference between the performances for the two systems was statistically significant (p-value < 0.05). Conclusions: The image patterns learned from the mammograms were transferred to the mass detection on DBT slices through the DCNN. This study demonstrated that large data sets collected from mammography are useful for developing new CAD systems for DBT, alleviating the problem and effort of collecting entirely new large data sets for the new modality. PMID:27908154

Evidence for the Existing American Nurses Association-Recognized Standardized Nursing Terminologies: A Systematic Review

PubMed Central

Tastan, Sevinc; Linch, Graciele C. F.; Keenan, Gail M.; Stifter, Janet; McKinney, Dawn; Fahey, Linda; Dunn Lopez, Karen; Yao, Yingwei; Wilkie, Diana J.

2014-01-01

Objective To determine the state of the science for the five standardized nursing terminology sets in terms of level of evidence and study focus. Design Systematic Review. Data sources Keyword search of PubMed, CINAHL, and EMBASE databases from 1960s to March 19, 2012 revealed 1,257 publications. Review Methods From abstract review we removed duplicate articles, those not in English or with no identifiable standardized nursing terminology, and those with a low-level of evidence. From full text review of the remaining 312 articles, eight trained raters used a coding system to record standardized nursing terminology names, publication year, country, and study focus. Inter-rater reliability confirmed the level of evidence. We analyzed coded results. Results On average there were 4 studies per year between 1985 and 1995. The yearly number increased to 14 for the decade between 1996–2005, 21 between 2006–2010, and 25 in 2011. Investigators conducted the research in 27 countries. By evidence level for the 312 studies 72.4% were descriptive, 18.9% were observational, and 8.7% were intervention studies. Of the 312 reports, 72.1% focused on North American Nursing Diagnosis-International, Nursing Interventions Classification, Nursing Outcome Classification, or some combination of those three standardized nursing terminologies; 9.6% on Omaha System; 7.1% on International Classification for Nursing Practice; 1.6% on Clinical Care Classification/Home Health Care Classification; 1.6% on Perioperative Nursing Data Set; and 8.0% on two or more standardized nursing terminology sets. There were studies in all 10 foci categories including those focused on concept analysis/classification infrastructure (n = 43), the identification of the standardized nursing terminology concepts applicable to a health setting from registered nurses’ documentation (n = 54), mapping one terminology to another (n = 58), implementation of standardized nursing terminologies into electronic health records (n = 12), and secondary use of electronic health record data (n = 19). Conclusions Findings reveal that the number of standardized nursing terminology publications increased primarily since 2000 with most focusing on North American Nursing Diagnosis-International, Nursing Interventions Classification, and Nursing Outcome Classification. The majority of the studies were descriptive, qualitative, or correlational designs that provide a strong base for understanding the validity and reliability of the concepts underlying the standardized nursing terminologies. There is evidence supporting the successful integration and use in electronic health records for two standardized nursing terminology sets: (1) the North American Nursing Diagnosis-International, Nursing Interventions Classification, and Nursing Outcome Classification set; and (2) the Omaha System set. Researchers, however, should continue to strengthen standardized nursing terminology study designs to promote continuous improvement of the standardized nursing terminologies and use in clinical practice. PMID:24412062

Consumer attitudes towards and satisfaction with emergency contraception counselling: experience from clinic and retail pharmacy settings.

PubMed

Ragland, Denise; Battle, Marlene; Kueter, Teddi J; Payakachat, Nalin

2015-10-01

To collectively assess consumer attitudes towards and satisfaction with emergency contraception (EC) counselling by student pharmacists in two different locations: an academic healthcare clinic and a retail pharmacy. EC counselling was provided by trained student pharmacists utilizing a standardized education toolkit. Participants were asked to rate the counselling at the end of the knowledge survey. In addition to descriptive statistics, we compared the self-reported attitudes and satisfaction with the counselling between the two sites. The majority of participants from both settings rated 'strongly agree' on the attitude and satisfaction statements for the EC counselling. Participants from the clinic setting rated higher in two of the four statements than the participants from the retail setting. Participants had positive attitudes towards and were highly satisfied with the EC counselling in both settings. EC counselling should be encouraged in practice settings. © 2014 Royal Pharmaceutical Society.

Role of inspectors in external review mechanisms: criteria for selection, training and appraisal.

PubMed

Plebani, M

2001-07-20

There is a wide consensus that an external review mechanism, both in the form of a peer review, accreditation and certification according to the ISO 9000 series, is more than its standards. The survey process, the role of inspectors and standard interpretation contribute to the essence of the programme itself. Above all, the criteria used for the selection, training and appraisal of inspectors are of paramount importance. While the ISO norms do not require certification bodies to employ "peer reviewers" for the healthcare sector, experience in this sector is the main criterion for recruiting inspectors in accreditation and peer review programmes. However, the ISO/IEC Guide 58, for the setting up and operation of a laboratory accreditation body, specifies that inspectors should have appropriate technical knowledge of the specific calibrations, tests or types of calibration or tests for which accreditation is sought. Training, updating and assessment of inspectors are clearly defined under ISO, but are also systematic under accreditation programmes. Part-time inspectors who are professionals currently practising in a healthcare facility and are in touch with the day-to-day work reality are preferred for accreditation programmes which have self-regulation, education and quality improvement as their main concerns, while full-time and external inspectors are used in external review mechanisms with registration and certification as their main concerns. As well as harmonising the standards for accreditation, it is important to obtain consensus on the criteria to use for the selection, training and assessment of inspectors in order to ensure that different national or international programmes gain mutual recognition.

Feasibility and effectiveness of circuit training in acute stroke rehabilitation.

PubMed

Rose, Dorian; Paris, Trevor; Crews, Erin; Wu, Samuel S; Sun, Anqi; Behrman, Andrea L; Duncan, Pamela

2011-02-01

Task-specificity, repetition and progression are key variables in the acquisition of motor skill however they have not been consistently implemented in post-stroke rehabilitation. To evaluate the effectiveness of a stroke rehabilitation plan of care that incorporated task-specific practice, repetition and progression to facilitate functional gain compared to standard physical therapy for individuals admitted to an inpatient stroke unit. Individuals participated in either a circuit training (CTPT) model (n = 72) or a standard (SPT) model (n = 108) of physical therapy, 5 days/week. Each 60 minute circuit training session, delivered according to severity level, consisted of four functional mobility tasks. Daily exercise logs documented both task repetition and progression. The CTPT model was successfully implemented in an acute rehabilitation setting. The CTPT group showed a significantly greater improved change in gait speed from hospital admission to discharge than the SPT group (0.21 ± 0.25 m/sec vs. 0.13 ± 0.22 m/sec; p = 0.03). The difference between groups occurred primarily among those who were ambulatory upon admission. There were no significant differences between the two cohorts at 90 days post-stroke as measured by the FONE-FIM, SF-36 and living location. Therapy focused on systematically progressed functional tasks can be successfully implemented in an inpatient rehabilitation stroke program. This circuit-training model resulted in greater gains in gait velocity over the course of inpatient rehabilitation compared to the standard model of care. Community-based services following hospital discharge to maintain these gains should be included in the continuum of post-stroke care.

Fourier spatial frequency analysis for image classification: training the training set

NASA Astrophysics Data System (ADS)

Johnson, Timothy H.; Lhamo, Yigah; Shi, Lingyan; Alfano, Robert R.; Russell, Stewart

2016-04-01

The Directional Fourier Spatial Frequencies (DFSF) of a 2D image can identify similarity in spatial patterns within groups of related images. A Support Vector Machine (SVM) can then be used to classify images if the inter-image variance of the FSF in the training set is bounded. However, if variation in FSF increases with training set size, accuracy may decrease as the size of the training set increases. This calls for a method to identify a set of training images from among the originals that can form a vector basis for the entire class. Applying the Cauchy product method we extract the DFSF spectrum from radiographs of osteoporotic bone, and use it as a matched filter set to eliminate noise and image specific frequencies, and demonstrate that selection of a subset of superclassifiers from within a set of training images improves SVM accuracy. Central to this challenge is that the size of the search space can become computationally prohibitive for all but the smallest training sets. We are investigating methods to reduce the search space to identify an optimal subset of basis training images.

Training With Curved Laparoscopic Instruments in Single-Port Setting Improves Performance Using Straight Instruments: A Prospective Randomized Simulation Study.

PubMed

Lukovich, Peter; Sionov, Valery Ben; Kakucs, Timea

2016-01-01

Lately single-port surgery is becoming a widespread procedure, but it is more difficult than conventional laparoscopy owing to the lack of triangulation. Although, these operations are also possible with standard laparoscopic instruments, curved instruments are being developed. The aims of the study were to identify the effect of training on a box trainer in single-port setting on the quality of acquired skills, and transferred with the straight and curved instruments for the basic laparoscopic tasks, and highlight the importance of a special laparoscopic training curriculum. A prospective study on a box trainer in single-port setting was conducted using 2 groups. Each group performed 2 tasks on the box trainer in single-port setting. Group-S used conventional straight laparoscopic instruments, and Group-C used curved laparoscopic instruments. Learning curves were obtained by daily measurements recorded in 7-day sessions. On the last day, the 2 groups changed instruments between each other. 1st Department of Surgery, Semmelweis University of Medicine from Budapest, Hungary, a university teaching hospital. In all, 20 fifth-year medical students were randomized into 2 groups. None of them had any laparoscopic or endoscopic experience. Participation was voluntary. Although Group-S performed all tasks significantly faster than Group-C on the first day, the difference proved to be nonsignificant on the last day. All participants achieved significantly shorter task completion time on the last day than on the first day, regardless of the instrument they used. Group-S showed improvement of 63.5%, and Group-C 69.0% improvement by the end of the session. After swapping the instruments, Group-S reached significantly higher task completion time with curved instruments, whereas Group-C showed further progression of 8.9% with straight instruments. Training with curved instruments in a single-port setting allows for a better acquisition of skills in a shorter period. For this reason, there is a need for proficiency-based conventional, but also for a single-port, laparoscopic training curriculum in general surgery residency education. Copyright © 2015 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

An implementation strategy to improve the guideline adherence of insurance physicians: an experiment in a controlled setting

PubMed Central

2011-01-01

Background The aim of this study was to investigate the efficacy of a newly developed implementation strategy for the insurance medicine guidelines for depression in the Netherlands. We hypothesized that an educational intervention would increase the insurance physicians' (IPs) guideline adherence in a controlled setting. Methods Forty IPs were allocated in a randomised controlled trial (RCT) to an intervention group (IG) (n = 21) and a control group (CG) (n = 19). The IG received tailored training in applying the guidelines for depression, while the CG received an alternative programme. Baseline (T0) and follow-up (T1) measurements were conducted before and after the intervention within a period of two weeks. The intervention consisted of a workshop in which the evidence-based theory of the guidelines was translated for use in practice, with the help of various tools. The IPs had to write a case-report on the basis of video cases, two before and two after the training. Specially trained and blinded test IPs judged the case reports independently on the basis of six performance indicators. Primary outcome measure in the controlled setting of the trial was guideline adherence measured by six performance indicators on a scale of one to seven. Secondary outcome measure was knowledge of the guidelines for depression. Analyses were performed using Linear Mixed Models, and ANCOVA. Results We found significantly higher scores in the IG than in the CG at T1 for both outcomes. The interaction effect (standard error; p-value) of group crossed with time was 0.97 (0.19; p < 0.0005) for guideline adherence in the controlled setting. The group effect at T1 for the knowledge test was 0.86 (0.40; p = 0.038). Conclusions The newly developed implementation strategy for the insurance medicine guidelines for depression improved the guideline adherence of the trained IPs in disability assessments of clients with depression when performed in a controlled setting. Furthermore, the trained IPs showed gains in knowledge of the guidelines for depression. Trial registration Netherlands' Trial Register NTR1863. PMID:22188876

Your Place or Mine? Evaluating the Perspectives of the Practical Legal Training Work Experience Placement through the Eyes of the Supervisors and the Students

ERIC Educational Resources Information Center

Spencer, Rachel

2007-01-01

In order to qualify as a lawyer in Australia, each law graduate must complete a recognised practical qualification. In 2002, the Australasian Professional Legal Education Council (APLEC) published a recommended set of competency standards which all entry level lawyers should meet in order to be eligible to be admitted as a legal practitioner. Upon…

Applying Japanese management tips to patient accounts.

PubMed

Groenevelt, C J

1990-04-01

"Just in time," a Japanese management philosophy that has been applied successfully in manufacturing operations, also can be used to improve management of patient accounts departments. Under its principles, healthcare organizations would develop standardized procedures; involve workers in decision making; set up training and education programs aimed at creating a multi-skilled pool of workers; establish smooth production schedules; and foster cooperation and commitment to the philosophy throughout the organization.

Methodological Issues in Predicting Pediatric Epilepsy Surgery Candidates Through Natural Language Processing and Machine Learning

PubMed Central

Cohen, Kevin Bretonnel; Glass, Benjamin; Greiner, Hansel M.; Holland-Bouley, Katherine; Standridge, Shannon; Arya, Ravindra; Faist, Robert; Morita, Diego; Mangano, Francesco; Connolly, Brian; Glauser, Tracy; Pestian, John

2016-01-01

Objective: We describe the development and evaluation of a system that uses machine learning and natural language processing techniques to identify potential candidates for surgical intervention for drug-resistant pediatric epilepsy. The data are comprised of free-text clinical notes extracted from the electronic health record (EHR). Both known clinical outcomes from the EHR and manual chart annotations provide gold standards for the patient’s status. The following hypotheses are then tested: 1) machine learning methods can identify epilepsy surgery candidates as well as physicians do and 2) machine learning methods can identify candidates earlier than physicians do. These hypotheses are tested by systematically evaluating the effects of the data source, amount of training data, class balance, classification algorithm, and feature set on classifier performance. The results support both hypotheses, with F-measures ranging from 0.71 to 0.82. The feature set, classification algorithm, amount of training data, class balance, and gold standard all significantly affected classification performance. It was further observed that classification performance was better than the highest agreement between two annotators, even at one year before documented surgery referral. The results demonstrate that such machine learning methods can contribute to predicting pediatric epilepsy surgery candidates and reducing lag time to surgery referral. PMID:27257386

Training Manager Competencies: The Standards. Third Edition.

ERIC Educational Resources Information Center

Foxon, Marguerite; Richey, Rita C.; Roberts, Robert C.; Spannaus, Timothy W.

In this third edition of "Training Manager Competencies: The Standards," the International Board of Standards for Training, Performance and Instruction (IBSTPI) presents an updated definition and discussion of the competencies of training managers. It is an expanded view that reflects the complexities and pressures of current practice…

[Occupational exposure to blood in multiple trauma care].

PubMed

Wicker, S; Wutzler, S; Schachtrupp, A; Zacharowski, K; Scheller, B

2015-01-01

Trauma care personnel are at risk of occupational exposure to blood-borne pathogens. Little is known regarding compliance with standard precautions or occupational exposure to blood and body fluids among multiple trauma care personnel in Germany. Compliance rates of multiple trauma care personnel in applying standard precautions, knowledge about transmission risks of blood-borne pathogens, perceived risks of acquiring hepatitis B, hepatitis C and human immunodeficiency virus (HIV) and the personal attitude towards testing of the index patient for blood-borne pathogens after a needlestick injury were evaluated. In the context of an advanced multiple trauma training an anonymous questionnaire was administered to the participants. Almost half of the interviewees had sustained a needlestick injury within the last 12 months. Approximately three quarters of the participants were concerned about the risk of HIV and hepatitis. Trauma care personnel had insufficient knowledge of the risk of blood-borne pathogens, overestimated the risk of hepatitis C infection and underused standard precautionary measures. Although there was excellent compliance for using gloves, there was poor compliance in using double gloves (26.4 %), eye protectors (19.7 %) and face masks (15.8 %). The overwhelming majority of multiple trauma care personnel believed it is appropriate to test an index patient for blood-borne pathogens following a needlestick injury. The process of treatment in prehospital settings is less predictable than in other settings in which invasive procedures are performed. Periodic training and awareness programs for trauma care personnel are required to increase the knowledge of occupational infections and the compliance with standard precautions. The legal and ethical aspects of testing an index patient for blood-borne pathogens after a needlestick injury of a healthcare worker have to be clarified in Germany.

Development of Vocational Education and Training Standards: The Impact of Labour Market Information. Manual. Qualifications and Training Methods.

ERIC Educational Resources Information Center

Mansfield, Bob, Ed.

This is the third publication in the European Training Foundation's (ETF's) series of manuals designed to support development of vocational education and training (VET) standards. This volume looks at ways in which VET standards are linked to labor market demands and how relevant VET standards are to the needs of employment in a market economy.…

Can robotic surgery be done efficiently while training residents?

PubMed

Honaker, Michael Drew; Paton, Beverly L; Stefanidis, Dimitrios; Schiffern, Lynnette M

2015-01-01

Robotic surgery is a rapidly growing area in surgery. In an era of emphasis on cost reduction, the question becomes how do you train residents in robotic surgery? The aim of this study was to determine if there was a difference in operative time and complications when comparing general surgery residents learning robotic cholecystectomies to those learning standard laparoscopic cholecystectomies. A retrospective analysis of adult patients undergoing robotic and laparoscopic cholecystectomy by surgical residents between March 2013 and February 2014 was conducted. Demographic data, operative factors, length of stay (LOS), and complications were examined. Univariate and multivariate analyses were performed. The significance was set at p < 0.05. A total of 58 patients were included in the study (18 in the robotic cholecystectomy group and 40 in the laparoscopic group). Age, diagnosis, and American Society of Anesthesiologists score were not significantly different between groups. There was only 1 complication in the standard laparoscopic group in which a patient had to be taken back to surgery because of an incarcerated port site. LOS was significantly higher in the standard laparoscopic group (mean = 2.28) than in the robotic group (mean = 0.56; p < 0.0001). Operating room (OR) time was not statistically different between the standard laparoscopic group (mean = 90.98 minutes) and the robotic group (mean = 97.00 minutes; p = 0.4455). When intraoperative cholangiogram was evaluated, OR time was shorter in the robotic group. Robotic training in general surgery residency does not amount to extra OR time. LOS in our study was significantly longer in the standard laparoscopic group. Copyright © 2015 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Implementation of sustainable evidence-based practice for the assessment and management of pain in residential aged care facilities.

PubMed

Savvas, Steven; Toye, Christine; Beattie, Elizabeth; Gibson, Stephen J

2014-12-01

Pain is common in residential aged care facilities (RACFs). In 2005, the Australian Pain Society developed 27 recommendations for good practice in the identification, assessment, and management of pain in these settings. This study aimed to address implementation of the standards and evaluate outcomes. Five facilities in Australia participated in a comprehensive evaluation of RACF pain practice and outcomes. Pre-existing pain management practices were compared with the 27 recommendations, before an evidence-based pain management program was introduced that included training and education for staff and revised in-house pain-management procedures. Post-implementation audits evaluated the program's success. Aged care staff teams also were assessed on their reports of self-efficacy in pain management. The results show that before the implementation program, the RACFs demonstrated full compliance on 6 to 12 standards. By the project's completion, RACFs demonstrated full compliance with 10 to 23 standards and major improvements toward compliance in the remaining standards. After implementation, the staff also reported better understanding of the standards (p < .001) or of facility pain management guidelines (p < .001), increased confidence in therapies for pain management (p < .001), and increased confidence in their training to assess pain (p < .001) and recognize pain in residents with dementia who are nonverbal (p = .003). The results show that improved evidence-based practice in RACFs can be achieved with appropriate training and education. Investing resources in the aged care workforce via this implementation program has shown improvements in staff self-efficacy and practice. Copyright © 2014 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

Effect of training on the reliability of satiety evaluation and use of trained panellists to determine the satiety effect of dietary fibre: a randomised controlled trial.

PubMed

Solah, Vicky A; Meng, Xingqiong; Wood, Simon; Gahler, Roland J; Kerr, Deborah A; James, Anthony P; Pal, Sebely; Fenton, Haelee K; Johnson, Stuart K

2015-01-01

The assessment of satiety effects on foods is commonly performed by untrained volunteers marking their perceived hunger or fullness on line scales, marked with pre-set descriptors. The lack of reproducibility of satiety measurement using this approach however results in the tool being unable to distinguish between foods that have small, but possibly important, differences in their satiety effects. An alternate approach is used in sensory evaluation; panellists can be trained in the correct use of the assessment line-scale and brought to consensus on the meanings of descriptors used for food quality attributes to improve the panel reliability. The effect of training on the reliability of a satiety panel has not previously been reported. In a randomised controlled parallel intervention, the effect of training in the correct use of a satiety labelled magnitude scale (LMS) was assessed versus no-training. The test-retest precision and reliability of two hour postprandial satiety evaluation after consumption of a standard breakfast was compared. The trained panel then compared the satiety effect of two breakfast meals containing either a viscous or a non-viscous dietary fibre in a crossover trial. A subgroup of the 23 panellists (n = 5) improved their test re-test precision after training. Panel satiety area under the curve, "after the training" intervention was significantly different to "before training" (p < 0.001). Reliability of the panel determined by intraclass correlation (ICC) of test and retest showed improved strength of the correlation from 0.70 pre-intervention to 0.95 post intervention. The trained "satiety expert panel" determined that a standard breakfast with 5g of viscous fibre gave significantly higher satiety than with 5g non-viscous fibre (area under curve (AUC) of 478.2, 334.4 respectively) (p ≤ 0.002). Training reduced between panellist variability. The improved strength of test-retest ICC as a result of the training intervention suggests that training satiety panellists can improve the discriminating power of satiety evaluation.

Impact of Asynchronous Training on Radiology Learning Curve among Emergency Medicine Residents and Clerkship Students

PubMed Central

Pourmand, Ali; Woodward, Christina; Shokoohi, Hamid; King, Jordan B; Taheri, M Reza; King, Jackson; Lawrence, Christopher

2018-01-01

Context Web-based learning (WBL) modules are effectively used to improve medical education curriculum; however, they have not been evaluated to improve head computed tomography (CT) scan interpretation in an emergency medicine (EM) setting. Objective To evaluate the effectiveness of a WBL module to aid identification of cranial structures on CT and to improve ability to distinguish between normal and abnormal findings. Design Prospective, before-and-after trial in the Emergency Department of an academic center. Baseline head CT knowledge was assessed via a standardized test containing ten head CT scans, including normal scans and those showing hemorrhagic stroke, trauma, and infection (abscess). All trainees then participated in a WBL intervention. Three weeks later, they were given the same ten CT scans to evaluate in a standardized posttest. Main Outcome Measures Improvement in test scores. Results A total of 131 EM clerkship students and 32 EM residents were enrolled. Pretest scores correlated with stage of training, with students and first-year residents demonstrating the lowest scores. Overall, there was a significant improvement in percentage of correctly classified CT images after the training intervention from a mean pretest score of 32% ± 12% to posttest score of 67% ± 13% (mean improvement = 35% ± 13%, p < 0.001). Among subsets by training level, all subgroups except first-year residents demonstrated a statistically significant increase in scores after the training. Conclusion Incorporating asynchronous WBL modules into EM clerkship and residency curriculum provides early radiographic exposure in their clinical training and can enhance diagnostic head CT scan interpretation. PMID:29272248

Is it time to include point-of-care ultrasound in general surgery training? A review to stimulate discussion.

PubMed

Mollenkopf, Maximilian; Tait, Noel

2013-12-01

Point-of-care ultrasound scanning or POCUS is a focused ultrasound (US) scan, performed by non-imaging clinicians during physical examination, an invasive procedure or surgery. As this technology becomes cheaper, smaller and easier to use, its scope for use by surgeons grows, a trend that may generate a gap between use and training. Opportunities for enhanced general surgery skill sets may be reduced unless consideration is given to inclusion of POCUS in general surgery training. To stimulate discussion regarding inclusion of POCUS in the general surgery curriculum; to resource this discussion with an overview of current trends and issues around POCUS; and to discuss concerns and controversies that may arise if POCUS was adopted into general surgery training. A literature search was performed using PUBMED, MEDLINE, Google and Google Scholar, using the terms 'ultrasound', 'point-of-care-ultrasound', 'bedside ultrasound', 'portable ultrasound' and 'hand-held ultrasound'. Literature, references and non-literature resources found were reviewed for relevance to US education in general surgery. Increasingly, medical students are graduating with basic POCUS skills. Specialty-specific uses of POCUS are proliferating. Training and assessment resources are not keeping up, in accessibility or standardization. A learned surgical college led training and accreditation process would require aligned education in anatomy and US technology and collaboration with the specialist imaging community to ensure appropriate standards are clarified and met. Research is also required into how general surgery trainees can best achieve and maintain POCUS competence. © 2013 Royal Australasian College of Surgeons.

Manual of Standards for Juvenile Training Schools and Services.

ERIC Educational Resources Information Center

Commission on Accreditation for Corrections, Rockville, MD.

This manual of standards for juvenile training schools and services contains 487 American Correctional Association standards for the accreditation of juvenile training schools (youth development centers, villages, correction centers, treatment centers, service centers, homes for boys and girls, camps, and ranches). Standards presented are…

National Apprenticeship and Training Standards for Painting and Decorating and Drywall Finishing.

ERIC Educational Resources Information Center

Manpower Administration (DOL), Washington, DC. Bureau of Apprenticeship and Training.

The booklet presents the ninth edition of the national apprenticeship and training standards developed by the painting and decorating and drywall industry in cooperation with the Department of Labor's Bureau of Apprenticeship and Training. Provisions of national apprenticeship and training standards for painting and decorating and drywall…

77 FR 20743 - Protective Force Personnel Medical, Physical Readiness, Training, and Access Authorization Standards

Federal Register 2010, 2011, 2012, 2013, 2014

2012-04-06

...-HQ-2012-0002] RIN 1992-AA40 Protective Force Personnel Medical, Physical Readiness, Training, and... the proposed rule to amend the standards for medical, physical performance, training, and access... proposed rule to revise the standards for medical, physical performance, training, and access...

[New professional field in France: Analysis of the training needs of case managers].

PubMed

Somme, Dominique; Corvol, Aline; Couturier, Yves; Pimouguet, Clément; Moreau, Olivier; Perivier, Samuel; Balard, Frédéric; de Stampa, Matthieu

2015-01-01

Case management is a relatively new career field in France. It was first introduced on an experimental basis in 2007-2008, and was then developedfollowing the National Alzheimer Plan and finally enshrined in legislation in 2012. This careerfield is based on a set of tasks widely described internationally: identifying the right level of intervention, standardized multidimensional assessment, planning all aid (care and social services), implementation of the plan, monitoring and reassessment and periodic reassessment of all needs in a continuous and long-term process. The specific, systematic and dedicated nature of these tasks to these tasks makes training essential. Regulations also stipulate that the professional must acquire additional training by a dedicated inter-university degree. This requirement is a French specificity The authors present the history of case management and training in France and analyze the various international training frameworks identified by an Internet search. Moreover, based on the opinions expressed by case managers at different times of the scientific assessment and a review ofseveral studies conducted by inter-university case management program students, this article highlights the specific training needs of case managers and how the proposed training can meet these needs.

Supervision in neuropsychological assessment: a survey of training, practices, and perspectives of supervisors.

PubMed

Shultz, Laura A Schwent; Pedersen, Heather A; Roper, Brad L; Rey-Casserly, Celiane

2014-01-01

Within the psychology supervision literature, most theoretical models and practices pertain to general clinical or counseling psychology. Supervision specific to clinical neuropsychology has garnered little attention. This survey study explores supervision training, practices, and perspectives of neuropsychology supervisors. Practicing neuropsychologists were invited to participate in an online survey via listservs and email lists. Of 451 respondents, 382 provided supervision to students, interns, and/or fellows in settings such as VA medical centers (37%), university medical centers (35%), and private practice (15%). Most supervisors (84%) reported supervision was discussed in graduate school "minimally" or "not at all." Although 67% completed informal didactics or received continuing education in supervision, only 27% reported receiving training specific to neuropsychology supervision. Notably, only 39% were satisfied with their training in providing supervision and 77% indicated they would likely participate in training in providing supervision, if available at professional conferences. Results indicate that clinical neuropsychology as a specialty has paid scant attention to developing supervision models and explicit training in supervision skills. We recommend that the specialty develop models of supervision for neuropsychological practice, supervision standards and competencies, training methods in provision of supervision, and benchmark measures for supervision competencies.

Odor Perception by Dogs: Evaluating Two Training Approaches for Odor Learning of Sniffer Dogs.

PubMed

Fischer-Tenhagen, Carola; Johnen, Dorothea; Heuwieser, Wolfgang; Becker, Roland; Schallschmidt, Kristin; Nehls, Irene

2017-06-01

In this study, a standardized experimental set-up with various combinations of herbs as odor sources was designed. Two training approaches for sniffer dogs were compared; first, training with a pure reference odor, and second, training with a variety of odor mixtures with the target odor as a common denominator. The ability of the dogs to identify the target odor in a new context was tested. Six different herbs (basil, St. John's wort, dandelion, marjoram, parsley, ribwort) were chosen to produce reference materials in various mixtures with (positive) and without (negative) chamomile as the target odor source. The dogs were trained to show 1 of 2 different behaviors, 1 for the positive, and 1 for the negative sample as a yes/no task. Tests were double blind with one sample presented at a time. In both training approaches, dogs were able to detect chamomile as the target odor in any presented mixture with an average sensitivity of 72% and a specificity of 84%. Dogs trained with odor mixture containing the target odor had more correct indications in the transfer task. © The Author 2017. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

SKYNET: an efficient and robust neural network training tool for machine learning in astronomy

NASA Astrophysics Data System (ADS)

Graff, Philip; Feroz, Farhan; Hobson, Michael P.; Lasenby, Anthony

2014-06-01

We present the first public release of our generic neural network training algorithm, called SKYNET. This efficient and robust machine learning tool is able to train large and deep feed-forward neural networks, including autoencoders, for use in a wide range of supervised and unsupervised learning applications, such as regression, classification, density estimation, clustering and dimensionality reduction. SKYNET uses a `pre-training' method to obtain a set of network parameters that has empirically been shown to be close to a good solution, followed by further optimization using a regularized variant of Newton's method, where the level of regularization is determined and adjusted automatically; the latter uses second-order derivative information to improve convergence, but without the need to evaluate or store the full Hessian matrix, by using a fast approximate method to calculate Hessian-vector products. This combination of methods allows for the training of complicated networks that are difficult to optimize using standard backpropagation techniques. SKYNET employs convergence criteria that naturally prevent overfitting, and also includes a fast algorithm for estimating the accuracy of network outputs. The utility and flexibility of SKYNET are demonstrated by application to a number of toy problems, and to astronomical problems focusing on the recovery of structure from blurred and noisy images, the identification of gamma-ray bursters, and the compression and denoising of galaxy images. The SKYNET software, which is implemented in standard ANSI C and fully parallelized using MPI, is available at http://www.mrao.cam.ac.uk/software/skynet/.

Perceived exertion responses to changing resistance training programming variables.

PubMed

Hiscock, Daniel J; Dawson, Brian; Peeling, Peter

2015-06-01

This study examined the influence of intensity (%1 repetition maximum [1RM]), tonnage (sets × repetitions × load), rate of fatigue (percentage decrement in repetitions from set to set), work rate (total tonnage per unit of time), rest interval (time between sets), time under load, and session duration on session rating of perceived exertion (sRPE: Borg's CR-10 scale). Here, participants performed a standardized lifting session of 5 exercises (bench press, leg press, lat pulldown, leg curl, and triceps pushdown) as either: (a) 3 sets × 8 repetitions × 3-minute recovery at 70% 1RM, (b) 3 sets × 14 repetitions × 3-minute recovery at 40% 1RM, (c) 3 sets × MNR (maximum number of repetitions) × 1-minute recovery at 70% 1RM, (d) 3 sets × MNR × 3-minute recovery at 70% 1RM, (e) 3 sets × MNR × 1-minute recovery at 40% 1RM, or (f) 3 sets × MNR × 3-minute recovery at 40% 1RM. The sRPE for session A (4 ± 1) was significantly higher than session B (2.5 ± 1), despite matched tonnage. Protocols involving MNR showed no significant difference in sRPE. Work rate was the only variable to significantly relate with sRPE (r = 0.45). Additionally, sRPE at 15-minute postexercise (5 ± 2) was not different to 30-minute postexercise (5 ± 2). In resistance training with matched tonnage and rest duration between sets, sRPE increases with intensity. In sets to volitional failure, sRPE is likely to be similar, regardless of intensity or rest duration between sets.

The effects of training volume and competition on the salivary cortisol concentrations of Olympic weightlifters.

PubMed

Crewther, Blair T; Heke, Taati; Keogh, Justin W L

2011-01-01

This study examined the effects of training volume and competition on the salivary cortisol (Sal-C) concentrations of Olympic weightlifters. Male (n = 5) and female (n = 4) Olympic weightlifters provided saliva samples across a 5-week experimental = period. The first aim was to assess the weekly effects of high (≥ 200 sets) and low (≤ 100 sets) training volume on Sal-C. The second aim was to compare Sal-C concentrations and 1 repetition maximum (1RM) performance during 2 simulated and 2 actual competitions. Performance was assessed using the snatch, clean and jerk, and the Olympic total lift. Data from each competition setting were pooled before analysis. There were no significant weekly changes in Sal-C levels (p > 0.05). The actual competitions produced higher (128-130%) Sal-C concentrations (p < 0.001) and superior 1RM lifts (1.9-2.6%) for the clean and jerk, and the Olympic total, than the simulated competitions (p < 0.05). Individual Sal-C concentrations before the simulated competitions were positively correlated to all of the 1RM lifts (r = 0.48-0.49, p < 0.05). In conclusion, actual competitions produced greater Sal-C responses than simulated competitions, and this appeared to benefit the 1RM performance of Olympic weightlifters. Individuals with higher Sal-C concentrations also tended to exhibit superior 1RM lifts during the simulated competitions. Given these findings, greater emphasis should be placed upon the monitoring of C to establish normative values, training standards and to assist with performance prediction.

The Teaching of Ethics and Professionalism in Plastic Surgery Residency: A Cross-Sectional Survey.

PubMed

Bennett, Katelyn G; Ingraham, John M; Schneider, Lisa F; Saadeh, Pierre B; Vercler, Christian J

2017-05-01

The ethical practice of medicine has always been of utmost importance, and plastic surgery is no exception. The literature is devoid of information on the teaching of ethics and professionalism in plastic surgery. In light of this, a survey was sent to ascertain the status of ethics training in plastic surgery residencies. A 21-question survey was sent from the American Council of Academic Plastic Surgeons meeting to 180 plastic surgery program directors and coordinators via email. Survey questions inquired about practice environment, number of residents, presence of a formal ethics training program, among others. Binary regression was used to determine if any relationships existed between categorical variables, and Poisson linear regression was used to assess relationships between continuous variables. Statistical significance was set at a P value of 0.05. A total of 104 members responded to the survey (58% response rate). Sixty-three percent were program directors, and most (89%) practiced in academic settings. Sixty-two percent in academics reported having a formal training program, and 60% in private practice reported having one. Only 40% of programs with fewer than 10 residents had ethics training, whereas 78% of programs with more than 20 residents did. The odds of having a training program were slightly higher (odds ratio, 1.1) with more residents (P = 0.17). Despite the lack of information in the literature, formal ethics and professionalism training does exist in many plastic surgery residencies, although barriers to implementation do exist. Plastic surgery leadership should be involved in the development of standardized curricula to help overcome these barriers.

Recovery Act: Develop a Modular Curriculum for Training University Students in Industry Standard CO{sub 2} Sequestration and Enhanced Oil Recovery Methodologies

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

Trentham, R. C.; Stoudt, E. L.

CO{sub 2} Enhanced Oil Recovery, Sequestration, & Monitoring Measuring & Verification are topics that are not typically covered in Geoscience, Land Management, and Petroleum Engineering curriculum. Students are not typically exposed to the level of training that would prepare them for CO{sub 2} reservoir and aquifer sequestration related projects when they begin assignments in industry. As a result, industry training, schools & conferences are essential training venues for new & experienced personnel working on CO{sub 2} projects for the first time. This project collected and/or generated industry level CO{sub 2} training to create modules which faculties can utilize as presentations,more » projects, field trips and site visits for undergrad and grad students and prepare them to "hit the ground running" & be contributing participants in CO{sub 2} projects with minimal additional training. In order to create the modules, UTPB/CEED utilized a variety of sources. Data & presentations from industry CO{sub 2} Flooding Schools & Conferences, Carbon Management Workshops, UTPB Classes, and other venues was tailored to provide introductory reservoir & aquifer training, state-of-the-art methodologies, field seminars and road logs, site visits, and case studies for students. After discussions with faculty at UTPB, Sul Ross, Midland College, other universities, and petroleum industry professionals, it was decided to base the module sets on a series of road logs from Midland to, and through, a number of Permian Basin CO{sub 2} Enhanced Oil Recovery (EOR) projects, CO{sub 2} Carbon Capture and Storage (CCUS) projects and outcrop equivalents of the formations where CO{sub 2} is being utilized or will be utilized, in EOR projects in the Permian Basin. Although road logs to and through these projects exist, none of them included CO{sub 2} specific information. Over 1400 miles of road logs were created, or revised specifically to highlight CO{sub 2} EOR projects. After testing a number of different entry points into the data set with students and faculty form a number of different universities, it was clear that a standard website presentation with a list of available power point presentations, excel spreadsheets, word documents and pdf's would not entice faculty, staff, and students at universities to delve deeper into the website http://www.utpb.edu/ceed/student modules.« less

Evaluation of the Tuberculosis Infection Control Training Center, Tajikistan, 2014–2015

PubMed Central

Scott, C.; Mangan, J.; Tillova, Z.; Jensen, P. A.; Ahmedov, S.; Ismoilova, J.; Trusov, A.

2017-01-01

SUMMARY SETTING Training center on tuberculosis (TB) infection control (IC) for health care workers in the Central Asian Republics region. OBJECTIVE To assess the effects of TB IC training courses conducted at the Tuberculosis Infection Control Training Center in Machiton, Tajikistan. DESIGN Participants who participated in training (n = 89) during the first year of operation (April 2014–February 2015) were invited to participate in a post-training interview. RESULTS Of the 89 participants, 84 (94%) completed the interview and expressed satisfaction with the training. Eighty (95%) participants reported meeting with workplace leadership to discuss the training. Of these, 69 (85%) reported discussing changes required to meet TB IC standards. Self-reported changes in TB IC practices at work facilities post training included the creation of TB IC committees, designation of a TB IC focal person, TB IC planning, policies to separate infectious patients in waiting rooms, provision of masks for infectious patients, development of cough etiquette policies, improved glove availability, hand hygiene programs, and TB IC posters in waiting rooms. CONCLUSIONS Participant satisfaction and reported changes in TB IC activities illustrate the potential of these training courses to improve TB IC in the region. Future training courses may be tailored to specific audiences using a structured conceptual framework to impact administration, budgeting, and facilities management of TB IC practices. PMID:28399974

Virtual reality simulation training of mastoidectomy - studies on novice performance.

PubMed

Andersen, Steven Arild Wuyts

2016-08-01

Virtual reality (VR) simulation-based training is increasingly used in surgical technical skills training including in temporal bone surgery. The potential of VR simulation in enabling high-quality surgical training is great and VR simulation allows high-stakes and complex procedures such as mastoidectomy to be trained repeatedly, independent of patients and surgical tutors, outside traditional learning environments such as the OR or the temporal bone lab, and with fewer of the constraints of traditional training. This thesis aims to increase the evidence-base of VR simulation training of mastoidectomy and, by studying the final-product performances of novices, investigates the transfer of skills to the current gold-standard training modality of cadaveric dissection, the effect of different practice conditions and simulator-integrated tutoring on performance and retention of skills, and the role of directed, self-regulated learning. Technical skills in mastoidectomy were transferable from the VR simulation environment to cadaveric dissection with significant improvement in performance after directed, self-regulated training in the VR temporal bone simulator. Distributed practice led to a better learning outcome and more consolidated skills than massed practice and also resulted in a more consistent performance after three months of non-practice. Simulator-integrated tutoring accelerated the initial learning curve but also caused over-reliance on tutoring, which resulted in a drop in performance when the simulator-integrated tutor-function was discontinued. The learning curves were highly individual but often plateaued early and at an inadequate level, which related to issues concerning both the procedure and the VR simulator, over-reliance on the tutor function and poor self-assessment skills. Future simulator-integrated automated assessment could potentially resolve some of these issues and provide trainees with both feedback during the procedure and immediate assessment following each procedure. Standard setting by establishing a proficiency level that can be used for mastery learning with deliberate practice could also further sophisticate directed, self-regulated learning in VR simulation-based training. VR simulation-based training should be embedded in a systematic and competency-based training curriculum for high-quality surgical skills training, ultimately leading to improved safety and patient care.

Who is in Your Waiting Room? Health Care Professionals as Culturally Responsive and Trauma-Informed First Responders to Human Trafficking.

PubMed

Rollins, Rochelle; Gribble, Anna; Barrett, Sharon E; Powell, Clydette

2017-01-01

Evidence-based practice standards are not yet well defined for assisting potential victims of human trafficking. Nonetheless, health care professionals are learning to be first responders in identifying, treating, and referring potential victims. As more public and private sector resources are used to train health care professionals about human trafficking, more evaluation and research are needed to develop an effective standard of care. Adopting a public health lens and using the "National Standards for Culturally and Linguistically Appropriate Services in Health and Health Care" can guide critical decision making and actions. Through collaboration between researchers and policymakers, lessons learned in health care settings can inform future evidence-based standards of care so that all patients receive the services that they need. © 2017 American Medical Association. All Rights Reserved.

Native Residential Construction Worker. Apprenticeship Training Standards = Construction residentielle autochtone. Normes de formation en apprentissage.

ERIC Educational Resources Information Center

Ontario Ministry of Skills Development, Toronto.

These training standards for native residential construction workers are intended to be used by apprentice/trainees, instructors, and companies in Ontario, Canada, as a blueprint for training or as a prerequisite for prerequisite for accreditation/certification. The training standards identify skills required for this occupation and its related…

Bench press exercise: the key points.

PubMed

Padulo, J; Laffaye, G; Chaouachi, A; Chamari, K

2015-06-01

The bench press exercise (BPE) is receiving increasing interest as a field testing, training/therapeutic modality to improve neuromuscular performance or to increase bone mass density. Several studies have been performed using BPE as a standard for increasing upper-limb strength. For this purpose, the position of the bar, the loads, the sets, the number of repetitions, the recovery time in-between sets, the movement speed, the muscular work and the use of the determination of the one repetition maximum (1-RM) are the classical tools investigated in the literature that have been shown to affect the BPE effect on neuromuscular. The goal of the present short review is to make a picture of the current knowledge on the bench press exercise, which could be very helpful for a better understanding of this standard movement and its effects. Based on the related literature, several recommendations on these key points are presented here.

A Voltammetric Electronic Tongue for the Resolution of Ternary Nitrophenol Mixtures

PubMed Central

González-Calabuig, Andreu; Cetó, Xavier

2018-01-01

This work reports the applicability of a voltammetric sensor array able to quantify the content of 2,4-dinitrophenol, 4-nitrophenol, and picric acid in artificial samples using the electronic tongue (ET) principles. The ET is based on cyclic voltammetry signals, obtained from an array of metal disk electrodes and a graphite epoxy composite electrode, compressed using discrete wavelet transform with chemometric tools such as artificial neural networks (ANNs). ANNs were employed to build the quantitative prediction model. In this manner, a set of standards based on a full factorial design, ranging from 0 to 300 mg·L−1, was prepared to build the model; afterward, the model was validated with a completely independent set of standards. The model successfully predicted the concentration of the three considered phenols with a normalized root mean square error of 0.030 and 0.076 for the training and test subsets, respectively, and r ≥ 0.948. PMID:29342848

Transfer and Use of Training Technology: A Model for Matching Training Approaches with Training Settings. Technical Report No. 74-24.

ERIC Educational Resources Information Center

Haverland, Edgar M.

The report describes a project designed to facilitate the transfer and utilization of training technology by developing a model for evaluating training approaches or innovtions in relation to the requirements, resources, and constraints of specific training settings. The model consists of two parallel sets of open-ended questions--one set…

Implementing standardized, inter-unit communication in an international setting: handoff of patients from emergency medicine to internal medicine.

PubMed

Balhara, Kamna S; Peterson, Susan M; Elabd, Mohamed Moheb; Regan, Linda; Anton, Xavier; Al-Natour, Basil Ali; Hsieh, Yu-Hsiang; Scheulen, James; Stewart de Ramirez, Sarah A

2018-04-01

Standardized handoffs may reduce communication errors, but research on handoff in community and international settings is lacking. Our study at a community hospital in the United Arab Emirates characterizes existing handoff practices for admitted patients from emergency medicine (EM) to internal medicine (IM), develops a standardized handoff tool, and assesses its impact on communication and physician perceptions. EM physicians completed a survey regarding handoff practices and expectations. Trained observers utilized a checklist based on the Systems Engineering Initiative for Patient Safety model to observe 40 handoffs. EM and IM physicians collaboratively developed a written tool encouraging bedside handoff of admitted patients. After the intervention, surveys of EM physicians and 40 observations were subsequently repeated. 77.5% of initial observed handoffs occurred face-to-face, with 42.5% at bedside, and in four different languages. Most survey respondents considered face-to-face handoff ideal. Respondents noted 9-13 patients suffering harm due to handoff in the prior month. After handoff tool implementation, 97.5% of observed handoffs occurred face-to-face (versus 77.5%, p = 0.014), with 82.5% at bedside (versus 42.5%, p < 0.001), and all in English. Handoff was streamlined from 7 possible pathways to 3. Most post-intervention survey respondents reported improved workflow (77.8%) and safety (83.3%); none reported patient harm. Respondents and observers noted reduced inefficiency (p < 0.05). Our standardized tool increased face-to-face and bedside handoff, positively impacted workflow, and increased perceptions of safety by EM physicians in an international, non-academic setting. Our three-step approach can be applied towards developing standardized, context-specific inter-specialty handoff in a variety of settings.

Outcomes of Fundamentals of Laparoscopic Surgery (FLS) mastery training standards applied to an ergonomically different, lower cost platform.

PubMed

Placek, Sarah B; Franklin, Brenton R; Haviland, Sarah M; Wagner, Mercy D; O'Donnell, Mary T; Cryer, Chad T; Trinca, Kristen D; Silverman, Elliott; Matthew Ritter, E

2017-06-01

Using previously established mastery learning standards, this study compares outcomes of training on standard FLS (FLS) equipment with training on an ergonomically different (ED-FLS), but more portable, lower cost platform. Subjects completed a pre-training FLS skills test on the standard platform and were then randomized to train on the FLS training platform (n = 20) or the ED-FLS platform (n = 19). A post-training FLS skills test was administered to both groups on the standard FLS platform. Group performance on the pretest was similar. Fifty percent of FLS and 32 % of ED-FLS subjects completed the entire curriculum. 100 % of subjects completing the curriculum achieved passing scores on the post-training test. There was no statistically discernible difference in scores on the final FLS exam (FLS 93.4, ED-FLS 93.3, p = 0.98) or training sessions required to complete the curriculum (FLS 7.4, ED-FLS 9.8, p = 0.13). These results show that when applying mastery learning theory to an ergonomically different platform, skill transfer occurs at a high level and prepares subjects to pass the standard FLS skills test.

A new polyvinyl alcohol hydrogel vascular model (KEZLEX) for microvascular anastomosis training

PubMed Central

Mutoh, Tatsushi; Ishikawa, Tatsuya; Ono, Hidenori; Yasui, Nobuyuki

2010-01-01

Background: Microvascular anastomosis is a challenging neurosurgical technique that requires extensive training for one to master it. We developed a new vascular model (KEZLEX, Ono and Co., Ltd., Tokyo, Japan) as a non-animal, realistic tool for practicing microvascular anastomosis under realistic circumstances. Methods: The model was manufactured from polyvinyl alcohol hydrogel to provide 1.0–3.0 mm diameter (available for 0.5-mm pitch), 6–8 cm long tubes that have qualitatively similar surface characteristics, visibility, and stiffness to human donor and recipient arteries for various bypass surgeries based on three-dimensional computed tomography/magnetic resonance imaging scanning data reconstruction using visible human data set and vessel casts. Results: Trainees can acquire basic microsuturing techniques for end-to-end, end-to-side, and side-to-side anastomoses with handling similar to that for real arteries. To practice standard deep bypass techniques under realistic circumstances, the substitute vessel can be fixed to specific locations of a commercially available brain model with pins. Conclusion: Our vascular prosthesis model is simple and easy to set up for repeated practice, and will contribute to facilitate “off-the-job” training by trainees. PMID:21170365

Intercultural Competency in Public Health: A Call for Action to Incorporate Training into Public Health Education

PubMed Central

Fleckman, Julia M.; Dal Corso, Mark; Ramirez, Shokufeh; Begalieva, Maya; Johnson, Carolyn C.

2015-01-01

Due to increasing national diversity, programs addressing cultural competence have multiplied in U.S. medical training institutions. Although these programs share common goals for improving clinical care for patients and reducing health disparities, there is little standardization across programs. Furthermore, little progress has been made to translate cultural competency training from the clinical setting into the public health setting where the focus is on population-based health, preventative programming, and epidemiological and behavioral research. The need for culturally relevant public health programming and culturally sensitive public health research is more critical than ever. Awareness of differing cultures needs to be included in all processes of planning, implementation and evaluation. By focusing on community-based health program planning and research, cultural competence implies that it is possible for public health professionals to completely know another culture, whereas intercultural competence implies it is a dual-sided process. Public health professionals need a commitment toward intercultural competence and skills that demonstrate flexibility, openness, and self-reflection so that cultural learning is possible. In this article, the authors recommend a number of elements to develop, adapt, and strengthen intercultural competence education in public health educational institutions. PMID:26389109

Intercultural Competency in Public Health: A Call for Action to Incorporate Training into Public Health Education.

PubMed

Fleckman, Julia M; Dal Corso, Mark; Ramirez, Shokufeh; Begalieva, Maya; Johnson, Carolyn C

2015-01-01

Due to increasing national diversity, programs addressing cultural competence have multiplied in U.S. medical training institutions. Although these programs share common goals for improving clinical care for patients and reducing health disparities, there is little standardization across programs. Furthermore, little progress has been made to translate cultural competency training from the clinical setting into the public health setting where the focus is on population-based health, preventative programming, and epidemiological and behavioral research. The need for culturally relevant public health programming and culturally sensitive public health research is more critical than ever. Awareness of differing cultures needs to be included in all processes of planning, implementation and evaluation. By focusing on community-based health program planning and research, cultural competence implies that it is possible for public health professionals to completely know another culture, whereas intercultural competence implies it is a dual-sided process. Public health professionals need a commitment toward intercultural competence and skills that demonstrate flexibility, openness, and self-reflection so that cultural learning is possible. In this article, the authors recommend a number of elements to develop, adapt, and strengthen intercultural competence education in public health educational institutions.

A preliminary report on resident emergency psychiatry training from a survey of psychiatry chief residents.

PubMed

Bennett, Jeffrey I; Dzara, Kristina; Mazhar, Mir Nadeem; Behere, Aniruddh

2011-03-01

The Accreditation Council for Graduate Medical Education (ACGME) requirements stipulate that psychiatry residents need to be educated in the area of emergency psychiatry. Existing research investigating the current state of this training is limited, and no research to date has assessed whether the ACGME Residency Review Committee requirements for psychiatry residency training are followed by psychiatry residency training programs. We administered, to chief resident attendees of a national leadership conference, a 24-item paper survey on the types and amount of emergency psychiatry training provided by their psychiatric residency training programs. Descriptive statistics were used in the analysis. Of 154 surveys distributed, 111 were returned (72% response rate). Nearly one-third of chief resident respondents indicated that more than 50% of their program's emergency psychiatry training was provided during on-call periods. A minority indicated that they were aware of the ACGME program requirements for emergency psychiatry training. While training in emergency psychiatry occurred in many programs through rotations-different from the on-call period-direct supervision was available during on-call training only about one-third of the time. The findings suggest that about one-third of psychiatry residency training programs do not adhere to the ACGME standards for emergency psychiatry training. Enhanced knowledge of the ACGME requirements may enhance psychiatry residents' understanding on how their programs are fulfilling the need for more emergency psychiatry training. Alternative settings to the on-call period for emergency psychiatry training are more likely to provide for direct supervision.

CT Urography: Segmentation of Urinary Bladder using CLASS with Local Contour Refinement

PubMed Central

Cha, Kenny; Hadjiiski, Lubomir; Chan, Heang-Ping; Caoili, Elaine M.; Cohan, Richard H.; Zhou, Chuan

2016-01-01

Purpose We are developing a computerized system for bladder segmentation on CT urography (CTU), as a critical component for computer-aided detection of bladder cancer. Methods The presence of regions filled with intravenous contrast and without contrast presents a challenge for bladder segmentation. Previously, we proposed a Conjoint Level set Analysis and Segmentation System (CLASS). In case the bladder is partially filled with contrast, CLASS segments the non-contrast (NC) region and the contrast-filled (C) region separately and automatically conjoins the NC and C region contours; however, inaccuracies in the NC and C region contours may cause the conjoint contour to exclude portions of the bladder. To alleviate this problem, we implemented a local contour refinement (LCR) method that exploits model-guided refinement (MGR) and energy-driven wavefront propagation (EDWP). MGR propagates the C region contours if the level set propagation in the C region stops prematurely due to substantial non-uniformity of the contrast. EDWP with regularized energies further propagates the conjoint contours to the correct bladder boundary. EDWP uses changes in energies, smoothness criteria of the contour, and previous slice contour to determine when to stop the propagation, following decision rules derived from training. A data set of 173 cases was collected for this study: 81 cases in the training set (42 lesions, 21 wall thickenings, 18 normal bladders) and 92 cases in the test set (43 lesions, 36 wall thickenings, 13 normal bladders). For all cases, 3D hand segmented contours were obtained as reference standard and used for the evaluation of the computerized segmentation accuracy. Results For CLASS with LCR, the average volume intersection ratio, average volume error, absolute average volume error, average minimum distance and Jaccard index were 84.2±11.4%, 8.2±17.4%, 13.0±14.1%, 3.5±1.9 mm, 78.8±11.6%, respectively, for the training set and 78.0±14.7%, 16.4±16.9%, 18.2±15.0%, 3.8±2.3 mm, 73.8±13.4% respectively, for the test set. With CLASS only, the corresponding values were 75.1±13.2%, 18.7±19.5%, 22.5±14.9%, 4.3±2.2 mm, 71.0±12.6%, respectively, for the training set and 67.3±14.3%, 29.3±15.9%, 29.4±15.6%, 4.9±2.6 mm, 65.0±13.3%, respectively, for the test set. The differences between the two methods for all five measures were statistically significant (p<0.001) for both the training and test sets. Conclusions The results demonstrate the potential of CLASS with LCR for segmentation of the bladder. PMID:24801066

Effect of set configuration on hemodynamics and cardiac autonomic modulation after high-intensity squat exercise.

PubMed

Iglesias-Soler, Eliseo; Boullosa, Daniel A; Carballeira, Eduardo; Sánchez-Otero, Tania; Mayo, Xian; Castro-Gacio, Xabier; Dopico, Xurxo

2015-07-01

The aim of this study was to compare the effect of two different high-intensity resistance exercise (RE) set configurations on the following: systolic blood pressure (SBP), rate pressure product (RPP), heart rate (HR) variability (HRV), and HR complexity (HRC). Ten well-trained males performed three parallel squat sets until failure (traditional training; TT) with the four repetitions maximum load (4RM), and a rest of 3 min between sets. Thereafter, participants performed a cluster training session (CT) of equated load but with resting time distributed between each repetition. Dependent variables were recorded before, during, and after RE. Mean SBP (25·7 versus 10·9% percentage increase; P = 0·016) and RPP (112·5 versus 69·9%; P = 0·01) were significantly higher in TT. The decrease in HRV after exercise and the drop of HRC during exercise were similar in CT and TT. Change of standard deviation of normal RR intervals after TT correlated with change in SBP (r = 0·803; P = 0·009) while the change of Sample Entropy during exercise correlated with the increment of RPP during CT (ρ = -0·667; P = 0·05). This study suggests that set configuration influences acute cardiovascular responses during RE. When intensity, volume and work-to-rest ratio are equated, CT is less demanding in terms of SBP and RPP. A greater hemodynamic response during exercise would be associated with a faster parasympathetic recovery. © 2014 Scandinavian Society of Clinical Physiology and Nuclear Medicine. Published by John Wiley & Sons Ltd.

Prognostic factors in patients with advanced cancer: use of the patient-generated subjective global assessment in survival prediction.

PubMed

Martin, Lisa; Watanabe, Sharon; Fainsinger, Robin; Lau, Francis; Ghosh, Sunita; Quan, Hue; Atkins, Marlis; Fassbender, Konrad; Downing, G Michael; Baracos, Vickie

2010-10-01

To determine whether elements of a standard nutritional screening assessment are independently prognostic of survival in patients with advanced cancer. A prospective nested cohort of patients with metastatic cancer were accrued from different units of a Regional Palliative Care Program. Patients completed a nutritional screen on admission. Data included age, sex, cancer site, height, weight history, dietary intake, 13 nutrition impact symptoms, and patient- and physician-reported performance status (PS). Univariate and multivariate survival analyses were conducted. Concordance statistics (c-statistics) were used to test the predictive accuracy of models based on training and validation sets; a c-statistic of 0.5 indicates the model predicts the outcome as well as chance; perfect prediction has a c-statistic of 1.0. A training set of patients in palliative home care (n = 1,164) was used to identify prognostic variables. Primary disease site, PS, short-term weight change (either gain or loss), dietary intake, and dysphagia predicted survival in multivariate analysis (P < .05). A model including only patients separated by disease site and PS with high c-statistics between predicted and observed responses for survival in the training set (0.90) and validation set (0.88; n = 603). The addition of weight change, dietary intake, and dysphagia did not further improve the c-statistic of the model. The c-statistic was also not altered by substituting physician-rated palliative PS for patient-reported PS. We demonstrate a high probability of concordance between predicted and observed survival for patients in distinct palliative care settings (home care, tertiary inpatient, ambulatory outpatient) based on patient-reported information.

IMI's teaching design, feedback system and its localization

NASA Astrophysics Data System (ADS)

Wen, Tingting; Zhang, Xuexin

2017-08-01

In Britain, the Institute of the Motor Industry (IMI) sets the National Occupational Standards for all sectors of the automotive industry. The IMI certificate and associated training programs are well recognized for its high quality both in the United Kingdom (UK) and internationally. Using China's first groups studying IMI Level 3 certificate for teachers and Level 2 certificate for students as a sample, we analyzed the seven central aspects in IMI teaching, namely, assessment standard, environment, method, content, procedure, quality control and feedback. We then proposed strategies and guidelines for its localization in China, which would be particularly important for the establishment and expansion of IMI centers.

Training set extension for SVM ensemble in P300-speller with familiar face paradigm.

PubMed

Li, Qi; Shi, Kaiyang; Gao, Ning; Li, Jian; Bai, Ou

2018-03-27

P300-spellers are brain-computer interface (BCI)-based character input systems. Support vector machine (SVM) ensembles are trained with large-scale training sets and used as classifiers in these systems. However, the required large-scale training data necessitate a prolonged collection time for each subject, which results in data collected toward the end of the period being contaminated by the subject's fatigue. This study aimed to develop a method for acquiring more training data based on a collected small training set. A new method was developed in which two corresponding training datasets in two sequences are superposed and averaged to extend the training set. The proposed method was tested offline on a P300-speller with the familiar face paradigm. The SVM ensemble with extended training set achieved 85% classification accuracy for the averaged results of four sequences, and 100% for 11 sequences in the P300-speller. In contrast, the conventional SVM ensemble with non-extended training set achieved only 65% accuracy for four sequences, and 92% for 11 sequences. The SVM ensemble with extended training set achieves higher classification accuracies than the conventional SVM ensemble, which verifies that the proposed method effectively improves the classification performance of BCI P300-spellers, thus enhancing their practicality.

Nephrology training curriculum and implications for optimal kidney care in the developing world.

PubMed

Okel, Julius; Okpechi, Ike G; Qarni, Bilal; Olanrewaju, Timothy; Courtney, Mark J; Luyckx, Valerie; Naicker, Sarala; Bello, Aminu K

An effective workforce is essential for delivery of high-quality chronic disease care. Low-income nations are challenged by a dearth and/or maldistribution of an essential workforce required for all chronic disease care including chronic kidney disease (CKD). Nephrology education and training in developed countries have grown at pace with the technological advancement in the practice of medicine in order to meet the standards required of kidney health professionals towards high-quality, patient-centered medical care. The standards designed by institutions and/or professional societies, such as Royal Colleges and Medical Councils in high-income nations with well-developed health systems and infrastructures, are often not easily translatable to issues critical to nephrology practice in low-income nations. Little or no guidance is provided on common nephrological issues of regional nature or pertaining to ethnic minorities and disadvantaged groups living in those countries. There is an emergent need for a training curriculum that meets the needs and peculiarities of the developing nations, and this needs to leverage on the existing and well-validated systems of training across the globe. We evaluated nephrology training programs across 25 upper-middle and high-income nations to identify best practices and opportunities for adoption in low-income nations. We reviewed training guidelines from major professional societies on content and process of training. There are similarities and differences in structure, content, and process of training programs across countries, and there are clearly adoptable concepts/frameworks for application in low-income nations. We provide recommendations and a strategic plan for the future focus of nephrology training in the developing world to align with current trends in technological advancement and development as well as the need for emphasis on prevention of CKD. The essential competencies (patient- and population--based) required of a nephrologist in a developing world setting are outlined with practical measures and an action plan for adoption.

Critical Appraisal Skills Among Canadian Obstetrics and Gynaecology Residents: How Do They Fare?

PubMed

Bougie, Olga; Posner, Glenn; Black, Amanda Y

2015-07-01

Evidence-based medicine has become the standard of care in clinical practice. In this study, our objectives were to (1) determine the type of epidemiology and/or biostatistical training being given in Canadian obstetrics and gynaecology post-graduate programs, (2) determine obstetrics and gynaecology residents' level of confidence with critical appraisal, and (3) assess knowledge of fundamental biostatistical and epidemiological principles among Canadian obstetrics and gynaecology trainees. During a national standardized in-training examination, all Canadian obstetrics and gynaecology residents were invited to complete an anonymous cross-sectional survey to determine their levels of confidence with critical appraisal. Fifteen critical appraisal questions were integrated into the standardized examination to assess critical appraisal skills objectively. Primary outcomes were the residents' level of confidence interpreting biostatistical results and applying research findings to clinical practice, their desire for more biostatistics/epidemiological training in residency, and their performance on knowledge questions. A total of 301 of 355 residents completed the survey (response rate=84.8%). Most (76.7%) had little/no confidence interpreting research statistics. Confidence was significantly higher in those with increased seniority (OR=1.93), in those who had taken a previous epidemiology/statistics course (OR=2.65), and in those who had prior publications (OR=1.82). Many (68%) had little/no confidence applying research findings to clinical practice. Confidence increased significantly with increasing training year (P<0.001) and with formal epidemiology training during residency (OR=2.01). The mean score of the 355 residents on the knowledge assessment questions was 69.8%. Increasing seniority was associated with improved overall test performance (P=0.02). Poorer performance topics included analytical study method (9.9%), study design (36.9%), and sample size (42.0%). Most (84.4%) wanted more epidemiology teaching. Canadian obstetrics and gynaecology residents may have the biostatistical and epidemiological knowledge to interpret results published in the literature, but lack confidence applying these skills in clinical settings. Most residents want additional training in these areas, and residency programs should include training in formal curriculums to improve their confidence and prepare them for a lifelong practice of evidence-based medicine.

LAHYSTOTRAIN development and evaluation of a complex training system for hysteroscopy.

PubMed

Müller-Wittig, W K; Bisler, A; Bockholt, U; Los Arcos, J L; Oppelt, P; Stähler, J; Voss, G

2001-01-01

Hysteroscopy has already become an irreplaceable method in gynaecoloic diagnosis and therapy. In the diagnostic case the hysteroscope with a 30 degrees optic is insert transvaginally, in the therapeutic case the resectoscope with a 12 degrees optic is used. The endoscopic intervention requires special surgical skills for endoscope handling and remote instrument control. To acquire these skills currently hands-on training in clinical praxis has become standard, which is linked with higher danger for the women. To overcome current drawbacks of traditional training methods the European project LAHYSTOTRAIN was set up, that tries to combine Virtual Reality (VR), Multimedia (MM) technology, and Intelligent Tutoring Systems (ITS) to develop an alternative training system for hysteroscopic interventions. The first prototype of the LAHYSTOTRAIN demonstrator has been shown on several European conferences. An evaluation of the system was performed, with the idea, to collect feedback and impressions, that should be considered in further developments. This paper presents the LAHYSTOTRAIN prototype and the results of these evaluations.

Convolutional networks for vehicle track segmentation

NASA Astrophysics Data System (ADS)

Quach, Tu-Thach

2017-10-01

Existing methods to detect vehicle tracks in coherent change detection images, a product of combining two synthetic aperture radar images taken at different times of the same scene, rely on simple and fast models to label track pixels. These models, however, are unable to capture natural track features, such as continuity and parallelism. More powerful but computationally expensive models can be used in offline settings. We present an approach that uses dilated convolutional networks consisting of a series of 3×3 convolutions to segment vehicle tracks. The design of our networks considers the fact that remote sensing applications tend to operate in low power and have limited training data. As a result, we aim for small and efficient networks that can be trained end-to-end to learn natural track features entirely from limited training data. We demonstrate that our six-layer network, trained on just 90 images, is computationally efficient and improves the F-score on a standard dataset to 0.992, up from 0.959 obtained by the current state-of-the-art method.

A family medicine training program in the Republic of Georgia: incorporating a model of chronic disease management.

PubMed

Sanders, James

2007-01-01

This study describes a different approach to increase the number of family medicine physicians trained with specific competencies in the management of chronic disease. In 1999 the Republic of Georgia initiated an ambitious program designed to retrain practicing physicians in the specialty of family medicine. At 2 of the implementation sites, the Center for International Health worked with local health authorities to augment the official 940-hour curriculum to include lesson plans, workshops, and practicum experiences emphasizing a model of chronic disease management, giving particular attention to hypertension. The population served by the training sites has benefited in a cost-effective manner by achieving blood pressure control for as little as $8 per year per patient; the physician learners have performed above their peer group on standardized national testing. Family medicine training programs in resource-poor settings can incorporate chronic disease management models into their curriculum and achieve high-quality patient care outcomes.

Getting It Right the First Time: Defining Regionally Relevant Training Curricula and Provider Core Competencies for Point-of-Care Ultrasound Education on the African Continent.

PubMed

Salmon, Margaret; Landes, Megan; Hunchak, Cheryl; Paluku, Justin; Malemo Kalisya, Luc; Salmon, Christian; Muller, Mundenga Mutendi; Wachira, Benjamin; Mangan, James; Chhaganlal, Kajal; Kalanzi, Joseph; Azazh, Aklilu; Berman, Sara; Zied, El-Sayed; Lamprecht, Hein

2017-02-01

Significant evidence identifies point-of-care ultrasound (PoCUS) as an important diagnostic and therapeutic tool in resource-limited settings. Despite this evidence, local health care providers on the African continent continue to have limited access to and use of ultrasound, even in potentially high-impact fields such as obstetrics and trauma. Dedicated postgraduate emergency medicine residency training programs now exist in 8 countries, yet no current consensus exists in regard to core PoCUS competencies. The current practice of transferring resource-rich PoCUS curricula and delivery methods to resource-limited health systems fails to acknowledge the unique challenges, needs, and disease burdens of recipient systems. As emergency medicine leaders from 8 African countries, we introduce a practical algorithmic approach, based on the local epidemiology and resource constraints, to curriculum development and implementation. We describe an organizational structure composed of nexus learning centers for PoCUS learners and champions on the continent to keep credentialing rigorous and standardized. Finally, we put forth 5 key strategic considerations: to link training programs to hospital systems, to prioritize longitudinal learning models, to share resources to promote health equity, to maximize access, and to develop a regional consensus on training standards and credentialing. Copyright © 2016 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.

The creative arts therapies: making health care whole.

PubMed

Goodill, Sharon W

2010-07-01

The creative arts therapies are six fields that combine artistic expression with psychotherapy to promote healing, wellness, and personal change. Although they are well-established fields, they are garnering renewed attention with the recent focus on health care and the arts. This article describes these fields and provides information about the training and professional standards of creative arts therapists and examples of how these therapies are being used in health care settings.

cStress: Towards a Gold Standard for Continuous Stress Assessment in the Mobile Environment

PubMed Central

Hovsepian, Karen; al’Absi, Mustafa; Ertin, Emre; Kamarck, Thomas; Nakajima, Motohiro; Kumar, Santosh

2015-01-01

Recent advances in mobile health have produced several new models for inferring stress from wearable sensors. But, the lack of a gold standard is a major hurdle in making clinical use of continuous stress measurements derived from wearable sensors. In this paper, we present a stress model (called cStress) that has been carefully developed with attention to every step of computational modeling including data collection, screening, cleaning, filtering, feature computation, normalization, and model training. More importantly, cStress was trained using data collected from a rigorous lab study with 21 participants and validated on two independently collected data sets — in a lab study on 26 participants and in a week-long field study with 20 participants. In testing, the model obtains a recall of 89% and a false positive rate of 5% on lab data. On field data, the model is able to predict each instantaneous self-report with an accuracy of 72%. PMID:26543926

A 'mystery shopper' project to evaluate sexual health and contraceptive services for young people in Croydon.

PubMed

Sykes, Susie; O'Sullivan, Karin

2006-01-01

The purpose of the study was to evaluate the accessibility of, and advice provided by, sexual health and advice services for young people in Croydon, UK using a 'mystery shopper' approach. Nineteen young people aged 13-21 years were trained as mystery shoppers. The group developed a set of standards, based in part on existing guidelines of best practice, that should be met when working with young people. The group accessed local sexual health services in pairs posing as genuine patients. Using one of four scenarios, the mystery shoppers assessed the service they received against the predefined standards. The main access difficulties occurred in the reception area. Confidentiality was a major concern and was frequently not explained. The advice and information received was generally clearly given and with an appropriate level of detail. Additional training and support needs to be offered to receptionists. Confidentiality policies and statements need to be more effectively communicated.

Leadership training to improve nurse retention.

PubMed

Wallis, Allan; Kennedy, Kathy I

2013-05-01

This paper discusses findings from an evaluation of a training programme designed to promote collaborative, team-based approaches to improve nurse retention within health care organizations. A year-long leadership training programme was designed and implemented to develop effective teams that could address retention challenges in a diverse set of organizations in Colorado ranging from public, private to non-profit. An evaluation, based on a combination of participant observation, group interviews, and the use of standardized tests measuring individual emotional intelligence and team dynamics was conducted to assess the effectiveness of the training programme. What role do the emotional intelligence of individual members and organizational culture play in team effectiveness? Out of five teams participating in the training programme, two performed exceptionally well, one experienced moderate success and two encountered significant problems. Team dynamics were significantly affected by the emotional intelligence of key members holding supervisory positions and by the existing culture and structure of the participating organizations. Team approaches to retention hold promise but require careful development and are most likely to work where organizations have a collaborative problem-solving environment. © 2012 Blackwell Publishing Ltd.

Pilot test of cooperative learning format for training mental health researchers and black community leaders in partnership skills.

PubMed

Laborde, Danielle J; Brannock, Kristen; Breland-Noble, Alfiee; Parrish, Theodore

2007-12-01

To support reduction of racial disparities in mental health diagnosis and treatment, mental health researchers and black community-based organization (CBO) leaders need training on how to engage in collaborative research partnerships. In this study, we pilot tested a series of partnership skills training modules for researchers and CBO leaders in a collaborative learning format. Two different sets of three modules, designed for separate training of researchers and CBO leaders, covered considering, establishing and managing mental health research partnerships and included instructions for self-directed activities and discussions. Eight CBO leaders participated in 10 sessions, and six researchers participated in eight sessions. The effectiveness of the training content and format was evaluated through standardized observations, focus group discussions, participant evaluation forms and retrospective pre-/posttests to measure perceived gains in knowledge. Participants generally were satisfied with the training experience and gained new partnership knowledge and skills. Although the CBO leaders were more engaged in the cooperative learning process, this training format appealed to both audiences. Pilot testing demonstrated that: 1) our modules can equip researchers and CBO leaders with new partnership knowledge and skills and 2) the cooperative learning format is a well-received and suitable option for mental health research partnership training.

The effect of open kinetic chain knee extensor resistance training at different training loads on anterior knee laxity in the uninjured.

PubMed

Barcellona, Massimo G; Morrissey, Matthew C

2016-04-01

The commonly used open kinetic chain knee extensor (OKCKE) exercise loads the sagittal restraints to knee anterior tibial translation. To investigate the effect of different loads of OKCKE resistance training on anterior knee laxity (AKL) in the uninjured knee. non-clinical trial. Randomization into one of three supervised training groups occurred with training 3 times per week for 12 weeks. Subjects in the LOW and HIGH groups performed OKCKE resistance training at loads of 2 sets of 20 repetition maximum (RM) and 20 sets of 2RM, respectively. Subjects in the isokinetic training group (ISOK) performed isokinetic OKCKE resistance training using 2 sets of 20 maximal efforts. AKL was measured using the KT2000 arthrometer with concurrent measurement of lateral hamstrings muscle activity at baseline, 6 weeks and 12 weeks. Twenty six subjects participated (LOW n = 9, HIGH n = 10, ISOK n = 7). The main finding from this study is that a 12-week OKCKE resistance training programme at loads of 20 sets of 2RM, leads to an increase in manual maximal AKL. OKCKE resistance training at high loads (20 sets of 2RM) increases AKL while low load OKCKE resistance training (2 sets of 20RM) and isokinetic OKCKE resistance training at 2 sets of 20RM does not. Copyright © 2015 Elsevier Ltd. All rights reserved.

Child-Focused and Context-Focused Behaviors of Physical and Occupational Therapists during Treatment of Young Children with Cerebral Palsy.

PubMed

Kruijsen-Terpstra, Anne J A; Ellens, Mariëlle; Ketelaar, Marjolijn; Verschuren, Olaf; Di Rezze, Briano; Gorter, Jan Willem; Visser-Meily, Anne M A; Jongmans, Marian J

2016-11-01

To (1) describe the child- and context-focused behaviors of physical and occupational therapists, and (2) compare the behaviors of therapists in a standard therapy session with those of therapists trained to deliver child- and context-focused services. Videos of 49 therapy sessions provided by 36 therapists were analyzed using the intervention domains of the Paediatric Rehabilitation Observational measure of Fidelity (PROF) to examine the therapeutic behaviors of physical and occupational therapists with young children with cerebral palsy (CP) (24 to 48 months) in a Dutch rehabilitation setting. The PROF ratings of 18 standard therapy sessions were compared with the ratings of 16 child- and 15 context-focused therapy sessions. Therapists who provided standard therapy demonstrated a mix of child- and context-focused behaviors. PROF ratings indicated fewer child- and context-focused behaviors during standard therapy sessions compared with sessions where therapists were instructed to use either child- or context-focused behaviors. A sample of Dutch physical and occupational therapists of young children with CP demonstrated a mix of child- and context-focused therapy behaviors during standard therapy. Further research is recommended on clinical reasoning and the effect of setting to better understand therapists' use of child- and context-focused behaviors during therapy sessions.

75 FR 72664 - System Personnel Training Reliability Standards

Federal Register 2010, 2011, 2012, 2013, 2014

2010-11-26

...Under section 215 of the Federal Power Act, the Commission approves two Personnel Performance, Training and Qualifications (PER) Reliability Standards, PER-004-2 (Reliability Coordination--Staffing) and PER-005-1 (System Personnel Training), submitted to the Commission for approval by the North American Electric Reliability Corporation, the Electric Reliability Organization certified by the Commission. The approved Reliability Standards require reliability coordinators, balancing authorities, and transmission operators to establish a training program for their system operators, verify each of their system operators' capability to perform tasks, and provide emergency operations training to every system operator. The Commission also approves NERC's proposal to retire two existing PER Reliability Standards that are replaced by the standards approved in this Final Rule.

Effect of Training on the Reliability of Satiety Evaluation and Use of Trained Panellists to Determine the Satiety Effect of Dietary Fibre: A Randomised Controlled Trial

PubMed Central

Solah, Vicky A.; Meng, Xingqiong; Wood, Simon; Gahler, Roland J.; Kerr, Deborah A.; James, Anthony P.; Pal, Sebely; Fenton, Haelee K.; Johnson, Stuart K.

2015-01-01

Background The assessment of satiety effects on foods is commonly performed by untrained volunteers marking their perceived hunger or fullness on line scales, marked with pre-set descriptors. The lack of reproducibility of satiety measurement using this approach however results in the tool being unable to distinguish between foods that have small, but possibly important, differences in their satiety effects. An alternate approach is used in sensory evaluation; panellists can be trained in the correct use of the assessment line-scale and brought to consensus on the meanings of descriptors used for food quality attributes to improve the panel reliability. The effect of training on the reliability of a satiety panel has not previously been reported. Method In a randomised controlled parallel intervention, the effect of training in the correct use of a satiety labelled magnitude scale (LMS) was assessed versus no-training. The test-retest precision and reliability of two hour postprandial satiety evaluation after consumption of a standard breakfast was compared. The trained panel then compared the satiety effect of two breakfast meals containing either a viscous or a non-viscous dietary fibre in a crossover trial. Results A subgroup of the 23 panellists (n = 5) improved their test re-test precision after training. Panel satiety area under the curve, “after the training” intervention was significantly different to “before training” (p < 0.001). Reliability of the panel determined by intraclass correlation (ICC) of test and retest showed improved strength of the correlation from 0.70 pre-intervention to 0.95 post intervention. The trained “satiety expert panel” determined that a standard breakfast with 5g of viscous fibre gave significantly higher satiety than with 5g non-viscous fibre (area under curve (AUC) of 478.2, 334.4 respectively) (p ≤ 0.002). Conclusion Training reduced between panellist variability. The improved strength of test-retest ICC as a result of the training intervention suggests that training satiety panellists can improve the discriminating power of satiety evaluation. PMID:25978321

[From the Residency Training in the United States to See the Challenges and Directions of China Residency Standardized Training].

PubMed

Cui, Yong; Wang, Tianyou

2016-06-20

Resident standardization training has been started and spreaded out gradually in China. Resident standardization training is crucial to ensure the clinician homogenization, improve medical service quality and level of medical treatment and health care, so it received much attention from all sides. Residency training in American has a history of nearly a century. Systematic model of residency training in the United States had been established for nearly 50 years, and it is a typical representative and successful example of the western medical education. The purpose of this paper is to discuss the institutional arrangements and development direction of the resident standardization training in China, based on comparison of the two residency training system between the two countries on target, schedule, management institution, evaluation and remuneration.

Brain structural changes following adaptive cognitive training assessed by Tensor-Based Morphometry (TBM).

PubMed

Colom, Roberto; Hua, Xue; Martínez, Kenia; Burgaleta, Miguel; Román, Francisco J; Gunter, Jeffrey L; Carmona, Susanna; Jaeggi, Susanne M; Thompson, Paul M

2016-10-01

Tensor-Based Morphometry (TBM) allows the automatic mapping of brain changes across time building 3D deformation maps. This technique has been applied for tracking brain degeneration in Alzheimer's and other neurodegenerative diseases with high sensitivity and reliability. Here we applied TBM to quantify changes in brain structure after completing a challenging adaptive cognitive training program based on the n-back task. Twenty-six young women completed twenty-four training sessions across twelve weeks and they showed, on average, large cognitive improvements. High-resolution MRI scans were obtained before and after training. The computed longitudinal deformation maps were analyzed for answering three questions: (a) Are there differential brain structural changes in the training group as compared with a matched control group? (b) Are these changes related to performance differences in the training program? (c) Are standardized changes in a set of psychological factors (fluid and crystallized intelligence, working memory, and attention control) measured before and after training, related to structural changes in the brain? Results showed (a) greater structural changes for the training group in the temporal lobe, (b) a negative correlation between these changes and performance across training sessions (the greater the structural change, the lower the cognitive performance improvements), and (c) negligible effects regarding the psychological factors measured before and after training. Copyright © 2016 Elsevier Ltd. All rights reserved.

Final Report of the Working Group Meeting C, "Standards in Vocational Training" (Berlin, Germany, February 15-16, 1996). [and] Minutes of the Working Group Meeting C, "Standards in Vocational Education and Training."

ERIC Educational Resources Information Center

German Federal Inst. for Vocational Training Affairs, Berlin (Germany).

Representatives from 13 Central and Eastern European countries, the European Centre for the Development of Vocational Training, and the Organization for Economic Cooperation and Development met for 2 days in Berlin to continue European Training Foundation (ETF) efforts to design a methodology for formulating standards in vocational training (VT)…

The use of three-dimensional ultrasound does not improve training in fetal biometric measurements.

PubMed

Chan, Lin W; Ting, Yuen H; Lao, Terence T; Chau, Macy M C; Fung, Tak Y; Leung, Tak Y; Sahota, Daljit S; Lau, Tze K

2011-09-01

To investigate whether three-dimensional (3D) technology offers any advantage over two-dimensional (2D) ultrasound in fetal biometric measurement training. Ten midwives with no hands-on experience in ultrasound were randomized to receive training on 2D or 3D ultrasound fetal biometry assessment. Midwives were taught how to obtain fetal biometric measurements (biparietal diameter (BPD), head circumference (HC), abdominal circumference (AC), and femur length (FL)) by a trainer. Subsequently, each midwife measured the parameters on another 10 fetuses. The same set of measurements was repeated by the trainer. The percentage deviation between the midwives' and the trainer's measurements was determined and compared between training groups. Time required for completion was recorded. Frozen images were reviewed by another sonographer to assess the image quality using a standardized scoring system. The median time for the complete set of measurements was significantly shorter in the 2D than in 3D group (13.4 min versus 17.8 min, P = 0.03). The mean percentage deviations did not reach statistical significance between the two groups except for FL (3.83% in 2D group versus 2.23% in 3D group (P = 0.046)). There were no significant differences in the quality scores. This study showed that the only demonstrable advantage of 3D ultrasound was a slightly more accurate measurement of FL, at the expense of a significantly longer time required.

Improvement of Predictive Ability by Uniform Coverage of the Target Genetic Space

PubMed Central

Bustos-Korts, Daniela; Malosetti, Marcos; Chapman, Scott; Biddulph, Ben; van Eeuwijk, Fred

2016-01-01

Genome-enabled prediction provides breeders with the means to increase the number of genotypes that can be evaluated for selection. One of the major challenges in genome-enabled prediction is how to construct a training set of genotypes from a calibration set that represents the target population of genotypes, where the calibration set is composed of a training and validation set. A random sampling protocol of genotypes from the calibration set will lead to low quality coverage of the total genetic space by the training set when the calibration set contains population structure. As a consequence, predictive ability will be affected negatively, because some parts of the genotypic diversity in the target population will be under-represented in the training set, whereas other parts will be over-represented. Therefore, we propose a training set construction method that uniformly samples the genetic space spanned by the target population of genotypes, thereby increasing predictive ability. To evaluate our method, we constructed training sets alongside with the identification of corresponding genomic prediction models for four genotype panels that differed in the amount of population structure they contained (maize Flint, maize Dent, wheat, and rice). Training sets were constructed using uniform sampling, stratified-uniform sampling, stratified sampling and random sampling. We compared these methods with a method that maximizes the generalized coefficient of determination (CD). Several training set sizes were considered. We investigated four genomic prediction models: multi-locus QTL models, GBLUP models, combinations of QTL and GBLUPs, and Reproducing Kernel Hilbert Space (RKHS) models. For the maize and wheat panels, construction of the training set under uniform sampling led to a larger predictive ability than under stratified and random sampling. The results of our methods were similar to those of the CD method. For the rice panel, all training set construction methods led to similar predictive ability, a reflection of the very strong population structure in this panel. PMID:27672112

Machine Learning of Parameters for Accurate Semiempirical Quantum Chemical Calculations

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

Dral, Pavlo O.; von Lilienfeld, O. Anatole; Thiel, Walter

2015-05-12

We investigate possible improvements in the accuracy of semiempirical quantum chemistry (SQC) methods through the use of machine learning (ML) models for the parameters. For a given class of compounds, ML techniques require sufficiently large training sets to develop ML models that can be used for adapting SQC parameters to reflect changes in molecular composition and geometry. The ML-SQC approach allows the automatic tuning of SQC parameters for individual molecules, thereby improving the accuracy without deteriorating transferability to molecules with molecular descriptors very different from those in the training set. The performance of this approach is demonstrated for the semiempiricalmore » OM2 method using a set of 6095 constitutional isomers C7H10O2, for which accurate ab initio atomization enthalpies are available. The ML-OM2 results show improved average accuracy and a much reduced error range compared with those of standard OM2 results, with mean absolute errors in atomization enthalpies dropping from 6.3 to 1.7 kcal/mol. They are also found to be superior to the results from specific OM2 reparameterizations (rOM2) for the same set of isomers. The ML-SQC approach thus holds promise for fast and reasonably accurate high-throughput screening of materials and molecules.« less

Machine learning of parameters for accurate semiempirical quantum chemical calculations

DOE PAGES

Dral, Pavlo O.; von Lilienfeld, O. Anatole; Thiel, Walter

2015-04-14

We investigate possible improvements in the accuracy of semiempirical quantum chemistry (SQC) methods through the use of machine learning (ML) models for the parameters. For a given class of compounds, ML techniques require sufficiently large training sets to develop ML models that can be used for adapting SQC parameters to reflect changes in molecular composition and geometry. The ML-SQC approach allows the automatic tuning of SQC parameters for individual molecules, thereby improving the accuracy without deteriorating transferability to molecules with molecular descriptors very different from those in the training set. The performance of this approach is demonstrated for the semiempiricalmore » OM2 method using a set of 6095 constitutional isomers C 7H 10O 2, for which accurate ab initio atomization enthalpies are available. The ML-OM2 results show improved average accuracy and a much reduced error range compared with those of standard OM2 results, with mean absolute errors in atomization enthalpies dropping from 6.3 to 1.7 kcal/mol. They are also found to be superior to the results from specific OM2 reparameterizations (rOM2) for the same set of isomers. The ML-SQC approach thus holds promise for fast and reasonably accurate high-throughput screening of materials and molecules.« less

Evidence based general practice: a retrospective study of interventions in one training practice.

PubMed Central

Gill, P.; Dowell, A. C.; Neal, R. D.; Smith, N.; Heywood, P.; Wilson, A. E.

1996-01-01

OBJECTIVES--To estimate the proportion of interventions in general practice that are based on evidence from clinical trials and to assess the appropriateness of such an evaluation. DESIGN--Retrospective review of case notes. SETTING--One suburban training general practice. SUBJECTS--122 consecutive doctor-patient consultations over two days. MAIN OUTCOME MEASURES--Proportions of interventions based on randomised controlled trials (from literature search with Medline, pharmaceutical databases, and standard textbooks), on convincing non-experimental evidence, and without substantial evidence. RESULTS--21 of the 122 consultations recorded were excluded due to insufficient data; 31 of the interventions were based on randomised controlled trial evidence and 51 based on convincing non-experimental evidence. Hence 82/101 (81%) of interventions were based on evidence meeting our criteria. CONCLUSIONS--Most interventions within general practice are based on evidence from clinical trials, but the methods used in such trials may not be the most appropriate to apply to this setting. PMID:8608291

Information based universal feature extraction

NASA Astrophysics Data System (ADS)

Amiri, Mohammad; Brause, Rüdiger

2015-02-01

In many real world image based pattern recognition tasks, the extraction and usage of task-relevant features are the most crucial part of the diagnosis. In the standard approach, they mostly remain task-specific, although humans who perform such a task always use the same image features, trained in early childhood. It seems that universal feature sets exist, but they are not yet systematically found. In our contribution, we tried to find those universal image feature sets that are valuable for most image related tasks. In our approach, we trained a neural network by natural and non-natural images of objects and background, using a Shannon information-based algorithm and learning constraints. The goal was to extract those features that give the most valuable information for classification of visual objects hand-written digits. This will give a good start and performance increase for all other image learning tasks, implementing a transfer learning approach. As result, in our case we found that we could indeed extract features which are valid in all three kinds of tasks.

Masivukeni: Development of a Multimedia Based Antiretroviral Therapy Adherence Intervention for Counselors and Patients in South Africa

PubMed Central

Remien, Robert H; Mellins, Claude A.; Robbins, Reuben N.; Kelsey, Ryan; Rowe, Jessica; Warne, Patricia; Chowdhury, Jenifar; Lalkhen, Nuruneesa; Hoppe, Lara; Abrams, Elaine J.; El-Bassel, Nabila; Witte, Susan; Stein, Dan J.

2013-01-01

Effective medical treatment for HIV/AIDS requires patients’ optimal adherence to antiretroviral therapy (ART). In resource-constrained settings, lack of adequate standardized counseling for patients on ART remains a significant barrier to adherence. Masivukeni (“Lets Wake Up” in Xhosa) is an innovative multimedia-based intervention designed to help people living with HIV in resource-limited settings achieve and maintain high levels of ART adherence. Adapted from a couples-based intervention tested in the United States (US), Masivukeni was developed through community-based participatory research with US and South African partners and informed by Ewart’s Social Action Theory. Innovative computer-based multimedia strategies were used to translate a labor- and training-intensive intervention into one that could be readily and widely used by lay counselors with relatively little training with low-literacy patients. In this paper, we describe the foundations of this new intervention, the process of its development, and the evidence of its high acceptability and feasibility. PMID:23468079

Quantitative analysis of single- vs. multiple-set programs in resistance training.

PubMed

Wolfe, Brian L; LeMura, Linda M; Cole, Phillip J

2004-02-01

The purpose of this study was to examine the existing research on single-set vs. multiple-set resistance training programs. Using the meta-analytic approach, we included studies that met the following criteria in our analysis: (a) at least 6 subjects per group; (b) subject groups consisting of single-set vs. multiple-set resistance training programs; (c) pretest and posttest strength measures; (d) training programs of 6 weeks or more; (e) apparently "healthy" individuals free from orthopedic limitations; and (f) published studies in English-language journals only. Sixteen studies generated 103 effect sizes (ESs) based on a total of 621 subjects, ranging in age from 15-71 years. Across all designs, intervention strategies, and categories, the pretest to posttest ES in muscular strength was (chi = 1.4 +/- 1.4; 95% confidence interval, 0.41-3.8; p < 0.001). The results of 2 x 2 analysis of variance revealed simple main effects for age, training status (trained vs. untrained), and research design (p < 0.001). No significant main effects were found for sex, program duration, and set end point. Significant interactions were found for training status and program duration (6-16 weeks vs. 17-40 weeks) and number of sets performed (single vs. multiple). The data indicated that trained individuals performing multiple sets generated significantly greater increases in strength (p < 0.001). For programs with an extended duration, multiple sets were superior to single sets (p < 0.05). This quantitative review indicates that single-set programs for an initial short training period in untrained individuals result in similar strength gains as multiple-set programs. However, as progression occurs and higher gains are desired, multiple-set programs are more effective.

Training Requirements in OSHA Standards and Training Guidelines.

ERIC Educational Resources Information Center

Occupational Safety and Health Administration, Washington, DC.

This booklet contains Occupational Safety and Health Administration (OSHA) training requirements, excerpted from OSHA standards. The booklet is designed to help employers, safety and health professionals, training directors, and others who need to know training requirements. (Requirements for posting information, warning signs, labels, and the…

Chile: Acceptability of a Training Program for Depression Management in Primary Care.

PubMed

Marín, Rigoberto; Martínez, Pablo; Cornejo, Juan P; Díaz, Berta; Peralta, José; Tala, Álvaro; Rojas, Graciela

2016-01-01

In Chile, there are inconsistencies in the management of depression in primary care settings, and the National Depression Program, currently in effect, was implemented without a standardized training program. The objective of this study is to evaluate the acceptability of a training program on the management of depression for primary care health teams. The study was a randomized controlled trial, and two primary centers from the Metropolitan Region of Santiago were randomly selected to carry out the intervention training program. Pre-post surveys were applied, to evaluate expectations and satisfaction with the intervention, respectively. Descriptive and content analysis was carried out. The sample consisted of 41 health professionals, 56.1% of who reported that their expectations for the intervention were met. All of the training activities were evaluated with scores higher than 6.4 (on a 1-7 scale). The trainers, the methodology, and the learning environment were considered strengths and facilitators of the program, while the limited duration of the training, the logistical problems faced during part of the program, and the lack of educational material were viewed as weaknesses. The intervention was well accepted by primary health care teams. However, the clinical impact in patients still has to be evaluated.

Infrared imagery acquisition process supporting simulation and real image training

NASA Astrophysics Data System (ADS)

O'Connor, John

2012-05-01

The increasing use of infrared sensors requires development of advanced infrared training and simulation tools to meet current Warfighter needs. In order to prepare the force, a challenge exists for training and simulation images to be both realistic and consistent with each other to be effective and avoid negative training. The US Army Night Vision and Electronic Sensors Directorate has corrected this deficiency by developing and implementing infrared image collection methods that meet the needs of both real image trainers and real-time simulations. The author presents innovative methods for collection of high-fidelity digital infrared images and the associated equipment and environmental standards. The collected images are the foundation for US Army, and USMC Recognition of Combat Vehicles (ROC-V) real image combat ID training and also support simulations including the Night Vision Image Generator and Synthetic Environment Core. The characteristics, consistency, and quality of these images have contributed to the success of these and other programs. To date, this method has been employed to generate signature sets for over 350 vehicles. The needs of future physics-based simulations will also be met by this data. NVESD's ROC-V image database will support the development of training and simulation capabilities as Warfighter needs evolve.

Deep learning in the small sample size setting: cascaded feed forward neural networks for medical image segmentation

NASA Astrophysics Data System (ADS)

Gaonkar, Bilwaj; Hovda, David; Martin, Neil; Macyszyn, Luke

2016-03-01

Deep Learning, refers to large set of neural network based algorithms, have emerged as promising machine- learning tools in the general imaging and computer vision domains. Convolutional neural networks (CNNs), a specific class of deep learning algorithms, have been extremely effective in object recognition and localization in natural images. A characteristic feature of CNNs, is the use of a locally connected multi layer topology that is inspired by the animal visual cortex (the most powerful vision system in existence). While CNNs, perform admirably in object identification and localization tasks, typically require training on extremely large datasets. Unfortunately, in medical image analysis, large datasets are either unavailable or are extremely expensive to obtain. Further, the primary tasks in medical imaging are organ identification and segmentation from 3D scans, which are different from the standard computer vision tasks of object recognition. Thus, in order to translate the advantages of deep learning to medical image analysis, there is a need to develop deep network topologies and training methodologies, that are geared towards medical imaging related tasks and can work in a setting where dataset sizes are relatively small. In this paper, we present a technique for stacked supervised training of deep feed forward neural networks for segmenting organs from medical scans. Each `neural network layer' in the stack is trained to identify a sub region of the original image, that contains the organ of interest. By layering several such stacks together a very deep neural network is constructed. Such a network can be used to identify extremely small regions of interest in extremely large images, inspite of a lack of clear contrast in the signal or easily identifiable shape characteristics. What is even more intriguing is that the network stack achieves accurate segmentation even when it is trained on a single image with manually labelled ground truth. We validate this approach,using a publicly available head and neck CT dataset. We also show that a deep neural network of similar depth, if trained directly using backpropagation, cannot acheive the tasks achieved using our layer wise training paradigm.

Promoting A-Priori Interoperability of HLA-Based Simulations in the Space Domain: The SISO Space Reference FOM Initiative

NASA Technical Reports Server (NTRS)

Moller, Bjorn; Garro, Alfredo; Falcone, Alberto; Crues, Edwin Z.; Dexter, Daniel E.

2016-01-01

Distributed and Real-Time Simulation plays a key-role in the Space domain being exploited for missions and systems analysis and engineering as well as for crew training and operational support. One of the most popular standards is the 1516-2010 IEEE Standard for Modeling and Simulation (M&S) High Level Architecture (HLA). HLA supports the implementation of distributed simulations (called Federations) in which a set of simulation entities (called Federates) can interact using a Run-Time Infrastructure (RTI). In a given Federation, a Federate can publish and/or subscribes objects and interactions on the RTI only in accordance with their structures as defined in a FOM (Federation Object Model). Currently, the Space domain is characterized by a set of incompatible FOMs that, although meet the specific needs of different organizations and projects, increases the long-term cost for interoperability. In this context, the availability of a reference FOM for the Space domain will enable the development of interoperable HLA-based simulators for related joint projects and collaborations among worldwide organizations involved in the Space domain (e.g. NASA, ESA, Roscosmos, and JAXA). The paper presents a first set of results achieved by a SISO standardization effort that aims at providing a Space Reference FOM for international collaboration on Space systems simulations.

Automatic classification of retinal vessels into arteries and veins

NASA Astrophysics Data System (ADS)

Niemeijer, Meindert; van Ginneken, Bram; Abràmoff, Michael D.

2009-02-01

Separating the retinal vascular tree into arteries and veins is important for quantifying vessel changes that preferentially affect either the veins or the arteries. For example the ratio of arterial to venous diameter, the retinal a/v ratio, is well established to be predictive of stroke and other cardiovascular events in adults, as well as the staging of retinopathy of prematurity in premature infants. This work presents a supervised, automatic method that can determine whether a vessel is an artery or a vein based on intensity and derivative information. After thinning of the vessel segmentation, vessel crossing and bifurcation points are removed leaving a set of vessel segments containing centerline pixels. A set of features is extracted from each centerline pixel and using these each is assigned a soft label indicating the likelihood that it is part of a vein. As all centerline pixels in a connected segment should be the same type we average the soft labels and assign this average label to each centerline pixel in the segment. We train and test the algorithm using the data (40 color fundus photographs) from the DRIVE database1 with an enhanced reference standard. In the enhanced reference standard a fellowship trained retinal specialist (MDA) labeled all vessels for which it was possible to visually determine whether it was a vein or an artery. After applying the proposed method to the 20 images of the DRIVE test set we obtained an area under the receiver operator characteristic (ROC) curve of 0.88 for correctly assigning centerline pixels to either the vein or artery classes.

49 CFR 232.403 - Design standards for one-way end-of-train devices.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 49 Transportation 4 2011-10-01 2011-10-01 false Design standards for one-way end-of-train devices... Design standards for one-way end-of-train devices. (a) General. A one-way end-of-train device shall be... the rear unit from the brake pipe; (3) Designed so that an internal failure will not cause an...

Truck and Coach Mechanic. Apprenticeship Training Standards = Mecanicien de camions et d'autobus. Normes de formation en apprentissage.

ERIC Educational Resources Information Center

Ontario Ministry of Skills Development, Toronto.

This manual presents training standards for truck and coach mechanics and is intended to be used by apprentice/trainees, instructors, and companies in Ontario, Canada, as a blueprint for training or as a prerequisite for accreditation/certification. The training standards identify skills required for this occupation and its related training…

Fuel and Electrical Systems Mechanic. Apprenticeship Training Standards = Mecanicien de systemes d'alimentation en carburant et electriques. Normes de formation en apprentissage.

ERIC Educational Resources Information Center

Ontario Ministry of Skills Development, Toronto.

These training standards for fuel and electrical systems mechanics are intended to be used by apprentice/trainees, instructors, and companies in Ontario, Canada, as a blueprint for training or as a prerequisite for prerequisite for accreditation/certification. The training standards identify skills required for this occupation and its related…

49 CFR 232.403 - Design standards for one-way end-of-train devices.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 49 Transportation 4 2013-10-01 2013-10-01 false Design standards for one-way end-of-train devices... Design standards for one-way end-of-train devices. (a) General. A one-way end-of-train device shall be... the rear unit from the brake pipe; (3) Designed so that an internal failure will not cause an...

49 CFR 232.403 - Design standards for one-way end-of-train devices.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 49 Transportation 4 2014-10-01 2014-10-01 false Design standards for one-way end-of-train devices... Design standards for one-way end-of-train devices. (a) General. A one-way end-of-train device shall be... the rear unit from the brake pipe; (3) Designed so that an internal failure will not cause an...

49 CFR 232.405 - Design and performance standards for two-way end-of-train devices.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 49 Transportation 4 2014-10-01 2014-10-01 false Design and performance standards for two-way end... Design and performance standards for two-way end-of-train devices. Two-way end-of-train devices shall be designed and perform with the features applicable to one-way end-of-train devices described in § 232.403...

49 CFR 232.405 - Design and performance standards for two-way end-of-train devices.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 49 Transportation 4 2010-10-01 2010-10-01 false Design and performance standards for two-way end... Design and performance standards for two-way end-of-train devices. Two-way end-of-train devices shall be designed and perform with the features applicable to one-way end-of-train devices described in § 232.403...

49 CFR 232.405 - Design and performance standards for two-way end-of-train devices.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 49 Transportation 4 2011-10-01 2011-10-01 false Design and performance standards for two-way end... Design and performance standards for two-way end-of-train devices. Two-way end-of-train devices shall be designed and perform with the features applicable to one-way end-of-train devices described in § 232.403...

49 CFR 232.405 - Design and performance standards for two-way end-of-train devices.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 49 Transportation 4 2013-10-01 2013-10-01 false Design and performance standards for two-way end... Design and performance standards for two-way end-of-train devices. Two-way end-of-train devices shall be designed and perform with the features applicable to one-way end-of-train devices described in § 232.403...

Emergency medical personnel training: I. An historical perspective.

PubMed

Sytkowski, P A; Jacobs, L M; Meany, M

1983-01-01

The status of Emergency Medical Technicians has evolved from an undefined role with few rules, regulations, or standards to an established health care profession and a nationally administered program. The evolution of this profession received major impetus from the 1966 report by the National Academy of Science/National Research Council that provided recommended training standards. Development of a training course curriculum for basic life support (BLS) followed. The need for coordinated training of Emergency Medical Technical Technicians was recognized, and funds became available to aid in the national standardization of education, examination, certification, and recertification procedures for EMTs. Concomitant with the attempt to standardize BLS training, advanced life support (ALS) programs grew in number. By 1977 the National Standard Training Curriculum became available and was soon followed by a national certification exam. As states have the option to accept or reject the federal standards embodied in the national training course, there remains variation among programs offered by each state. Because of the difference in need for specific emergency services among the states at a time of increased professional mobility, arguments still exist regarding the desirability of federally mandated training and certification programs.

Changing the Learning Environment in the College of Engineering and Applied Science: The impact of Educational Training on Future Faculty and Student- Centered Pedagogy on Undergraduate Students

NASA Astrophysics Data System (ADS)

Gaskins, Whitney

Over the past 20 years there have been many changes to the primary and secondary educational system that have impacted students, teachers, and post-secondary institutions across the United States of America. One of the most important is the large number of standardized tests students are required to take to show adequate performance in school. Students think differently because they are taught differently due to this focus on standardized testing, thus changing the skill sets students acquire in secondary school. This presents a critical problem for colleges and universities, as they now are using practices for and have expectations of these students that are unrealistic for the changing times. High dropout rates in the College of Engineering have been attributed to the cultural atmosphere of the institution. Students have reported a low sense of belonging and low relatability to course material. This study developed a "preparing the future" faculty program that gave graduate students at the University of Cincinnati a unique training experience that helped them understand the students they will educate. They received educational training, developed from a future educator's curriculum that covered classroom management, standards, and pedagogy. Graduate students who participated in the training program reported increases in self-efficacy and student understanding. To reduce negative experiences and increase motivation, Challenge Based Learning (CBL) was introduced in an undergraduate Basic Electric Circuits (BEC) course. CBL is a structured model for course content with a foundation in problem-based learning. CBL offers general concepts from which students derive the challenges they will address. Results show an improved classroom experience for students who were taught with CBL.

Challenges in standardization of blood pressure measurement at the population level.

PubMed

Tolonen, Hanna; Koponen, Päivikki; Naska, Androniki; Männistö, Satu; Broda, Grazyna; Palosaari, Tarja; Kuulasmaa, Kari

2015-04-10

Accurate blood pressure measurements are needed in clinical practice, intervention studies and health examination surveys. Blood pressure measurements are sensitive: their accuracy can be affected by measurement environment, behaviour of the subject, measurement procedures, devices used for the measurement and the observer. To minimize errors in blood pressure measurement, a standardized measurement protocol is needed. The European Health Examination Survey (EHES) Pilot project was conducted in 2009-2012. A pilot health examination survey was conducted in 12 countries using a standardized protocol. The measurement protocols used in each survey, training provided for the measurers, measurement data, and observations during site visits were collected and evaluated to assess the level of standardization. The EHES measurement protocol for blood pressure was followed accurately in all 12 pilot surveys. Most of the surveys succeeded in organizing a quiet and comfortable measurement environment, and staff instructed survey participants appropriately before examination visits. In all surveys, blood pressure was measured three times, from the right arm in a sitting posture. The biggest variation was in the device used for the blood pressure measurement. It is possible to reach a high level of standardization for blood pressure measurements across countries and over time. A detailed, standardized measurement protocol, and adequate training and monitoring during the fieldwork and centrally organized quality assessment of the data are needed. The recent EU regulation banning the sale of mercury sphygmomanometer in European Union Member States has set new challenges for the standardization of measurement devices since the validity of oscillometric measurements is device-specific and performance of aneroid devices depends very much on calibration.

Avoiding complications by a hands-on mentor programme.

PubMed

Lefebvre, Guylaine G; Shore, Eliane M

2016-08-01

The complexity of gynaecologic surgery has increased in recent years, while the duration of residency training has remained fixed with reduced work hours compared with our predecessors. Residents may not be graduating with the advanced surgical skill set required for complex cases, which are now considered standard of care. The ever-changing advancements in the field of gynaecologic surgery warrant the development of training programmes for practicing surgeons to incorporate recent advances and best practices. This can be accomplished through mentorship in training residents as well as the continuing professional development of safe gynaecologic surgeons. This review outlines the process of mentorship to enhance surgical skills, and objective feedback tools for surgeons seeking to improve performance. Mentorship programmes can help surgeons incorporate new technologies in a structured environment, which seeks to decrease the risk of complications for our patients. Copyright © 2015 Elsevier Ltd. All rights reserved.

Simulation Based Training Improves Airway Management for Helicopter EMS Teams

NASA Technical Reports Server (NTRS)

Dhindsa, Harinder S.; Reid, Renee; Murray, David; Lovelady, James; Powell, Katie; Sayles, Jeff; Stevenson, Christopher; Baker, Kathy; Solada, Brian; Carroll, Scott;

on-course(®) portal: a tool for in-service training and career development for biomedical scientists.

PubMed

Payton, Antony; Janko, Christa; Renn, Oliver; Hardman, Michael

2013-09-01

Successfully navigating through the jungle of biomedical postgraduate courses in Europe has recently been made possible by the release of an Innovative Medicines Initiative (IMI) funded project called on-course(®) (http://www.on-course.eu). on-course(®) lists all master, continued professional development (CPD) and PhD courses in Europe and hosts advanced search options designed by the pharmaceutical industry, academia and regulatory bodies allowing the course seeker to find courses that are most relevant for them. In addition, an IMI cross education and training topic task force has developed a set of quality standards that have been applied to CPD courses. The comprehensive nature of on-course(®) offers a new level of transparency to biomedical course provision in Europe that will help steer future education and training. Copyright © 2013 Elsevier Ltd. All rights reserved.

Impact of food allergies on school nursing practice.

PubMed

Weiss, Christopher; Muñoz-Furlong, Anne; Furlong, Terence J; Arbit, Julie

2004-10-01

Food allergies affect 11 million Americans, including 6-8% of children. The rate of peanut allergies in children doubled from 1997 to 2002. There is no cure; therefore, strict avoidance of the allergen is the only way to avoid a reaction. Fatalities are associated with delays in or lack of epinephrine administration. Severe reactions, called anaphylaxis, have occurred in schools. In a nationwide telephone survey of 400 elementary school nurses, 44% reported an increase in children with food allergies in their schools over the last 5 years; more than one third had 10 or more students with food allergies; 78% did staff training as a preventive strategy, with 74% developing their own training guidelines; and 90% stated students' epinephrine was stored in the nurse's office. Standardized training in food allergies as well as timely access to epinephrine is needed to respond appropriately to an anaphylactic reaction in the school setting.

Training, Retention, and Transfer of Data Entry Perceptual and Motoric Processes Over Long Retention Intervals

NASA Technical Reports Server (NTRS)

Kole, James A.; Schneider, Vivian I.; Healy, Alice F.; Barshi, Immanuel

2017-01-01

Subjects trained in a standard data entry task, which involved typing numbers (e.g., 5421) using their right hands. At test (6 months post-training), subjects completed the standard task, followed by a left-hand variant (typing with their left hands) that involved the same perceptual, but different motoric, processes as the standard task. At a second test (8 months post-training), subjects completed the standard task, followed by a code variant (translating letters into digits, then typing the digits with their right hands) that involved different perceptual, but the same motoric, processes as the standard task. For each of the three tasks, half the trials were trained numbers (old) and half were new. Repetition priming (faster response times to old than new numbers) was found for each task. Repetition priming for the standard task reflects retention of trained numbers; for the left-hand variant reflects transfer of perceptual processes; and for the code variant reflects transfer of motoric processes. There was thus evidence for both specificity and generalizability of training data entry perceptual and motoric processes over very long retention intervals.

Improving practice in community-based settings: a randomized trial of supervision – study protocol

PubMed Central

2013-01-01

Background Evidence-based treatments for child mental health problems are not consistently available in public mental health settings. Expanding availability requires workforce training. However, research has demonstrated that training alone is not sufficient for changing provider behavior, suggesting that ongoing intervention-specific supervision or consultation is required. Supervision is notably under-investigated, particularly as provided in public mental health. The degree to which supervision in this setting includes ‘gold standard’ supervision elements from efficacy trials (e.g., session review, model fidelity, outcome monitoring, skill-building) is unknown. The current federally-funded investigation leverages the Washington State Trauma-focused Cognitive Behavioral Therapy Initiative to describe usual supervision practices and test the impact of systematic implementation of gold standard supervision strategies on treatment fidelity and clinical outcomes. Methods/Design The study has two phases. We will conduct an initial descriptive study (Phase I) of supervision practices within public mental health in Washington State followed by a randomized controlled trial of gold standard supervision strategies (Phase II), with randomization at the clinician level (i.e., supervisors provide both conditions). Study participants will be 35 supervisors and 130 clinicians in community mental health centers. We will enroll one child per clinician in Phase I (N = 130) and three children per clinician in Phase II (N = 390). We use a multi-level mixed within- and between-subjects longitudinal design. Audio recordings of supervision and therapy sessions will be collected and coded throughout both phases. Child outcome data will be collected at the beginning of treatment and at three and six months into treatment. Discussion This study will provide insight into how supervisors can optimally support clinicians delivering evidence-based treatments. Phase I will provide descriptive information, currently unavailable in the literature, about commonly used supervision strategies in community mental health. The Phase II randomized controlled trial of gold standard supervision strategies is, to our knowledge, the first experimental study of gold standard supervision strategies in community mental health and will yield needed information about how to leverage supervision to improve clinician fidelity and client outcomes. Trial registration ClinicalTrials.gov NCT01800266 PMID:23937766

A comparative study of two hazard handling training methods for novice drivers.

PubMed

Wang, Y B; Zhang, W; Salvendy, G

2010-10-01

The effectiveness of two hazard perception training methods, simulation-based error training (SET) and video-based guided error training (VGET), for novice drivers' hazard handling performance was tested, compared, and analyzed. Thirty-two novice drivers participated in the hazard perception training. Half of the participants were trained using SET by making errors and/or experiencing accidents while driving with a desktop simulator. The other half were trained using VGET by watching prerecorded video clips of errors and accidents that were made by other people. The two groups had exposure to equal numbers of errors for each training scenario. All the participants were tested and evaluated for hazard handling on a full cockpit driving simulator one week after training. Hazard handling performance and hazard response were measured in this transfer test. Both hazard handling performance scores and hazard response distances were significantly better for the SET group than the VGET group. Furthermore, the SET group had more metacognitive activities and intrinsic motivation. SET also seemed more effective in changing participants' confidence, but the result did not reach the significance level. SET exhibited a higher training effectiveness of hazard response and handling than VGET in the simulated transfer test. The superiority of SET might benefit from the higher levels of metacognition and intrinsic motivation during training, which was observed in the experiment. Future research should be conducted to assess whether the advantages of error training are still effective under real road conditions.

Detecting effects of the indicated prevention Programme for Externalizing Problem behaviour (PEP) on child symptoms, parenting, and parental quality of life in a randomized controlled trial.

PubMed

Hanisch, Charlotte; Freund-Braier, Inez; Hautmann, Christopher; Jänen, Nicola; Plück, Julia; Brix, Gabriele; Eichelberger, Ilka; Döpfner, Manfred

2010-01-01

Behavioural parent training is effective in improving child disruptive behavioural problems in preschool children by increasing parenting competence. The indicated Prevention Programme for Externalizing Problem behaviour (PEP) is a group training programme for parents and kindergarten teachers of children aged 3-6 years with externalizing behavioural problems. To evaluate the effects of PEP on child problem behaviour, parenting practices, parent-child interactions, and parental quality of life. Parents and kindergarten teachers of 155 children were randomly assigned to an intervention group (n = 91) and a nontreated control group (n = 64). They rated children's problem behaviour before and after PEP training; parents also reported on their parenting practices and quality of life. Standardized play situations were video-taped and rated for parent-child interactions, e.g. parental warmth. In the intention to treat analysis, mothers of the intervention group described less disruptive child behaviour and better parenting strategies, and showed more parental warmth during a standardized parent-child interaction. Dosage analyses confirmed these results for parents who attended at least five training sessions. Children were also rated to show less behaviour problems by their kindergarten teachers. Training effects were especially positive for parents who attended at least half of the training sessions. CBCL: Child Behaviour Checklist; CII: Coder Impressions Inventory; DASS: Depression anxiety Stress Scale; HSQ: Home-situation Questionnaire; LSS: Life Satisfaction Scale; OBDT: observed behaviour during the test; PCL: Problem Checklist; PEP: prevention programme for externalizing problem behaviour; PPC: Parent Problem Checklist; PPS: Parent Practices Scale; PS: Parenting Scale; PSBC: Problem Setting and Behaviour checklist; QJPS: Questionnaire on Judging Parental Strains; SEFS: Self-Efficacy Scale; SSC: Social Support Scale; TRF: Caregiver-Teacher Report Form.

Set Shifting Training with Categorization Tasks

PubMed Central

Soveri, Anna; Waris, Otto; Laine, Matti

2013-01-01

The very few cognitive training studies targeting an important executive function, set shifting, have reported performance improvements that also generalized to untrained tasks. The present randomized controlled trial extends set shifting training research by comparing previously used cued training with uncued training. A computerized adaptation of the Wisconsin Card Sorting Test was utilized as the training task in a pretest-posttest experimental design involving three groups of university students. One group received uncued training (n = 14), another received cued training (n = 14) and the control group (n = 14) only participated in pre- and posttests. The uncued training group showed posttraining performance increases on their training task, but neither training group showed statistically significant transfer effects. Nevertheless, comparison of effect sizes for transfer effects indicated that our results did not differ significantly from the previous studies. Our results suggest that the cognitive effects of computerized set shifting training are mostly task-specific, and would preclude any robust generalization effects with this training. PMID:24324717

National Apprenticeship and Training Standards for Bricklaying. Revised.

ERIC Educational Resources Information Center

Manpower Administration (DOL), Washington, DC. Bureau of Apprenticeship and Training.

Developed as a guide for local joint apprenticeship and training committees in establishing local bricklaying apprenticeship programs, this booklet represents the sixth revision of the national apprenticeship and training standards for bricklaying apprenticeship. (The standards were prepared and approved by the National Joint Bricklaying…

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

PubMed

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

2014-03-01

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

28 CFR 115.131 - Employee and volunteer training.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 28 Judicial Administration 2 2013-07-01 2013-07-01 false Employee and volunteer training. 115.131... NATIONAL STANDARDS Standards for Lockups Training and Education § 115.131 Employee and volunteer training. (a) The agency shall train all employees and volunteers who may have contact with lockup detainees to...

28 CFR 115.131 - Employee and volunteer training.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 28 Judicial Administration 2 2014-07-01 2014-07-01 false Employee and volunteer training. 115.131... NATIONAL STANDARDS Standards for Lockups Training and Education § 115.131 Employee and volunteer training. (a) The agency shall train all employees and volunteers who may have contact with lockup detainees to...

28 CFR 115.131 - Employee and volunteer training.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 28 Judicial Administration 2 2012-07-01 2012-07-01 false Employee and volunteer training. 115.131... NATIONAL STANDARDS Standards for Lockups Training and Education § 115.131 Employee and volunteer training. (a) The agency shall train all employees and volunteers who may have contact with lockup detainees to...

Training Requirements in OSHA Standards and Training Guidelines. Revised.

ERIC Educational Resources Information Center

Occupational Safety and Health Administration, Washington, DC.

This guide provides an overview of Occupational Safety and Health Act (OSHA) standards and training guidelines for various industries. The first section introduces the concept of voluntary training guidelines, explaining that the guidelines are designed to help employers determine whether a worksite problem can be solved by training, what training…

Inconsistencies in quality of life data collection in clinical trials: a potential source of bias? Interviews with research nurses and trialists.

PubMed

Kyte, Derek; Ives, Jonathan; Draper, Heather; Keeley, Thomas; Calvert, Melanie

2013-01-01

Patient-reported outcomes (PROs), such as health-related quality of life (HRQL) are increasingly used to evaluate treatment effectiveness in clinical trials, are valued by patients, and may inform important decisions in the clinical setting. It is of concern, therefore, that preliminary evidence, gained from group discussions at UK-wide Medical Research Council (MRC) quality of life training days, suggests there are inconsistent standards of HRQL data collection in trials and appropriate training and education is often lacking. Our objective was to investigate these reports, to determine if they represented isolated experiences, or were indicative of a potentially wider problem. We undertook a qualitative study, conducting 26 semi-structured interviews with research nurses, data managers, trial coordinators and research facilitators involved in the collection and entry of HRQL data in clinical trials, across one primary care NHS trust, two secondary care NHS trusts and two clinical trials units in the UK. We used conventional content analysis to analyze and interpret our data. Our study participants reported (1) inconsistent standards in HRQL measurement, both between, and within, trials, which appeared to risk the introduction of bias; (2), difficulties in dealing with HRQL data that raised concern for the well-being of the trial participant, which in some instances led to the delivery of non-protocol driven co-interventions, (3), a frequent lack of HRQL protocol content and appropriate training and education of trial staff, and (4) that HRQL data collection could be associated with emotional and/or ethical burden. Our findings suggest there are inconsistencies in the standards of HRQL data collection in some trials resulting from a general lack of HRQL-specific protocol content, training and education. These inconsistencies could lead to biased HRQL trial results. Future research should aim to develop HRQL guidelines and training programmes aimed at supporting researchers to carry out high quality data collection.

Inconsistencies in Quality of Life Data Collection in Clinical Trials: A Potential Source of Bias? Interviews with Research Nurses and Trialists

PubMed Central

Kyte, Derek; Ives, Jonathan; Draper, Heather; Keeley, Thomas; Calvert, Melanie

2013-01-01

Background Patient-reported outcomes (PROs), such as health-related quality of life (HRQL) are increasingly used to evaluate treatment effectiveness in clinical trials, are valued by patients, and may inform important decisions in the clinical setting. It is of concern, therefore, that preliminary evidence, gained from group discussions at UK-wide Medical Research Council (MRC) quality of life training days, suggests there are inconsistent standards of HRQL data collection in trials and appropriate training and education is often lacking. Our objective was to investigate these reports, to determine if they represented isolated experiences, or were indicative of a potentially wider problem. Methods And Findings We undertook a qualitative study, conducting 26 semi-structured interviews with research nurses, data managers, trial coordinators and research facilitators involved in the collection and entry of HRQL data in clinical trials, across one primary care NHS trust, two secondary care NHS trusts and two clinical trials units in the UK. We used conventional content analysis to analyze and interpret our data. Our study participants reported (1) inconsistent standards in HRQL measurement, both between, and within, trials, which appeared to risk the introduction of bias; (2), difficulties in dealing with HRQL data that raised concern for the well-being of the trial participant, which in some instances led to the delivery of non-protocol driven co-interventions, (3), a frequent lack of HRQL protocol content and appropriate training and education of trial staff, and (4) that HRQL data collection could be associated with emotional and/or ethical burden. Conclusions Our findings suggest there are inconsistencies in the standards of HRQL data collection in some trials resulting from a general lack of HRQL-specific protocol content, training and education. These inconsistencies could lead to biased HRQL trial results. Future research should aim to develop HRQL guidelines and training programmes aimed at supporting researchers to carry out high quality data collection. PMID:24124580

Mental Health Communications Skills Training for Medical Assistants in Pediatric Primary Care

PubMed Central

Brown, Jonathan D.; Wissow, Lawrence S.; Cook, Benjamin L.; Longway, Shaina; Caffery, Emily; Pefaure, Chris

2012-01-01

Paraprofessional medical assistants (MAs) could help to promote pediatric primary care as a source of mental health services, particularly among patient populations who receive disparate mental health care. This project piloted a brief training to enhance the ability of MAs to have therapeutic encounters with Latino families who have mental health concerns in pediatric primary care. The evaluation of the pilot found that MAs were able to master most of the skills taught during the training, which improved their ability to have patient-centered encounters with families during standardized patient visits coded with the Roter Interaction Analysis System. Parents interviewed one and six months following the training were more than twice as willing as parents interviewed one month before the training to discuss mental health concerns with MAs and they had better perceptions of their interactions with MAs (all p < 0.01) even after controlling for a range of patient and visit characteristics. Before training, 10.2% of parents discussed a mental health concern with the MA but not the physician; this never happened six months after training. This pilot provides preliminary evidence that training MAs holds potential to supplement other educational and organizational interventions aimed at improving mental health services in pediatric primary care but further research is necessary to test this type of training in other settings and among different patient populations. PMID:23070564

Automated human skull landmarking with 2D Gabor wavelets

NASA Astrophysics Data System (ADS)

de Jong, Markus A.; Gül, Atilla; de Gijt, Jan Pieter; Koudstaal, Maarten J.; Kayser, Manfred; Wolvius, Eppo B.; Böhringer, Stefan

2018-05-01

Landmarking of CT scans is an important step in the alignment of skulls that is key in surgery planning, pre-/post-surgery comparisons, and morphometric studies. We present a novel method for automatically locating anatomical landmarks on the surface of cone beam CT-based image models of human skulls using 2D Gabor wavelets and ensemble learning. The algorithm is validated via human inter- and intra-rater comparisons on a set of 39 scans and a skull superimposition experiment with an established surgery planning software (Maxilim). Automatic landmarking results in an accuracy of 1–2 mm for a subset of landmarks around the nose area as compared to a gold standard derived from human raters. These landmarks are located in eye sockets and lower jaw, which is competitive with or surpasses inter-rater variability. The well-performing landmark subsets allow for the automation of skull superimposition in clinical applications. Our approach delivers accurate results, has modest training requirements (training set size of 30–40 items) and is generic, so that landmark sets can be easily expanded or modified to accommodate shifting landmark interests, which are important requirements for the landmarking of larger cohorts.

Effectiveness of an Evidence-Based Quality Improvement Approach to Cultural Competence Training: The Veterans Affairs' "Caring for Women Veterans" Program.

PubMed

Fox, Annie B; Hamilton, Alison B; Frayne, Susan M; Wiltsey-Stirman, Shannon; Bean-Mayberry, Bevanne; Carney, Diane; Di Leone, Brooke A L; Gierisch, Jennifer M; Goldstein, Karen M; Romodan, Yasmin; Sadler, Anne G; Yano, Elizabeth M; Yee, Ellen F; Vogt, Dawne

2016-01-01

Although providing culturally sensitive health care is vitally important, there is little consensus regarding the most effective strategy for implementing cultural competence trainings in the health care setting. Evidence-based quality improvement (EBQI), which involves adapting evidence-based practices to meet local needs, may improve uptake and effectiveness of a variety of health care innovations. Yet, to our knowledge, EBQI has not yet been applied to cultural competence training. To evaluate whether EBQI could enhance the impact of an evidence-based training intended to improve veterans affairs health care staff gender sensitivity and knowledge (Caring for Women Veterans; CWV), we compared the reach and effectiveness of EBQI delivery versus standard web-based implementation strategies of CWV and assessed barriers and facilitators to EBQI implementation. Workgroups at four diverse veterans affairs health care sites were randomized to either an EBQI or standard web-based implementation condition (SI). All EBQI sites selected a group-based implementation strategy. Employees (N = 84) completed pretraining and posttraining assessments of gender sensitivity and knowledge, and focus groups/interviews were conducted with leadership and staff before and after implementation. Reach of CWV was greater in the EBQI condition versus the SI condition. Whereas both gender sensitivity and knowledge improved in the EBQI condition, only gender sensitivity improved in the SI condition. Qualitative analyses revealed that the EBQI approach was well received, although a number of barriers were identified. Findings suggest that EBQI can enhance the uptake and effectiveness of employee trainings. However, the decision to pursue EBQI must be informed by a consideration of available resources.

Setting Priorities in the Age of Austerity: British, French, and German Experiences

DTIC Science & Technology

2013-01-01

the cuts had not gone far enough, but that the scale of the necessary reductions made it impossible to get away with simply trimming the existing...2020, House of Commons Library, Standard Note 06396, July 26, 2012, pp. 27–28. 9 scale . For example, the 2008 “Future Land Operational Concept...paper called for maintaining broad capabilities: Land forces will need to project suitably configured, scaled and trained forces at appropriate

Results of a Prospective Echocardiography Trial in International Space Station Crew

NASA Technical Reports Server (NTRS)

Hamilton, Douglas R.; Sargsyan, Ashot E.; Martin, David; Garcia, Kathleen M.; Melton, Shannon; Feiverson, Alan; Dulchavsky, Scott A.

2009-01-01

In the framework of an operationally oriented investigation, we conducted a prospective trial of a standard clinical echocardiography protocol in a cohort of long-duration crewmembers. The resulting primary and processed data appear to have no precedents. Our tele-echocardiography paradigm, including just-in-time e-training methods, was also assessed. A critical review of the imaging technique, equipment and setting limitations, and quality assurance is provided, as well as the analysis of "space normal" data.

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.

The implementation and evaluation of a communication skills training program for oncology nurses.

PubMed

Banerjee, Smita C; Manna, Ruth; Coyle, Nessa; Penn, Stacey; Gallegos, Tess E; Zaider, Talia; Krueger, Carol A; Bialer, Philip A; Bylund, Carma L; Parker, Patricia A

2017-09-01

Many nurses express difficulty in communicating with their patients, especially in oncology settings where there are numerous challenges and high-stake decisions during the course of diagnosis and treatment. Providing specific training in communication skills is one way to enhance the communication between nurses and their patients. We developed and implemented a communication skills training program for nurses, consisting of three teaching modules: responding empathically to patients; discussing death, dying, and end-of-life goals of care; and responding to challenging interactions with families. Training included didactic and experiential small group role plays. This paper presents results on program evaluation, self-efficacy, and behavioral demonstration of learned communication skills. Three hundred forty-two inpatient oncology nurses participated in a 1-day communication skills training program and completed course evaluations, self-reports, and pre- and post-standardized patient assessments. Participants rated the training favorably, and they reported significant gains in self-efficacy in their ability to communicate with patients in various contexts. Participants also demonstrated significant improvement in several empathic skills, as well as in clarifying skill. Our work demonstrates that implementation of a nurse communication skills training program at a major cancer center is feasible and acceptable and has a significant impact on participants' self-efficacy and uptake of communication skills.

Korean standard nuclear plant ex-vessel neutron dosimetry program Ulchin 4

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

Duo, J.I.; Chen, J.; Kulesza, J.A.

2011-07-01

A comprehensive ex-vessel neutron dosimetry (EVND) surveillance program has been deployed in 16 pressurized water reactors (PWR) in South Korea and EVND dosimetry sets have already been installed and analyzed in Westinghouse reactor designs. In this paper, the unique features of the design, training, and installation in the Korean standard nuclear plant (KSNP) Ulchin Unit 4 are presented. Ulchin Unit 4 Cycle 9 represents the first dosimetry analyzed from the EVND design deployed in KSNP plants: Yonggwang Units 3 through 6 and Ulchin Units 3 through 6. KSNP's cavity configuration precludes a conventional installation from the cavity floor. The solution,more » requiring the installation crew to access the cavity at an elevation of the active core, places a premium on rapid installation due to high area dose rates. Numerous geometrical features warranted the use of a detailed design in true 3D mechanical design software to control interferences. A full-size training mockup maximized the crew ability to correctly install the instrument in minimum time. The analysis of the first dosimetry set shows good agreements between measurement and calculation within the associated uncertainties. A complete EVND system has been successfully designed, installed, and analyzed for a KNSP plant. Current and future EVND analyses will continue supporting the successful operation of PWR units in South Korea. (authors)« less

Relevance Vector Machine and Support Vector Machine Classifier Analysis of Scanning Laser Polarimetry Retinal Nerve Fiber Layer Measurements

PubMed Central

Bowd, Christopher; Medeiros, Felipe A.; Zhang, Zuohua; Zangwill, Linda M.; Hao, Jiucang; Lee, Te-Won; Sejnowski, Terrence J.; Weinreb, Robert N.; Goldbaum, Michael H.

2010-01-01

Purpose To classify healthy and glaucomatous eyes using relevance vector machine (RVM) and support vector machine (SVM) learning classifiers trained on retinal nerve fiber layer (RNFL) thickness measurements obtained by scanning laser polarimetry (SLP). Methods Seventy-two eyes of 72 healthy control subjects (average age = 64.3 ± 8.8 years, visual field mean deviation =−0.71 ± 1.2 dB) and 92 eyes of 92 patients with glaucoma (average age = 66.9 ± 8.9 years, visual field mean deviation =−5.32 ± 4.0 dB) were imaged with SLP with variable corneal compensation (GDx VCC; Laser Diagnostic Technologies, San Diego, CA). RVM and SVM learning classifiers were trained and tested on SLP-determined RNFL thickness measurements from 14 standard parameters and 64 sectors (approximately 5.6° each) obtained in the circumpapillary area under the instrument-defined measurement ellipse (total 78 parameters). Tenfold cross-validation was used to train and test RVM and SVM classifiers on unique subsets of the full 164-eye data set and areas under the receiver operating characteristic (AUROC) curve for the classification of eyes in the test set were generated. AUROC curve results from RVM and SVM were compared to those for 14 SLP software-generated global and regional RNFL thickness parameters. Also reported was the AUROC curve for the GDx VCC software-generated nerve fiber indicator (NFI). Results The AUROC curves for RVM and SVM were 0.90 and 0.91, respectively, and increased to 0.93 and 0.94 when the training sets were optimized with sequential forward and backward selection (resulting in reduced dimensional data sets). AUROC curves for optimized RVM and SVM were significantly larger than those for all individual SLP parameters. The AUROC curve for the NFI was 0.87. Conclusions Results from RVM and SVM trained on SLP RNFL thickness measurements are similar and provide accurate classification of glaucomatous and healthy eyes. RVM may be preferable to SVM, because it provides a Bayesian-derived probability of glaucoma as an output. These results suggest that these machine learning classifiers show good potential for glaucoma diagnosis. PMID:15790898

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.

Abortion training in Canadian obstetrics and gynecology residency programs.

PubMed

Liauw, J; Dineley, B; Gerster, K; Hill, N; Costescu, D

2016-11-01

To evaluate the current state of abortion training in Canadian Obstetrics and Gynecology residency programs. Surveys were distributed to all Canadian Obstetrics and Gynecology residents and program directors. Data were collected on inclusion of abortion training in the curriculum, structure of the training and expected competency of residents in various abortion procedures. We distributed and collected surveys between November 2014 and May 2015. In total, 301 residents and 15 program directors responded, giving response rates of 55% and 94%, respectively. Based on responses by program directors, half of the programs had "opt-in" abortion training, and half of the programs had "opt-out" abortion training. Upon completion of residency, 66% of residents expected to be competent in providing first-trimester surgical abortion in an ambulatory setting, and 35% expected to be competent in second-trimester surgical abortion. Overall, 15% of residents reported that they were not aware of or did not have access to abortion training within their program, and 69% desired more abortion training during residency. Abortion training in Canadian Obstetrics and Gynecology residency programs is inconsistent, and residents desire more training in abortion. This suggests an ongoing unmet need for training in this area. Policies mandating standardized abortion training in obstetrics and gynecology residency programs are necessary to improve delivery of family planning services to Canadian women. Abortion training in Canadian Obstetrics and Gynecology residency programs is inconsistent, does not meet resident demand and is unlikely to fulfill the Royal College of Physicians and Surgeons of Canada objectives of training in the specialty. Copyright © 2016 Elsevier Inc. All rights reserved.

User-generated quality standards for youth mental health in primary care: a participatory research design using mixed methods

PubMed Central

Graham, Tanya; Rose, Diana; Murray, Joanna; Ashworth, Mark; Tylee, André

2014-01-01

Objectives To develop user-generated quality standards for young people with mental health problems in primary care using a participatory research model. Methods 50 young people aged 16–25 from community settings and primary care participated in focus groups and interviews about their views and experiences of seeking help for mental health problems in primary care, cofacilitated by young service users and repeated to ensure respondent validation. A second group of young people also aged 16–25 who had sought help for any mental health problem from primary care or secondary care within the last 5 years were trained as focus groups cofacilitators (n=12) developed the quality standards from the qualitative data and participated in four nominal groups (n=28). Results 46 quality standards were developed and ranked by young service users. Agreement was defined as 100% of scores within a two-point region. Group consensus existed for 16 quality standards representing the following aspects of primary care: better advertising and information (three); improved competence through mental health training and skill mix within the practice (two); alternatives to medication (three); improved referral protocol (three); and specific questions and reassurances (five). Alternatives to medication and specific questions and reassurances are aspects of quality which have not been previously reported. Conclusions We have demonstrated the feasibility of using participatory research methods in order to develop user-generated quality standards. The development of patient-generated quality standards may offer a more formal method of incorporating the views of service users into quality improvement initiatives. This method can be adapted for generating quality standards applicable to other patient groups. PMID:24920648

28 CFR 115.134 - Specialized training: Investigations.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 28 Judicial Administration 2 2014-07-01 2014-07-01 false Specialized training: Investigations. 115.134 Section 115.134 Judicial Administration DEPARTMENT OF JUSTICE (CONTINUED) PRISON RAPE ELIMINATION ACT NATIONAL STANDARDS Standards for Lockups Training and Education § 115.134 Specialized training...

28 CFR 115.134 - Specialized training: Investigations.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 28 Judicial Administration 2 2012-07-01 2012-07-01 false Specialized training: Investigations. 115.134 Section 115.134 Judicial Administration DEPARTMENT OF JUSTICE (CONTINUED) PRISON RAPE ELIMINATION ACT NATIONAL STANDARDS Standards for Lockups Training and Education § 115.134 Specialized training...

28 CFR 115.134 - Specialized training: Investigations.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 28 Judicial Administration 2 2013-07-01 2013-07-01 false Specialized training: Investigations. 115.134 Section 115.134 Judicial Administration DEPARTMENT OF JUSTICE (CONTINUED) PRISON RAPE ELIMINATION ACT NATIONAL STANDARDS Standards for Lockups Training and Education § 115.134 Specialized training...

Pilot study comparing changes in postural control after training using a video game balance board program and 2 standard activity-based balance intervention programs.

PubMed

Pluchino, Alessandra; Lee, Sae Yong; Asfour, Shihab; Roos, Bernard A; Signorile, Joseph F

2012-07-01

To compare the impacts of Tai Chi, a standard balance exercise program, and a video game balance board program on postural control and perceived falls risk. Randomized controlled trial. Research laboratory. Independent seniors (N=40; 72.5±8.40) began the training, 27 completed. Tai Chi, a standard balance exercise program, and a video game balance board program. The following were used as measures: Timed Up & Go, One-Leg Stance, functional reach, Tinetti Performance Oriented Mobility Assessment, force plate center of pressure (COP) and time to boundary, dynamic posturography (DP), Falls Risk for Older People-Community Setting, and Falls Efficacy Scale. No significant differences were seen between groups for any outcome measures at baseline, nor were significant time or group × time differences for any field test or questionnaire. No group × time differences were seen for any COP measures; however, significant time differences were seen for total COP, 3 of 4 anterior/posterior displacement and both velocity, and 1 displacement and 1 velocity medial/lateral measure across time for the entire sample. For DP, significant improvements in the overall score (dynamic movement analysis score), and in 2 of the 3 linear and angular measures were seen for the sample. The video game balance board program, which can be performed at home, was as effective as Tai Chi and the standard balance exercise program in improving postural control and balance dictated by the force plate postural sway and DP measures. This finding may have implications for exercise adherence because the at-home nature of the intervention eliminates many obstacles to exercise training. Copyright © 2012 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Aiming for a holistic integrated service for men diagnosed with prostate cancer - Definitions of standards and skill sets for nurses and allied healthcare professionals.

PubMed

Lamb, Alastair D; Thompson, Sue; Kinsella, Netty; Gerbitz, Ingmar; Chapman, Elaine; Putt, Lisa; Bennett, Sophie; Thankappannair, Vineetha; Geoghegan, Lisa; Wright, Naomi; Stirton-Croft, Alison; Nixon, Penny; Styling, Andrew; Whitney, Diane; Hodgson, Lindsay; Punt, Lisa; Longmore, Jenny; Carter, Mike; Petch, Bill; Rimmer, Yvonne; Russell, Simon; Hughes-Davies, Luke; Mazhar, Danish; Shah, Nimish C; Gnanapragasam, Vincent J; Doble, Andrew; Bratt, Ola; Kastner, Christof

2017-08-01

To establish a comprehensive set of recommendations for the service structure and skill set of nurses and allied healthcare professionals in prostate cancer care. Using components of formal consensus methodology, a 30-member multidisciplinary panel produced 53 items for discussion relating to the provision of care for prostate cancer patients by specialist nurses and allied healthcare professionals. Items were developed by two rounds of email correspondence in which, first, items were generated and, second, items refined to form the basis of a consensus meeting which constituted the third round of review. The fourth and final round was an email review of the consensus output. The panel agreed on 33 items that were appropriate for recommendations to be made. These items were grouped under categories of "Environment" and "Patient Pathway" and included comments on training, leadership, communication and quality assessment as well as specific items related to prostate diagnosis clinics, radical treatment clinics and follow-up survivor groups. Specialist nurses and allied healthcare professionals play a vital role alongside urologists and oncologists to provide care to men with prostate cancer and their families. We present a set of standards and consensus recommendations for the roles and skill-set required for these practitioners to provide gold-standard prostate cancer care. These recommendations could form the basis for development of comprehensive integrated prostate cancer pathways in prostate cancer centres as well as providing guidance for any units treating men with prostate cancer. Copyright © 2017. Published by Elsevier Ltd.

A Random Forest-based ensemble method for activity recognition.

PubMed

Feng, Zengtao; Mo, Lingfei; Li, Meng

2015-01-01

This paper presents a multi-sensor ensemble approach to human physical activity (PA) recognition, using random forest. We designed an ensemble learning algorithm, which integrates several independent Random Forest classifiers based on different sensor feature sets to build a more stable, more accurate and faster classifier for human activity recognition. To evaluate the algorithm, PA data collected from the PAMAP (Physical Activity Monitoring for Aging People), which is a standard, publicly available database, was utilized to train and test. The experimental results show that the algorithm is able to correctly recognize 19 PA types with an accuracy of 93.44%, while the training is faster than others. The ensemble classifier system based on the RF (Random Forest) algorithm can achieve high recognition accuracy and fast calculation.

AVETMISS: The Standard for VET Financial Data. Release 1.7. Updated

ERIC Educational Resources Information Center

National Centre for Vocational Education Research (NCVER), 2009

2009-01-01

The Standard for Vocational Education and Training (VET) financial data offers a nationally consistent standard for the collection, reporting and analysis of the public vocational education and training system information throughout Australia. It forms part of the Australian Vocational Education and Training Management Information Statistical…

78 FR 24289 - Aviation Rulemaking Advisory Committee (ARAC) Airman Testing Standards and Training Working Group...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-04-24

... Rulemaking Advisory Committee (ARAC) Airman Testing Standards and Training Working Group (ATSTWG) AGENCY... FAA will post all comments it receives, without change, to http://www.regulations.gov , including any... several draft documents developed by the Airman Testing Standards and Training Working Group. The...

75 FR 54223 - Petition for Waiver of Compliance

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-03

... requirements of 49 CFR Part 232--Brake System Safety Standards for Freight and Other Non-Passenger Trains and Equipment; End-of Train Devices, CFR Part 229--Railroad Locomotive Safety Standards, and CFR Part 215--Railroad Freight Car Safety Standards. Specifically, UP seeks relief to permit trains received at the U.S...

Single- vs. Multiple-Set Strength Training in Women.

ERIC Educational Resources Information Center

Schlumberger, Andreas; Stec, Justyna; Schmidtbleicher, Dietmar

2001-01-01

Compared the effects of single- and multiple-set strength training in women with basic experience in resistance training. Both training groups had significant strength improvements in leg extension. In the seated bench press, only the three-set group showed a significant increase in maximal strength. There were higher strength gains overall in the…

Optimizing support vector machine learning for semi-arid vegetation mapping by using clustering analysis

NASA Astrophysics Data System (ADS)

Su, Lihong

In remote sensing communities, support vector machine (SVM) learning has recently received increasing attention. SVM learning usually requires large memory and enormous amounts of computation time on large training sets. According to SVM algorithms, the SVM classification decision function is fully determined by support vectors, which compose a subset of the training sets. In this regard, a solution to optimize SVM learning is to efficiently reduce training sets. In this paper, a data reduction method based on agglomerative hierarchical clustering is proposed to obtain smaller training sets for SVM learning. Using a multiple angle remote sensing dataset of a semi-arid region, the effectiveness of the proposed method is evaluated by classification experiments with a series of reduced training sets. The experiments show that there is no loss of SVM accuracy when the original training set is reduced to 34% using the proposed approach. Maximum likelihood classification (MLC) also is applied on the reduced training sets. The results show that MLC can also maintain the classification accuracy. This implies that the most informative data instances can be retained by this approach.

Handwritten word preprocessing for database adaptation

NASA Astrophysics Data System (ADS)

Oprean, Cristina; Likforman-Sulem, Laurence; Mokbel, Chafic

2013-01-01

Handwriting recognition systems are typically trained using publicly available databases, where data have been collected in controlled conditions (image resolution, paper background, noise level,...). Since this is not often the case in real-world scenarios, classification performance can be affected when novel data is presented to the word recognition system. To overcome this problem, we present in this paper a new approach called database adaptation. It consists of processing one set (training or test) in order to adapt it to the other set (test or training, respectively). Specifically, two kinds of preprocessing, namely stroke thickness normalization and pixel intensity normalization are considered. The advantage of such approach is that we can re-use the existing recognition system trained on controlled data. We conduct several experiments with the Rimes 2011 word database and with a real-world database. We adapt either the test set or the training set. Results show that training set adaptation achieves better results than test set adaptation, at the cost of a second training stage on the adapted data. Accuracy of data set adaptation is increased by 2% to 3% in absolute value over no adaptation.

Classification of pulmonary emphysema from chest CT scans using integral geometry descriptors

NASA Astrophysics Data System (ADS)

van Rikxoort, E. M.; Goldin, J. G.; Galperin-Aizenberg, M.; Brown, M. S.

2011-03-01

To gain insight into the underlying pathways of emphysema and monitor the effect of treatment, methods to quantify and phenotype the different types of emphysema from chest CT scans are of crucial importance. Current standard measures rely on density thresholds for individual voxels, which is influenced by inspiration level and does not take into account the spatial relationship between voxels. Measures based on texture analysis do take the interrelation between voxels into account and therefore might be useful for distinguishing different types of emphysema. In this study, we propose to use Minkowski functionals combined with rotation invariant Gaussian features to distinguish between healthy and emphysematous tissue and classify three different types of emphysema. Minkowski functionals characterize binary images in terms of geometry and topology. In 3D, four Minkowski functionals are defined. By varying the threshold and size of neighborhood around a voxel, a set of Minkowski functionals can be defined for each voxel. Ten chest CT scans with 1810 annotated regions were used to train the method. A set of 108 features was calculated for each training sample from which 10 features were selected to be most informative. A linear discriminant classifier was trained to classify each voxel in the lungs into a subtype of emphysema or normal lung. The method was applied to an independent test set of 30 chest CT scans with varying amounts and types of emphysema with 4347 annotated regions of interest. The method is shown to perform well, with an overall accuracy of 95%.

DeepSleepNet: A Model for Automatic Sleep Stage Scoring Based on Raw Single-Channel EEG.

PubMed

Supratak, Akara; Dong, Hao; Wu, Chao; Guo, Yike

2017-11-01

This paper proposes a deep learning model, named DeepSleepNet, for automatic sleep stage scoring based on raw single-channel EEG. Most of the existing methods rely on hand-engineered features, which require prior knowledge of sleep analysis. Only a few of them encode the temporal information, such as transition rules, which is important for identifying the next sleep stages, into the extracted features. In the proposed model, we utilize convolutional neural networks to extract time-invariant features, and bidirectional-long short-term memory to learn transition rules among sleep stages automatically from EEG epochs. We implement a two-step training algorithm to train our model efficiently. We evaluated our model using different single-channel EEGs (F4-EOG (left), Fpz-Cz, and Pz-Oz) from two public sleep data sets, that have different properties (e.g., sampling rate) and scoring standards (AASM and R&K). The results showed that our model achieved similar overall accuracy and macro F1-score (MASS: 86.2%-81.7, Sleep-EDF: 82.0%-76.9) compared with the state-of-the-art methods (MASS: 85.9%-80.5, Sleep-EDF: 78.9%-73.7) on both data sets. This demonstrated that, without changing the model architecture and the training algorithm, our model could automatically learn features for sleep stage scoring from different raw single-channel EEGs from different data sets without utilizing any hand-engineered features.

Auto Body and Collision Damage Repairer (Branch 1). Apprenticeship Training Standards = Reparateur de carrossiers et de dommages resultant d'une collision (categorie 1). Normes de formation en apprentissage.

ERIC Educational Resources Information Center

Ontario Ministry of Skills Development, Toronto.

This manual presents training standards for auto body and collision damage repairers (branch 1) and is intended to be used by apprentice/trainees, instructors, and companies in Ontario, Canada as a blueprint for training or as a prerequisite for accreditation/certification. The training standards identify skills required for this occupation and…

The feasibility of employing a home healthcare model for education and treatment of opioid overdose using a naloxone auto-injector in a private practice pain medicine clinic.

PubMed

Dragovich, Anthony; Brason, Fred; Beltran, Thomas; McCoart, Amy; Plunkett, Anthony R

2018-04-18

The purpose of this study was to determine if employing a home healthcare model for education and treatment of opioid overdose using Evzio® (Naloxone)* auto-injector in a private practice pain clinic. A prospective survey was used to determine the feasibility of integrating a naloxone auto-injector within the patient's home with a home care training model. Twenty moderate or high-risk patients were enrolled from our chronic pain clinic. Patients who were moderate or high risk completed an evaluation survey. The naloxone auto-injector was dispensed to all patients meeting criteria. The treating provider after prescribing the naloxone auto-injector then consulted home health per standard clinical practice. All patients had home health consulted to perform overdose identification and rescue training. A Cochran's Q test was conducted to examine differences in patient knowledge pre and post training. The post training test was done 2-4 weeks later. Forty subjects enrolled after meeting inclusion/exclusion criteria. Twenty withdrew because their insurance declined coverage for the naloxone auto-injector. Those completing home health showed a statistically significant difference in their ability to correctly identify the steps needed to effectively respond to an overdose p = 0.03 Discussion: Preliminary evidence would suggest training on overdose symptom recognition and proper use of prescription naloxone for treatment in the home setting by home health staff would prove more beneficial than the clinic setting, but feasibility was hindered by unaffordable costs related to insurance coverage limitations.

Area Determination of Diabetic Foot Ulcer Images Using a Cascaded Two-Stage SVM-Based Classification.

PubMed

Wang, Lei; Pedersen, Peder C; Agu, Emmanuel; Strong, Diane M; Tulu, Bengisu

2017-09-01

The standard chronic wound assessment method based on visual examination is potentially inaccurate and also represents a significant clinical workload. Hence, computer-based systems providing quantitative wound assessment may be valuable for accurately monitoring wound healing status, with the wound area the best suited for automated analysis. Here, we present a novel approach, using support vector machines (SVM) to determine the wound boundaries on foot ulcer images captured with an image capture box, which provides controlled lighting and range. After superpixel segmentation, a cascaded two-stage classifier operates as follows: in the first stage, a set of k binary SVM classifiers are trained and applied to different subsets of the entire training images dataset, and incorrectly classified instances are collected. In the second stage, another binary SVM classifier is trained on the incorrectly classified set. We extracted various color and texture descriptors from superpixels that are used as input for each stage in the classifier training. Specifically, color and bag-of-word representations of local dense scale invariant feature transformation features are descriptors for ruling out irrelevant regions, and color and wavelet-based features are descriptors for distinguishing healthy tissue from wound regions. Finally, the detected wound boundary is refined by applying the conditional random field method. We have implemented the wound classification on a Nexus 5 smartphone platform, except for training which was done offline. Results are compared with other classifiers and show that our approach provides high global performance rates (average sensitivity = 73.3%, specificity = 94.6%) and is sufficiently efficient for a smartphone-based image analysis.

Patients in palliative care-Development of a predictive model for anxiety using routine data.

PubMed

Hofmann, Sonja; Hess, Stephanie; Klein, Carsten; Lindena, Gabriele; Radbruch, Lukas; Ostgathe, Christoph

2017-01-01

Anxiety is one of the most common psychological symptoms in patients in a palliative care situation. This study aims to develop a predictive model for anxiety using data from the standard documentation routine. Data sets of palliative care patients collected by the German quality management benchmarking system called Hospice and Palliative Care Evaluation (HOPE) from 2007 to 2011 were randomly divided into a training set containing two-thirds of the data and a test set with the remaining one-third. We dichotomized anxiety levels, proxy rated by medical staff using the validated HOPE Symptom and Problem Checklist, into two groups with no or mild anxiety versus moderate or severe anxiety. Using the training set, a multivariable logistic regression model was developed by backward stepwise selection. Predictive accuracy was evaluated by the area under the receiver operating characteristic curve (AUC) based on the test set. An analysis of 9924 data sets suggests a predictive model for anxiety in patients receiving palliative care which contains gender, age, ECOG, living situation, pain, nausea, dyspnea, loss of appetite, tiredness, need for assistance with activities of daily living, problems with organization of care, medication with sedatives/anxiolytics, antidepressants, antihypertensive drugs, laxatives, and antibiotics. It results in a fair predictive value (AUC = 0.72). Routinely collected data providing individual-, disease- and therapy-related information contain valuable information that is useful for the prediction of anxiety risks in patients receiving palliative care. These findings could thus be advantageous for providing appropriate support for patients in palliative care settings and should receive special attention in future research.

Toward accelerating landslide mapping with interactive machine learning techniques

NASA Astrophysics Data System (ADS)

Stumpf, André; Lachiche, Nicolas; Malet, Jean-Philippe; Kerle, Norman; Puissant, Anne

2013-04-01

Despite important advances in the development of more automated methods for landslide mapping from optical remote sensing images, the elaboration of inventory maps after major triggering events still remains a tedious task. Image classification with expert defined rules typically still requires significant manual labour for the elaboration and adaption of rule sets for each particular case. Machine learning algorithm, on the contrary, have the ability to learn and identify complex image patterns from labelled examples but may require relatively large amounts of training data. In order to reduce the amount of required training data active learning has evolved as key concept to guide the sampling for applications such as document classification, genetics and remote sensing. The general underlying idea of most active learning approaches is to initialize a machine learning model with a small training set, and to subsequently exploit the model state and/or the data structure to iteratively select the most valuable samples that should be labelled by the user and added in the training set. With relatively few queries and labelled samples, an active learning strategy should ideally yield at least the same accuracy than an equivalent classifier trained with many randomly selected samples. Our study was dedicated to the development of an active learning approach for landslide mapping from VHR remote sensing images with special consideration of the spatial distribution of the samples. The developed approach is a region-based query heuristic that enables to guide the user attention towards few compact spatial batches rather than distributed points resulting in time savings of 50% and more compared to standard active learning techniques. The approach was tested with multi-temporal and multi-sensor satellite images capturing recent large scale triggering events in Brazil and China and demonstrated balanced user's and producer's accuracies between 74% and 80%. The assessment also included an experimental evaluation of the uncertainties of manual mappings from multiple experts and demonstrated strong relationships between the uncertainty of the experts and the machine learning model.

Developing children’s palliative care in Africa through beacon centres: lessons learnt

PubMed Central

2013-01-01

Much progress has been made in the provision of palliative care across sub-Saharan Africa, however much still remains to be done, particularly in the area of children’s palliative care (CPC). The Beacon Centres programme was set up in 2009, aimed at improving access to CPC in South Africa, Uganda and Tanzania through more and better-trained health professionals and CPC clinical services of a high standard. Having identified sites in each country to develop into CPC Beacon Centres, Navigators were identified who would be the ‘champions’ for CPC in those sites and lead a programme of training, mentorship and support. Five navigators (2 in Uganda and Tanzania and 1 in South Africa) were trained between September and December 2009. Following this they undertook CPC needs assessments at the 3 centres and set up and delivered a six-month CPC training programme, providing mentorship and support to students to enable them to integrate CPC into their workplaces. To date, 188 participants have commenced the six-month course, with 80 having completed it. CPC has been integrated into the activities of the centres and a CPC virtual resource centre set up in South Africa. The achievements from the Beacon project have been great and the work of the navigators immense, but as in all projects it has not been without its challenges. Lessons learnt include issues around: the focus of the project; the length and nature of the training; assessment; accreditation; the choice of navigators; mentoring; administrative support; co-ordination; the choice of project sites; and the integration of CPC into services. The need for CPC is not going to go away and it is therefore important that models of scaling-up are found that are not only practical, feasible, affordable and sustainable, but that focus on the outcome of improved CPC for all those who need it. It is hoped that the lessons shared from the Beacon Project will help in developing and implementing such models. PMID:23419095

A combination of routine blood analytes predicts fitness decrement in elderly endurance athletes.

PubMed

Haslacher, Helmuth; Ratzinger, Franz; Perkmann, Thomas; Batmyagmar, Delgerdalai; Nistler, Sonja; Scherzer, Thomas M; Ponocny-Seliger, Elisabeth; Pilger, Alexander; Gerner, Marlene; Scheichenberger, Vanessa; Kundi, Michael; Endler, Georg; Wagner, Oswald F; Winker, Robert

2017-01-01

Endurance sports are enjoying greater popularity, particularly among new target groups such as the elderly. Predictors of future physical capacities providing a basis for training adaptations are in high demand. We therefore aimed to estimate the future physical performance of elderly marathoners (runners/bicyclists) using a set of easily accessible standard laboratory parameters. To this end, 47 elderly marathon athletes underwent physical examinations including bicycle ergometry and a blood draw at baseline and after a three-year follow-up period. In order to compile a statistical model containing baseline laboratory results allowing prediction of follow-up ergometry performance, the cohort was subgrouped into a model training (n = 25) and a test sample (n = 22). The model containing significant predictors in univariate analysis (alanine aminotransferase, urea, folic acid, myeloperoxidase and total cholesterol) presented with high statistical significance and excellent goodness of fit (R2 = 0.789, ROC-AUC = 0.951±0.050) in the model training sample and was validated in the test sample (ROC-AUC = 0.786±0.098). Our results suggest that standard laboratory parameters could be particularly useful for predicting future physical capacity in elderly marathoners. It hence merits further research whether these conclusions can be translated to other disciplines or age groups.

A combination of routine blood analytes predicts fitness decrement in elderly endurance athletes

PubMed Central

Ratzinger, Franz; Perkmann, Thomas; Batmyagmar, Delgerdalai; Nistler, Sonja; Scherzer, Thomas M.; Ponocny-Seliger, Elisabeth; Pilger, Alexander; Gerner, Marlene; Scheichenberger, Vanessa; Kundi, Michael; Endler, Georg; Wagner, Oswald F.; Winker, Robert

2017-01-01

Endurance sports are enjoying greater popularity, particularly among new target groups such as the elderly. Predictors of future physical capacities providing a basis for training adaptations are in high demand. We therefore aimed to estimate the future physical performance of elderly marathoners (runners/bicyclists) using a set of easily accessible standard laboratory parameters. To this end, 47 elderly marathon athletes underwent physical examinations including bicycle ergometry and a blood draw at baseline and after a three-year follow-up period. In order to compile a statistical model containing baseline laboratory results allowing prediction of follow-up ergometry performance, the cohort was subgrouped into a model training (n = 25) and a test sample (n = 22). The model containing significant predictors in univariate analysis (alanine aminotransferase, urea, folic acid, myeloperoxidase and total cholesterol) presented with high statistical significance and excellent goodness of fit (R2 = 0.789, ROC-AUC = 0.951±0.050) in the model training sample and was validated in the test sample (ROC-AUC = 0.786±0.098). Our results suggest that standard laboratory parameters could be particularly useful for predicting future physical capacity in elderly marathoners. It hence merits further research whether these conclusions can be translated to other disciplines or age groups. PMID:28475643

A Canada-Bangladesh partnership for nurse education: case study.

PubMed

Berland, A; Richards, J; Lund, K D

2010-09-01

To describe the lessons learned from a partnership in nurse education between a Bangladesh university and a group of Canadian volunteers. In the host country, nursing enjoys low status and pay, which adversely affect professional standards. The paper describes implementation details of training a core of nurses to international standards, using limited resources. The first cohort received their Bachelor of Nursing degrees in 2009. The Bangladeshi partners benefit from access to up-to-date curriculum materials, current clinical expertise, and interaction with visiting faculty and students. The Canadian nursing instructors enjoy professional development opportunities; visiting Canadian students gain exposure to a practice setting in a low-income country. These include the importance of (1) integrating nurse training with a general university able to provide core courses (e.g. English as second language, computer training), (2) countering the low status of nursing and inculcating a caring attitude among students, and (3) instilling critical thinking as opposed to rote learning. Next, the following were identified: mechanisms to support networking in the local health system, sharing of resources (e.g. electronic course material adapted to host country context), and assuring programme quality. The paper will be of interest to those concerned with nurse education and human resource development in less developed countries.

"Doing the heavy lifting: health care workers take back their backs".

PubMed

Morse, Tim; Fekieta, Renee; Rubenstein, Harriet; Warren, Nick; Alexander, Darryl; Wawzyniecki, Patricia

2008-01-01

Health care workers have the highest musculoskeletal disorder prevalence and incidence of any occupational/industry group, and patient handling tasks are so biomechanically demanding that they cannot be made safe through the commonly used, technique-oriented methods such as "back school" training programs. Although there is standard-setting activity for "no-lift" programs in some states, there is still no federal standard. Health care worker unions and nurses' associations have begun to take action through training members in equipment need, use, and acceptance in programs to encourage adoption of no-lifting programs. Acceptance of lifting equipment is increasing due to recognition of the high human and economic costs of MSD, consistent documentation of cost savings from no-lift programs, major improvements in lifting equipment, and shortages of health care staff. An action-oriented training program for health care workers is described that provides knowledge about the 1) Scope of the current problem of back injuries in health care, 2) Costs of injuries, both to workers and to the hospital, 3) Elements of a safe patient-handling program, and 4) Success stories. The program also builds skills through: 1) Hands-on experience with safe lifting equipment, and 2) Assessing organizational and union readiness and planning for action at the workplace.

Thinking Outside of Outpatient: Underutilized Settings for Psychotherapy Education.

PubMed

Blumenshine, Philip; Lenet, Alison E; Havel, Lauren K; Arbuckle, Melissa R; Cabaniss, Deborah L

2017-02-01

Although psychiatry residents are expected to achieve competency in conducting psychotherapy during their training, it is unclear how psychotherapy teaching is integrated across diverse clinical settings. Between January and March 2015, 177 psychiatry residency training directors were sent a survey asking about psychotherapy training practices in their programs, as well as perceived barriers to psychotherapy teaching. Eighty-two training directors (44%) completed the survey. While 95% indicated that psychotherapy was a formal learning objective for outpatient clinic rotations, fifty percent or fewer noted psychotherapy was a learning objective in other settings. Most program directors would like to see psychotherapy training included (particularly supportive psychotherapy and cognitive behavioral therapy) on inpatient (82%) and consultation-liaison settings (57%). The most common barriers identified to teaching psychotherapy in these settings were time and perceived inadequate staff training and interest. Non-outpatient rotations appear to be an underutilized setting for psychotherapy teaching.

28 CFR 115.331 - Employee training.

Code of Federal Regulations, 2013 CFR

2013-07-01

... STANDARDS Standards for Juvenile Facilities Training and Education § 115.331 Employee training. (a) The... houses only female residents, or vice versa. (c) All current employees who have not received such...

28 CFR 115.231 - Employee training.

Code of Federal Regulations, 2013 CFR

2013-07-01

... STANDARDS Standards for Community Confinement Facilities Training and Education § 115.231 Employee training... reassigned from a facility that houses only male residents to a facility that houses only female residents...

28 CFR 115.231 - Employee training.

Code of Federal Regulations, 2014 CFR

2014-07-01

... STANDARDS Standards for Community Confinement Facilities Training and Education § 115.231 Employee training... reassigned from a facility that houses only male residents to a facility that houses only female residents...

28 CFR 115.231 - Employee training.

Code of Federal Regulations, 2012 CFR

2012-07-01

... STANDARDS Standards for Community Confinement Facilities Training and Education § 115.231 Employee training... reassigned from a facility that houses only male residents to a facility that houses only female residents...

28 CFR 115.331 - Employee training.

Code of Federal Regulations, 2012 CFR

2012-07-01

... STANDARDS Standards for Juvenile Facilities Training and Education § 115.331 Employee training. (a) The... houses only female residents, or vice versa. (c) All current employees who have not received such...

28 CFR 115.331 - Employee training.

Code of Federal Regulations, 2014 CFR

2014-07-01

... STANDARDS Standards for Juvenile Facilities Training and Education § 115.331 Employee training. (a) The... houses only female residents, or vice versa. (c) All current employees who have not received such...

Competencies for public health and interprofessional education in accreditation standards of complementary and alternative medicine disciplines.

PubMed

Brett, Jennifer; Brimhall, Joseph; Healey, Dale; Pfeifer, Joseph; Prenguber, Marcia

2013-01-01

This review examines the educational accreditation standards of four licensed complementary and alternative medicine (CAM) disciplines (naturopathic medicine, chiropractic health care, acupuncture and oriental medicine, and massage therapy), and identifies public health and other competencies found in those standards that contribute to cooperation and collaboration among the health care professions. These competencies may form a foundation for interprofessional education. The agencies that accredit the educational programs for each of these disciplines are individually recognized by the United States Department (Secretary) of Education. Patients and the public are served when healthcare practitioners collaborate and cooperate. This is facilitated when those practitioners possess competencies that provide them the knowledge and skills to work with practitioners from other fields and disciplines. Educational accreditation standards provide a framework for the delivery of these competencies. Requiring these competencies through accreditation standards ensures that practitioners are trained to optimally function in integrative clinical care settings. © 2013 Elsevier Inc. All rights reserved.

Establishing Fire Safety Skills Using Behavioral Skills Training

ERIC Educational Resources Information Center

Houvouras, Andrew J., IV; Harvey, Mark T.

2014-01-01

The use of behavioral skills training (BST) to educate 3 adolescent boys on the risks of lighters and fire setting was evaluated using in situ assessment in a school setting. Two participants had a history of fire setting. After training, all participants adhered to established rules: (a) avoid a deactivated lighter, (b) leave the training area,…

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

PubMed Central

Li, Xiaomeng; Yang, Zhuo

2017-01-01

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

Development of automatic body condition scoring using a low-cost 3-dimensional Kinect camera.

PubMed

Spoliansky, Roii; Edan, Yael; Parmet, Yisrael; Halachmi, Ilan

2016-09-01

Body condition scoring (BCS) is a farm-management tool for estimating dairy cows' energy reserves. Today, BCS is performed manually by experts. This paper presents a 3-dimensional algorithm that provides a topographical understanding of the cow's body to estimate BCS. An automatic BCS system consisting of a Kinect camera (Microsoft Corp., Redmond, WA) triggered by a passive infrared motion detector was designed and implemented. Image processing and regression algorithms were developed and included the following steps: (1) image restoration, the removal of noise; (2) object recognition and separation, identification and separation of the cows; (3) movie and image selection, selection of movies and frames that include the relevant data; (4) image rotation, alignment of the cow parallel to the x-axis; and (5) image cropping and normalization, removal of irrelevant data, setting the image size to 150×200 pixels, and normalizing image values. All steps were performed automatically, including image selection and classification. Fourteen individual features per cow, derived from the cows' topography, were automatically extracted from the movies and from the farm's herd-management records. These features appear to be measurable in a commercial farm. Manual BCS was performed by a trained expert and compared with the output of the training set. A regression model was developed, correlating the features with the manual BCS references. Data were acquired for 4 d, resulting in a database of 422 movies of 101 cows. Movies containing cows' back ends were automatically selected (389 movies). The data were divided into a training set of 81 cows and a test set of 20 cows; both sets included the identical full range of BCS classes. Accuracy tests gave a mean absolute error of 0.26, median absolute error of 0.19, and coefficient of determination of 0.75, with 100% correct classification within 1 step and 91% correct classification within a half step for BCS classes. Results indicated good repeatability, with all standard deviations under 0.33. The algorithm is independent of the background and requires 10 cows for training with approximately 30 movies of 4 s each. Copyright © 2016 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.