Eight weeks of a combination of high intensity interval training and conventional training reduce visceral adiposity and improve physical fitness: a group-based intervention.

PubMed

Giannaki, Christoforos D; Aphamis, George; Sakkis, Panikos; Hadjicharalambous, Marios

2016-04-01

High intensity interval training (HIIT) has been recently promoted as an effective, low volume and time-efficient training method for improving fitness and health related parameters. The aim of the current study was to examine the effect of a combination of a group-based HIIT and conventional gym training on physical fitness and body composition parameters in healthy adults. Thirty nine healthy adults volunteered to participate in this eight-week intervention study. Twenty three participants performed regular gym training 4 days a week (C group), whereas the remaining 16 participants engaged twice a week in HIIT and twice in regular gym training (HIIT-C group) as the other group. Total body fat and visceral adiposity levels were calculated using bioelectrical impedance analysis. Physical fitness parameters such as cardiorespiratory fitness, speed, lower limb explosiveness, flexibility and isometric arm strength were assessed through a battery of field tests. Both exercise programs were effective in reducing total body fat and visceral adiposity (P<0.05) and improving handgrip strength, sprint time, jumping ability and flexibility (P<0.05) whilst only the combination of HIIT and conventional training improved cardiorespiratory fitness levels (P<0.05). A between of group changes analysis revealed that HIIT-C resulted in significantly greater reduction in both abdominal girth and visceral adiposity compared with conventional training (P<0.05). Eight weeks of combined group-based HIIT and conventional training improve various physical fitness parameters and reduce both total and visceral fat levels. This type of training was also found to be superior compared with conventional exercise training alone in terms of reducing more visceral adiposity levels. Group-based HIIT may consider as a good methods for individuals who exercise in gyms and craving to acquire significant fitness benefits in relatively short period of time.

Effective and efficient learning in the operating theater with intraoperative video-enhanced surgical procedure training.

PubMed

van Det, M J; Meijerink, W J H J; Hoff, C; Middel, B; Pierie, J P E N

2013-08-01

INtraoperative Video Enhanced Surgical procedure Training (INVEST) is a new training method designed to improve the transition from basic skills training in a skills lab to procedural training in the operating theater. Traditionally, the master-apprentice model (MAM) is used for procedural training in the operating theater, but this model lacks uniformity and efficiency at the beginning of the learning curve. This study was designed to investigate the effectiveness and efficiency of INVEST compared to MAM. Ten surgical residents with no laparoscopic experience were recruited for a laparoscopic cholecystectomy training curriculum either by the MAM or with INVEST. After a uniform course in basic laparoscopic skills, each trainee performed six cholecystectomies that were digitally recorded. For 14 steps of the procedure, an observer who was blinded for the type of training determined whether the step was performed entirely by the trainee (2 points), partially by the trainee (1 point), or by the supervisor (0 points). Time measurements revealed the total procedure time and the amount of effective procedure time during which the trainee acted as the operating surgeon. Results were compared between both groups. Trainees in the INVEST group were awarded statistically significant more points (115.8 vs. 70.2; p < 0.001) and performed more steps without the interference of the supervisor (46.6 vs. 18.8; p < 0.001). Total procedure time was not lengthened by INVEST, and the part performed by trainees was significantly larger (69.9 vs. 54.1 %; p = 0.004). INVEST enhances effectiveness and training efficiency for procedural training inside the operating theater without compromising operating theater time efficiency.

Comparing procedures on the acquisition and generalization of tacts for children with autism spectrum disorder.

PubMed

Schnell, Lauren K; Vladescu, Jason C; Kodak, Tiffany; Nottingham, Casey L

2018-06-17

Generalization is a critical outcome for individuals with autism spectrum disorder (ASD) who display new skills in a limited range of contexts. In the absence of proper planning, generalization may not be observed. The purpose of the current study was to directly compare serial to concurrent multiple exemplar training using total training time per exemplar, mean total training time, and exposures to mastery across three children diagnosed with ASD. Additionally, we assessed the efficiency of presenting secondary targets in the antecedent and consequence portions of learning trials and evaluated generalization to tacts not associated with direct teaching. Results suggested that all training conditions produced acquisition and generalization for trained and untrained exemplars. However, the serial multiple exemplar training condition was more efficient for two participants, whereas the instructive feedback condition was the most efficient for the third. Findings are discussed considering previous studies and areas for future research. © 2018 Society for the Experimental Analysis of Behavior.

Feasibility of robotic exoskeleton ambulation in a C4 person with incomplete spinal cord injury: a case report.

PubMed

Lester, Robert M; Gorgey, Ashraf S

2018-01-01

To determine whether an individual with C4 incomplete spinal cord injury (SCI) with limited hand functions can effectively operate a powered exoskeleton (Ekso) to improve parameters of physical activity as determined by swing-time, up-time, walk-time, and total number of steps. A 21-year-old male with incomplete chronic (>1 year postinjury) SCI C4, participated in a clinical exoskeleton program to determine the feasibility of standing up and walking with limited hand functions. The participant was invited to attend 3 sessions including fitting, familiarization and gait training separated by one week intervals. Walk-time, up-time and total number of steps were measured during each training session. A complete body composition assessment using dual-energy X-ray absorptiometry (DXA) of the spine, knees and hips was conducted before training.Using a platform walker and cuffing both hands, the participant managed to stand up and ambulate successfully using exoskeleton. Over the course of 2 weeks, maximum walk-time increased from 7 to 17 min and number of steps increased from 83 to 589 steps. The total up-time increased from 19 to 31 min. Exoskeleton training may be a safe and feasible approach for persons with higher levels of SCI after effectively providing a supportive assistive device for weight shifting. The current case study demonstrates the use of a powered exoskeleton for an individual with high level tetraplegia (C4 and above) and limited hand functions.

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

DTIC Science & Technology

1990-12-12

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

Effects of interactive metronome training on upper extremity function, ADL and QOL in stroke patients.

PubMed

Yu, Ga-Hui; Lee, Jae-Shin; Kim, Su-Kyoung; Cha, Tae-Hyun

2017-01-01

Rhythm and timing training is stimulation that substitutes for a damaged function controls muscular movement or temporal element, which has positive impacts on the neurological aspect and movement of the brain. This study is to assess the changes caused by rhythm and timing training using an interactive metronome (IM) on upper extremity function, ADL and QOL in stroke patients. In order to assess the effects of IM training, a group experiment was conducted on 30 stroke patients. Twelve sessions of IM training were provided for the experimental group three times a week for four weeks, while the control group was trained with a Bilateral arm Self-Exercise (BSE) for the same period. Both groups were evaluated by pre- and post-tests through MFT, MAL, K-MBI and SS-QOL. There were more statistically significant differences (<0.05) in the total score of MFT and the finger control item in the IM Group than in the BSE Group. With respect to ADL, there were more statistically significant differences (<0.05) in the total score of K-MBI and the dressing item in the IM Group than in the BSE Group. The study proposes that IM training can be applied as an occupational therapy program in patients with various diseases who need to adjust the time for performing movements as well as stroke patients.

78 FR 20109 - Agency Forms Undergoing Paperwork Reduction Act Review

Federal Register 2010, 2011, 2012, 2013, 2014

2013-04-03

...Meeting (i.e., webinar) training session conducted by CDC staff. We estimate the burden of this training to be a maximum of 2 hours. Respondents will only have to take this training one time. Assuming a maximum number of outbreaks of 1,400, the estimated burden for this training is 2,800 hours. The total...

A Job Corps Study of Relative Cost Benefits, Volume I and II.

ERIC Educational Resources Information Center

Software Systems, Inc., Washington, DC.

This study was undertaken to relate Job Corps training outcomes to the costs of training, in terms of human talent, time, and material resources. Training outcomes or benefits were classified according to Job Corps objectives, then compared to total costs incurred by both training center and enrollee. Empirical validation and other evaluation of…

44 CFR 360.2 - Description of program.

Code of Federal Regulations, 2013 CFR

2013-10-01

... application, to be accompanied by a Training and Education (T&E) plan for a total of three years, only the... three year comprehensive Training and Education Program planning can proceed in a timely and logical... HOMELAND SECURITY PREPAREDNESS STATE ASSISTANCE PROGRAMS FOR TRAINING AND EDUCATION IN COMPREHENSIVE...

44 CFR 360.2 - Description of program.

Code of Federal Regulations, 2012 CFR

2012-10-01

... application, to be accompanied by a Training and Education (T&E) plan for a total of three years, only the... three year comprehensive Training and Education Program planning can proceed in a timely and logical... HOMELAND SECURITY PREPAREDNESS STATE ASSISTANCE PROGRAMS FOR TRAINING AND EDUCATION IN COMPREHENSIVE...

44 CFR 360.2 - Description of program.

Code of Federal Regulations, 2010 CFR

2010-10-01

... application, to be accompanied by a Training and Education (T&E) plan for a total of three years, only the... three year comprehensive Training and Education Program planning can proceed in a timely and logical... HOMELAND SECURITY PREPAREDNESS STATE ASSISTANCE PROGRAMS FOR TRAINING AND EDUCATION IN COMPREHENSIVE...

44 CFR 360.2 - Description of program.

Code of Federal Regulations, 2011 CFR

2011-10-01

... application, to be accompanied by a Training and Education (T&E) plan for a total of three years, only the... three year comprehensive Training and Education Program planning can proceed in a timely and logical... HOMELAND SECURITY PREPAREDNESS STATE ASSISTANCE PROGRAMS FOR TRAINING AND EDUCATION IN COMPREHENSIVE...

44 CFR 360.2 - Description of program.

Code of Federal Regulations, 2014 CFR

2014-10-01

... application, to be accompanied by a Training and Education (T&E) plan for a total of three years, only the... three year comprehensive Training and Education Program planning can proceed in a timely and logical... HOMELAND SECURITY PREPAREDNESS STATE ASSISTANCE PROGRAMS FOR TRAINING AND EDUCATION IN COMPREHENSIVE...

Bronchoscopy Simulation Training as a Tool in Medical School Education.

PubMed

Gopal, Mallika; Skobodzinski, Alexus A; Sterbling, Helene M; Rao, Sowmya R; LaChapelle, Christopher; Suzuki, Kei; Litle, Virginia R

2018-07-01

Procedural simulation training is rare at the medical school level and little is known about its usefulness in improving anatomic understanding and procedural confidence in students. Our aim is to assess the impact of bronchoscopy simulation training on bronchial anatomy knowledge and technical skills in medical students. Medical students were recruited by email, consented, and asked to fill out a survey regarding their baseline experience. Two thoracic surgeons measured their knowledge of bronchoscopy on a virtual reality bronchoscopy simulator using the Bronchoscopy Skills and Tasks Assessment Tool (BSTAT), a validated 65-point checklist (46 for anatomy, 19 for simulation). Students performed four self-directed training sessions of 15 minutes per week. A posttraining survey and BSTAT were completed afterward. Differences between pretraining and posttraining scores were analyzed with paired Student's t tests and random intercept linear regression models accounting for baseline BSTAT score, total training time, and training year. The study was completed by 47 medical students with a mean training time of 81.5 ± 26.8 minutes. Mean total BSTAT score increased significantly from 12.3 ± 5.9 to 48.0 ± 12.9 (p < 0.0001); mean scores for bronchial anatomy increased from 0.1 ± 0.9 to 31.1 ± 12.3 (p < 0.0001); and bronchoscopy navigational skills increased from 12.1 ± 5.7 to 17.4 ± 2.5 (p < 0.0001). Total training time and frequency of training did not have a significant impact on level of improvement. Self-driven bronchoscopy simulation training in medical students led to improvements in bronchial anatomy knowledge and bronchoscopy skills. Further investigation is under way to determine the impact of bronchoscopy simulation training on future specialty interest and long-term skills retention. Copyright © 2018 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

Injury rates and injury risk factors among federal bureau of investigation new agent trainees

PubMed Central

2011-01-01

Background A one-year prospective examination of injury rates and injury risk factors was conducted in Federal Bureau of Investigation (FBI) new agent training. Methods Injury incidents were obtained from medical records and injury compensation forms. Potential injury risk factors were acquired from a lifestyle questionnaire and existing data at the FBI Academy. Results A total of 426 men and 105 women participated in the project. Thirty-five percent of men and 42% of women experienced one or more injuries during training. The injury incidence rate was 2.5 and 3.2 injuries/1,000 person-days for men and women, respectively (risk ratio (women/men) = 1.3, 95% confidence interval = 0.9-1.7). The activities most commonly associated with injuries (% of total) were defensive tactics training (58%), physical fitness training (20%), physical fitness testing (5%), and firearms training (3%). Among the men, higher injury risk was associated with older age, slower 300-meter sprint time, slower 1.5-mile run time, lower total points on the physical fitness test (PFT), lower self-rated physical activity, lower frequency of aerobic exercise, a prior upper or lower limb injury, and prior foot or knee pain that limited activity. Among the women higher injury risk was associated with slower 300-meter sprint time, slower 1.5-mile run time, lower total points on the PFT, and prior back pain that limited activity. Conclusion The results of this investigation supported those of a previous retrospective investigation emphasizing that lower fitness and self-reported pain limiting activity were associated with higher injury risk among FBI new agents. PMID:22166096

Personal Best Time, Percent Body Fat, and Training Are Differently Associated with Race Time for Male and Female Ironman Triathletes

ERIC Educational Resources Information Center

Knechtle, Beat; Wirth, Andrea; Baumann, Barbara; Knechtle, Patrizia; Rosemann, Thomas

2010-01-01

We studied male and female nonprofessional Ironman triathletes to determine whether percent body fat, training, and/or previous race experience were associated with race performance. We used simple linear regression analysis, with total race time as the dependent variable, to investigate the relationship among athletes' percent body fat, average…

Training-Load Distribution in Endurance Runners: Objective Versus Subjective Assessment.

PubMed

Manzi, Vincenzo; Bovenzi, Antonio; Castagna, Carlo; Sinibaldi Salimei, Paola; Volterrani, Maurizio; Iellamo, Ferdinando

2015-11-01

To assess the distribution of exercise intensity in long-distance recreational athletes (LDRs) preparing for a marathon and to test the hypothesis that individual perception of effort could provide training responses similar to those provided by standardized training methodologies. Seven LDRs (age 36.5 ± 3.8 y) were followed during a 5-mo training period culminating with a city marathon. Heart rate at 2.0 and 4.0 mmol/L and maximal heart rate were used to establish 3 intensity training zones. Internal training load (TL) was assessed by training zones and TRIMPi methods. These were compared with the session-rating-of-perceived-exertion (RPE) method. Total time spent in zone 1 was higher than in zones 2 and 3 (76.3% ± 6.4%, 17.3% ± 5.8%, and 6.3% ± 0.9%, respectively; P = .000 for both, ES = 0.98, ES = 0.99). TL quantified by session-RPE provided the same result. The comparison between session-RPE and training-zones-based methods showed no significant difference at the lowest intensity (P = .07, ES = 0.25). A significant correlation was observed between TL RPE and TL TRIMPi at both individual and group levels (r = .79, P < .001). There was a significant correlation between total time spent in zone 1 and the improvement at the running speed of 2 mmol/L (r = .88, P < .001). A negative correlation was found between running speed at 2 mmol/L and the time needed to complete the marathon (r = -.83, P < .001). These findings suggest that in recreational LDRs most of the training time is spent at low intensity and that this is associated with improved performances. Session-RPE is an easy-to-use training method that provides responses similar to those obtained with standardized training methodologies.

Lost opportunity cost of surgical training in the Australian private sector.

PubMed

Aitken, R James

2012-03-01

To meet Australia's future demands, surgical training in the private sector will be required. The aim of this study was to estimate the time and lost opportunity cost of training in the private sector. A literature search identified studies that compared the operation time required by a supervised trainee with a consultant. This time was costed using a business model. In 22 studies (34 operations), the median operation duration of a supervised trainee was 34% longer than the consultant. To complete a private training list in the same time as a consultant list, one major case would have to be dropped. A consultant's average lost opportunity cost was $1186 per list ($106,698 per year). Training in rooms and administration requirements increased this to $155,618 per year. To train 400 trainees in the private sector to college standards would require 54,000 training lists per year. The consultants' national lost opportunity cost would be $137 million per year. The average lost hospital case payment was $5894 per list, or $330 million per year nationally. The total lost opportunity cost of surgical training in the private sector would be about $467 million per year. When trainee salaries, other specialties and indirect expenses are included, the total cost will be substantially greater. It is unlikely that surgeons or hospitals will be prepared to absorb these costs. There needs to be a public debate about the funding implications of surgical training in the private sector. © 2012 The Author. ANZ Journal of Surgery © 2012 Royal Australasian College of Surgeons.

Personal best time and training volume, not anthropometry, is related to race performance in the 'Swiss Bike Masters' mountain bike ultramarathon.

PubMed

Knechtle, Beat; Knechtle, Patrizia; Rosemann, Thomas; Senn, Oliver

2011-05-01

We investigated in 73 male ultraendurance mountain bikers, with (mean and SD) age 39.1 (8.6) years, weight 74.4 (8.3) kg, height 1.78 (0.07) m, and a body mass index of 23.3 (1.9) kg·m⁻², whether variables of anthropometry, training, or prerace experience were associated with race time using bi and multivariate analysis. Our investigation was conducted at the "Swiss Bike Masters," which covers a distance of 120 km and an altitude of 5,000 m. In the bivariate analysis, body mass index (r = 0.29), circumference of upper arm (r = 0.28), sum of upper body skinfolds (r = 0.38), sum of lower body skinfolds (r = 0.25), sum of 8 skinfolds (r = 0.36), percent body fat (r = 0.41), total cycling kilometers per year (r = -0.47), yearly volume in both mountain bike (r = -0.33) and road cycling (r = -0.52), number of training units per week (r = -0.48), distance per unit in road cycling (r = -0.33), average speed during training in road cycling (r = -0.33), and personal best time in the "Swiss Bike Masters"(r = 0.67) were related to race time. In the multiple linear regression analysis, personal best time in the "Swiss Bike Masters" (p = 0.000), total yearly cycling kilometers (p = 0.004), and yearly training kilometers in road cycling (p = 0.017) were related to race time. When the personal best time was the dependent variable in a separate regression model, total yearly cycling kilometers (p = 0.002) remained the single predictor variable. We concluded that finishing a particular mountain bike ultramarathon does not seem to require a special anthropometry but rather a specific skill and experience for this selective kind of race coupled with a high training volume. For practical use, we concluded that successful athletes in a mountain bike ultramarathon, in a special environment and using sophisticated equipment, need prerace experience coupled with high training volume, rather than any special anthropometry.

Criterion-based laparoscopic training reduces total training time.

PubMed

Brinkman, Willem M; Buzink, Sonja N; Alevizos, Leonidas; de Hingh, Ignace H J T; Jakimowicz, Jack J

2012-04-01

The benefits of criterion-based laparoscopic training over time-oriented training are unclear. The purpose of this study is to compare these types of training based on training outcome and time efficiency. During four training sessions within 1 week (one session per day) 34 medical interns (no laparoscopic experience) practiced on two basic tasks on the Simbionix LAP Mentor virtual-reality (VR) simulator: 'clipping and grasping' and 'cutting'. Group C (criterion-based) (N = 17) trained to reach predefined criteria and stopped training in each session when these criteria were met, with a maximum training time of 1 h. Group T (time-based) (N = 17) trained for a fixed time of 1 h each session. Retention of skills was assessed 1 week after training. In addition, transferability of skills was established using the Haptica ProMIS augmented-reality simulator. Both groups improved their performance significantly over the course of the training sessions (Wilcoxon signed ranks, P < 0.05). Both groups showed skill transferability and skill retention. When comparing the performance parameters of group C and group T, their performances in the first, the last and the retention training sessions did not differ significantly (Mann-Whitney U test, P > 0.05). The average number of repetitions needed to meet the criteria also did not differ between the groups. Overall, group C spent less time training on the simulator than did group T (74:48 and 120:10 min, respectively; P < 0.001). Group C performed significantly fewer repetitions of each task, overall and in session 2, 3 and 4. Criterion-based training of basic laparoscopic skills can reduce the overall training time with no impact on training outcome, transferability or retention of skills. Criterion-based should be the training of choice in laparoscopic skills curricula.

Comparison of Cardiopulmonary Resuscitation Quality Between Standard Versus Telephone-Basic Life Support Training Program in Middle-Aged and Elderly Housewives: A Randomized Simulation Study.

PubMed

Kim, Tae Han; Lee, Yu Jin; Lee, Eui Jung; Ro, Young Sun; Lee, KyungWon; Lee, Hyeona; Jang, Dayea Beatrice; Song, Kyoung Jun; Shin, Sang Do; Myklebust, Helge; Birkenes, Tonje Søraas

2018-02-01

For cardiac arrests witnessed at home, the witness is usually a middle-aged or older housewife. We compared the quality of cardiopulmonary resuscitation (CPR) performance of bystanders trained with the newly developed telephone-basic life support (T-BLS) program and those trained with standard BLS (S-BLS) training programs. Twenty-four middle-aged and older housewives without previous CPR education were enrolled and randomized into two groups of BLS training programs. The T-BLS training program included concepts and current instruction protocols for telephone-assisted CPR, whereas the S-BLS training program provided training for BLS. After each training course, the participants simulated CPR and were assisted by a dispatcher via telephone. Cardiopulmonary resuscitation quality was measured and recorded using a mannequin simulator. The primary outcome was total no-flow time (>1.5 seconds without chest compression) during simulation. Among 24 participants, two (8.3%) who experienced mechanical failure of simulation mannequin and one (4.2%) who violated simulation protocols were excluded at initial simulation, and two (8.3%) refused follow-up after 6 months. The median (interquartile range) total no-flow time during initial simulation was 79.6 (66.4-96.9) seconds for the T-BLS training group and 147.6 (122.5-184.0) seconds for the S-BLS training group (P < 0.01). Median cumulative interruption time and median number of interruption events during BLS at initial simulation and 6-month follow-up simulation were significantly shorter in the T-BLS than in the S-BLS group (1.0 vs. 9.5, P < 0.01, and 1.0 vs. 10.5, P = 0.02, respectively). Participants trained with the T-BLS training program showed shorter no-flow time and fewer interruptions during bystander CPR simulation assisted by a dispatcher.

Within-Season Distribution of External Training and Racing Workload in Professional Male Road Cyclists.

PubMed

Metcalfe, Alan J; Menaspà, Paolo; Villerius, Vincent; Quod, Marc; Peiffer, Jeremiah J; Govus, Andrew D; Abbiss, Chris R

2017-04-01

To describe the within-season external workloads of professional male road cyclists for optimal training prescription. Training and racing of 4 international competitive professional male cyclists (age 24 ± 2 y, body mass 77.6 ± 1.5 kg) were monitored for 12 mo before the world team-time-trial championships. Three within-season phases leading up to the team-time-trial world championships on September 20, 2015, were defined as phase 1 (Oct-Jan), phase 2 (Feb-May), and phase 3 (June-Sept). Distance and time were compared between training and racing days and over each of the various phases. Times spent in absolute (<100, 100-300, 400-500, >500 W) and relative (0-1.9, 2.0-4.9, 5.0-7.9, >8 W/kg) power zones were also compared for the whole season and between phases 1-3. Total distance (3859 ± 959 vs 10911 ± 620 km) and time (240.5 ± 37.5 vs 337.5 ± 26 h) were lower (P < .01) in phase 1 than phase 2. Total distance decreased (P < .01) from phase 2 to phase 3 (10911 ± 620 vs 8411 ± 1399 km, respectively). Mean absolute (236 ± 12.1 vs 197 ± 3 W) and relative (3.1 ± 0 vs 2.5 ± 0 W/kg) power output were higher (P < .05) during racing than training, respectively. Volume and intensity differed between training and racing over each of 3 distinct within-season phases.

Effect of concurrent training on risk factors and hepatic steatosis in obese adolescents

PubMed Central

Antunes, Barbara de Moura M.; Monteiro, Paula Alves; Silveira, Loreana Sanches; Cayres, Suziane Ungari; da Silva, Camila Buonani; F., Ismael Forte

2013-01-01

OBJECTIVE To analyze the effects of a 20-week concurrent training on the variables of body composition, lipid profile, and fatty liver diagnosis in obese adolescents. METHODS An open clinical trial was carried out with 34 obese adolescents aged between 12 and 15 years. Total body fat, trunk fat mass, total cholesterol and its fractions (HDL, LDL and VLDL), and triglycerides were analyzed; an upper abdominal ultrasound was performed in order to diagnose fatty liver. The participants underwent concurrent training (association of weight training with aerobic training) three times per week, lasting one hour for 20 weeks. Statistical analysis included paired Studentâ€(tm)s t-test and frequency analysis in order to verify the relative and absolute reductions of fatty liver diagnosis, being significant p<0.05. RESULTS The studied adolescents showed statistically significant improvement in body composition, with a decrease of total body fat percentage, total fat mass, trunk fat, and an a increase in the lean body mass. They also presented reduced size of liver lobes, decrease in total cholesterol and in LDL-cholesterol, with a lower prevalence of fatty liver. CONCLUSIONS The concurrent training was effective for promoting significant improvements in body fat composition and lipid profile variables, besides reducing fatty liver prevalence rate. PMID:24142321

Proficiency of virtual reality simulator training in flexible retrograde ureteroscopy renal stone management.

PubMed

Cai, Jian-liang; Zhang, Yi; Sun, Guo-feng; Li, Ning-chen; Yuan, Xue-li; Na, Yan-qun

2013-10-01

Minimally invasive flexible ureteroscopy techniques have widely adopted in the management of patients with renal stones. We performed this study to investigate the value of virtual reality simulator training in retrograde flexible ureteroscopy renal stone treatment for catechumen. Thirty catechumen, included 17 attending physicians and 13 associate chief physicians, were selected for study. The trainees first underwent 1-hour basic training to get familiar with the instrument and basic procedures, then followed by 4-hour practice on virtual reality simulators. Before and after the 4-hour training, all trainees undertake an assessment with task 7 program (right low pole calyces stone management). We documented for each trainee the total time of procedure, time of progressing from the orifice to stone, stone translocation and fragmentation time, laser operate proficiency scale, total laser energy, maximal size of residual stone fragments, number of trauma from the scopes and tools, damage to the scope and global rating scale (GRS). The proficiency of this training program was analyzed by the comparison of the first and second assessment outcomes. Significant improvement was observed in retrograde flexible ureteroscopy management of renal stone on virtual reality simulators after finishing the 4 hour special-purpose training. This was demonstrated by improvement in total procedure time ((18.37±2.59) minutes vs. (38.67±1.94) minutes), progressing time from the orifice to stone ((4.00±1.08) minutes vs. (13.80±2.01) minutes), time of stone translocation ((1.80±0.71) minutes vs. (6.57±1.01) minutes), fragmentation time ((4.43±1.25) minutes vs. (13.53±1.46) minutes), laser operate proficiency scale (8.47±0.73 vs. 3.77±0.77), total laser energy ((3231.6±401.4) W vs. (5329.8±448.9) W), maximal size of residual stone fragments ((2.66±0.39) mm vs. (5.77±0.63) mm), number of trauma from the scopes and tools (3.27±1.01 vs. 10.37±3.02), damage to the scope (0 vs. 0.97±0.76) and GRS (29.27±2.95 vs. 9.87±2.21). The differences between the first and the second assessment were all statistically significant (all P < 0.01). The virtual reality simulator training program can help the trainees to rapidly improve their retrograde flexible ureteroscopy skill in renal stone treatment.

Virtual Reality Simulation as a Tool to Monitor Surgical Performance Indicators: VIRESI Observational Study.

PubMed

Muralha, Nuno; Oliveira, Manuel; Ferreira, Maria Amélia; Costa-Maia, José

2017-05-31

Virtual reality simulation is a topic of discussion as a complementary tool to traditional laparoscopic surgical training in the operating room. However, it is unclear whether virtual reality training can have an impact on the surgical performance of advanced laparoscopic procedures. Our objective was to assess the ability of the virtual reality simulator LAP Mentor to identify and quantify changes in surgical performance indicators, after LAP Mentor training for digestive anastomosis. Twelve surgeons from Centro Hospitalar de São João in Porto (Portugal) performed two sessions of advanced task 5: anastomosis in LAP Mentor, before and after completing the tutorial, and were evaluated on 34 surgical performance indicators. The results show that six surgical performance indicators significantly changed after LAP Mentor training. The surgeons performed the task significantly faster as the median 'total time' significantly reduced (p < 0.05) from 759.5 to 523.5 seconds. Significant decreases (p < 0.05) were also found in median 'total needle loading time' (303.3 to 107.8 seconds), 'average needle loading time' (38.5 to 31.0 seconds), 'number of passages in which the needle passed precisely through the entrance dots' (2.5 to 1.0), 'time the needle was held outside the visible field' (20.9 to 2.4 seconds), and 'total time the needle-holders' ends are kept outside the predefined operative field' (88.2 to 49.6 seconds). This study raises the possibility of using virtual reality training simulation as a benchmark tool to assess the surgical performance of Portuguese surgeons. LAP Mentor is able to identify variations in surgical performance indicators of digestive anastomosis.

High-intensity interval training reduces abdominal fat mass in postmenopausal women with type 2 diabetes.

PubMed

Maillard, F; Rousset, S; Pereira, B; Traore, A; de Pradel Del Amaze, P; Boirie, Y; Duclos, M; Boisseau, N

2016-12-01

This study compared the effect of high-intensity interval training (HIIT) and moderate-intensity continuous training (MICT) for 16 weeks on whole-body and abdominal fat mass (FM) in postmenopausal women with type 2 diabetes (T2D). Seventeen women (69±1 years; BMI: 31±1kg.m -2 ) were randomly assigned to either a HIIT [60×(8s at 77-85% HR max , 12s of active recovery)] or MICT (40min at 55-60% of their individual HRR) cycling program for 16 weeks, 2 days/week. Dual-energy X-ray absorptiometry was used to measure whole-body and regional FM content, including abdominal adiposity and visceral adipose tissue. Plasma cholesterol, HDL, LDL, triglycerides, glucose and HbA 1c levels were measured. Levels of nutritional intake and physical activity were evaluated by 7-day self-reports. Dietary energy (caloric) intake, physical activity level and total body mass did not vary in either group from the beginning to the end of the training intervention. Overall, total FM decreased and total fat-free mass significantly increased over time (by around 2-3%). Total FM reduction at the end of the intervention was not significantly different between groups. However, significant loss of total abdominal (-8.3±2.2%) and visceral (-24.2±7.7%) FM was observed only with HIIT. Time effects were noted for HbA 1c and total cholesterol/HDL ratio. With no concomitant caloric restriction, an HIIT program in postmenopausal women with T2D (twice a week for 16 weeks) appeared to be more effective for reducing central obesity than MICT, and could be proposed as an alternative exercise training program for this population. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

Effects of a 2-Week High-Intensity Training Camp on Sleep Activity of Professional Rugby League Athletes.

PubMed

Thornton, Heidi R; Duthie, Grant M; Pitchford, Nathan W; Delaney, Jace A; Benton, Dean T; Dascombe, Ben J

2017-08-01

To investigate the effects of a training camp on the sleep characteristics of professional rugby league players compared with a home period. During a 7-d home and 13-d camp period, time in bed (TIB), total sleep time (TST), sleep efficiency (SE), and wake after sleep onset were measured using wristwatch actigraphy. Subjective wellness and training loads (TL) were also collected. Differences in sleep and TL between the 2 periods and the effect of daytime naps on nighttime sleep were examined using linear mixed models. Pearson correlations assessed the relationship of changes in TL on individuals' TST. During the training camp, TST (-85 min), TIB (-53 min), and SE (-8%) were reduced compared with home. Those who undertook daytime naps showed increased TIB (+33 min), TST (+30 min), and SE (+0.9%). Increases in daily total distance and training duration above individual baseline means during the training camp shared moderate (r = -.31) and trivial (r = -.04) negative relationships with TST. Sleep quality and quantity may be compromised during training camps; however, daytime naps may be beneficial for athletes due to their known benefits, without being detrimental to nighttime sleep.

Modified sprint interval training protocols: physiological and psychological responses to 4 weeks of training.

PubMed

McKie, Greg L; Islam, Hashim; Townsend, Logan K; Robertson-Wilson, Jennifer; Eys, Mark; Hazell, Tom J

2018-06-01

Sprint interval training (SIT) protocols involving brief (≤15 s) work bouts improve aerobic and anaerobic performance, highlighting peak speed generation as a potentially important adaptive stimulus. To determine the physiological and psychological effects of reducing the SIT work bout duration, while maintaining total exercise and recovery time, 43 healthy males (n = 27) and females (n = 16) trained for 4 weeks (3 times/week) using one of the following running SIT protocols: (i) 30:240 (n = 11; 4-6 × 30-s bouts, 4 min rest); (ii) 15:120 (n = 11; 8-12 × 15-s bouts, 2 min rest); (iii) 5:40 (n = 12; 24-36 × 5-s bouts, 40 s rest); or (iv) served as a nonexercising control (n = 9). Protocols were matched for total work (2-3 min) and rest (16-24 min) durations, as well as the work-to-rest ratio (1:8 s). Pre- and post-training measures included a graded maximal oxygen consumption test, a 5-km time trial, and a 30-s maximal sprint test. Self-efficacy, enjoyment, and intentions were assessed following the last training session. Training improved maximal oxygen consumption (5.5%; P = 0.006) and time-trial performance (5.2%; P = 0.039), with a main effect of time for peak speed (1.7%; P = 0.042), time to peak speed (25%; P < 0.001), and body fat percentage (1.4%; P < 0.001) that appeared to be driven by the training. There were no group effects for self-efficacy (P = 0.926), enjoyment (P = 0.249), or intentions to perform SIT 3 (P = 0.533) or 5 (P = 0.951) times/week. This study effectively demonstrated that the repeated generation of peak speed during brief SIT work bouts sufficiently stimulates adaptive mechanisms promoting increases in aerobic and anaerobic capacity.

Shallow-Water Nitrox Diving, the NASA Experience

NASA Technical Reports Server (NTRS)

Fitzpatrick, Daniel T.

2009-01-01

NASA s Neutral Buoyancy Laboratory (NBL) contains a 6.2 million gallon, 12-meter deep pool where astronauts prepare for space missions involving space walks (extravehicular activity EVA). Training is conducted in a space suit (extravehicular mobility unit EMU) pressurized to 4.0 - 4.3 PSI for up to 6.5 hours while breathing a 46% NITROX mix. Since the facility opened in 1997, over 30,000 hours of suited training has been completed with no occurrence of decompression sickness (DCS) or oxygen toxicity. This study examines the last 5 years of astronaut suited training runs. All suited runs are computer monitored and data is recorded in the Environmental Control System (ECS) database. Astronaut training runs from 2004 - 2008 were reviewed and specific data including total run time, maximum depth and average depth were analyzed. One hundred twenty seven astronauts and cosmonauts completed 2,231 training runs totaling 12,880 exposure hours. Data was available for 96% of the runs. It was revealed that the suit configuration produces a maximum equivalent air depth of 7 meters, essentially eliminating the risk of DCS. Based on average run depth and time, approximately 17% of the training runs exceeded the NOAA oxygen maximum single exposure limits, with no resulting oxygen toxicity. The NBL suited training protocols are safe and time tested. Consideration should be given to reevaluate the NOAA oxygen exposure limits for PO2 levels at or below 1 ATA.

The epidemiology of ankle injuries occurring in English Football Association academies.

PubMed

Cloke, D J; Spencer, S; Hodson, A; Deehan, D

2009-12-01

To ascertain the epidemiology of ankle injuries in elite youth football. Retrospective analysis of prospectively collected injury data from English Football Association (FA) academies. Forty-one FA football academies, between 1998 and 2006. For the complete seasons studied, a total of 14 776 players was registered from U9 to the U16 age category, a mean of 2463 players per year. All ankle injuries of sufficient severity to miss 48 h or more of training were studied, 2563 injuries in total. The incidence and burden of ankle injuries in this population and factors associated with injury. There was a mean incidence of one ankle injury per player per year, and a mean of 20 training days and two matches were missed per ankle injury. Increased injury rates were seen in older players, in competition and later in each half of match time. Peaks in injury were observed early in the season and after the winter break. In competition, more injuries were associated with a contact situation than in training. Eighty-eight injuries (3.4%) required a lay-off of 3 months or more and in 18 (0.7%) cases the player failed to return to training. In total, 52 290 training days and 5182 match appearances were lost through ankle injury. The majority of injuries were sprains, but more severe injuries occurred accounted for 3.9% of the total. Ankle injuries are common in young football players and are often severe, with prolonged loss of training time. This has potential far-reaching implications, both on and off the field.

The efficacy of virtual reality simulation training in laparoscopy: a systematic review of randomized trials.

PubMed

Larsen, Christian Rifbjerg; Oestergaard, Jeanett; Ottesen, Bent S; Soerensen, Jette Led

2012-09-01

Virtual reality (VR) simulators for surgical training might possess the properties needed for basic training in laparoscopy. Evidence for training efficacy of VR has been investigated by research of varying quality over the past decade. To review randomized controlled trials regarding VR training efficacy compared with traditional or no training, with outcome measured as surgical performance in humans or animals. In June 2011 Medline, Embase, the Cochrane Central Register of Controlled Trials, Web of Science and Google Scholar were searched using the following medical subject headings (MeSh) terms: Laparoscopy/standards, Computing methodologies, Programmed instruction, Surgical procedures, Operative, and the following free text terms: Virtual real* OR simulat* AND Laparoscop* OR train* Controlled trials. All randomized controlled trials investigating the effect of VR training in laparoscopy, with outcome measured as surgical performance. A total of 98 studies were screened, 26 selected and 12 included, with a total of 241 participants. Operation time was reduced by 17-50% by VR training, depending on simulator type and training principles. Proficiency-based training appeared superior to training based on fixed time or fixed numbers of repetition. Simulators offering training for complete operative procedures came out as more efficient than simulators offering only basic skills training. Skills in laparoscopic surgery can be increased by proficiency-based procedural VR simulator training. There is substantial evidence (grade IA - IIB) to support the use of VR simulators in laparoscopic training. © 2012 The Authors  Acta Obstetricia et Gynecologica Scandinavica© 2012 Nordic Federation of Societies of Obstetrics and Gynecology.

Military Manpower Training Report for FY 1981.

DTIC Science & Technology

1980-03-01

1,167 483 102 Fort Benning, GA 2,808 1,081 134 Fort B. Harrison, IN 2,444 379 92 Fort Bliss, TX 1,442 958 265 Fort Bragg, NC 446 618 90 Fort Devens ...management action to reduce the administrative time used to form recruit training platoons. This action reduces the average time in training for new...must be made for course attrition, the number of students entering a course of instruction who fail to complete it. The total input requirement must

Applied Research on Laparoscopic Simulator in the Resident Surgical Laparoscopic Operation Technical Training.

PubMed

Fu, Shangxi; Liu, Xiao; Zhou, Li; Zhou, Meisheng; Wang, Liming

2017-08-01

The purpose of this study was to estimate the effects of surgical laparoscopic operation course on laparoscopic operation skills after the simulated training for medical students with relatively objective results via data gained before and after the practice course of laparoscopic simulator of the resident standardized trainees. Experiment 1: 20 resident standardized trainees with no experience in laparoscopic surgery were included in the inexperienced group and finished simulated cholecystectomy according to simulator videos. Simulator data was collected (total operation time, path length, average speed of instrument movement, movement efficiency, number of perforations, the time cautery is applied without appropriate contact with adhesions, number of serious complications). Ten attending doctors were included in the experienced group and conducted the operation of simulated cholecystectomy directly. Data was collected with simulator. Data of two groups was compared. Experiment 2: Participants in inexperienced group were assigned to basic group (receiving 8 items of basic operation training) and special group (receiving 8 items of basic operation training and 4 items of specialized training), and 10 persons for each group. They received training course designed by us respectively. After training level had reached the expected target, simulated cholecystectomy was performed, and data was collected. Experimental data between basic group and special group was compared and then data between special group and experienced group was compared. Results of experiment 1 showed that there is significant difference between data in inexperienced group in which participants operated simulated cholecystectomy only according to instructors' teaching and operation video and data in experienced group. Result of experiment 2 suggested that, total operation time, number of perforations, number of serious complications, number of non-cauterized bleeding and the time cautery is applied without appropriate contact with adhesions in special group were all superior to those in basic group. There was no statistical difference on other data between special group and basic group. Comparing special group with experienced group, data of total operation time and the time cautery is applied without appropriate contact with adhesions in experienced group was superior to that in special group. There was no statistical difference on other data between special group and experienced group. Laparoscopic simulators are effective for surgical skills training. Basic courses could mainly improve operator's hand-eye coordination and perception of sense of the insertion depth for instruments. Specialized training courses could not only improve operator's familiarity with surgeries, but also reduce operation time and risk, and improve safety.

Is Marathon Training Harder than the Ironman Training? An ECO-method Comparison.

PubMed

Esteve-Lanao, Jonathan; Moreno-Pérez, Diego; Cardona, Claudia A; Larumbe-Zabala, Eneko; Muñoz, Iker; Sellés, Sergio; Cejuela, Roberto

2017-01-01

Purpose: To compare the absolute and relative training load of the Marathon (42k) and the Ironman (IM) training in recreational trained athletes. Methods: Fifteen Marathoners and Fifteen Triathletes participated in the study. Their performance level was the same relative to the sex's absolute winner at the race. No differences were presented neither in age, nor in body weight, height, BMI, running VO 2max max, or endurance training experience ( p > 0.05). They all trained systematically for their respective event (IM or 42k). Daily training load was recorded in a training log, and the last 16 weeks were compared. Before this, gas exchange and lactate metabolic tests were conducted in order to set individual training zones. The Objective Load Scale (ECOs) training load quantification method was applied. Differences between IM and 42k athletes' outcomes were assessed using Student's test and significance level was set at p < 0.05. Results: As expected, Competition Time was significantly different (IM 11 h 45 min ± 1 h 54 min vs. 42k 3 h 6 min ± 28 min, p < 0.001). Similarly, Training Weekly Avg Time (IM 12.9 h ± 2.6 vs. 42k 5.2 ± 0.9), and Average Weekly ECOs (IM 834 ± 171 vs. 42k 526 ± 118) were significantly higher in IM ( p < 0.001). However, the Ratio between Training Load and Training Time was superior for 42k runners when comparing ECOs (IM 65.8 ± 11.8 vs. 42k 99.3 ± 6.8) ( p < 0.001). Finally, all ratios between training time or load vs. Competition Time were superior for 42k ( p < 0.001) (Training Time/Race Time: IM 1.1 ± 0.3 vs. 42k 1.7 ± 0.5), (ECOs Training Load/Race Time: IM 1.2 ± 0.3 vs. 42k 2.9 ± 1.0). Conclusions: In spite of IM athletes' superior training time and total or weekly training load, when comparing the ratios between training load and training time, and training time or training load vs. competition time, the preparation of a 42k showed to be harder.

Is Marathon Training Harder than the Ironman Training? An ECO-method Comparison

PubMed Central

Esteve-Lanao, Jonathan; Moreno-Pérez, Diego; Cardona, Claudia A.; Larumbe-Zabala, Eneko; Muñoz, Iker; Sellés, Sergio; Cejuela, Roberto

2017-01-01

Purpose: To compare the absolute and relative training load of the Marathon (42k) and the Ironman (IM) training in recreational trained athletes. Methods: Fifteen Marathoners and Fifteen Triathletes participated in the study. Their performance level was the same relative to the sex's absolute winner at the race. No differences were presented neither in age, nor in body weight, height, BMI, running VO2max max, or endurance training experience (p > 0.05). They all trained systematically for their respective event (IM or 42k). Daily training load was recorded in a training log, and the last 16 weeks were compared. Before this, gas exchange and lactate metabolic tests were conducted in order to set individual training zones. The Objective Load Scale (ECOs) training load quantification method was applied. Differences between IM and 42k athletes' outcomes were assessed using Student's test and significance level was set at p < 0.05. Results: As expected, Competition Time was significantly different (IM 11 h 45 min ± 1 h 54 min vs. 42k 3 h 6 min ± 28 min, p < 0.001). Similarly, Training Weekly Avg Time (IM 12.9 h ± 2.6 vs. 42k 5.2 ± 0.9), and Average Weekly ECOs (IM 834 ± 171 vs. 42k 526 ± 118) were significantly higher in IM (p < 0.001). However, the Ratio between Training Load and Training Time was superior for 42k runners when comparing ECOs (IM 65.8 ± 11.8 vs. 42k 99.3 ± 6.8) (p < 0.001). Finally, all ratios between training time or load vs. Competition Time were superior for 42k (p < 0.001) (Training Time/Race Time: IM 1.1 ± 0.3 vs. 42k 1.7 ± 0.5), (ECOs Training Load/Race Time: IM 1.2 ± 0.3 vs. 42k 2.9 ± 1.0). Conclusions: In spite of IM athletes' superior training time and total or weekly training load, when comparing the ratios between training load and training time, and training time or training load vs. competition time, the preparation of a 42k showed to be harder. PMID:28611674

Self-Efficacy and Outcome Expectancy in Beginning Weight Training Class: Their Relations to Students' Behavioral Intention and Actual Behavior

ERIC Educational Resources Information Center

Gao, Zan; Xiang, Ping; Lee, Amelia M.; Harrison, Louis, Jr.

2008-01-01

This study was an initial attempt to investigate the relationships among self-efficacy, outcome expectancy, behavioral intention, and actual behavior over time in a beginning weight training class. A total of 109 participants completed questionnaires assessing their self-efficacy, outcome expectancy, and intentions for future weight training.…

Total VET Graduate Outcomes, 2016: Australian Vocational Education and Training Statistics

ERIC Educational Resources Information Center

National Centre for Vocational Education Research (NCVER), 2016

2016-01-01

This publication provides a summary of the outcomes of graduates who completed their vocational education and training (VET) in Australia during 2015 and were awarded a qualification. For the first time, the outcomes of all graduates are reported; that is, those in receipt of Commonwealth or state funding and those who paid for their training. The…

Heart-rate variability and training-intensity distribution in elite rowers.

PubMed

Plews, Daniel J; Laursen, Paul B; Kilding, Andrew E; Buchheit, Martin

2014-11-01

Elite endurance athletes may train in a polarized fashion, such that their training-intensity distribution preserves autonomic balance. However, field data supporting this are limited. The authors examined the relationship between heart-rate variability and training-intensity distribution in 9 elite rowers during the 26-wk build-up to the 2012 Olympic Games (2 won gold and 2 won bronze medals). Weekly averaged log-transformed square root of the mean sum of the squared differences between R-R intervals (Ln rMSSD) was examined, with respect to changes in total training time (TTT) and training time below the first lactate threshold (LT(2). Correlations (± 90% confidence limits) for Ln rMSSD were small vs TTT (r = .37 ± .80), moderate vs time LT2 (r = -.22 ± .50). These data provide supportive rationale for the polarized model of training, showing that training phases with increased time spent at high intensity suppress parasympathetic activity, while low-intensity training preserves and increases it. As such, periodized low-intensity training may be beneficial for optimal training programming.

Dose-Response Outcomes Associated with Different Forms of Locomotor Training in Persons with Chronic Motor-Incomplete Spinal Cord Injury.

PubMed

Sandler, Evan B; Roach, Kathryn E; Field-Fote, Edelle C

2017-05-15

Outcomes of training are thought to be related to the amount of training (training dose). Although various approaches to locomotor training have been used to improve walking function in persons with spinal cord injury (SCI), little is known about the relationship between dose of locomotor training and walking outcomes. This secondary analysis aimed to identify the relationship between training dose and improvement in walking distance and speed associated with locomotor training in participants with chronic motor-incomplete spinal cord injury (MISCI). We compared the dose-response relationships associated with each of four different locomotor training approaches. Participants were randomized to either: treadmill-based training with manual assistance (TM = 17), treadmill-based training with stimulation (TS = 18), overground training with stimulation (OG = 15), and treadmill-based training with locomotor robotic device assistance (LR = 14). Subjects trained 5 days/week for 12 weeks, with a target of 60 training sessions. The distance-dose and time-dose were calculated based on the total distance and total time, respectively, participants engaged in walking over all sessions combined. Primary outcome measures included walking distance (traversed in 2 min) and walking speed (over 10 m). Only OG training showed a good correlation between distance-dose and change in walking distance and speed walked over ground (r = 0.61, p = 0.02; r = 0.62, p = 0.01). None of the treadmill-based training approaches were associated with significant correlations between training dose and improvement of functional walking outcome. The findings suggest that greater distance achieved over the course of OG training is associated with better walking outcomes in the studied population. Further investigation to identify the essential elements that determine outcomes would be valuable for guiding rehabilitation.

High-intensity exercise training for the prevention of type 2 diabetes mellitus.

PubMed

Rynders, Corey A; Weltman, Arthur

2014-02-01

Aerobic exercise training and diet are recommended for the primary prevention of type 2 diabetes mellitus and cardiovascular disease. The American Diabetes Association (ADA) recommends that adults with prediabetes engage in ≥ 150 minutes per week of moderate activity and target a 7% weight loss. However, traditional moderate-intensity (MI) exercise training programs are often difficult to sustain for prediabetic adults; a commonly cited barrier to physical activity in this population is the "lack of time" to exercise. When matched for total energy expenditure, high-intensity (HI) exercise training has a lower overall time commitment compared with traditional low-intensity (LI) or MI exercise training. Several recent studies comparing HI exercise training with LI and MI exercise training reported that HI exercise training improves skeletal muscle metabolic control and cardiovascular function in a comparable and/or superior way relative to LI and MI exercise training. Although patients can accrue all exercise benefits by performing LI or MI activities such as walking, HI activities represent a time-efficient alternative to meeting physical activity guidelines. High-intensity exercise training is a potent tool for improving cardiometabolic risk for prediabetic patients with limited time and may be prescribed when appropriate.

[The comparison of efficacy of female sterilization by modified Uchida technique and silver clips in China].

PubMed

Qiu, Hong-yan; Zou, Yan; Li, Li; Liang, Hong; Zhang, Hong-yan; Wu, Shang-chun

2011-02-01

To compare efficacy of female sterilization by modified Uchida technique and silver clips and to evaluate the influence on operation procedure and clinical effect with or without surgery training of service providers. A comparative, multicenter clinical trial was performed in 18 county and township-level service centers. Totally 2198 women underwent sterilization from these 18 study center were divided into 1116 women sterilized by modified Uchida technique and 1082 women by silver clips. Those 18 centers were classified into 9 training groups which provide surgical skills of sterilization and other contents and 9 non training groups. Clinical documents of sterilization were recorded. All women were follow-up at 3, 6 and 12 months after surgery. There were no complications during surgery by both sterilization. The failure rate was 2.03% (22/1082) in silver clip method and the mean operative time were (12.4 ± 6.4) minutes in training group and (14.4 ± 8.1) minutes in non training group. In modified Uchida method, the failure rate was 0.18% (2/1116) and the mean operative time were (16.2 ± 4.9) minutes in training group and (19.0 ± 8.6) minutes in non training group. The mean operative time between two groups reached statistical difference (all P < 0.05). Total ended rate in modified Uchida technique were 2.2/hundred women year in training group and 2.5/hundred women year in non training group, and the rate of silver slips were 3.9/hundred women year and 4.8/hundred women year, which did not show significant difference (all P > 0.05). There was no significant difference in acceptability and side effects of all women between two methods (P > 0.05). The training of service providers could influence acceptability of women (P < 0.05). Clinical efficacy was not influenced by those two methods. The operative time and acceptability were improved by training surgeons in silver clips method.

Early self-managed focal sensorimotor rehabilitative training enhances functional mobility and sensorimotor function in patients following total knee replacement: a controlled clinical trial.

PubMed

Moutzouri, Maria; Gleeson, Nigel; Coutts, Fiona; Tsepis, Elias; John, Gliatis

2018-02-01

To assess the effects of early self-managed focal sensorimotor training compared to functional exercise training after total knee replacement on functional mobility and sensorimotor function. A single-blind controlled clinical trial. University Hospital of Rion, Greece. A total of 52 participants following total knee replacement. The primary outcome was the Timed Up and Go Test and the secondary outcomes were balance, joint position error, the Knee Outcome Survey Activities of Daily Living Scale, and pain. Patients were assessed on three separate occasions (presurgery, 8 weeks post surgery, and 14 weeks post surgery). Participants were randomized to either focal sensorimotor exercise training (experimental group) or functional exercise training (control group). Both groups received a 12-week home-based programme prescribed for 3-5 sessions/week (35-45 minutes). Consistently greater improvements ( F 2,98  = 4.3 to 24.8; P < 0.05) in group mean scores favour the experimental group compared to the control group: Timed Up and Go (7.8 ± 2.9 seconds vs. 4.6 ± 2.6 seconds); balance (2.1 ± 0.9° vs. 0.7 ± 1.2°); joint position error (13.8 ± 7.3° vs. 6.2 ± 9.1°); Knee Outcome Survey Activities of Daily Living Scale (44.2 ± 11.3 vs. 26.1 ± 11.4); and pain (5.9 ± 1.3 cm vs. 4.6 ± 1.1 cm). Patterns of improvement for the experimental group over time were represented by a relative effect size range of 1.3-6.5. Overall, the magnitude of improvements in functional mobility and sensorimotor function endorses using focal sensorimotor training as an effective mode of rehabilitation following knee replacement.

Personal best times in an Olympic distance triathlon and in a marathon predict Ironman race time in recreational male triathletes.

PubMed

Rüst, Christoph Alexander; Knechtle, Beat; Knechtle, Patrizia; Rosemann, Thomas; Lepers, Romuald

2011-01-01

The purpose of this study was to define predictor variables for recreational male Ironman triathletes, using age and basic measurements of anthropometry, training, and previous performance to establish an equation for the prediction of an Ironman race time for future recreational male Ironman triathletes. Age and anthropometry, training, and previous experience variables were related to Ironman race time using bivariate and multivariate analysis. A total of 184 recreational male triathletes, of mean age 40.9 ± 8.4 years, height 1.80 ± 0.06 m, and weight 76.3 ± 8.4 kg completed the Ironman within 691 ± 83 minutes. They spent 13.9 ± 5.0 hours per week in training, covering 6.3 ± 3.1 km of swimming, 194.4 ± 76.6 km of cycling, and 45.0 ± 15.9 km of running. In total, 149 triathletes had completed at least one marathon, and 150 athletes had finished at least one Olympic distance triathlon. They had a personal best time of 130.4 ± 44.2 minutes in an Olympic distance triathlon and of 193.9 ± 31.9 minutes in marathon running. In total, 126 finishers had completed both an Olympic distance triathlon and a marathon. After multivariate analysis, both a personal best time in a marathon (P < 0.0001) and in an Olympic distance triathlon (P < 0.0001) were the best variables related to Ironman race time. Ironman race time (minutes) might be partially predicted by the following equation: (r (2) = 0.65, standard error of estimate = 56.8) = 152.1 + 1.332 × (personal best time in a marathon, minutes) + 1.964 × (personal best time in an Olympic distance triathlon, minutes). These results suggest that, in contrast with anthropometric and training characteristics, both the personal best time in an Olympic distance triathlon and in a marathon predict Ironman race time in recreational male Ironman triathletes.

Personal best times in an Olympic distance triathlon and in a marathon predict Ironman race time in recreational male triathletes

PubMed Central

Rüst, Christoph Alexander; Knechtle, Beat; Knechtle, Patrizia; Rosemann, Thomas; Lepers, Romuald

2011-01-01

Background The purpose of this study was to define predictor variables for recreational male Ironman triathletes, using age and basic measurements of anthropometry, training, and previous performance to establish an equation for the prediction of an Ironman race time for future recreational male Ironman triathletes. Methods Age and anthropometry, training, and previous experience variables were related to Ironman race time using bivariate and multivariate analysis. Results A total of 184 recreational male triathletes, of mean age 40.9 ± 8.4 years, height 1.80 ± 0.06 m, and weight 76.3 ± 8.4 kg completed the Ironman within 691 ± 83 minutes. They spent 13.9 ± 5.0 hours per week in training, covering 6.3 ± 3.1 km of swimming, 194.4 ± 76.6 km of cycling, and 45.0 ± 15.9 km of running. In total, 149 triathletes had completed at least one marathon, and 150 athletes had finished at least one Olympic distance triathlon. They had a personal best time of 130.4 ± 44.2 minutes in an Olympic distance triathlon and of 193.9 ± 31.9 minutes in marathon running. In total, 126 finishers had completed both an Olympic distance triathlon and a marathon. After multivariate analysis, both a personal best time in a marathon (P < 0.0001) and in an Olympic distance triathlon (P < 0.0001) were the best variables related to Ironman race time. Ironman race time (minutes) might be partially predicted by the following equation: (r2 = 0.65, standard error of estimate = 56.8) = 152.1 + 1.332 × (personal best time in a marathon, minutes) + 1.964 × (personal best time in an Olympic distance triathlon, minutes). Conclusion These results suggest that, in contrast with anthropometric and training characteristics, both the personal best time in an Olympic distance triathlon and in a marathon predict Ironman race time in recreational male Ironman triathletes. PMID:24198578

The effect on glycaemic control of low-volume high-intensity interval training versus endurance training in individuals with type 2 diabetes.

PubMed

Winding, Kamilla M; Munch, Gregers W; Iepsen, Ulrik W; Van Hall, Gerrit; Pedersen, Bente K; Mortensen, Stefan P

2018-05-01

To evaluate whether high-intensity interval training (HIIT) with a lower time commitment can be as effective as endurance training (END) on glycaemic control, physical fitness and body composition in individuals with type 2 diabetes. A total of 29 individuals with type 2 diabetes were allocated to control (CON; no training), END or HIIT groups. Training groups received 3 training sessions per week consisting of either 40 minutes of cycling at 50% of peak workload (END) or 10 1-minute intervals at 95% of peak workload interspersed with 1 minute of active recovery (HIIT). Glycaemic control (HbA1c, oral glucose tolerance test, 3-hour mixed meal tolerance test with double tracer technique and continuous glucose monitoring [CGM]), lipolysis, VO 2 peak and body composition were evaluated before and after 11 weeks of intervention. Exercise training increased VO 2 peak more in the HIIT group (20% ± 20%) compared with the END group (8% ± 9%) despite lower total energy expenditure and time usage during the training sessions. HIIT decreased whole body and android fat mass compared with the CON group. In addition, visceral fat mass, HbA1c, fasting glucose, postprandial glucose, glycaemic variability and HOMA-IR decreased after HIIT. The reduced postprandial glucose in the HIIT group was driven primarily by a lower rate of exogenous glucose appearance. In the CON group, postprandial lipolysis was augmented over the 11-week control period. Despite a ~45% lower training volume, HIIT resulted in similar or even better improvements in physical fitness, body composition and glycemic control compared to END. HIIT therefore appears to be an important time-efficient treatment for individuals with type 2 diabetes. © 2017 John Wiley & Sons Ltd.

Accelerating locomotor savings in learning: compressing four training days to one.

PubMed

Day, Kevin A; Leech, Kristan A; Roemmich, Ryan T; Bastian, Amy J

2018-06-01

Acquiring new movements requires the capacity of the nervous system to remember previously experienced motor patterns. The phenomenon of faster relearning after initial learning is termed "savings." Here we studied how savings of a novel walking pattern develops over several days of practice and how this process can be accelerated. We introduced participants to a split-belt treadmill adaptation paradigm for 30 min for 5 consecutive days. By training day 5, participants were able to produce near-perfect performance when switching between split and tied-belt environments. We found that this was due to their ability to shift specific elements of their stepping pattern to account for the split treadmill speeds from day to day. We also applied a state-space model to further characterize multiday locomotor savings. We then explored methods of achieving comparable savings with less total training time. We studied people training only on day 1, with either one extended split-belt exposure or alternating four times between split-belt and tied-belt conditions rapidly in succession. Both of these single-day training groups were tested again on day 5. Experiencing four abbreviated exposures on day 1 improved the performance on day 5 compared with one extended exposure on day 1. Moreover, this abbreviated group performed similarly to the group that trained for 4 consecutive days before testing on day 5, despite only having one-quarter of the total training time. These results demonstrate that we can leverage training structure to achieve a high degree of performance while minimizing training sessions. NEW & NOTEWORTHY Learning a new movement requires repetition. Here, we demonstrate how to more efficiently train an adapted walking pattern. By compressing split-belt treadmill training delivered over 4 days to four abbreviated bouts of training delivered on the first day of training, we were able to induce equivalent savings over a 5-day span. These results suggest that we can manipulate the delivery of training to most efficiently drive multiday learning of a novel walking pattern.

A Study To Determine the Effect of Resistance Training and Specificity Training on Sprint Times Compared to the Effect of Natural Growth Development of Middle School Age Students.

ERIC Educational Resources Information Center

Havens, Craig M.

The purpose of this study was to determine how physical education teachers and coaches could best help students/athletes increase sprint speed, investigating whether running speed over short distances could be improved significantly through resistance training or specificity training for middle school age students. A total of 70 7th- and 8th-grade…

Dissociated time course between peak torque and total work recovery following bench press training in resistance trained men.

PubMed

Ferreira, Diogo V; Gentil, Paulo; Ferreira-Junior, João B; Soares, Saulo R S; Brown, Lee E; Bottaro, Martim

2017-10-01

To evaluate the time course of peak torque and total work recovery after a resistance training session involving the bench press exercise. Repeated measures with a within subject design. Twenty-six resistance-trained men (age: 23.7±3.7years; height: 176.0±5.7cm; mass: 79.65±7.61kg) performed one session involving eight sets of the bench press exercise performed to momentary muscle failure with 2-min rest between sets. Shoulder horizontal adductors peak torque (PT), total work (TW), delayed onset muscle soreness (DOMS) and subjective physical fitness were measured pre, immediately post, 24, 48, 72 and 96h following exercise. The exercise protocol resulted in significant pectoralis major DOMS that lasted for 72h. Immediately after exercise, the reduction in shoulder horizontal adductors TW (25%) was greater than PT (17%). TW, as a percentage of baseline values, was also less than PT at 24, 48 and 96h after exercise. Additionally, PT returned to baseline at 96h, while TW did not. Resistance trained men presented dissimilar PT and TW recovery following free weight bench press exercise. This indicates that recovery of maximal voluntary contraction does not reflect the capability to perform multiple contractions. Strength and conditioning professionals should be cautious when evaluating muscle recovery by peak torque, since it can lead to the repetition of a training session sooner than recommended. Copyright © 2017. Published by Elsevier Inc.

Effect of training frequency on the learning curve on the da Vinci Skills Simulator.

PubMed

Walliczek, Ute; Förtsch, Arne; Dworschak, Philipp; Teymoortash, Afshin; Mandapathil, Magis; Werner, Jochen; Güldner, Christian

2016-04-01

The purpose of this study was to evaluate the effect of training on the performance outcome with the da Vinci Skills Simulator. Forty novices were enrolled in a prospective training curriculum. Participants were separated into 2 groups. Group 1 performed 4 training sessions and group 2 had 2 training sessions over a 4-week period. Five exercises were performed 3 times consecutively. On the last training day, a new exercise was added. A significant skills gain from the first to the final practice day in overall performance, time to complete, and economy of motion was seen for both groups. Group 1 had a significantly better outcome in overall performance, time to complete, and economy of motion in all exercises. There was no significant difference found regarding the new exercise in group 1 versus group 2 in nearly all parameters. Longer time distances between training sessions are assumed to play a secondary role, whereas total repetition frequency is crucial for improvement of technical performance. © 2015 Wiley Periodicals, Inc. Head Neck 38: E1762-E1769, 2016. © 2015 Wiley Periodicals, Inc.

Private sector surgical training: feasibility through the lens of appendicectomy.

PubMed

Yap, Raymond; Cullinan, Mark

2017-12-01

Training in medicine and surgery has been a public hospital responsibility in Australia. Increasing specialist training needs has led to pressure on speciality societies to find additional training posts, with one utilized solution being the establishment of private hospital training. This growing use has been despite no previously published evaluations of private hospital training in Australia. This article seeks to evaluate the feasibility of surgical training in private hospitals in appendicectomy. Data were prospectively collected on registrar involvement in appendicectomy cases at a single private tertiary institution over 1 year. These data were divided into groups according to registrar involvement and analysed, looking at training caseload, operating theatre time and complications. A total of 122 cases were analysed over the study period. Registrars were more likely to have increased primary operator responsibility if they were an accredited versus unaccredited registrar (P = 0.04) and if the case was open versus laparoscopic (P < 0.001). There was an increase of 15% in total procedure time when the registrar was involved (P = 0.04). There was no significant difference in complications whether the registrar was involved or not. Training in the private sector in Australia appears feasible, with a small loss of efficiency and no increase in complications. This article hopes to further encourage implementation and evaluation of private sector training programs to expand current training positions. Further studies, in different specialty and procedural domains, are needed to assess and evaluate the ongoing feasibility of private sector training. © 2016 Royal Australasian College of Surgeons.

Green Tea Consumption after Intense Taekwondo Training Enhances Salivary Defense Factors and Antibacterial Capacity

PubMed Central

Lin, Shiuan-Pey; Li, Chia-Yang; Suzuki, Katsuhiko; Chang, Chen-Kang; Chou, Kuei-Ming; Fang, Shih-Hua

2014-01-01

The aim of this study was to investigate the short-term effects of green tea consumption on selected salivary defense proteins, antibacterial capacity and anti-oxidation activity in taekwondo (TKD) athletes, following intensive training. Twenty-two TKD athletes performed a 2-hr TKD training session. After training, participants ingested green tea (T, caffeine 6 mg/kg and catechins 22 mg/kg) or an equal volume of water (W). Saliva samples were collected at three time points: before training (BT-T; BT-W), immediately after training (AT-T; AT-W), and 30 min after drinking green tea or water (Rec-T; Rec-W). Salivary total protein, immunoglobulin A (SIgA), lactoferrin, α-amylase activity, free radical scavenger activity (FRSA) and antibacterial capacity were measured. Salivary total protein, lactoferrin, SIgA concentrations and α-amylase activity increased significantly immediately after intensive TKD training. After tea drinking and 30 min rest, α-amylase activity and the ratio of α-amylase to total protein were significantly higher than before and after training. In addition, salivary antibacterial capacity was not affected by intense training, but green tea consumption after training enhanced salivary antibacterial capacity. Additionally, we observed that salivary FRSA was markedly suppressed immediately after training and quickly returned to pre-exercise values, regardless of which fluid was consumed. Our results show that green tea consumption significantly enhances the activity of α-amylase and salivary antibacterial capacity. PMID:24498143

Influences of a yoga intervention on the postural skills of the Italian short track speed skating team

PubMed Central

Brunelle, Jean-François; Blais-Coutu, Sébastien; Gouadec, Kenan; Bédard, Éric; Fait, Philippe

2015-01-01

Introduction In preparation for a short track speed skating season, eight men and seven women were given yoga sessions during an 8-week high volume training cycle. The sessions were planned according to the postural aspects specific to short track speed skating technical requirements. Three specific goals were selected for the intervention: 1) to observe whether the practice of yoga as postural training could improve the efficiency and the athlete’s repertoire along the muscular synergies solicited in the short track speed skating specific technique; 2) to enhance and diversify the motor time-on-task of athletes without changing the prescription of other training stimulus; and 3) to lower the risk of injury during periods with high volumes of training. Methods A total of 36 sessions of yoga were given. Three postural tests were administered before and after the intervention with 14 angles analyzed. Non-parametric Wilcoxon test was used to compare angles’ variations. Results The 36 yoga sessions totalized 986 minutes of motor time-on-task, registering a proportion of 30% of the global motor time-on-task of the training cycle. Improvements were found in eleven of the 14 angles measured when comparing pre- and post-postural tests (P-value from 0.01 to 0.005). During the 8 weeks, excepting traumatic injuries due to short track speed skating accidents, no skaters suffered injuries linked to the high volume of training. Following the intervention, coaches noticed, following their on-ice feedbacks, an adjustment in the efficiency of the skating technique, in particular regarding hip dissociation. Conclusion These results suggest that yoga could be inserted into out-of-season training cycles, even in a high volume training cycle. Planned with the decision training tools, it allows athletes to diversify their motor time-on-task by integrating a new functional range of generic movements with the solicitation of neuromuscular synergies related to the specificity of their sport. PMID:25709511

Effects of Ibuprofen and Resistance Training on Bone and Muscle: A Randomized Controlled Trial in Older Women.

PubMed

Duff, Whitney R D; Chilibeck, Philip D; Candow, Darren G; Gordon, Julianne J; Mason, Riley S; Taylor-Gjevre, Regina; Nair, Bindu; Szafron, Michael; Baxter-Jones, Adam; Zello, Gordon A; Kontulainen, Saija A

2017-04-01

Resistance training with ibuprofen supplementation may improve musculoskeletal health in postmenopausal women. The study purpose was to determine the efficacy of resistance training and ibuprofen supplementation on bone and muscle properties in postmenopausal women. Participants (n = 90, 65.3 ± 4.9 yr) were randomly assigned to: supervised resistance training or stretching (placebo-exercise) with postexercise ibuprofen (400 mg) or placebo supplementation for 3 d·wk (9 months). Baseline and postintervention measurements included distal and shaft scans of the forearm and lower leg using peripheral quantitative computed tomography. Distal site outcomes included cross-sectional area, content, and density for total and trabecular bone, as well as estimated bone strength in compression. Shaft site outcomes included total bone area; cortical bone area, content, and density; estimated bone strength in torsion; and muscle area and density. Exercise-supplement-time interactions for total bone content at the distal radius (P = 0.009) and cortical density at the radius shaft (P = 0.038) were significant. Resistance training with ibuprofen decreased total bone content (-1.5%) at the distal radius in comparison to the resistance training (0.6%; P = 0.032) and ibuprofen alone (0.5%; P = 0.050). Change in cortical density at the radius shaft differed between the stretching with placebo and ibuprofen supplementation groups (-1.8% vs 1.1%; P = 0.050). Resistance training preserved muscle density in the lower leg more so than stretching (-3.1% vs -5.4%; P = 0.015). Ibuprofen consumed immediately after resistance training had a deleterious effect on bone mineral content at the distal radius, whereas resistance training or ibuprofen supplementation individually prevented bone loss. Resistance training prevented muscle density decline in the lower leg.

NATIONAL EXPOSURE RESEARCH LABORATORY (NERL) INTEGRATED INFORMATOIN AND QUALITY MANAGEMENT PLAN TRAINING

EPA Science Inventory

The success of the NERL quality system relies on participation by all managers and staff. This training was developed for the purpose of communicating the basic features of the quality system in a convenient and efficient manner. The total time to complete a review of all five ...

Self-rotations in simulated microgravity: performance effects of strategy training.

PubMed

Stirling, Leia; Newman, Dava; Willcox, Karen

2009-01-01

This research studies reorientation methodologies in a simulated microgravity environment using an experimental framework to reduce astronaut adaptation time and provide for a safety countermeasure during extravehicular activity. There were 20 subjects (10 men, 10 women, mean age of 23.6 +/- 3.5) who were divided into 2 groups, fully trained and minimally trained, which determined the amount of motion strategy training received. Subjects performed a total of 48 rotations about their pitch, roll, and yaw axes in a suspension system that simulated microgravity. In each trial subjects either rotated 90 degrees in pitch, 90 degrees in roll, or 180 degrees in yaw. Experimental measures include subject coordination, performance time, cognitive workload assessments, and qualitative motion control strategies. Subjects in the fully trained group had better initial performance with respect to performance time and workload scores for the pitch and yaw rotations. Further, trained subjects reached a steady-state performance time in fewer trials than those with minimal training. The subjects with minimal training tended to use motions that were common in an Earth environment since no technique was provided. For roll rotations they developed motions that would have led to significant off-axis (pitch and yaw) rotations in a true microgravity environment. We have shown that certain body axes are easier to rotate about than others and that fully trained subjects had an easier time performing the body rotations than the minimally trained subjects. This study has provided the groundwork for the development of an astronaut motion-control training program.

The effectiveness of continuing training for traditional birth attendants on their reproductive health-care knowledge and performance.

PubMed

Chen, Solomon Chih-Cheng; Wang, Jung-Der; Ward, Aimee Lou; Chan, Chang-Chuan; Chen, Pau-Chung; Chiang, Hung-Che; Kolola-Dzimadzi, Rose; Nyasulu, Yohane M Z; Yu, Joseph Kwong-Leung

2011-10-01

to evaluate the effectiveness of continuing training for traditional birth attendants (TBAs) on their reproductive knowledge and performance. Mzuzu Central Hospital in the northern region of Malawi. PARTICIPANTS AND ANALYSIS: a total of 81 TBAs trained during 2004 and 2006 in Mzuzu, Malawi received continuing training courses. Their reproductive knowledge was assessed by a structured questionnaire during 2004 and 2007. A multivariate generalised estimating equation (GEE) model was constructed to determine the associations between their reproductive knowledge scores and age, years of education, time since the last training course, test frequency and number of babies delivered. from July 2004 to June 2007, a total of 1984 pregnant women visited these trained TBAs. A total of 79 (4.0%) mothers were referred to health facilities before the birth due to first-born or difficult pregnancies. No maternal deaths occurred among the remaining mothers. There were 26 deaths among 1905 newborn babies, giving a perinatal mortality rate of 13.6 per 1000 live births. The GEE model demonstrated that knowledge scores of TBAs were significantly higher for TBAs under the age of 45 years, TBAs with more than five years of education, TBAs who had taken a training course within one year, and TBAs with a higher test frequency. continuing training courses are effective to maintain the reproductive knowledge and performance of trained TBAs. It is recommended that continuing training should be offered regularly, at least annually. Copyright © 2010 Elsevier Ltd. All rights reserved.

Young weightlifters' performance across time.

PubMed

Byrd, Ronald; Pierce, Kyle; Rielly, Lee; Brady, Jenny

2003-01-01

Prestigious professional organisations have questioned the efficacy of resistive training by children or have often neglected to address weightlifting in their position papers on resistive training for children. The purpose of this paper was to address the deficit in data regarding the efficacy of training children for weightlifting and to report data regarding to safety in this population. Eleven subjects (3 female, 8 male) who had trained at the USA Weightlifting Development Centre in Shreveport Louisiana for a minimum of 22 months (mean = 28.8; SD +/- 4.4) served as subjects for this study. Means for the pool of subjects subjected to t-test to compare data obtained at each subject's initial competition with that obtained at the individual's most recent competition revealed significant positive changes in body weight, snatch weight, clean and jerk weight, and total weight lifted. The latter three were significant both in absolute weight and in weight lifted per kg of body weight. Total weight lifted at competitions plotted separately for boys and for girls across time indicated an apparently steeper slope of improvement for boys. The latter were not tested for significance because of the small sample sizes. The lack of injury in training and in 534 competitive lifts was discussed. None required medical attention or loss of training time. It was concluded that there can be no doubt regarding the efficacy of weightlifting as carried out at the USA Weightlifting Development Centre. The importance of proper application of scientific theory of conditioning in a conservative manner for this population was emphasised.

Player Load in Elite Netball: Match, Training, and Positional Comparisons.

PubMed

Young, Christopher M; Gastin, Paul B; Sanders, Nick; Mackey, Luke; Dwyer, Dan B

2016-11-01

The activity profile of competition and training in elite netball has not been comprehensively reported in the literature. To measure and analyze player load in elite netballers during matches and training sessions. The primary research question was, How does player load vary between playing positions in a match and between matches and training sessions? Various measures of player load were recorded in 12 elite professional netballers with a mean ± SD age of 26 ± 4.9 y and height of 183.2 ± 8.7 cm. Player load was assessed using a published method that uses accelerometry. Load was represented as total load in arbitrary units (au), playing intensity (au/min), and relative time spent in each of 4 playing intensity zones (low, low to moderate, moderate, and high). Data from 15 games and up to 17 training sessions were analyzed for each player. Player load in matches for the goal-based positions (goal shooter, goal keeper, and goal defense) tended to be lower than the attacking and wing-based positions (goal attack, wing attack, wing defense, and center). The difference was largely due to the amount of time spent in low-intensity activity. Playing intensity of matches was greater than in training sessions; however, the total time spent in moderate- to high-intensity activities was not practically different. Accelerometry is a valuable method of measuring player load in netball, and the present results provide new information about the activity profile of different playing positions.

Cost Comparison Model: Blended eLearning versus traditional training of community health workers.

PubMed

Sissine, Mysha; Segan, Robert; Taylor, Mathew; Jefferson, Bobby; Borrelli, Alice; Koehler, Mohandas; Chelvayohan, Meena

2014-01-01

Another one million community healthcare workers are needed to address the growing global population and increasing demand of health care services. This paper describes a cost comparison between two training approaches to better understand costs implications of training community health workers (CHWs) in Sub-Saharan Africa. Our team created a prospective model to forecast and compare the costs of two training methods as described in the Dalburge Report - (1) a traditional didactic training approach ("baseline") and (2) a blended eLearning training approach ("blended"). After running the model for training 100,000 CHWs, we compared the results and scaled up those results to one million CHWs. A substantial difference exists in total costs between the baseline and blended training programs. RESULTS indicate that using a blended eLearning approach for training community health care workers could provide a total cost savings of 42%. Scaling the model to one million CHWs, the blended eLearning training approach reduces total costs by 25%. The blended eLearning savings are a result of decreased classroom time, thereby reducing the costs associated with travel, trainers and classroom costs; and using a tablet with WiFi plus a feature phone rather than a smartphone with data plan. The results of this cost analysis indicate significant savings through using a blended eLearning approach in comparison to a traditional didactic method for CHW training by as much as 67%. These results correspond to the Dalberg publication which indicates that using a blended eLearning approach is an opportunity for closing the gap in training community health care workers.

An effective CPR home learning system. A program evaluation.

PubMed

Starr, L M

1998-06-01

1. Program evaluation using a self instruction CPR home learning system indicated that people could learn CPR without attending a formal class. Reported training time for adult CPR averaged 1 hour, and ease of understanding was rated 4.9 on a 5 point scale. 2. Use of a home learning system can benefit a workplace by reducing reliance on a CPR instructor, reducing total training time, and exposing families and others in the community to the learning experience. 3. This program evaluation suggests that this training methodology supports the mission of AHA, and also can meet corporate objectives.

Patient-specific academic detailing for smoking cessation

PubMed Central

Jin, Margaret; Gagnon, Antony; Levine, Mitchell; Thabane, Lehana; Rodriguez, Christine; Dolovich, Lisa

2014-01-01

Abstract Objective To describe and to determine the feasibility of a patient-specific academic detailing (PAD) smoking cessation (SC) program in a primary care setting. Design Descriptive cohort feasibility study. Setting Hamilton, Ont. Participants Pharmacists, physicians, nurse practitioners, and their patients. Interventions Integrated pharmacists received basic academic detailing training and education on SC and then delivered PAD to prescribers using structured verbal education and written materials. Data were collected using structured forms. Main outcome measures Five main feasibility criteria were generated based on Canadian academic detailing programs: PAD coordinator time to train pharmacists less than 40 hours; median time of SC education per pharmacist less than 20 hours; median time per PAD session less than 60 minutes for initial visit; percentage of prescribers receiving PAD within 3 months greater than 50%; and number of new SC referrals to pharmacists at 6 months more than 10 patients per 1.0 full-time equivalent (FTE) pharmacist (total of approximately 30 patients). Results Eight pharmacists (5.8 FTE) received basic academic detailing training and education on SC PAD. Forty-eight physicians and 9 nurse practitioners consented to participate in the study. The mean PAD coordinator training time was 29.1 hours. The median time for SC education was 3.1 hours. The median times for PAD sessions were 15 and 25 minutes for an initial visit and follow-up visit, respectively. The numbers of prescribers who had received PAD at 3 and 6 months were 50 of 64 (78.1%) and 57 of 64 (89.1%), respectively. The numbers of new SC referrals at 3 and 6 months were 11 patients per FTE pharmacist (total of 66 patients) and 34 patients per FTE pharmacist (total of 200 patients), respectively. Conclusion This study met the predetermined feasibility criteria with respect to the management, resources, process, and scientific components. Further study is warranted to determine whether PAD is more effective than conventional academic detailing. PMID:24452574

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

NASA Astrophysics Data System (ADS)

Hua, Wei; Liu, Jun

2006-04-01

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

A comparison of whole-body vibration and resistance training on total work in the rotator cuff.

PubMed

Hand, Jason; Verscheure, Susan; Osternig, Louis

2009-01-01

Whole-body vibration machines are a relatively new technology being implemented in the athletic setting. Numerous authors have examined the proposed physiologic mechanisms of vibration therapy and performance outcomes. Changes have mainly been observed in the lower extremity after individual exercises, with minimal attention to the upper extremity and resistance training programs. To examine the effects of a novel vibration intervention directed at the upper extremity as a precursor to a supervised, multijoint dynamic resistance training program. Randomized controlled trial. National Collegiate Athletic Association Division IA institution. Thirteen female student-athletes were divided into the following 2 treatment groups: (1) whole-body vibration and resistance training or (2) resistance training only. Participants in the vibration and resistance training group used an experimental vibration protocol of 2 x 60 seconds at 4 mm and 50 Hz, in a modified push-up position, 3 times per week for 10 weeks, just before their supervised resistance training session. Isokinetic total work measurements of the rotator cuff were collected at baseline and at week 5 and week 10. No differences were found between the treatment groups (P > .05). However, rotator cuff output across time increased in both groups (P < .05). Although findings did not differ between the groups, the use of whole-body vibration as a precursor to multijoint exercises warrants further investigation because of the current lack of literature on the topic. Our results indicate that indirectly strengthening the rotator cuff using a multijoint dynamic resistance training program is possible.

Simulated Environments with Animated Agents: Effects on Visual Attention, Emotion, Performance, and Perception

ERIC Educational Resources Information Center

Romero-Hall, E.; Watson, G. S.; Adcock, A.; Bliss, J.; Adams Tufts, K.

2016-01-01

This research assessed how emotive animated agents in a simulation-based training affect the performance outcomes and perceptions of the individuals interacting in real time with the training application. A total of 56 participants consented to complete the study. The material for this investigation included a nursing simulation in which…

Virtual reality training for endoscopic surgery: voluntary or obligatory?

PubMed

van Dongen, K W; van der Wal, W A; Rinkes, I H M Borel; Schijven, M P; Broeders, I A M J

2008-03-01

Virtual reality (VR) simulators have been developed to train basic endoscopic surgical skills outside of the operating room. An important issue is how to create optimal conditions for integration of these types of simulators into the surgical training curriculum. The willingness of surgical residents to train these skills on a voluntary basis was surveyed. Twenty-one surgical residents were given unrestricted access to a VR simulator for a period of four months. After this period, a competitive element was introduced to enhance individual training time spent on the simulator. The overall end-scores for individual residents were announced periodically to the full surgical department, and the winner was awarded a prize. In the first four months of study, only two of the 21 residents (10%) trained on the simulator, for a total time span of 163 minutes. After introducing the competitive element the number of trainees increased to seven residents (33%). The amount of training time spent on the simulator increased to 738 minutes. Free unlimited access to a VR simulator for training basic endoscopic skills, without any form of obligation or assessment, did not motivate surgical residents to use the simulator. Introducing a competitive element for enhancing training time had only a marginal effect. The acquisition of expensive devices to train basic psychomotor skills for endoscopic surgery is probably only effective when it is an integrated and mandatory part of the surgical curriculum.

A Profile of Academic Training Program Directors and Chairs in Radiation Oncology

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

Wilson, Lynn D., E-mail: Lynn.wilson@yale.edu; Haffty, Bruce G.; Smith, Benjamin D.

Purpose: To identify objective characteristics and benchmarks for program leadership in academic radiation oncology. Methods and Materials: A study of the 87 Accreditation Council for Graduate Medical Education radiation oncology training program directors (PD) and their chairs was performed. Variables included age, gender, original training department, highest degree, rank, endowed chair assignment, National Institutes of Health (NIH) funding, and Hirsch index (H-index). Data were gathered from online sources such as departmental websites, NIH RePORTER, and Scopus. Results: There were a total of 87 PD. The median age was 48, and 14 (16%) were MD/PhD. A total of 21 (24%) weremore » female, and rank was relatively equally distributed above instructor. Of the 26 professors, at least 7 (27%) were female. At least 24 (28%) were working at the institution from which they had received their training. A total of 6 individuals held endowed chairs. Only 2 PD had active NIH funding in 2012. The median H-index was 12 (range, 0-51) but the index dropped to 9 (range, 0-38) when those who served as both PD and chair were removed from the group. A total of 76 chairs were identified at the time of the study. The median age was 55, and 9 (12%) were MD/PhD. A total of 7 (9%) of the chairs were female, and rank was professor for all with the exception of 1 who was listed as “Head” and was an associate professor. Of the 76 chairs, at least 10 (13%) were working at the institution from which they received their training. There were a total of 21 individuals with endowed chairs. A total of 13 (17%) had NIH funding in 2012. The median H-index was 29 (range, 3-60). Conclusions: These data provide benchmarks for individuals and departments evaluating leadership positions in the field of academic radiation oncology. Such data are useful for evaluating leadership trends over time and comparing academic radiation oncology with other specialties.« less

Effects of Different Resistance Training Frequencies on Fat in Overweight/Obese Older Women.

PubMed

Cavalcante, Edilaine F; Ribeiro, Alex S; do Nascimento, Matheus A; Silva, Analiza M; Tomeleri, Crisieli M; Nabuco, Hellen C G; Pina, Fábio L C; Mayhew, Jerry L; Da Silva-Grigoletto, Marzo E; da Silva, Danilo R P; Fleck, Steven J; Cyrino, Edilson S

2018-05-18

This study compared the effect of different resistance training (RT) frequencies on total, android, gynoid and trunk body fat in overweight/obese older women. Fifty-seven overweight/obese older women (66.9±5.3 years and 39.9±4.9% body fat) were randomly assigned to one of three groups: a group performing RT twice a week (G2X), a group performing RT three times a week (G3X), or a non-exercise control group (CG). Both training groups performed the same 12-week RT program consisting of 8 exercises that trained all major muscle groups. Dual-energy X-ray absorptiometry was used to assess body composition. After the intervention period, both G2X and G3X demonstrated significant (P<0.05) reductions in adiposity compared to the CG for total body fat (G2X=-1.7%, G3X=-2.7%, CG=+2.1%), android fat (G2X=-6.2%, G3X=-7.0%, CG=+8.6%), gynoid fat (G2X=-2.5%, G3X=-2.9%, CG=+1.0%), and trunk fat (G2X=-2.5%, G3X=-3.0%, CG=+2.9%), with no significant differences between training groups. These results demonstrate that a low-volume 12-week RT program performed two or three times per week causes decreases in total and regional fat deposition with the greatest reductions occurring in the android region. © Georg Thieme Verlag KG Stuttgart · New York.

Functional outcomes of outpatient balance training following total knee replacement in patients with knee osteoarthritis: a randomized controlled trial.

PubMed

Liao, Chun-De; Lin, Li-Fong; Huang, Yi-Ching; Huang, Shih-Wei; Chou, Lin-Chuan; Liou, Tsan-Hon

2015-09-01

To evaluate whether balance training after total knee replacement surgery improves functional outcomes and to determine whether postoperative balance is associated with mobility. A prospective intervention study and randomized controlled trial with an intention-to-treat analysis. The rehabilitation center of a university-based teaching hospital. A total of 130 patients with knee osteoarthritis who had undergone total knee replacement surgery were recruited to attend an outpatient rehabilitation program. They were randomly allocated to additional balance rehabilitation and functional rehabilitation groups. During the eight-week outpatient rehabilitation program, both groups received general functional training. Patients in the balance rehabilitation group received an additional balance-based rehabilitation program. The functional reach test, single-leg stance test, 10-m walk test, Timed Up and Go Test, timed chair-stand test, stair-climb test, and Western Ontario and McMaster Universities Osteoarthritis Index were measured at baseline, eight weeks (T(1)), and 32 weeks (T(2)). The balance rehabilitation group patients demonstrated significant improvement in the results of the functional reach test at T(1) (37.6 ±7.8 cm) and T(2) (39.3 ±9.7 cm) compared with the baseline assessment (11.5 ±2.9 cm) and Timed Up and Go Test at T(1) (8.9 ±1.2 seconds) and T(2) (8.0 ±1.9 seconds) compared with the baseline assessment (12.5 ±1.8 seconds). Moreover, the balance rehabilitation group patients exhibited significantly greater improvements in balance and mobility than did the functional rehabilitation group patients (all P < 0.001). Furthermore, improved balance was significantly associated with improved mobility at T(2). Postoperative outpatient rehabilitation with balance training improves the balance, mobility, and functional outcomes in patients with knee osteoarthritis after total knee replacement. © The Author(s) 2014.

An Exploratory Study of Intensive Neurofeedback Training for Schizophrenia.

PubMed

Nan, Wenya; Wan, Feng; Chang, Lanshin; Pun, Sio Hang; Vai, Mang I; Rosa, Agostinho

2017-01-01

Schizophrenia is a chronic and devastating brain disorder with ongoing cognitive, behavioral, and emotional deteriorated functions. Neurofeedback training, which enables the individuals to regulate their brain activity using a real-time feedback loop, is increasingly investigated as a potential alternative intervention for schizophrenia. This study aimed to explore the effect of short but intensive neurofeedback training for schizophrenic patients with difficulty for long-time training. A middle-aged woman with chronic schizophrenia completed the intensive training of alpha/beta2 (20-30 Hz) in four consecutive days with a total training duration of 13.5 hours. The results showed that her alpha/beta2 increased over sessions, and her behavior performance including short-term memory, mood, and speech pattern was improved at the end of neurofeedback training. Importantly, a 22-month follow-up found a dramatic improvement in both positive and negative symptoms. These positive outcomes suggest that such intensive neurofeedback training may provide new insight into the treatment of schizophrenia and thus deserves further study to fully examine its scope.

Increasing Lean Mass and Strength: A Comparison of High Frequency Strength Training to Lower Frequency Strength Training.

PubMed

Thomas, Michael H; Burns, Steve P

The purpose of this study was to determine the effect strength training frequency has on improvements in lean mass and strength. Participants were 7 women and 12 men, age ( χ̄ = 34.64 years ± 6.91 years), with strength training experience, training age ( χ̄ = 51.16 months ± 39.02 months). Participants were assigned to one of two groups to equal baseline group demographics. High frequency training group (HFT) trained each muscle group as the agonist, 3 times per week, exercising with 3 sets per muscle group per session (3 total body workouts). Low frequency training group (LFT) trained each muscle group as the agonist one time per week, completing all 9 sets during that one workout. LFT consisted of a routine split over three days: 1) pectoralis, deltoids, and triceps; 2) upper back and biceps; 3) quadriceps, hamstrings, calves, and abdominals. Following eight weeks of training, HFT increased lean mass by 1.06 kg ± 1.78 kg, (1.9%), and LFT increased lean mass by .99 kg ± 1.31 kg, (2.0%). HFT strength improvements on the chest press was 9.07 kg ± 6.33 kg, (11%), and hack squat 20.16 kg ± 11.59 kg, (21%). LFT strength improvements on chest press was 5.80kg ± 4.26 kg, (7.0%), and hack squat 21.83 kg ± 11.17 kg, (24 %). No mean differences between groups were significant. These results suggest that HFT and LFT of equal set totals result in similar improvements in lean mass and strength, following 8 weeks of strength training.

Autonomic function responses to training: Correlation with body composition changes.

PubMed

Tian, Ye; Huang, Chuanye; He, Zihong; Hong, Ping; Zhao, Jiexiu

2015-11-01

The causal relation between autonomic function and adiposity is an unresolved issue. Thus, we studied whether resting heart rate variability (HRV) changes could be used to predict changes in body composition after 16 weeks of individualized exercise training. A total of 117 sedentary overweight/obese adults volunteered to join an intervention group (IN, n=82) or a control group (CON, n=35). The intervention group trained for 30-40 min three times a week with an intensity of 85-100% of individual ventilatory threshold (Thvent). At baseline and after a 16-week training period, resting HRV variables, body composition and peak oxygen uptake (VO2peak) were assessed. Compared with CON, exercise training significantly improved HRV and body composition and increased VO2peak (P<0.05). Significant correlations were observed between changes of HRV variables and body composition indices and VO2peak (P<0.05). Greater individual changes in HRV in response to exercise training were observed for those with greater total and central fat loss. Individual aerobic-based exercise training was for improving autonomic function and resting HRV responses to aerobic training is a potential indicator for adaptations to exercise training. Copyright © 2015. Published by Elsevier Inc.

Effect of High-Intensity Interval Training on Total, Abdominal and Visceral Fat Mass: A Meta-Analysis.

PubMed

Maillard, Florie; Pereira, Bruno; Boisseau, Nathalie

2018-02-01

High-intensity interval training (HIIT) is promoted as a time-efficient strategy to improve body composition. The aim of this meta-analysis was to assess the efficacy of HIIT in reducing total, abdominal, and visceral fat mass in normal-weight and overweight/obese adults. Electronic databases were searched to identify all related articles on HIIT and fat mass. Stratified analysis was performed using the nature of HIIT (cycling versus running, target intensity), sex and/or body weight, and the methods of measuring body composition. Heterogeneity was also determined RESULTS: A total of 39 studies involving 617 subjects were included (mean age 38.8 years ± 14.4, 52% females). HIIT significantly reduced total (p = 0.003), abdominal (p = 0.007), and visceral (p = 0.018) fat mass, with no differences between the sexes. A comparison showed that running was more effective than cycling in reducing total and visceral fat mass. High-intensity (above 90% peak heart rate) training was more successful in reducing whole body adiposity, while lower intensities had a greater effect on changes in abdominal and visceral fat mass. Our analysis also indicated that only computed tomography scan or magnetic resonance imaging showed significant abdominal and/or visceral fat-mass loss after HIIT interventions. HIIT is a time-efficient strategy to decrease fat-mass deposits, including those of abdominal and visceral fat mass. There was some evidence of the greater effectiveness of HIIT running versus cycling, but owing to the wide variety of protocols used and the lack of full details about cycling training, further comparisons need to be made. Large, multicenter, prospective studies are required to establish the best HIIT protocols for reducing fat mass according to subject characteristics.

Cost Comparison Model: Blended eLearning versus traditional training of community health workers

PubMed Central

Sissine, Mysha; Segan, Robert; Taylor, Mathew; Jefferson, Bobby; Borrelli, Alice; Koehler, Mohandas; Chelvayohan, Meena

2014-01-01

Objectives: Another one million community healthcare workers are needed to address the growing global population and increasing demand of health care services. This paper describes a cost comparison between two training approaches to better understand costs implications of training community health workers (CHWs) in Sub-Saharan Africa. Methods: Our team created a prospective model to forecast and compare the costs of two training methods as described in the Dalburge Report - (1) a traditional didactic training approach (“baseline”) and (2) a blended eLearning training approach (“blended”). After running the model for training 100,000 CHWs, we compared the results and scaled up those results to one million CHWs. Results: A substantial difference exists in total costs between the baseline and blended training programs. Results indicate that using a blended eLearning approach for training community health care workers could provide a total cost savings of 42%. Scaling the model to one million CHWs, the blended eLearning training approach reduces total costs by 25%. Discussion: The blended eLearning savings are a result of decreased classroom time, thereby reducing the costs associated with travel, trainers and classroom costs; and using a tablet with WiFi plus a feature phone rather than a smartphone with data plan. Conclusion: The results of this cost analysis indicate significant savings through using a blended eLearning approach in comparison to a traditional didactic method for CHW training by as much as 67%. These results correspond to the Dalberg publication which indicates that using a blended eLearning approach is an opportunity for closing the gap in training community health care workers. PMID:25598868

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

NASA Technical Reports Server (NTRS)

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

2003-01-01

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

Problem Solving Teams in a Total Quality Management Environment.

ERIC Educational Resources Information Center

Towler, Constance F.

1993-01-01

Outlines the problem-solving team training process used at Harvard University (Massachusetts), including the size and formation of teams, roles, and time commitment. Components of the process are explained, including introduction to Total Quality Management (TQM), customer satisfaction, meeting management, Parker Team Player Survey, interactive…

A human factors curriculum for surgical clerkship students.

PubMed

Cahan, Mitchell A; Larkin, Anne C; Starr, Susan; Wellman, Scott; Haley, Heather-Lyn; Sullivan, Kate; Shah, Shimul; Hirsh, Michael; Litwin, Demetrius; Quirk, Mark

2010-12-01

Early introduction of a full-day human factors training experience into the surgical clerkship curriculum will teach effective communication skills and strategies to gain professional satisfaction from a career in surgery. In pilot 1, which took place between July 1, 2007, and December 31, 2008, 50 students received training and 50 did not; all received testing at the end of the rotation for comparison of control vs intervention group performance. In pilot 2, a total of 50 students were trained and received testing before and after rotation to examine individual change over time. University of Massachusetts Medical School. A total of 148 third-year medical students in required 12-week surgical clerkship rotations. Full-day training with lecture and small-group exercises, cotaught by surgeons and educators, with focus on empathetic communication, time management, and teamwork skills. Empathetic communication skill, teamwork, and patient safety attitudes and self-reported use of time management strategies. Empathy scores were not higher for trained vs untrained groups in pilot 1 but improved from 2.32 to 3.45 on a 5-point scale (P < .001) in pilot 2. Students also were more likely to ask for the nurse's perspective and to seek agreement on an action plan after team communication training (pilot 1, f = 7.52, P = .007; pilot 2, t = 2.65, P = .01). Results were mixed for work-life balance, with some trained groups scoring significantly lower than untrained groups in pilot 1 and no significant improvement shown in pilot 2. The significant increase in student-patient communication scores suggests that a brief focused presentation followed by simulation of difficult patient encounters can be successful. A video demonstration can improve interdisciplinary teamwork.

Cortical Thickness Changes Correlate with Cognition Changes after Cognitive Training: Evidence from a Chinese Community Study

PubMed Central

Jiang, Lijuan; Cao, Xinyi; Li, Ting; Tang, Yingying; Li, Wei; Wang, Jijun; Chan, Raymond C.; Li, Chunbo

2016-01-01

The aim of this study was to investigate whether changes in cortical thickness correlated with cognitive function changes in healthy older adults after receiving cognitive training interventions. Moreover, it also aimed to examine the differential impacts of a multi-domain and a single-domain cognitive training interventions. Longitudinal magnetic resonance imaging (MRI) scanning was performed on participants 65–75 years of age using the Siemens 3.0 T Trio Tim with the Magnetization Prepared Rapid Gradient Echo (MPRAGE) sequence. The cortical thickness was determined using FreeSurfer Software. Cognitive functioning was evaluated using the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). There were significant group × time interaction effects on the left supramarginal, the left frontal pole cortical regions; and a marginal significant group × time interaction effects on visuospatial/constructional and delayed memory scores. In a multi-domain cognitive training group, a number of cortical region changes were significantly positively correlated with changes in attention, delayed memory, and the total score, but significantly negatively correlated with changes in immediate memory and language scores. In the single-domain cognitive training group, some cortical region changes were significantly positively associated with changes in immediate memory, delayed memory, and the total score, while they were significantly negatively associated with changes in visuospatial/constructional, language, and attention scores. Overall, multi-domain cognitive training offered more advantages in visuospatial/constructional, attention, and delayed memory abilities, while single-domain cognitive training benefited immediate memory ability more effectively. These findings suggest that healthy older adults benefit more from the multi-domain cognitive training than single-domain cognitive training. Cognitive training has impacted on cortical thickness changes in healthy elderly. PMID:27252649

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

PubMed Central

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

2017-01-01

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

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

PubMed

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

2017-05-25

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

Aviation Pilot Training I & II. Flight Syllabus. Field Review Copy.

ERIC Educational Resources Information Center

Upchurch, Richard

This guide for aviation pilot training I and II begins with a course description, resource information, and a course outline. The syllabus is designed to be used concurrently with the ground school program. A minimum of 29 flights are scheduled with a minimum of 40 hours total flight time. Tasks/competencies are categorized into five concept/duty…

A Grounded Theory of Western-Trained Asian Group Leaders Leading Groups in Asia

ERIC Educational Resources Information Center

Taephant, Nattasuda; Rubel, Deborah; Champe, Julia

2015-01-01

This grounded theory research explored the experiences of Western-trained Asian group leaders leading groups in Asia. A total of 6 participants from Japan, Taiwan, and Thailand were interviewed 3 times over 9 months. The recursive process of data collection and analysis yielded substantive theory describing the participants' process of reconciling…

Training Working Memory in Adolescents Using Serious Game Elements: Pilot Randomized Controlled Trial

PubMed Central

Gladwin, Thomas E; Peeters, Margot; Prins, Pier J M; Wiers, Reinout W

2018-01-01

Background Working memory capacity has been found to be impaired in adolescents with various psychological problems, such as addictive behaviors. Training of working memory capacity can lead to significant behavioral improvements, but it is usually long and tedious, taxing participants’ motivation to train. Objective This study aimed to evaluate whether adding game elements to the training could help improve adolescents’ motivation to train while improving cognition. Methods A total of 84 high school students were allocated to a working memory capacity training, a gamified working memory capacity training, or a placebo condition. Working memory capacity, motivation to train, and drinking habits were assessed before and after training. Results Self-reported evaluations did not show a self-reported preference for the game, but participants in the gamified working memory capacity training condition did train significantly longer. The game successfully increased motivation to train, but this effect faded over time. Working memory capacity increased equally in all conditions but did not lead to significantly lower drinking, which may be due to low drinking levels at baseline. Conclusions We recommend that future studies attempt to prolong this motivational effect, as it appeared to fade over time. PMID:29792294

Effects of a feeding skills training programme on nursing assistants and dementia patients.

PubMed

Chang, Chia-Chi; Lin, Li-Chan

2005-11-01

The purposes of this study were to develop a comprehensive feeding skills training programme for nursing assistants and to test the effects of this training programme on their knowledge, attitude and behaviour and the outcome of dementia patients including total eating time, food intake and feeding difficulty. Dementia patients have a high probability of feeding problems that result in a substantial risk of malnutrition. Assisting residents with eating is a major task for nursing assistants and they require better training to provide adequate quality of nutritional care. A quasi-experimental study was conducted. Two convenience-chosen dementia-specialized long-term care facilities in North Taiwan were randomly assigned into either a control or a treatment group. Sixty-seven nursing assistants were enrolled (treatment: 31; control: 36). Twenty nursing assistants and the same number of dementia patients were observed during mealtime. The treatment group participated in a feeding skills training programme including three hours of in-service classes and one hour of hands-on training, whereas the control group did not receive any training. The treatment group had significantly more knowledge (F = 47.7, P < 0.001), more positive attitude (F = 15.75, P = 0.001) and better behaviours (t = 6.0, P < 0.001) than the control group after the intervention. Dementia patients in the treatment group had significantly longer total eating time (t = 2.7, P < 0.05) and higher Edinburgh Feeding Evaluation in Dementia scores (more feeding difficulty) (t = 2.1, P < 0.05) than the control group. There was no significant difference on food intake between the two groups (t = 0.8, P = 0.49). This feeding skills training programme has been found to change nursing assistants' knowledge, attitude, and behaviour as well as increasing the eating time for the dementia patients. This study raises attention regarding on-the-job training for nursing assistants. Furthermore, the feeding problems among dementia patients should be further explored as well as the nutritional care.

The Effect of Different Resistance Training Load Schemes on Strength and Body Composition in Trained Men

PubMed Central

Lopes, Charles Ricardo; Aoki, Marcelo Saldanha; Crisp, Alex Harley; de Mattos, Renê Scarpari; Lins, Miguel Alves; da Mota, Gustavo Ribeiro; Schoenfeld, Brad Jon; Marchetti, Paulo Henrique

2017-01-01

Abstract The purpose of this study was to evaluate the impact of moderate-load (10 RM) and low-load (20 RM) resistance training schemes on maximal strength and body composition. Sixteen resistance-trained men were randomly assigned to 1 of 2 groups: a moderate-load group (n = 8) or a low-load group (n = 8). The resistance training schemes consisted of 8 exercises performed 4 times per week for 6 weeks. In order to equate the number of repetitions performed by each group, the moderate load group performed 6 sets of 10 RM, while the low load group performed 3 sets of 20 RM. Between-group differences were evaluated using a 2-way ANOVA and independent t-tests. There was no difference in the weekly total load lifted (sets × reps × kg) between the 2 groups. Both groups equally improved maximal strength and measures of body composition after 6 weeks of resistance training, with no significant between-group differences detected. In conclusion, both moderate-load and low-load resistance training schemes, similar for the total load lifted, induced a similar improvement in maximal strength and body composition in resistance-trained men. PMID:28828088

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

PubMed

Kamesh, Lavanya; Clapham, Mike; Foggensteiner, Lukas

2012-08-01

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

Effects of beta-alanine supplementation and high-intensity interval training on endurance performance and body composition in men; a double-blind trial.

PubMed

Smith, Abbie E; Walter, Ashley A; Graef, Jennifer L; Kendall, Kristina L; Moon, Jordan R; Lockwood, Christopher M; Fukuda, David H; Beck, Travis W; Cramer, Joel T; Stout, Jeffrey R

2009-02-11

Intermittent bouts of high-intensity exercise result in diminished stores of energy substrates, followed by an accumulation of metabolites, promoting chronic physiological adaptations. In addition, beta-alanine has been accepted has an effective physiological hydrogen ion (H+) buffer. Concurrent high-intensity interval training (HIIT) and beta-alanine supplementation may result in greater adaptations than HIIT alone. The purpose of the current study was to evaluate the effects of combining beta-alanine supplementation with high-intensity interval training (HIIT) on endurance performance and aerobic metabolism in recreationally active college-aged men. Forty-six men (Age: 22.2 +/- 2.7 yrs; Ht: 178.1 +/- 7.4 cm; Wt: 78.7 +/- 11.9; VO2peak: 3.3 +/- 0.59 l.min-1) were assessed for peak O2 utilization (VO2peak), time to fatigue (VO2TTE), ventilatory threshold (VT), and total work done at 110% of pre-training VO2peak (TWD). In a double-blind fashion, all subjects were randomly assigned into one either a placebo (PL - 16.5 g dextrose powder per packet; n = 18) or beta-alanine (BA - 1.5 g beta-alanine plus 15 g dextrose powder per packet; n = 18) group. All subjects supplemented four times per day (total of 6 g/day) for the first 21-days, followed by two times per day (3 g/day) for the subsequent 21 days, and engaged in a total of six weeks of HIIT training consisting of 5-6 bouts of a 2:1 minute cycling work to rest ratio. Significant improvements in VO2peak, VO2TTE, and TWD after three weeks of training were displayed (p < 0.05). Increases in VO2peak, VO2TTE, TWD and lean body mass were only significant for the BA group after the second three weeks of training. The use of HIIT to induce significant aerobic improvements is effective and efficient. Chronic BA supplementation may further enhance HIIT, improving endurance performance and lean body mass.

Acute Effects of Two Different Resistance Circuit Training Protocols on Performance and Perceived Exertion in Semiprofessional Basketball Players.

PubMed

Freitas, Tomás T; Calleja-González, Julio; Alarcón, Francisco; Alcaraz, Pedro E

2016-02-01

This study aimed to investigate the acute effects of two different resistance circuit training protocols on basketball players' physical and technical performance and rating of perceived exertion (RPE). In a repeated-measures, crossover experimental design, 9 semiprofessional basketball players performed a Power Circuit Training (PCT; 45% 1RM) and a High-Resistance Circuit Training (HRC; 6RM), on consecutive weeks. Vertical and horizontal jump performance, 3-points shooting accuracy, repeated-sprint ability (RSA), agility, and upper body power output were measured before and after training. The RPE was assessed 20 minutes after resistance training. One-way repeated-measures analysis of variance showed performance decrements in vertical jump height and peak power, horizontal jump distance, 3-points percentage, bench-press power output, RSA total and ideal time, and agility T-Test at total time following HRC, but not PCT (p ≤ 0.05). The RPE was higher in HRC compared with PCT. The results of this study indicated that HRC was perceived as being harder and produced higher fatigue levels, which in turn lowered acute performance. However, low-to-moderate intensity loads did not negatively affect performance. Thus, completing a PCT session may be the most appropriate option before a practice or game as it avoids acute-resistance-training-induced performance decrements. However, if the objective of the basketball session is to develop or perfect technical skills during fatiguing conditions, HRC may be the more suitable option.

Monitoring Elite Soccer Players' External Loads Using Real-Time Data.

PubMed

Barrett, Steve

2017-11-01

To assess the validity of measuring locomotor activities and PlayerLoad using real-time (RT) data collection during soccer training. Twenty-nine English soccer players participated. Each player wore the same MEMS device (Micromechanical Electrical Systems; S5, Optimeye; CatapultSports, Melbourne, Australia) during 21 training sessions (N = 331 data sets) in the 2015-16 and 2016-17 seasons. An RT receiver (TRX; Catapultsports, Melbourne, Australia) was used to collect the locomotor activities and PlayerLoad data in RT and compared with the postevent downloaded (PED) data. PlayerLoad and locomotor activities (total distance covered; total high-speed running distance covered, >5.5#x00A0;m/s; total sprinting distance covered, >7 m/s; maximum velocity) were analyzed. Correlations were near perfect for all variables analyzed (r = .98-1.00), with a varied level of noise between RT and PED also (0.3-9.7% coefficient of variation). Locomotor activities and PlayerLoad can use both RT and PED concurrently to quantify a player's physical output during a training session. Caution should be taken with higher-velocity-based locomotor activities during RT compared to PED.

Positive Effects of an Anti-Aggression and De-Escalation Training on Ward Atmosphere and Subjective Safety May Depend on Previous Training Experience.

PubMed

Fröhlich, Daniela; Rabenschlag, Franziska; Schoppmann, Susanne; Borgwardt, Stefan; Lang, Undine E; Huber, Christian G

2018-01-01

Anti-aggression and de-escalation (ADE) trainings of health-care professionals working on psychiatric inpatient wards have been shown to increase staff knowledge and confidence, which could be connected with higher subjective safety. Additionally, a potential reduction of aggressive incidents could improve ward atmosphere. Thus, the current study aimed to investigate the effects of ADE training on ward atmosphere and subjective safety. In 2015, an ADE training was established at the Psychiatric University Clinics (UPK), University of Basel. Nursing staff from 22 wards received theoretical and practical training over the course of 5 days. Ward atmosphere and subjective safety were assessed using the Essen Climate Evaluation Schema (EssenCES). A total of 46 people had been assessed in 2012 before training implementation (baseline), and 45 persons in 2016 after implementation. In the 2016 group, 23 people had previously participated in an ADE training, and 22 were first-time participants. Patients' coherence ( p  = 0.004), subjective safety ( p  = 0.004), and ward atmosphere ( p  = 0.001) were rated significantly higher by first-time ADE training participants compared to baseline, and patients' coherence ( p  = 0.029) and ward atmosphere ( p  = 0.011) were rated significantly higher by first-time ADE training participants than by nurses with prior ADE training. There were no significant differences regarding any EssenCES ratings by nurses with prior ADE training compared to baseline. ADE training was exclusively connected with higher ratings on most EssenCES scales for first-time participants. This indicates that the positive effects of ADE training may depend on previous training experience.

Early Career Experiences of Pediatricians Pursuing or Not Pursuing Fellowship Training.

PubMed

Byrne, Bobbi J; Katakam, Shesha K; Frintner, Mary Pat; Cull, William L

2015-10-01

Choosing career paths can be difficult decisions for residents contemplating fellowship training. This study compares the experiences of early career pediatricians who did and did not pursue fellowships. We analyzed national, weighted data from pediatricians 8 to 10 years after residency (n = 842). Work environment, work-life balance, and satisfaction were compared for pediatricians who had pursued fellowship training (fellowship trained) and those who did not pursue fellowship training (generalist trained). Logistic and linear regression examined the independent effects of fellowship training while controlling for demographic differences. A total of 39% of the pediatricians (328/842) pursued fellowship training. The fellowship-trained group was less likely than the generalist-trained group to spend time in direct patient care and more likely to report learning opportunities in their work environment. This group was also more likely to report an income of ≥$150,000, although no difference was found when only full-time pediatricians were examined. Generalist-trained pediatricians were more likely to work <50 hours per week, have flexibility with their schedules, and be satisfied with time spent with their own children. Pediatricians in both the fellowship-trained and generalist-trained groups generally found their work to be rewarding and were satisfied with their lives. Although residents need to consider important life and career differences when contemplating fellowship training and general care, pediatricians in both groups can achieve overall life and career satisfaction. Copyright © 2015 by the American Academy of Pediatrics.

Total Habilitation: A Concept Whose Time Has Come--Reactions to Four Responses.

ERIC Educational Resources Information Center

Drash, Philip W.; Raver, Sharon A.

1987-01-01

The original authors address several concerns expressed in four responses to their article: terminology; the need for expert and intensive pedagogy (including early intensive language training); pessimistic attitudes; the need for caution in setting total habilitation as a goal; and a research model. (KM)

Total Quality Management: Public Sector Applications for Training Programs.

ERIC Educational Resources Information Center

Davis, David S.

Total quality management (TQM) is based on the fundamental philosophy that it is always more effective to do something right the first time than it is to correct deficiencies. It seeks to improve quality and increase customer satisfaction by restructuring traditional management and organizational practices. Common characteristics of TQM include…

The cost of local, multi-professional obstetric emergencies training.

PubMed

Yau, Christopher W H; Pizzo, Elena; Morris, Steve; Odd, David E; Winter, Cathy; Draycott, Timothy J

2016-10-01

We aim to outline the annual cost of setting up and running a standard, local, multi-professional obstetric emergencies training course, PROMPT (PRactical Obstetric Multi-Professional Training), at Southmead Hospital, Bristol, UK - a unit caring for approximately 6500 births per year. A retrospective, micro-costing analysis was performed. Start-up costs included purchasing training mannequins and teaching props, printing of training materials and assembly of emergency boxes (real and training). The variable costs included administration time, room hire, additional printing and the cost of releasing all maternity staff in the unit, either as attendees or trainers. Potential, extra start-up costs for maternity units without established training were also included. The start-up costs were €5574 and the variable costs for 1 year were €143 232. The total cost of establishing and running training at Southmead for 1 year was €148 806. Releasing staff as attendees or trainers accounted for 89% of the total first year costs, and 92% of the variable costs. The cost of running training in a maternity unit with around 6500 births per year was approximately €23 000 per 1000 births for the first year and around €22 000 per 1000 births in subsequent years. The cost of local, multi-professional obstetric emergencies training is not cheap, with staff costs potentially representing over 90% of the total expenditure. It is therefore vital that organizations consider the clinical effectiveness of local training packages before implementing them, to ensure the optimal allocation of finite healthcare budgets. © 2016 Nordic Federation of Societies of Obstetrics and Gynecology.

Implicit Learning of a Finger Motor Sequence by Patients with Cerebral Palsy After Neurofeedback.

PubMed

Alves-Pinto, Ana; Turova, Varvara; Blumenstein, Tobias; Hantuschke, Conny; Lampe, Renée

2017-03-01

Facilitation of implicit learning of a hand motor sequence after a single session of neurofeedback training of alpha power recorded from the motor cortex has been shown in healthy individuals (Ros et al., Biological Psychology 95:54-58, 2014). This facilitation effect could be potentially applied to improve the outcome of rehabilitation in patients with impaired hand motor function. In the current study a group of ten patients diagnosed with cerebral palsy trained reduction of alpha power derived from brain activity recorded from right and left motor areas. Training was distributed in three periods of 8 min each. In between, participants performed a serial reaction time task with their non-dominant hand, to a total of five runs. A similar procedure was repeated a week or more later but this time training was based on simulated brain activity. Reaction times pooled across participants decreased on each successive run faster after neurofeedback training than after the simulation training. Also recorded were two 3-min baseline conditions, once with the eyes open, another with the eyes closed, at the beginning and end of the experimental session. No significant changes in alpha power with neurofeedback or with simulation training were obtained and no correlation with the reductions in reaction time could be established. Contributions for this are discussed.

Simple training tricks for mastering and taming bypass procedures in neurosurgery

PubMed Central

Hafez, Ahmad; Raj, Rahul; Lawton, Michael T.; Niemelä, Mika

2017-01-01

Background: Neurosurgeons devoted to bypass neurosurgery or revascularization neurosurgery are becoming scarcer. From a practical point of view, “bypass neurosurgeons” are anastomosis makers, vessels technicians, and time-racing repairers of vessel walls. This requires understanding the key features and hidden tricks of bypass surgery. The goal of this paper is to provide simple and inexpensive tricks for taming the art of bypass neurosurgery. Most of these tricks and materials described can be borrowed, donated, or purchased inexpensively. Methods: We performed a review of relevant training materials and recorded videos for training bypass procedures for 3 years between June 2014 and July 2017. In total, 1,300 training bypass procedures were performed, of which 200 procedures were chosen for this paper. Results: A training laboratory bypass procedures is required to enable a neurosurgeon to develop the necessary skills. The important skills for training bypass procedures gained through meticulous practice to be as reflexes are coordination, speed, agility, flexibility, and reaction time. Bypassing requires synchronization between the surgeon's gross movements, fine motoric skills, and mental strength. The suturing rhythm must be timed in a brain–body–hand fashion. Conclusion: Bypass-training is a critical part of neurosurgical training and not for a selected few. Diligent and meticulous training can enable every neurosurgeon to tame the art of bypass neurosurgery. This requires understanding the key features and hidden tricks of bypass surgery, as well as uncountable hours of training. In bypass neurosurgery, quality and time goes hand in hand. PMID:29285411

Influence of musical and psychoacoustical training on pitch discrimination.

PubMed

Micheyl, Christophe; Delhommeau, Karine; Perrot, Xavier; Oxenham, Andrew J

2006-09-01

This study compared the influence of musical and psychoacoustical training on auditory pitch discrimination abilities. In a first experiment, pitch discrimination thresholds for pure and complex tones were measured in 30 classical musicians and 30 non-musicians, none of whom had prior psychoacoustical training. The non-musicians' mean thresholds were more than six times larger than those of the classical musicians initially, and still about four times larger after 2h of training using an adaptive two-interval forced-choice procedure; this difference is two to three times larger than suggested by previous studies. The musicians' thresholds were close to those measured in earlier psychoacoustical studies using highly trained listeners, and showed little improvement with training; this suggests that classical musical training can lead to optimal or nearly optimal pitch discrimination performance. A second experiment was performed to determine how much additional training was required for the non-musicians to obtain thresholds as low as those of the classical musicians from experiment 1. Eight new non-musicians with no prior training practiced the frequency discrimination task for a total of 14 h. It took between 4 and 8h of training for their thresholds to become as small as those measured in the classical musicians from experiment 1. These findings supplement and qualify earlier data in the literature regarding the respective influence of musical and psychoacoustical training on pitch discrimination performance.

Influence of handrim wheelchair propulsion training in adolescent wheelchair users, a pilot study.

PubMed

Dysterheft, Jennifer L; Rice, Ian M; Rice, Laura A

2015-01-01

Ten full-time adolescent wheelchair users (ages 13-18) completed a total of three propulsion trials on carpet and tile surfaces, at a self-selected velocity, and on a concrete surface, at a controlled velocity. All trials were performed in their personal wheelchair with force and moment sensing wheels attached bilaterally. The first two trials on each surface were used as pre-intervention control trials. The third trial was performed after receiving training on proper propulsion technique. Peak resultant force, contact angle, stroke frequency, and velocity were recorded during all trials for primary analysis. Carpet and tile trials resulted in significant increases in contact angle and peak total force with decreased stroke frequency after training. During the velocity controlled trials on concrete, significant increases in contact angle occurred, as well as decreases in stroke frequency after training. Overall, the use of a training video and verbal feedback may help to improve short-term propulsion technique in adolescent wheelchair users and decrease the risk of developing upper limb pain and injury.

Four Weeks of Classical Altitude Training Increases Resting Metabolic Rate in Highly Trained Middle-Distance Runners.

PubMed

Woods, Amy L; Sharma, Avish P; Garvican-Lewis, Laura A; Saunders, Philo U; Rice, Anthony J; Thompson, Kevin G

2017-02-01

High altitude exposure can increase resting metabolic rate (RMR) and induce weight loss in obese populations, but there is a lack of research regarding RMR in athletes at moderate elevations common to endurance training camps. The present study aimed to determine whether 4 weeks of classical altitude training affects RMR in middle-distance runners. Ten highly trained athletes were recruited for 4 weeks of endurance training undertaking identical programs at either 2200m in Flagstaff, Arizona (ALT, n = 5) or 600m in Canberra, Australia (CON, n = 5). RMR, anthropometry, energy intake, and hemoglobin mass (Hb mass ) were assessed pre- and posttraining. Weekly run distance during the training block was: ALT 96.8 ± 18.3km; CON 103.1 ± 5.6km. A significant interaction for Time*Group was observed for absolute (kJ.day -1 ) (F-statistic, p-value: F (1,8) =13.890, p = .01) and relative RMR (F (1,8) =653.453, p = .003) POST-training. No significant changes in anthropometry were observed in either group. Energy intake was unchanged (mean ± SD of difference, ALT: 195 ± 3921kJ, p = .25; CON: 836 ± 7535kJ, p = .75). A significant main effect for time was demonstrated for total Hb mass (g) (F (1,8) =13.380, p = .01), but no significant interactions were observed for either variable [Total Hb mass (g): F (1,8) =1.706, p = .23; Relative Hb mass (g.kg -1 ): F (1,8) =0.609, p = .46]. These novel findings have important practical application to endurance athletes routinely training at moderate altitude, and those seeking to optimize energy management without compromising training adaptation. Altitude exposure may increase RMR and enhance training adaptation,. During training camps at moderate altitude, an increased energy intake is likely required to support an increased RMR and provide sufficient energy for training and performance.

Study on the Effectiveness of Virtual Reality Game-Based Training on Balance and Functional Performance in Individuals with Paraplegia

PubMed Central

Khurana, Meetika; Walia, Shefali

2017-01-01

Objective: To determine whether there is any difference between virtual reality game–based balance training and real-world task-specific balance training in improving sitting balance and functional performance in individuals with paraplegia. Methods: The study was a pre test–post test experimental design. There were 30 participants (28 males, 2 females) with traumatic spinal cord injury randomly assigned to 2 groups (group A and B). The levels of spinal injury of the participants were between T6 and T12. The virtual reality game–based balance training and real-world task-specific balance training were used as interventions in groups A and B, respectively. The total duration of the intervention was 4 weeks, with a frequency of 5 times a week; each training session lasted 45 minutes. The outcome measures were modified Functional Reach Test (mFRT), t-shirt test, and the self-care component of the Spinal Cord Independence Measure–III (SCIM-III). Results: There was a significant difference for time (p = .001) and Time × Group effect (p = .001) in mFRT scores, group effect (p = .05) in t-shirt test scores, and time effect (p = .001) in the self-care component of SCIM-III. Conclusions: Virtual reality game–based training is better in improving balance and functional performance in individuals with paraplegia than real-world task-specific balance training. PMID:29339902

Feasibility and short-term impact of the "case study in-house group training program for family nursing" at medical facilities.

PubMed

Yamazaki, Akemi; Tsumura, Akemi; Mine, Hiroko; Kimura, Chisato; Soeda, Akemi; Odatsu, Kazumi; Kiwado, Wataru

2017-02-01

The aim of this study was to evaluate the feasibility and short-term impact of case study training in family nursing care targeting midlevel nursing professionals. The intervention group participated in four 90-minute case study training sessions over 6 months, while the control group participated in two 90-minute lectures. Using primary outcome variables as evaluation indexes, we measured the participants' total scores on the Family Importance in Nursing Care Scale and 4 subitems 3 times (before, immediately after and 1 month after training) from May 2014 to March 2015 and then conducted 2-way repeated-measure analysis of variance. We asked the participants and training planners/managers to provide feedback on their evaluation and then performed content analysis on their responses. Although the primary impact due to the different measurement times was significant, no significant difference was observed in the interaction between measurement time and training differences. Of the 4 subitems, significant interactions because of measurement time and training differences were observed only in Fam-B. Feedback data showed all participants felt that their understanding of the importance of family nursing care was strengthened, and participants in the intervention group specifically described how they were utilizing what they had learned from training in practice. © 2016 John Wiley & Sons Australia, Ltd.

Study on the Effectiveness of Virtual Reality Game-Based Training on Balance and Functional Performance in Individuals with Paraplegia.

PubMed

Khurana, Meetika; Walia, Shefali; Noohu, Majumi M

2017-01-01

Objective: To determine whether there is any difference between virtual reality game-based balance training and real-world task-specific balance training in improving sitting balance and functional performance in individuals with paraplegia. Methods: The study was a pre test-post test experimental design. There were 30 participants (28 males, 2 females) with traumatic spinal cord injury randomly assigned to 2 groups (group A and B). The levels of spinal injury of the participants were between T6 and T12. The virtual reality game-based balance training and real-world task-specific balance training were used as interventions in groups A and B, respectively. The total duration of the intervention was 4 weeks, with a frequency of 5 times a week; each training session lasted 45 minutes. The outcome measures were modified Functional Reach Test (mFRT), t-shirt test, and the self-care component of the Spinal Cord Independence Measure-III (SCIM-III). Results: There was a significant difference for time ( p = .001) and Time × Group effect ( p = .001) in mFRT scores, group effect ( p = .05) in t-shirt test scores, and time effect ( p = .001) in the self-care component of SCIM-III. Conclusions: Virtual reality game-based training is better in improving balance and functional performance in individuals with paraplegia than real-world task-specific balance training.

Combined Aerobic/Strength Training and Energy Expenditure in Older Women

PubMed Central

Hunter, Gary R.; Bickel, C. Scott; Fisher, Gordon; Neumeier, William; McCarthy, John

2013-01-01

Purpose To examine the effects of three different frequencies of combined resistance and aerobic training on total energy expenditure (TEE) and activity related energy expenditure (AEE) in a group of older adults. Methods Seventy-two women, 60 – 74 years old, were randomly assigned to one of three groups: 1 day/week of aerobic and 1 day/week of resistance (1+1); 2 days/week of aerobic and 2 days/week resistance (2+2); or 3 days/week aerobic and 3 days/week resistance (3+3). Body composition (DXA), feeling of fatigue, depression, and vigor (questionnaire), strength (1RM), serum cytokines (ELISA), maximal oxygen uptake (progressive treadmill test), resting energy expenditure, and TEE were measured before and after 16 weeks of training. Aerobic training consisted of 40 minutes of aerobic exercise at 80% maximum heart rate and resistance training consisted of 2 sets of 10 repetitions for 10 different exercises at 80% of one repetition maximum. Results All groups increased fat free mass, strength and aerobic fitness and decreased fat mass. No changes were observed in cytokines or perceptions of fatigue/depression. No time by group interaction was found for any fitness/body composition variable. TEE and AEE increased with the 2+2 group but not with the other two groups. Non-exercise training AEE (NEAT) increased significantly in the 2+2 group (+200 kcal/day), group 1×1 showed a trend for an increase (+68 kcal/day) and group 3+3 decreased significantly (−150 kcal/day). Conclusion Results indicate that 3+3 training may inhibit NEAT by being too time consuming and does not induce superior training adaptations to 1+1 and 2+2 training. Key words: physical activity, older adults, total energy expenditure, maximum oxygen uptake. PMID:23774582

Lesson plans in surgical training.

PubMed

Lester, S E; Robson, A K R

2007-06-01

Lesson plans in surgery enable trainers and trainees to agree on goals that balance training needs with service commitments. Lesson plans are individualised to the trainee and encourage ownership of learning. They are based on SMART criteria and therefore have a sound educational footing. Most of the work in creating a lesson plan falls to the trainee. The total time for creation of each plan is approximately 20 min. Our use of lesson plans for surgical training has been met with favourable response from both trainer and trainees.

Effectiveness of pharmacovigilance training of general practitioners: a retrospective cohort study in the Netherlands comparing two methods.

PubMed

Gerritsen, Roald; Faddegon, Hans; Dijkers, Fred; van Grootheest, Kees; van Puijenbroek, Eugène

2011-09-01

Spontaneous reporting is a cornerstone of pharmacovigilance. Unfamiliarity with the reporting of suspected adverse drug reactions (ADRs) is a major factor leading to not reporting these events. Medical education may promote more effective reporting. Numerous changes have been implemented in medical education over the last decade, with a shift in training methods from those aimed predominantly at the transfer of knowledge towards those that are more practice based and skill oriented. It is conceivable that these changes have an impact on pharmacovigilance training in vocational training programmes. Therefore, this study compares the effectiveness of a skill-oriented, practice-based pharmacovigilance training method, with a traditional, lecture-based pharmacovigilance training method in the vocational training of general practitioners (GPs). The traditional, lecture-based method is common practice in the Netherlands. The purpose of this study was to establish whether the use of a practice-based, skill-oriented method in pharmacovigilance training during GP traineeship leads to an increase of reported ADRs after completion of this traineeship, compared with a lecture-based method. We also investigated whether the applied training method has an impact on the documentation level of the reports and on the number of unlabelled events reported. A retrospective cohort study. The number of ADR reports submitted to the Netherlands Pharmacovigilance Centre Lareb (between January 2006 and October 2010) after completion of GP vocational training was compared between the two groups. Documentation level of the reports and the number of labelled/unlabelled events reported were also compared. The practice-based cohort reported 32 times after completion of training (124 subjects, 6.8 reports per 1000 months of follow-up; total follow-up of 4704 months). The lecture-based cohort reported 12 times after training (135 subjects, 2.1 reports per 1000 months of follow-up; total follow-up of 5824 months) [odds ratio 2.9; 95% CI 1.4, 6.1]. Reports from GPs with practice-based training had a better documentation grade than those from GPs with lecture-based training, and more often concerned unlabelled events. The practice-based method resulted in significantly more and better-documented reports and more often concerned unlabelled events than the lecture-based method. This effect persisted and did not appear to diminish over time.

An Investigation of Consulting-Training; as a Part-Time or Ultimate Career Option for Business Educators and Their Graduates.

ERIC Educational Resources Information Center

Church, Olive D.

A study examined the feasibility of consulting-training as a career option for business professionals. Data were gathered from a mail survey completed by a total of 60 firms in Arizona and Colorado and also from interviews, the investigator's participation and collaboration experiences with consultants, and a comparison of the literature on…

Collision activity during training increases total energy expenditure measured via doubly labelled water.

PubMed

Costello, Nessan; Deighton, Kevin; Preston, Thomas; Matu, Jamie; Rowe, Joshua; Sawczuk, Thomas; Halkier, Matt; Read, Dale B; Weaving, Daniel; Jones, Ben

2018-06-01

Collision sports are characterised by frequent high-intensity collisions that induce substantial muscle damage, potentially increasing the energetic cost of recovery. Therefore, this study investigated the energetic cost of collision-based activity for the first time across any sport. Using a randomised crossover design, six professional young male rugby league players completed two different 5-day pre-season training microcycles. Players completed either a collision (COLL; 20 competitive one-on-one collisions) or non-collision (nCOLL; matched for kinematic demands, excluding collisions) training session on the first day of each microcycle, exactly 7 days apart. All remaining training sessions were matched and did not involve any collision-based activity. Total energy expenditure was measured using doubly labelled water, the literature gold standard. Collisions resulted in a very likely higher (4.96 ± 0.97 MJ; ES = 0.30 ± 0.07; p = 0.0021) total energy expenditure across the 5-day COLL training microcycle (95.07 ± 16.66 MJ) compared with the nCOLL training microcycle (90.34 ± 16.97 MJ). The COLL training session also resulted in a very likely higher (200 ± 102 AU; ES = 1.43 ± 0.74; p = 0.007) session rating of perceived exertion and a very likely greater (- 14.6 ± 3.3%; ES = - 1.60 ± 0.51; p = 0.002) decrease in wellbeing 24 h later. A single collision training session considerably increased total energy expenditure. This may explain the large energy expenditures of collision-sport athletes, which appear to exceed kinematic training and match demands. These findings suggest fuelling professional collision-sport athletes appropriately for the "muscle damage caused" alongside the kinematic "work required".

Back muscle response to sudden trunk loading can be modified by training among healthcare workers.

PubMed

Pedersen, Mogens Theisen; Essendrop, Morten; Skotte, Jørgen H; Jørgensen, Kurt; Schibye, Bente; Fallentin, Nils

2007-06-01

Experimental study of the effect of physical training on the reaction to sudden back loading. To investigate the effect and sustainability of "on the job training" on the reaction to sudden back loading among employees at a geriatric ward. Available data suggest that a delayed muscle reflex response to sudden trunk loading may increase the risk of low back injuries. We have previously shown that training may alter the response to sudden trunk loading in healthy subjects and decrease the time elapsed until stopping of the forward movement of the trunk (stopping time). Data on the possibilities of a training-induced improvement in the reflex response among workers exposed to sudden trunk loading on the job are, however, nonexistent, and there is no evidence of long-term benefits, i.e., the sustainability of a positive training effect. The study included 23 participants and 14 controls. All were healthy without prior history of low back pain (LBP). The training group participated in a total of 18 training sessions during a 9-week period. The training focused on reactions to a variety of sudden trunk loadings. Before and after the training intervention and at a 1-year follow-up, all subjects were tested for their reaction to expected and unexpected sudden trunk loading by applying a horizontal force of 58 N to the upper back of the subjects and measuring the electromyographic (EMG) response from the erector spinae muscles. In the training group, the stopping time and the distance moved after unexpected sudden trunk loading decreased significantly (13%-19%, P = 0.02). The improved stopping time was associated with marked changes in the time-wise distribution of the EMG signal after training. In addition, the follow-up study showed a high sustainability of the training effect. The results demonstrated a training-induced improvement of the response to sudden trunk loading that may be beneficial in workers, such as nurses, who are exposed to sudden trunk perturbations during patient handling.

Effect of maximal oxygen uptake and different forms of physical training on serum lipoproteins.

PubMed

Schnabel, A; Kindermann, W

1982-01-01

260 well trained male sportsmen between 17 and 30 years of age participating in a variety of events were examined for total serum cholesterol and lipoprotein cholesterol and compared with 37 moderately active leisure-time sportsmen and 20 sedentary controls of similar ages and sex. Lipoprotein cholesterol distribution was determined by quantitative electrophoresis. Mean HDL-cholesterol increased progressively from the mean of the sedentary control to the mean of the long-distance runners, indicating a graded effect of physical activity on HDL-cholesterol. In all sporting groups mean LDL-cholesterol tended to be lower than in the controls, no association between LDL-cholesterol and form of training being apparent. Except for the long-distance runners, all sporting groups tended to be lower in total cholesterol than the controls. The HDL-/total cholesterol and LDL/HDL ratios yielded a better discrimination between the physically active and inactive than the HDL-cholesterol alone. Significant positive correlations with maximal oxygen uptake and roentgenologically determined heart volume were found for HDL-cholesterol and HDL-/total cholesterol, and negative ones for LDL/HDL. Differences in the regressions among subsets made up of sporting groups under different physical demands suggest a positive relationship between lipoprotein distribution and the magnitude of the trained muscle mass.

[Influence of sports on development of 10 and 11-year-old boys. II. Spiroergometry].

PubMed

Popow, C; Haschke, F; Haber, P; Schuster, E; Salzer, H R

1984-01-01

We performed ergometric tests on a bicycle ergometer at the beginning and at the end of a nine month training period of track-and field athletics at school in 21 10 to 11 year old boys (8 hours training per week) and in 12 control subjects (3 1/2 hours training per week). With the exception of total work both groups had similar results at the first test. After nine months most test parameters were significantly improved in both groups. Total working time, total and maximal work, systolic blood pressure at maximal work and relative VO2max. were significantly different in the boys with 8 hours training from values obtained in the control subjects. VO2max. per kg body weight increased from a mean of 48.03 to 57.43 ml x min-1 x kg-2 (19.6%) in the boys with 8 hours training and from 44.70 tp 49.20 ml x min-1 x kg-1 (10.1%) in the control subjects. VO2-max. per kg lean body mass increased only in the boys with 8 hours training. VO2max. related to heart rate increased by 33% in the boys with 8 hours training and by 12% in the controls. The maximal minute ventilation and the minute ventilation at different submaximal working loads decreased in both groups. We conclude that the higher physical activity significantly improved the physical performance and the performance of the cardiovascular and respiratory system in preadolescent boys.

Curriculum for Commissioning Energy Efficient Buildings

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

Webster, Lia

2012-12-27

In July 2010, the U.S. Department of Energy (DOE) awarded funding to PECI to develop training curriculum in commercial energy auditing and building commissioning. This program was created in response to the high demand for auditing and commissioning services in the U.S. commercial buildings market and to bridge gaps and barriers in existing training programs. Obstacles addressed included: lack of focus on entry level candidates; prohibitive cost and time required for training; lack of hands-on training; trainings that focus on certifications & process overviews; and lack of comprehensive training. PECI organized several other industry players to create a co-funded projectmore » sponsored by DOE, PECI, New York State Energy and Research Development Authority (NYSERDA), California Energy Commission (CEC), Northwest Energy Efficiency Alliance (NEEA) and California Commissioning Collaborative (CCC). After awarded, PECI teamed with another DOE awardee, New Jersey Institute of Technology (NJIT), to work collaboratively to create one comprehensive program featuring two training tracks. NJIT’s Center for Building Knowledge is a research and training institute affiliated with the College of Architecture and Design, and provided e-learning and video enhancements. This project designed and developed two training programs with a comprehensive, energy-focused curriculum to prepare new entrants to become energy auditors or commissioning authorities (CxAs). The following are the key elements of the developed trainings, which is depicted graphically in Figure 1: • Online classes are self-paced, and can be completed anywhere, any time • Commissioning Authority track includes 3 online modules made up of 24 courses delivered in 104 individual lessons, followed by a 40 hour hands-on lab. Total time required is between 75 and 100 hours, depending on the pace of the independent learner. • Energy Auditor track includes 3 online modules made up of 18 courses delivered in 72 individual lessons, followed by a 24 hour hands-on lab. Total time required is between 50 and 70 hours, depending on the pace of the independent learner. • Individual courses can be taken for continuing education credits. • Assessments are included for each course, and a score of at least 80% is required for completion. • Completion of Modules 1 through 3 is prerequisite for participating in the laboratory. More experienced participants have the option to test out of Modules 1 and 2 and complete Module 3 to progress to the laboratory.« less

Does intentional support of degree programs in general surgery residency affect research productivity or pursuit of academic surgery?

PubMed

Joshua Smith, Jesse; Patel, Ravi K; Chen, Xi; Tarpley, Margaret J; Terhune, Kyla P

2014-01-01

Many residents supplement general surgery training with years of dedicated research, and an increasing number at our institution pursue additional degrees. We sought to determine whether it was worth the financial cost for residency programs to support degrees. We reviewed graduating chief residents (n = 69) in general surgery at Vanderbilt University from 2001 to 2010 and collected the data including research time and additional degrees obtained. We then compared this information with the following parameters: (1) total papers, (2) first-author papers, (3) Journal Citation Reports impact factors of journals in which papers were published, and (4) first job after residency or fellowship training. The general surgery resident training program at Vanderbilt University is an academic program, approved to finish training 7 chief residents yearly during the time period studied. Chief residents in general surgery at Vanderbilt who finished their training 2001 through 2010. We found that completion of a degree during residency was significantly associated with more total and first-author publications as compared with those by residents with only dedicated research time (p = 0.001 and p = 0.017). Residents completing a degree also produced publications of a higher caliber and level of authorship as determined by an adjusted resident impact factor score as compared with those by residents with laboratory research time only (p = 0.005). Degree completion also was significantly correlated with a first job in academia if compared to those with dedicated research time only (p = 0.046). Our data support the utility of degree completion when economically feasible and use of dedicated research time as an effective way to significantly increase research productivity and retain graduates in academic surgery. Aggregating data from other academic surgery programs would allow us to further determine association of funding of additional degrees as a means to encourage academic productivity and retention. Copyright © 2014 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Strength training, walking, and social activity improve sleep in nursing home and assisted living residents: randomized controlled trial.

PubMed

Richards, Kathy C; Lambert, Corinne; Beck, Cornelia K; Bliwise, Donald L; Evans, William J; Kalra, Gurpreet K; Kleban, Morton H; Lorenz, Rebecca; Rose, Karen; Gooneratne, Nalaka S; Sullivan, Dennis H

2011-02-01

To compare the effects of physical resistance strength training and walking (E), individualized social activity (SA), and E and SA (ESA) with a usual care control group on total nocturnal sleep time in nursing home and assisted living residents. Pretest-posttest experimental design with assignment to one of four groups for 7 weeks: E (n=55), SA (n=50), ESA (n=41), and usual care control (n=47). Ten nursing homes and three assisted living facilities. One hundred ninety-three residents were randomly assigned; 165 completed the study. The E group participated in high-intensity physical resistance strength training 3 days a week and on 2 days walked for up to 45 minutes, the SA group received social activity 1 hour daily 5 days a week, the ESA group received both E and SA, and the control group participated in usual activities provided in the homes. Total nocturnal sleep time was measured using 2 nights of polysomnography before and 2 nights of polysomnography after the intervention. Sleep efficiency (SE), non-rapid eye movement (NREM) sleep, rapid eye movement sleep, and sleep onset latency were also analyzed. Total nocturnal sleep time was significantly greater in the ESA group than in the control group (adjusted means 364.2 minutes vs 328.9 minutes), as was SE and NREM sleep. High-intensity physical resistance strength training and walking combined with social activity significantly improved sleep in nursing home and assisted living residents. The interventions by themselves did not have significant effects on sleep in this population. © 2011, Copyright the Authors. Journal compilation © 2011, The American Geriatrics Society.

[Influence of Training of Orthopaedic Surgeons on Clinical Outcome after Total Hip Arthroplasty in a High Volume Endoprosthetic Centre].

PubMed

Osmanski-Zenk, Katrin; Finze, Susanne; Lenz, Robert; Bader, Rainer; Mittelmeier, Wolfram

2018-06-26

The study aims to evaluate whether the postoperative outcome and the probability of complications of patients with total hip arthroplasty increases significantly when surgeons in training are in charge, assisted by a high volume surgeon, compared to a highly experienced orthopaedic surgeon, within the context of a high volume hospital certified to EndoCert. 192 patients with a primary hip arthroplasty were included. To assess the outcome, the Harris Hip Score, WOMAC, SF-36 and EuroQol-5D were surveyed pre- and 12 months postoperatively. As complications we considered the quality indicators defined by EndoCert. We found significant improvements in the postoperative score values with the qualifications of the surgeon in charge, even when a high volume surgeon or a surgeon in training was responsible. If a surgeon in training is assisted by a highly experienced surgeon, the risk of complications does not increase, although the operating time was significantly increased. Both the surgeon in training as well as the arthroplasty patient benefit from implementing the EndoCert system, because the postoperative outcome and the complication probability is independent of the qualifcation of the operating orthopaedic surgeon performing total hip arthroplasty when assisted by an experienced surgeon. Georg Thieme Verlag KG Stuttgart · New York.

‘Making every contact count’: evaluation of the impact of an intervention to train health and social care practitioners in skills to support health behaviour change

PubMed Central

Black, Christina; Tinati, Tannaze; Cradock, Sue; Begum, Rufia; Jarman, Megan; Pease, Anna; Margetts, Barrie; Davies, Jenny; Inskip, Hazel; Cooper, Cyrus; Baird, Janis; Barker, Mary

2015-01-01

A total of 148 health and social care practitioners were trained in skills to support behaviour change: creating opportunities to discuss health behaviours, using open discovery questions, listening, reflecting and goal-setting. At three time points post-training, use of the skills was evaluated and compared with use of skills by untrained practitioners. Trained practitioners demonstrated significantly greater use of these client-centred skills to support behaviour change compared to their untrained peers up to one year post-training. Because it uses existing services to deliver support for behaviour change, this training intervention has the potential to improve public health at relatively low cost. PMID:24713156

Effect of Core Stability Training on Trunk Function, Standing Balance, and Mobility in Stroke Patients.

PubMed

Haruyama, Koshiro; Kawakami, Michiyuki; Otsuka, Tomoyoshi

2017-03-01

Trunk function is important for standing balance, mobility, and functional outcome after stroke, but few studies have evaluated the effects of exercises aimed at improving core stability in stroke patients. To investigate the effectiveness of core stability training on trunk function, standing balance, and mobility in stroke patients. An assessor-blinded, randomized controlled trial was undertaken in a stroke rehabilitation ward, with 32 participants randomly assigned to an experimental group or a control group (n = 16 each). The experimental group received 400 minutes of core stability training in place of conventional programs within total training time, while the control group received only conventional programs. Primary outcome measures were evaluated using the Trunk Impairment Scale (TIS), which reflects trunk function. Secondary outcome measures were evaluated by pelvic tilt active range of motion in the sagittal plane, the Balance Evaluation Systems Test-brief version (Brief-BESTest), Functional Reach test, Timed Up-and-Go test (TUG), and Functional Ambulation Categories (FAC). A general linear repeated-measures model was used to analyze the results. A treatment effect was found for the experimental group on the dynamic balance subscale and total score of the TIS ( P = .002 and P < .001, respectively), pelvic tilt active range of motion ( P < .001), Brief-BESTest ( P < .001), TUG ( P = .008), and FAC ( P = .022). Core stability training has beneficial effects on trunk function, standing balance, and mobility in stroke patients. Our findings might provide support for introducing core stability training in stroke rehabilitation.

Exercise training improves fat metabolism independent of total energy expenditure in sedentary overweight men, but does not restore lean metabolic phenotype.

PubMed

Lefai, E; Blanc, S; Momken, I; Antoun, E; Chery, I; Zahariev, A; Gabert, L; Bergouignan, A; Simon, C

2017-12-01

Obesity is a dietary fat storage disease. Although exercise prevents weight gain, effects of chronic training on dietary fat oxidation remains understudied in overweight adults. We tested whether 2 months of training at current guidelines increase dietary fat oxidation in sedentary overweight adults like in sedentary lean adults. Sedentary lean (n=10) and overweight (n=9) men trained on a cycle ergometer at 50% VO 2peak , 1 h day -1 , four times per week, for 2 months while energy balance was clamped. Metabolic fate of [d 31 ]palmitate and [1- 13 C]oleate mixed in standard meals, total substrate use, total energy expenditure (TEE), activity energy expenditure (AEE) and key muscle proteins/enzymes were measured before and at the end of the intervention. Conversely to lean subjects, TEE and AEE did not increase in overweight participants due to a spontaneous decrease in non-training AEE. Despite this compensatory behavior, aerobic fitness, insulin sensitivity and fat oxidation were improved by exercise training. The latter was not explained by changes in dietary fat trafficking but more likely by a coordinated response at the muscle level enhancing fat uptake, acylation and oxidation (FABPpm, CD36, FATP1, ACSL1, CPT1, mtGPAT). ACSL1 fold change positively correlated with total fasting (R 2 =0.59, P<0.0001) and post-prandial (R 2 =0.49, P=0.0006) fat oxidation whereas mtGPAT fold change negatively correlated with dietary palmitate oxidation (R 2 =0.40, P=0.009), suggesting modified fat trafficking between oxidation and storage within the muscle. However, for most of the measured parameters the post-training values observed in overweight adults remained lower than the pre-training values observed in the lean subjects. Independent of energy balance and TEE, exercise training at current recommendations improved fitness and fat oxidation in overweight adults. However the improved metabolic phenotype of overweight adults was not as healthy as the one of their lean counterparts before the 2-month training, likely due to the spontaneous reduction in non-training AEE.

Cognitive Load in Mastoidectomy Skills Training: Virtual Reality Simulation and Traditional Dissection Compared.

PubMed

Andersen, Steven Arild Wuyts; Mikkelsen, Peter Trier; Konge, Lars; Cayé-Thomasen, Per; Sørensen, Mads Sølvsten

2016-01-01

The cognitive load (CL) theoretical framework suggests that working memory is limited, which has implications for learning and skills acquisition. Complex learning situations such as surgical skills training can potentially induce a cognitive overload, inhibiting learning. This study aims to compare CL in traditional cadaveric dissection training and virtual reality (VR) simulation training of mastoidectomy. A prospective, crossover study. Participants performed cadaveric dissection before VR simulation of the procedure or vice versa. CL was estimated by secondary-task reaction time testing at baseline and during the procedure in both training modalities. The national Danish temporal bone course. A total of 40 novice otorhinolaryngology residents. Reaction time was increased by 20% in VR simulation training and 55% in cadaveric dissection training of mastoidectomy compared with baseline measurements. Traditional dissection training increased CL significantly more than VR simulation training (p < 0.001). VR simulation training imposed a lower CL than traditional cadaveric dissection training of mastoidectomy. Learning complex surgical skills can be a challenge for the novice and mastoidectomy skills training could potentially be optimized by employing VR simulation training first because of the lower CL. Traditional dissection training could then be used to supplement skills training after basic competencies have been acquired in the VR simulation. Copyright © 2015 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

A Comparison of Whole-Body Vibration and Resistance Training on Total Work in the Rotator Cuff

PubMed Central

Hand, Jason; Verscheure, Susan; Osternig, Louis

2009-01-01

Abstract Context: Whole-body vibration machines are a relatively new technology being implemented in the athletic setting. Numerous authors have examined the proposed physiologic mechanisms of vibration therapy and performance outcomes. Changes have mainly been observed in the lower extremity after individual exercises, with minimal attention to the upper extremity and resistance training programs. Objective: To examine the effects of a novel vibration intervention directed at the upper extremity as a precursor to a supervised, multijoint dynamic resistance training program. Design: Randomized controlled trial. Setting: National Collegiate Athletic Association Division IA institution. Patients or Other Participants: Thirteen female student-athletes were divided into the following 2 treatment groups: (1) whole-body vibration and resistance training or (2) resistance training only. Intervention(s): Participants in the vibration and resistance training group used an experimental vibration protocol of 2 × 60 seconds at 4 mm and 50 Hz, in a modified push-up position, 3 times per week for 10 weeks, just before their supervised resistance training session. Main Outcome Measure(s): Isokinetic total work measurements of the rotator cuff were collected at baseline and at week 5 and week 10. Results: No differences were found between the treatment groups (P > .05). However, rotator cuff output across time increased in both groups (P < .05). Conclusions: Although findings did not differ between the groups, the use of whole-body vibration as a precursor to multijoint exercises warrants further investigation because of the current lack of literature on the topic. Our results indicate that indirectly strengthening the rotator cuff using a multijoint dynamic resistance training program is possible. PMID:19771284

Underwater near-infrared spectroscopy can measure training adaptations in adolescent swimmers

PubMed Central

Parry, Dave; Cooper, Chris E.

2018-01-01

The development of an underwater near-infrared spectroscopy (uNIRS) device has enabled previously unattainable measurements of peripheral muscle hemodynamics and oxygenation to be taken within the natural aquatic environment. The purposes of this study were (i) to trial the use of uNIRS, in a real world training study, and (ii) to monitor the effects of a swim training program upon muscle oxygenation status in short distance swimming. A total of 14 junior club level swimmers completed a repeated swim sprint test before and after an eight week endurance training program. A waterproof, portable Near-Infrared Spectroscopy device was attached to the vastus lateralis. uNIRS successfully measured changes in muscle oxygenation and blood volume in all individuals; rapid sub-second time resolution of the device was able to demonstrate muscle oxygenation changes during the characteristic swim movements. Post training heart rate recovery and swim performance time were significantly improved. uNIRS data also showed significant changes. A larger rise in deoxyhemoglobin during individual sprints suggested training induced an increase in muscle oxygen extraction; a faster recovery time for muscle oxygenation suggested positive training induced changes and significant changes in muscle blood flow also occur. As a strong correlation was seen between an increased reoxygenation rate and an improved swim performance time, these findings support the use of uNIRS as a new performance analysis tool in swimming. PMID:29692951

Underwater near-infrared spectroscopy can measure training adaptations in adolescent swimmers.

PubMed

Jones, Ben; Parry, Dave; Cooper, Chris E

2018-01-01

The development of an underwater near-infrared spectroscopy (uNIRS) device has enabled previously unattainable measurements of peripheral muscle hemodynamics and oxygenation to be taken within the natural aquatic environment. The purposes of this study were (i) to trial the use of uNIRS, in a real world training study, and (ii) to monitor the effects of a swim training program upon muscle oxygenation status in short distance swimming. A total of 14 junior club level swimmers completed a repeated swim sprint test before and after an eight week endurance training program. A waterproof, portable Near-Infrared Spectroscopy device was attached to the vastus lateralis . uNIRS successfully measured changes in muscle oxygenation and blood volume in all individuals; rapid sub-second time resolution of the device was able to demonstrate muscle oxygenation changes during the characteristic swim movements. Post training heart rate recovery and swim performance time were significantly improved. uNIRS data also showed significant changes. A larger rise in deoxyhemoglobin during individual sprints suggested training induced an increase in muscle oxygen extraction; a faster recovery time for muscle oxygenation suggested positive training induced changes and significant changes in muscle blood flow also occur. As a strong correlation was seen between an increased reoxygenation rate and an improved swim performance time, these findings support the use of uNIRS as a new performance analysis tool in swimming.

Knee, Shoulder, and Fundamentals of Arthroscopic Surgery Training: Validation of a Virtual Arthroscopy Simulator.

PubMed

Tofte, Josef N; Westerlind, Brian O; Martin, Kevin D; Guetschow, Brian L; Uribe-Echevarria, Bastián; Rungprai, Chamnanni; Phisitkul, Phinit

2017-03-01

To validate the knee, shoulder, and virtual Fundamentals of Arthroscopic Training (FAST) modules on a virtual arthroscopy simulator via correlations with arthroscopy case experience and postgraduate year. Orthopaedic residents and faculty from one institution performed a standardized sequence of knee, shoulder, and FAST modules to evaluate baseline arthroscopy skills. Total operation time, camera path length, and composite total score (metric derived from multiple simulator measurements) were compared with case experience and postgraduate level. Values reported are Pearson r; alpha = 0.05. 35 orthopaedic residents (6 per postgraduate year), 2 fellows, and 3 faculty members (2 sports, 1 foot and ankle), including 30 male and 5 female residents, were voluntarily enrolled March to June 2015. Knee: training year correlated significantly with year-averaged knee composite score, r = 0.92, P = .004, 95% confidence interval (CI) = 0.84, 0.96; operation time, r = -0.92, P = .004, 95% CI = -0.96, -0.84; and camera path length, r = -0.97, P = .0004, 95% CI = -0.98, -0.93. Knee arthroscopy case experience correlated significantly with composite score, r = 0.58, P = .0008, 95% CI = 0.27, 0.77; operation time, r = -0.54, P = .002, 95% CI = -0.75, -0.22; and camera path length, r = -0.62, P = .0003, 95% CI = -0.8, -0.33. Shoulder: training year correlated strongly with average shoulder composite score, r = 0.90, P = .006, 95% CI = 0.81, 0.95; operation time, r = -0.94, P = .001, 95% CI = -0.97, -0.89; and camera path length, r = -0.89, P = .007, 95% CI = -0.95, -0.80. Shoulder arthroscopy case experience correlated significantly with average composite score, r = 0.52, P = .003, 95% CI = 0.2, 0.74; strongly with operation time, r = -0.62, P = .0002, 95% CI = -0.8, -0.33; and camera path length, r = -0.37, P = .044, 95% CI = -0.64, -0.01, by training year. FAST: training year correlated significantly with 3 combined FAST activity average composite scores, r = 0.81, P = .0279, 95% CI = 0.65, 0.90; operation times, r = -0.86, P = .012, 95% CI = -0.93, -0.74; and camera path lengths, r = -0.85, P = .015, 95% CI = -0.92, -0.72. Total arthroscopy cases performed did not correlate significantly with overall FAST performance. We found significant correlations between both training year and knee and shoulder arthroscopy experience when compared with performance as measured by composite score, camera path length, and operation time during a simulated diagnostic knee and shoulder arthroscopy, respectively. Three FAST activities demonstrated significant correlations with training year but not arthroscopy case experience as measured by composite score, camera path length, and operation time. We attempt to validate an arthroscopy simulator that could be used to supplement arthroscopy skills training for orthopaedic residents. Copyright © 2016 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

Shuttle flight experiment 30-day summary report

NASA Technical Reports Server (NTRS)

1985-01-01

A total of 12 AFT training sessions were administered to SL 3 Payload Specialists over a 7 month period. Nine of these sessions were 2 hours in duration and three were 3 hours in duration. A total of three rotating chair tests were conducted in this time frame with four subjects. The performance of these crewmen across tests is shown. Test 1, a baseline motion sickness test, was conducted approximately 10 months prior to the mission, before any AFT was administered. Test 2 was administered after 2 hours of AFT, test 3 after 4 hours and test 4 after 6 hours (total) of training in symptom control. Improvement in performance is reflected by a subject's ability to tolerate a greater number of rotations across tests. Additional training for crewman was not possible within the constraints of the mission. Results of the mission indicate that, as predicted preflight, subject #32 was relatively symptom free inflight while subject #33 was not. Other preflight and postflight tests and analyses are reported.

A parallel decision tree-based method for user authentication based on keystroke patterns.

PubMed

Sheng, Yong; Phoha, Vir V; Rovnyak, Steven M

2005-08-01

We propose a Monte Carlo approach to attain sufficient training data, a splitting method to improve effectiveness, and a system composed of parallel decision trees (DTs) to authenticate users based on keystroke patterns. For each user, approximately 19 times as much simulated data was generated to complement the 387 vectors of raw data. The training set, including raw and simulated data, is split into four subsets. For each subset, wavelet transforms are performed to obtain a total of eight training subsets for each user. Eight DTs are thus trained using the eight subsets. A parallel DT is constructed for each user, which contains all eight DTs with a criterion for its output that it authenticates the user if at least three DTs do so; otherwise it rejects the user. Training and testing data were collected from 43 users who typed the exact same string of length 37 nine consecutive times to provide data for training purposes. The users typed the same string at various times over a period from November through December 2002 to provide test data. The average false reject rate was 9.62% and the average false accept rate was 0.88%.

[Effects of training on static and dynamic balance in elderly subjects who have had a fall or not].

PubMed

Toulotte, C; Thévenon, A; Fabre, C

2004-11-01

To evaluate the effects of a physical training program on static and dynamic balance during single and dual task conditions in elderly subjects who have had a fall or not. Two groups, comprising a total of 33 elderly subjects, were trained: 16 who had a fall were 69.2 +/- 5.0 years old and 17 who had not had a fall were 67.3 +/- 3.8 years. All subjects underwent an unipedal test with eyes open and eyes closed, followed by gait assessment during single and dual motor task conditions, before and after a physical training program. All subjects showed a significant decrease, by six times for subjects who had fallen and four times by those who had not, in the number of touch-downs in the unipedal test with eyes open (P < 0.05), and by 2.5 and 2 times, respectively, with eyes closed (P < 0.05) after the training program. All subjects showed a significant increase in speed (P < 0.05), cadence (P < 0.05) and stride length (P < 0.05) and a significant decrease in the single support time (P < 0.05) and stride time (P < 0.05) in gait assessment during single and dual task conditions after the training program. During the training program, no subjects fell. The physical training program improved static balance and quality of gait in elderly subjects who had had a fall and those who had not, which could contribute to minimizing and/or retarding the effects of aging and maintaining physical independence.

Effect of sprint training: training once daily versus twice every second day.

PubMed

Ijichi, Toshiaki; Hasegawa, Yuta; Morishima, Takuma; Kurihara, Toshiyuki; Hamaoka, Takafumi; Goto, Kazushige

2015-01-01

This study compared training adaptations between once daily (SINGLE) and twice every second day (REPEATED) sprint training, with same number of training sessions. Twenty physically active males (20.9 ± 1.3 yr) were assigned randomly to the SINGLE (n = 10) or REPEATED (n = 10) group. The SINGLE group trained once per day (5 days per week) for 4 weeks (20 sessions in total). The REPEATED group conducted two consecutive training sessions on the same day, separated by a rest period of 1 h (2-3 days per week) for 4 weeks (20 sessions in total). Each training session consisted of three consecutive 30-s maximal pedalling sets with a 10-min rest between sets. Before and after the training period, the power output during two bouts of 30-s maximal pedalling, exercise duration during submaximal pedalling and resting muscle phosphocreatine (PCr) levels were evaluated. Both groups showed significant increases in peak and mean power output during the two 30-s bouts of maximal pedalling after the training period (P < 0.05). The groups showed similar increases in VO2max after the training period (P < 0.05). The REPEATED group showed a significant increase in the onset of blood lactate accumulation (OBLA) after the training period (P < 0.05), whereas no change was observed in the SINGLE group. The time to exhaustion at 90% of VO2max and muscle PCr concentration at baseline did not change significantly in either group. Sprint training twice every second day improved OBLA during endurance exercise more than the same training once daily.

A prospective interrupted time series study of interventions to improve the quality, rating, framing and structure of goal-setting in community-based brain injury rehabilitation.

PubMed

Hassett, Leanne; Simpson, Grahame; Cotter, Rachel; Whiting, Diane; Hodgkinson, Adeline; Martin, Diane

2015-04-01

To investigate whether the introduction of an electronic goals system followed by staff training improved the quality, rating, framing and structure of goals written by a community-based brain injury rehabilitation team. Interrupted time series design. Two interventions were introduced six months apart. The first intervention comprised the introduction of an electronic goals system. The second intervention comprised a staff goal training workshop. An audit protocol was devised to evaluate the goals. A random selection of goal statements from the 12 months prior to the interventions (Time 1 baseline) were compared with all goal statements written after the introduction of the electronic goals system (Time 2) and staff training (Time 3). All goals were de-identified for client and time-period, and randomly ordered. A total of 745 goals (Time 1 n = 242; Time 2 n = 283; Time 3 n = 220) were evaluated. Compared with baseline, the introduction of the electronic goals system alone significantly increased goal rating, framing and structure (χ(2) tests 144.7, 18.9, 48.1, respectively, p < 0.001). The addition of staff training meant that the improvement in goal quality, which was only a trend at Time 2, was statistically significant at Time 3 (χ(2) 15.0, p ≤ 001). The training also led to a further significant increase in the framing and structuring of goals over the electronic goals system (χ(2) 11.5, 12.5, respectively, p ≤ 0.001). An electronic goals system combined with staff training improved the quality, rating, framing and structure of goal statements. © The Author(s) 2014.

Pilot study on the effects of a 2-week hiking vacation at moderate versus low altitude on plasma parameters of carbohydrate and lipid metabolism in patients with metabolic syndrome.

PubMed

Gutwenger, Ivana; Hofer, Georg; Gutwenger, Anna K; Sandri, Marco; Wiedermann, Christian J

2015-03-28

Hypoxic and hypobaric conditions may augment the beneficial influence of training on cardiovascular risk factors. This pilot study aimed to explore for effects of a two-week hiking vacation at moderate versus low altitude on adipokines and parameters of carbohydrate and lipid metabolism in patients with metabolic syndrome. Fourteen subjects (mean age: 55.8 years, range: 39 - 69) with metabolic syndrome participated in a 2-week structured training program (3 hours of guided daily hiking 4 times a week, training intensity at 55-65% of individual maximal heart rate; total training time, 24 hours). Participants were divided for residence and training into two groups, one at moderate altitude (1,900 m; n = 8), and the other at low altitude (300 m; n = 6). Anthropometric, cardiovascular and metabolic parameters were measured before and after the training period. In study participants, training overall reduced circulating levels of total cholesterol (p = 0.024), low-density lipoprotein cholesterol (p = 0.025) and adiponectin (p < 0.001). In the group training at moderate altitude (n = 8), lowering effects on circulating levels were significant not only for total cholesterol, low-density-lipoprotein cholesterol and adiponectin (all, p < 0.05) but also for triglycerides (p = 0.025) and leptin (p = 0.015), whereas in the low altitude group (n = 6), none of the lipid parameters was significantly changed (each p > 0.05). Hiking-induced relative changes of triglyceride levels were positively associated with reductions in leptin levels (p = 0.006). As compared to 300 m altitude, training at 1,900 m showed borderline significant differences in the pre-post mean reduction rates of triglyceride (p = 0.050) and leptin levels (p = 0.093). Preliminary data on patients with metabolic syndrome suggest that a 2-week hiking vacation at moderate altitude may be more beneficial for adipokines and parameters of lipid metabolism than training at low altitude. In order to draw firm conclusions regarding better corrections of dyslipidemia and metabolic syndrome by physical exercise under mild hypobaric and hypoxic conditions, a sufficiently powered randomized clinical trial appears warranted. ClinicalTrials.gov ID NCT02013947 (first received November 6, 2013).

Teaching binocular indirect ophthalmoscopy to novice residents using an augmented reality simulator.

PubMed

Rai, Amandeep S; Rai, Amrit S; Mavrikakis, Emmanouil; Lam, Wai Ching

2017-10-01

To compare the traditional teaching approach of binocular indirect ophthalmoscopy (BIO) to the EyeSI augmented reality (AR) BIO simulator. Prospective randomized control trial. 28 post-graduate year one (PGY1) ophthalmology residents. Residents were recruited at the 2012 Toronto Ophthalmology Residents Introductory Course (TORIC). 15 were randomized to conventional teaching (Group 1), and 13 to augmented reality simulator training (Group 2). 3 vitreoretinal fellows were enrolled to serve as experts. Evaluations were completed on the simulator, with 3 tasks, and outcome measures were total raw score, total time elapsed, and performance. Following conventional training, Group 1 residents were outperformed by vitreoretinal fellows with respect to all 3 outcome measures. Following AR training, Group 2 residents demonstrated superior total scores and performance compared to Group 1 residents. Once the Group 1 residents also completed the AR BIO training, there was a significant improvement compared to their baseline scores, and were now on par with Group 2 residents. This study provides construct validity for the EyeSI AR BIO simulator and demonstrates that it may be superior to conventional BIO teaching for novice ophthalmology residents. Copyright © 2017 Canadian Ophthalmological Society. Published by Elsevier Inc. All rights reserved.

Robust feature extraction for rapid classification of damage in composites

NASA Astrophysics Data System (ADS)

Coelho, Clyde K.; Reynolds, Whitney; Chattopadhyay, Aditi

2009-03-01

The ability to detect anomalies in signals from sensors is imperative for structural health monitoring (SHM) applications. Many of the candidate algorithms for these applications either require a lot of training examples or are very computationally inefficient for large sample sizes. The damage detection framework presented in this paper uses a combination of Linear Discriminant Analysis (LDA) along with Support Vector Machines (SVM) to obtain a computationally efficient classification scheme for rapid damage state determination. LDA was used for feature extraction of damage signals from piezoelectric sensors on a composite plate and these features were used to train the SVM algorithm in parts, reducing the computational intensity associated with the quadratic optimization problem that needs to be solved during training. SVM classifiers were organized into a binary tree structure to speed up classification, which also reduces the total training time required. This framework was validated on composite plates that were impacted at various locations. The results show that the algorithm was able to correctly predict the different impact damage cases in composite laminates using less than 21 percent of the total available training data after data reduction.

Influence of Handrim Wheelchair Propulsion Training in Adolescent Wheelchair Users, A Pilot Study

PubMed Central

Dysterheft, Jennifer L.; Rice, Ian M.; Rice, Laura A.

2015-01-01

Ten full-time adolescent wheelchair users (ages 13–18) completed a total of three propulsion trials on carpet and tile surfaces, at a self-selected velocity, and on a concrete surface, at a controlled velocity. All trials were performed in their personal wheelchair with force and moment sensing wheels attached bilaterally. The first two trials on each surface were used as pre-intervention control trials. The third trial was performed after receiving training on proper propulsion technique. Peak resultant force, contact angle, stroke frequency, and velocity were recorded during all trials for primary analysis. Carpet and tile trials resulted in significant increases in contact angle and peak total force with decreased stroke frequency after training. During the velocity controlled trials on concrete, significant increases in contact angle occurred, as well as decreases in stroke frequency after training. Overall, the use of a training video and verbal feedback may help to improve short-term propulsion technique in adolescent wheelchair users and decrease the risk of developing upper limb pain and injury. PMID:26042217

Integer programming of cement distribution by train

NASA Astrophysics Data System (ADS)

Indarsih

2018-01-01

Cement industry in Central Java distributes cement by train to meet daily demand in Yogyakarta and Central Java area. There are five destination stations. For each destination station, there is a warehouse to load cements. Decision maker of cement industry have a plan to redesign the infrastructure and transportation system. The aim is to determine how many locomotives, train wagons, and containers and how to arrange train schedules with subject to the delivery time. For this purposes, we consider an integer programming to minimize the total of operational cost. Further, we will discuss a case study and the solution the problem can be calculated by LINGO software.

The beneficial effects of aerobic and concurrent training on metabolic profile and body composition after detraining: a 1-year follow-up in postmenopausal women.

PubMed

Rossi, F E; Diniz, T A; Neves, L M; Fortaleza, A C S; Gerosa-Neto, J; Inoue, D S; Buonani, C; Cholewa, J M; Lira, F S; Freitas, I F

2017-05-01

Aerobic and concurrent training (CT, aerobic and strength training) improves body composition and metabolic profile; however, it is not known whether these positive outcomes acquired after aerobic or CT are maintained long term (⩾6 months) after program interruption in postmenopausal women. This study investigated the changes in total and appendicular body composition, bone mineral density and metabolic profile following 16 weeks of aerobic or CT, and through 6 months and 1 year of detraining in postmenopausal women. In total, 60 postmenopausal women were divided into the following groups: aerobic (AT), aerobic plus strength training (CT) and control group (CG), and 31 participants were assessed for the 1 year follow-up. Body composition and bone mineral density were evaluated by dual-energy X-ray absorptiometry (DXA), and total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, triacylglycerol, glucose, insulin, leptin, adiponectin and plasminogen activator inhibitor-1 (PAI-1) were assessed. There were main effects of time for arm fat mass, arm lean mass and trunk lean mass (P<0.05). There was a statistical difference between AT and CG for leg fat mass and percentage of fat (P<0.05). After 6 months of detraining, leg lean mass decreased in relation to post-intervention, and there was a statistically significant interaction for total and appendicular lean mass (P<0.05). There were differences between CT and CG in glucose and between AT and CG in glucose and triacylglycerol (P<0.05). A duration of 16 weeks of aerobic or CT improved total and appendicular body composition and metabolic profile but after 6 months of detraining, leg lean mass returned to the values obtained pre-training in CT.

Neutrophil and Monocyte Bactericidal Responses to 10 Weeks of Low-Volume High-Intensity Interval or Moderate-Intensity Continuous Training in Sedentary Adults

PubMed Central

Shepherd, Sam O.; Wilson, Oliver J.; Adlan, Ahmed M.; Wagenmakers, Anton J. M.; Shaw, Christopher S.; Lord, Janet M.

2017-01-01

Neutrophils and monocytes are key components of the innate immune system that undergo age-associated declines in function. This study compared the impact of high-intensity interval training (HIIT) and moderate-intensity continuous training (MICT) on immune function in sedentary adults. Twenty-seven (43 ± 11 years) healthy sedentary adults were randomized into ten weeks of either a HIIT (>90% maximum heart rate) or MICT (70% maximum heart rate) group training program. Aerobic capacity (VO2peak), neutrophil and monocyte bacterial phagocytosis and oxidative burst, cell surface receptor expression, and systemic inflammation were measured before and after the training. Total exercise time commitment was 57% less for HIIT compared to that for MICT while both significantly improved VO2peak similarly. Neutrophil phagocytosis and oxidative burst and monocyte phagocytosis and percentage of monocytes producing an oxidative burst were improved by training similarly in both groups. Expression of monocyte but not neutrophil CD16, TLR2, and TLR4 was reduced by training similarly in both groups. No differences in systemic inflammation were observed for training; however, leptin was reduced in the MICT group only. With similar immune-enhancing effects for HIIT compared to those for MICT at 50% of the time commitment, our results support HIIT as a time efficient exercise option to improve neutrophil and monocyte function. PMID:28656073

Part-time general surgical training in South Australia: its success and future implications (or: pinnacles, pitfalls and lessons for the future).

PubMed

Neuhaus, Susan; Igras, Emma; Fosh, Beverley; Benson, Sarah

2012-12-01

Flexible training options are sought by an increasing number of Australasian surgical trainees. Reasons include increased participation of women in the surgical workforce, postgraduate training and changing attitudes to family responsibilities. Despite endorsement of flexible training by the Royal Australasian College of Surgeons and Board in General Surgery, part-time (PT) training in General Surgery in Australia and New Zealand is not well established. A permanent 'stand-alone' PT training position was established at the Royal Adelaide Hospital in 2007 under the Surgical Education and Training Program. This position offered 12 months of General Surgical training on a 0.5 full-time (FT) equivalent basis with pro rata emergency and on-call commitments and was accredited for 6 months of General Surgical training. This paper reviews the PT training experience in South Australia. De-identified logbook data were obtained from the South Australian Regional Subcommittee of the Board in General Surgery with consent of each of the trainees. Totals of operative cases were compared against matched FT trainees working on the same unit. Overall, PT trainees achieved comparable operative caseloads compared with their FT colleagues. All trainees included in this review have subsequently passed the Royal Australasian College of Surgeons Fellowship Examination in General Surgery and returned to FT workforce positions. This paper presents two validated models of PT training. Training, resource and regulatory requirements and individual and institutional barriers to flexible training are substantial. Successful PT models offer positive and beneficial training alternatives for General Surgical trainees and contribute to workforce flexibility. © 2012 The Authors. ANZ Journal of Surgery © 2012 Royal Australasian College of Surgeons.

Pharmacokinetics, safety, and effects on exercise performance of L-arginine alpha-ketoglutarate in trained adult men.

PubMed

Campbell, Bill; Roberts, Mike; Kerksick, Chad; Wilborn, Colin; Marcello, Brandon; Taylor, Lem; Nassar, Erika; Leutholtz, Brian; Bowden, Rodney; Rasmussen, Chris; Greenwood, Mike; Kreider, Richard

2006-09-01

We evaluated the pharmacokinetics, safety, and efficacy of l-arginine alpha-ketoglutarate (AAKG) in trained adult men. Subjects participated in two studies that employed a randomized, double-blind, controlled design. In study 1, 10 healthy men (30-50 y old) fasted for 8 h and then ingested 4 g of time-released or non-timed-released AAKG. Blood samples were taken for 8 h after AAKG ingestion to assess the pharmacokinetic profile of L-arginine. After 1 wk the alternative supplement was ingested. In study 2, which was placebo controlled, 35 resistance-trained adult men (30-50 y old) were randomly assigned to ingest 4 g of AAKG (three times a day, i.e., 12 g daily, n = 20) or placebo (n = 15). Participants performed 4 d of periodized resistance training per week for 8 wk. At 0, 4, and 8 wk of supplementation the following tests were performed: clinical blood markers, one repetition maximum bench press, isokinetic quadriceps muscle endurance, anaerobic power, aerobic capacity, total body water, body composition, and psychometric parameters tests. Data were analyzed by repeated measures analysis of variance. In study 1, significant differences were observed in plasma arginine levels in subjects taking non-timed-release and timed-release AAKG. In study 2, significant differences were observed in the AAKG group (P < 0.05) for 1RM bench press, Wingate peak power, blood glucose, and plasma arginine. No significant differences were observed between groups in body composition, total body water, isokinetic quadriceps muscle endurance, or aerobic capacity. AAKG supplementation appeared to be safe and well tolerated, and positively influenced 1RM bench press and Wingate peak power performance. AAKG did not influence body composition or aerobic capacity.

Soldier 2020 Injury Rates/Attrition Rates Working Group Medical Recommendations

DTIC Science & Technology

2015-06-24

upon arrival and are currently being provided a multivitamin in Basic Military Training. Female Specific Issues Pregnancy ...Approximately 5% of female Soldiers are pregnant at any given time. • This calculates to ~0.75% of the total force not available due to pregnancy and postpartum...performance Pregnancy affects approximately 0.75% of the total Army force at any given time M E D I C A L R E A D I N E S S Select SLIDE MASTER to Insert

Adding exercise training to rosuvastatin treatment: influence on serum lipids and biomarkers of muscle and liver damage.

PubMed

Coen, Paul M; Flynn, Michael G; Markofski, Melissa M; Pence, Brandt D; Hannemann, Robert E

2009-07-01

Statin treatment and exercise training can improve lipid profile when administered separately. The efficacy of exercise and statin treatment combined, and its impact on myalgia and serum creatine kinase (CK) have not been completely addressed. The purpose of this study was to determine the effect of statin treatment and the addition of exercise training on lipid profile, including oxidized low-density lipoprotein (oxLDL), and levels of CK and alanine transaminase. Thirty-one hypercholesterolemic and physically inactive subjects were randomly assigned to rosuvastatin (R) or rosuvastatin/exercise (RE) group. A third group of physically active hypercholesterolemic subjects served as an active control group (AC). The R and RE groups received rosuvastatin treatment (10 mg/d) for 20 weeks. From week 10 to week 20, the RE group also participated in a combined endurance and resistive exercise training program (3 d/wk). Lipid profile was determined for all subjects at week 0 (Pre), week 10 (Mid), and week 20 (Post). The CK and alanine transaminase levels were measured at the same time points in the RE and R groups and 48 hours after the first and fifth exercise bout in the RE group. Each RE subject was formally queried about muscle fatigue, soreness, and stiffness before each training session. Total, LDL, and oxLDL cholesterol was lower in the RE and R groups at Mid and Post time points when compared with Pre. Oxidized LDL was lower in the RE group compared with the R group at the Post time point. When treatment groups (R and RE) were combined, high-density lipoprotein levels were increased and triglycerides decreased across time. Creatine kinase increased in the RE group 48 hours after the first exercise bout, but returned to baseline levels 48 hours after the fifth exercise bout. Rosuvastatin treatment decreased total, LDL, and oxLDL cholesterol. The addition of an exercise training program resulted in a further decrease in oxLDL. There was no abnormal sustained increase in CK or reports of myalgia after the addition of exercise training to rosuvastatin treatment.

Teaching foster grandparents to train severely handicapped persons.

PubMed Central

Fabry, P L; Reid, D H

1978-01-01

Five foster grandparents were taught training skills for use in their daily interactions with severely handicapped persons in an institution. Following baseline, specific teaching procedures consisting of teacher instructions, prompts, modelling, and praise were implemented. The grandparents' frequency of training three skill areas increased as the specific teaching was implemented in multiple-baseline format. The total amount of training continued as teacher instructions, prompts, and modelling were terminated and praise continued, although the grandparents spent their training time emphasizing only two of the three skill areas. Teacher presence was gradually reduced over an 11-week period, with no decrease in grandparents' frequency of training. Four of the foster grandchildren, all profoundly retarded and multiply handicapped, demonstrated progress throughout the study. Results were discussed in light of the available contributions of foster grandparents in institutional settings and maintenance of staff training. PMID:148446

Effect of Training Status on Oxygen Consumption in Women After Resistance Exercise.

PubMed

Benton, Melissa J; Waggener, Green T; Swan, Pamela D

2016-03-01

This study compared acute postexercise oxygen consumption in 11 trained women (age, 46.5 ± 1.6 years; body mass index [BMI], 28.4 ± 1.7 kg·m(-2) and 11 untrained women (age, 46.5 ± 1.5 years; BMI, 27.5 ± 1.5 kg·m(-2)) after resistance exercise (RE). Resistance exercise consisted of 3 sets of 8 exercises (8-12 repetitions at 50-80% 1 repetition maximum). Oxygen consumption (VO2 ml·min(-1)) was measured before and after (0, 20, 40, 60, 90, and 120 minutes) RE. Immediately after cessation of RE (time 0), oxygen consumption increased in both trained and untrained women and remained significantly above baseline through 60 minutes after exercise (p < 0.01). Total oxygen consumption during recovery was 31.3 L in trained women and 27.4 L in untrained women (p = 0.07). In trained women, total oxygen consumption was strongly related to absolute (kg) lean mass (r = 0.88; p < 0.001), relative (kilogram per square meter) lean mass (r = 0.91; p < 0.001), and duration of exercise (r = 0.68; p ≤ 0.05), but in untrained women, only training volume-load was related to total oxygen consumption (r = 0.67; p ≤ 0.05). In trained women, 86% of the variance in oxygen consumption was explained by lean mass and exercise duration, whereas volume-load explained 45% in untrained women. Our findings suggest that, in women, resistance training increases metabolic activity of lean tissue. Postexercise energy costs of RE are determined by the duration of stimulation provided by RE rather than absolute work (volume-load) performed. This phenomenon may be related to type II muscle fibers and increased protein synthesis.

Injuries in women associated with a periodized strength training and running program.

PubMed

Reynolds, K L; Harman, E A; Worsham, R E; Sykes, M B; Frykman, P N; Backus, V L

2001-02-01

Forty-five women participated in a 24-week physical training program designed to improve lifting, load carriage, and running performance. Activities included weightlifting, running, backpacking, lift and carry drills, and sprint running. Physicians documented by passive surveillance all training-related injuries. Thirty-two women successfully completed training program. Twenty-two women (48.9%) suffered least 1 injury during training, but only 2 women had to drop out of the study because of injuries. The rate of injury associated with lost training time was 2.8 injuries per 1,000 training hours of exposure. Total clinic visits and days lost from training were 89 and 69, respectively. Most injuries were the overuse type involving the lower back, knees, and feet. Weightlifting accounted for a majority of the lost training days. A combined strength training and running program resulted in significant performance gains in women. Only 2 out of 45 participants left the training program cause of injuries.

Analysis of 10-Year Training Results of Medical Students Using the Microvascular Research Center Training Program.

PubMed

Onoda, Satoshi; Kimata, Yoshihiro; Sugiyama, Narushi; Tokuyama, Eijiro; Matsumoto, Kumiko; Ota, Tomoyuki; Thuzar, Moe

2016-06-01

Background In this article, we reviewed the training results of medical students using the Microvascular Research Center Training Program (MRCP), and proposed an ideal microsurgical training program for all individuals by analyzing the training results of medical students who did not have any surgical experience. Methods As of 2015, a total of 29 medical students completed the MRCP. In the most recent 12 medical students, the number of trials performed for each training stage and the number of rats needed to complete the training were recorded. Additionally, we measured the operating time upon finishing stage 5 for the recent six medical students after it became a current program. Results The average operating time upon finishing stage 5 for the recent six medical students was 120 minutes ± 11 minutes (standard deviation [SD]). The average vascular anastomosis time (for the artery and vein) was 52 minutes ± 2 minutes (SD). For the most recent 12 medical students, there was a negative correlation between the number of trials performed in the non-rat stages (stages 1-3) and the number of rats used in the rat stages (stages 4-5). Conclusion Analysis of the training results of medical students suggests that performing microsurgery first on silicon tubes and chicken wings saves animals' lives later during the training program. We believe that any person can learn the technique of microsurgery by performing 7 to 8 hours of training per day over a period of 15 days within this program setting. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Cognitive Task Analysis: Bringing Olympic Athlete Style Training to Surgical Education.

PubMed

Wingfield, Laura R; Kulendran, Myutan; Chow, Andre; Nehme, Jean; Purkayastha, Sanjay

2015-08-01

Surgical training is changing and evolving as time, pressure, and legislative demands continue to mount on trainee surgeons. A paradigm change in the focus of training has resulted in experts examining the cognitive steps needed to perform complex and often highly pressurized surgical procedures. To provide an overview of the collective evidence on cognitive task analysis (CTA) as a surgical training method, and determine if CTA improves a surgeon's performance as measured by technical and nontechnical skills assessment, including precision, accuracy, and operative errors. A systematic literature review was performed. PubMed, Cochrane, and reference lists were analyzed for appropriate inclusion. A total of 595 surgical participants were identified through the literature review and a total of 13 articles were included. Of these articles, 6 studies focused on general surgery, 2 focused on practical procedures relevant to surgery (central venous catheterization placement), 2 studies focused on head and neck surgical procedures (cricothyroidotomy and percutaneous tracheostomy placement), 2 studies highlighted vascular procedures (endovascular aortic aneurysm repair and carotid artery stenting), and 1 detailed endovascular repair (abdominal aorta and thoracic aorta). Overall, 92.3% of studies showed that CTA improves surgical outcome parameters, including time, precision, accuracy, and error reduction in both simulated and real-world environments. CTA has been shown to be a more effective training tool when compared with traditional methods of surgical training. There is a need for the introduction of CTA into surgical curriculums as this can improve surgical skill and ultimately create better patient outcomes. © The Author(s) 2014.

Drawing enhances cross-modal memory plasticity in the human brain: a case study in a totally blind adult

PubMed Central

Likova, Lora T.

2012-01-01

In a memory-guided drawing task under blindfolded conditions, we have recently used functional Magnetic Resonance Imaging (fMRI) to demonstrate that the primary visual cortex (V1) may operate as the visuo-spatial buffer, or “sketchpad,” for working memory. The results implied, however, a modality-independent or amodal form of its operation. In the present study, to validate the role of V1 in non-visual memory, we eliminated not only the visual input but all levels of visual processing by replicating the paradigm in a congenitally blind individual. Our novel Cognitive-Kinesthetic method was used to train this totally blind subject to draw complex images guided solely by tactile memory. Control tasks of tactile exploration and memorization of the image to be drawn, and memory-free scribbling were also included. FMRI was run before training and after training. Remarkably, V1 of this congenitally blind individual, which before training exhibited noisy, immature, and non-specific responses, after training produced full-fledged response time-courses specific to the tactile-memory drawing task. The results reveal the operation of a rapid training-based plasticity mechanism that recruits the resources of V1 in the process of learning to draw. The learning paradigm allowed us to investigate for the first time the evolution of plastic re-assignment in V1 in a congenitally blind subject. These findings are consistent with a non-visual memory involvement of V1, and specifically imply that the observed cortical reorganization can be empowered by the process of learning to draw. PMID:22593738

Drawing enhances cross-modal memory plasticity in the human brain: a case study in a totally blind adult.

PubMed

Likova, Lora T

2012-01-01

In a memory-guided drawing task under blindfolded conditions, we have recently used functional Magnetic Resonance Imaging (fMRI) to demonstrate that the primary visual cortex (V1) may operate as the visuo-spatial buffer, or "sketchpad," for working memory. The results implied, however, a modality-independent or amodal form of its operation. In the present study, to validate the role of V1 in non-visual memory, we eliminated not only the visual input but all levels of visual processing by replicating the paradigm in a congenitally blind individual. Our novel Cognitive-Kinesthetic method was used to train this totally blind subject to draw complex images guided solely by tactile memory. Control tasks of tactile exploration and memorization of the image to be drawn, and memory-free scribbling were also included. FMRI was run before training and after training. Remarkably, V1 of this congenitally blind individual, which before training exhibited noisy, immature, and non-specific responses, after training produced full-fledged response time-courses specific to the tactile-memory drawing task. The results reveal the operation of a rapid training-based plasticity mechanism that recruits the resources of V1 in the process of learning to draw. The learning paradigm allowed us to investigate for the first time the evolution of plastic re-assignment in V1 in a congenitally blind subject. These findings are consistent with a non-visual memory involvement of V1, and specifically imply that the observed cortical reorganization can be empowered by the process of learning to draw.

Evaluation of the Multi-Chambered Treatment Train, a retrofit water-quality management device

USGS Publications Warehouse

Corsi, Steven R.; Greb, Steven R.; Bannerman, Roger T.; Pitt, Robert E.

1999-01-01

This paper presents the results of an evaluation of the benefits and efficiencies of a device called the Multi-Chambered Treatment Train (MCTT), which was installed below the pavement surface at a municipal maintenance garage and parking facility in Milwaukee, Wisconsin. Flow-weighted water samples were collected at the inlet and outlet of the device during 15 storms, and the efficiency of the device was based on reductions in the loads of 68 chemical constituents and organic compounds. High reduction efficiencies were achieved for all particulate-associated constituents, including total suspended solids (98 percent), total phosphorus (88 percent), and total recoverable zinc (91 percent). Reduction rates for dissolved fractions of the constituents were substantial, but somewhat lower (dissolved solids, 13 percent; dissolved phosphorus, 78 percent; dissolved zinc, 68 percent). The total dissolved solids load, which originated from road salt storage, was more than four times the total suspended solids load. No appreciable difference was detected between particle-size distributions in inflow and outflow samples.

Cross-education after high-frequency versus low-frequency volume-matched handgrip training.

PubMed

Boyes, Natasha G; Yee, Peter; Lanovaz, Joel L; Farthing, Jonathan P

2017-10-01

Cross-education training programs cause interlimb asymmetry of strength and hypertrophy. We examined the cross-education effects from a high-frequency (HF) versus a low-frequency (LF) volume-matched handgrip training program on interlimb asymmetry. Right-handed participants completed either HF (n = 10; 2 × 6 repetitions 10 times per week) or LF (n = 9; 5 × 8 repetitions 3 times per week) training. Testing occurred twice before and once after 4 weeks of right-handed isometric handgrip training totaling 120 weekly repetitions. Measures were maximal isometric handgrip and wrist flexion torque, muscle thickness, and muscle activation (electromyography; EMG). Grip strength was greater in both limbs posttraining, pooled across groups (P < 0.001). Trained limb muscle thickness increased in both groups (P < 0.05; untrained, P = 0.897). EMG and wrist flexion torque did not change (all P > 0.103). Both LF and HF induced cross-education of grip strength to the untrained limb, but HF did not reduce asymmetry. These findings have implications for injury rehabilitation. Muscle Nerve 56: 689-695, 2017. © 2017 Wiley Periodicals, Inc.

Effects of dual-task balance training on postural performance in patients with Multiple Sclerosis: a double-blind, randomized controlled pilot trial.

PubMed

Monjezi, Saeideh; Negahban, Hossein; Tajali, Shirin; Yadollahpour, Nava; Majdinasab, Nastaran

2017-02-01

To investigate the effects of dual-task balance training on postural performance in patients with multiple sclerosis as compared with single-task balance training. Double-blind, pretest-posttest, randomized controlled pilot trial. Local Multiple Sclerosis Society. A total of 47 patients were randomly assigned to two equal groups labeled as single-task training and dual-task training groups. All patients received supervised balance training sessions, 3 times per week for 4 weeks. The patients in the single-task group performed balance activities, alone. However, patients in dual-task group practiced balance activities while simultaneously performing cognitive tasks. The 10-Meter Walk Test and Timed Up-and-Go under single-task and dual-task conditions, in addition to Activities-specific Balance Confidence, Berg Balance Scale, and Functional Gait Assessment were assessed pre-, and post intervention and also 6-weeks after the end of intervention. Only 38 patients completed the treatment plan. There was no difference in the amount of improvement seen between the two study groups. In both groups there was a significant effect of time for dual-10 Meter Walk Test (F 1, 36 =11.33, p=0.002) and dual-Timed Up-and-Go (F 1, 36 =14.27, p=0.001) but not for their single-tasks. Moreover, there was a significant effect of time for Activities-specific Balance Confidence, Berg Balance Scale, and Functional Gait Assessment ( P<0.01). This pilot study did not show more benefits from undertaking dual-task training than single-task training. A power analysis showed 71 patients per group would be needed to determine whether there was a clinically relevant difference for dual-task gait speed between the groups.

[Knowledge and attitudes of citizens in the Basque Country (Spain) towards cardiopulmonary resuscitation and automatic external defibrillators].

PubMed

Ballesteros-Peña, S; Fernández-Aedo, I; Pérez-Urdiales, I; García-Azpiazu, Z; Unanue-Arza, S

2016-03-01

To explore the training, ability and attitudes towards cardiopulmonary resuscitation and the use of automatic defibrillators among the population of the Basque Country (Spain). A face-to-face survey. Capital cities of the Basque Country. A total of 605 people between 15-64 years of age were randomly selected. Information about the knowledge, perceptions and self-perceived ability to identify and assist cardiopulmonary arrest was requested. A total of 56.4% of the responders were women, 61.8% were occupationally active, and 48.3% had higher education. Thirty-seven percent of the responders claimed to be trained in resuscitation techniques, but only 20.2% considered themselves able to apply such techniques. Public servants were almost 4 times more likely of being trained in defibrillation compared to the rest of workers (OR 3.7; P<.001), while people with elementary studies or no studies were almost 3 times more likely of not being trained in cardiopulmonary resuscitation, in comparison with the rest (OR 2.7; P=.001). A total of 94.7% of the responders considered it "quite or very important" for the general population to be able to apply resuscitation, though 55% considered themselves unable to identify an eye witnessed cardiac arrest, and 40.3% would not recognize a public-access defibrillator. Citizens of the Basque Country consider the early identification and treatment of cardiorespiratory arrest victims to be important, though their knowledge in cardiopulmonary resuscitation and defibrillation is limited. Copyright © 2015 Elsevier España, S.L.U. and SEMICYUC. All rights reserved.

Position-Dependent Cardiovascular Response and Time-Motion Analysis During Training Drills and Friendly Matches in Elite Male Basketball Players.

PubMed

Torres-Ronda, Lorena; Ric, Angel; Llabres-Torres, Ivan; de Las Heras, Bernat; Schelling I Del Alcazar, Xavi

2016-01-01

The purpose of this study was to measure differences in the cardiovascular workload (heart rate [HR]) and time-motion demands between positional groups, during numerous basketball training drills, and compare the results with in-game competition demands. A convenience sample of 14 top-level professional basketball players from the same club (Spanish First Division, ACB) participated in the study. A total of 146 basketball exercises per player (performed over an 8-week period in 32 team training sessions throughout the competitive season) and 7 friendly matches (FM) played during the preparatory phase were analyzed. The results reveal that HRavg and HRpeak were the highest in FM (158 ± 10; 198 ± 9 b · min(-1), respectively). Time-motion analysis showed 1v1 to be the most demanding drill (53 ± 8 and 46 ± 12 movements per minute for full and half court, respectively). During FM, players performed 33 ± 7 movements per minute. Positional differences exist for both HR and time-motion demands, ranging from moderate to very large for all basketball drills compared with FM. Constraints such as number of players, court size, work-to-rest ratios, and coach intervention are key factors influencing cardiovascular responses and time-motion demands during basketball training sessions. These results demonstrate that systematic monitoring of the physical demands and physiological responses during training and competition can inform and potentially improve coaching strategy, basketball-specific training drills, and ultimately, match performance.

Disorder generated by interacting neural networks: application to econophysics and cryptography

NASA Astrophysics Data System (ADS)

Kinzel, Wolfgang; Kanter, Ido

2003-10-01

When neural networks are trained on their own output signals they generate disordered time series. In particular, when two neural networks are trained on their mutual output they can synchronize; they relax to a time-dependent state with identical synaptic weights. Two applications of this phenomenon are discussed for (a) econophysics and (b) cryptography. (a) When agents competing in a closed market (minority game) are using neural networks to make their decisions, the total system relaxes to a state of good performance. (b) Two partners communicating over a public channel can find a common secret key.

Case study: Nutrition and training periodization in three elite marathon runners.

PubMed

Stellingwerf, Trent

2012-10-01

Laboratory-based studies demonstrate that fueling (carbohydrate; CHO) and fluid strategies can enhance training adaptations and race-day performance in endurance athletes. Thus, the aim of this case study was to characterize several periodized training and nutrition approaches leading to individualized race-day fluid and fueling plans for 3 elite male marathoners. The athletes kept detailed training logs on training volume, pace, and subjective ratings of perceived exertion (RPE) for each training session over 16 wk before race day. Training impulse/load calculations (TRIMP; min × RPE = load [arbitrary units; AU]) and 2 central nutritional techniques were implemented: periodic low-CHO-availability training and individualized CHO- and fluid-intake assessments. Athletes averaged ~13 training sessions per week for a total average training volume of 182 km/wk and peak volume of 231 km/wk. Weekly TRIMP peaked at 4,437 AU (Wk 9), with a low of 1,887 AU (Wk 16) and an average of 3,082 ± 646 AU. Of the 606 total training sessions, ~74%, 11%, and 15% were completed at an intensity in Zone 1 (very easy to somewhat hard), Zone 2 (at lactate threshold) and Zone 3 (very hard to maximal), respectively. There were 2.5 ± 2.3 low-CHO-availability training bouts per week. On race day athletes consumed 61 ± 15 g CHO in 604 ± 156 ml/hr (10.1% ± 0.3% CHO solution) in the following format: ~15 g CHO in ~150 ml every ~15 min of racing. Their resultant marathon times were 2:11:23, 2:12:39 (both personal bests), and 2:16:17 (a marathon debut). Taken together, these periodized training and nutrition approaches were successfully applied to elite marathoners in training and competition.

Quantification of training load during one-, two- and three-game week schedules in professional soccer players from the English Premier League: implications for carbohydrate periodisation.

PubMed

Anderson, Liam; Orme, Patrick; Di Michele, Rocco; Close, Graeme L; Morgans, Ryland; Drust, Barry; Morton, James P

2016-01-01

Muscle glycogen is the predominant energy source for soccer match play, though its importance for soccer training (where lower loads are observed) is not well known. In an attempt to better inform carbohydrate (CHO) guidelines, we quantified training load in English Premier League soccer players (n = 12) during a one-, two- and three-game week schedule (weekly training frequency was four, four and two, respectively). In a one-game week, training load was progressively reduced (P < 0.05) in 3 days prior to match day (total distance = 5223 ± 406, 3097 ± 149 and 2912 ± 192 m for day 1, 2 and 3, respectively). Whilst daily training load and periodisation was similar in the one- and two-game weeks, total accumulative distance (inclusive of both match and training load) was higher in a two-game week (32.5 ± 4.1 km) versus one-game week (25.9 ± 2 km). In contrast, daily training total distance was lower in the three-game week (2422 ± 251 m) versus the one- and two-game weeks, though accumulative weekly distance was highest in this week (35.5 ± 2.4 km) and more time (P < 0.05) was spent in speed zones >14.4 km · h(-1) (14%, 18% and 23% in the one-, two- and three-game weeks, respectively). Considering that high CHO availability improves physical match performance but high CHO availability attenuates molecular pathways regulating training adaptation (especially considering the low daily customary loads reported here, e.g., 3-5 km per day), we suggest daily CHO intake should be periodised according to weekly training and match schedules.

Compliance With Neuromuscular Training and Anterior Cruciate Ligament Injury Risk Reduction in Female Athletes: A Meta-Analysis

PubMed Central

Sugimoto, Dai; Myer, Gregory D.; Bush, Heather M.; Klugman, Maddie F.; McKeon, Jennifer M. Medina; Hewett, Timothy E.

2012-01-01

Context No consensus exists about the influence of compliance with neuromuscular training programs on reduction of the risk of anterior cruciate ligament (ACL) injury. Objective To systematically review and synthesize the published literature to determine if compliance with neuromuscular training is associated with reduced incidence of ACL injury in young female athletes. Data Sources We searched PubMed, SPORTDiscus, CINAHL, and MEDLINE for articles published from 1995 to 2010 using the key words anterior cruciate ligament prevention, ACL prevention, knee prevention, prospective knee prevention, neuromuscular training, and neuromuscular intervention. Study Selection Criteria for inclusion required that (1) the number of ACL injuries was reported, (2) a neuromuscular training program was used, (3) females were included as participants, (4) the study design was prospective and controlled, and (5) compliance data for the neuromuscular training program were provided. Data Extraction Extracted data included the number of ACL injuries, total number of participants per group, observation time period, number of participants who completed each session, number of sessions completed by an entire team, and number of total sessions. Attendance was calculated as the number of participants who completed each session converted into a percentage of the total number of participants. Intervention completion was calculated as the number of sessions completed by an entire team converted into a percentage of the total number of training sessions. These data were used to calculate an overall rate of compliance. Data Synthesis Six of 205 identified studies were included. Incidence rates of ACL injury were lower in studies with high rates of compliance with neuromuscular training than in studies with low compliance rates (incidence rate ratio = 0.27 [95% confidence interval = 0.07, 0.80]). Tertile analysis indicated rates of ACL injury incidence were lower in studies with high compliance rates than in studies with moderate and low compliance rates (incidence rate ratio = 0.18 [95% confidence interval = 0.02, 0.77]). Conclusions A potential inverse dose-response relationship exists between compliance with neuromuscular training and incidence of ACL injury. Attending and completing recommended neuromuscular sessions appears to be an important factor for preventing ACL injuries. PMID:23182020

Assessment of dietary intake using the healthy eating index during military training.

PubMed

Lutz, Laura J; Gaffney-Stomberg, Erin; Scisco, Jenna L; Cable, Sonya J; Karl, J Philip; Young, Andrew J; McClung, James P

2013-01-01

The objectives of this study were to use the healthy eating index (HEI) as a tool to characterize diet quality in Soldiers (n=135) during basic combat training (BCT), and to assess the effects of BCT on diet quality by comparing HEI scores before and after the training period. HEI scores were calculated from a 110-item semiquantitative food frequency questionnaire. Soldiers were then divided into tertiles (high, medium, and low) of diet quality based upon HEI scores at the start of BCT. No relationships between pre-BCT total HEI score and age, sex, racial background, or physical activity were observed. The odds of being a smoker were 4.75 times higher for those in the low HEI tertile and 3.03 times higher for those in the medium HEI tertile when compared to those in the high HEI tertile (95% CI, 1.67, 13.48 and 1.04, 8.82 respectively). Diet quality improved in the medium and low HEI tertiles over the course of BCT, as total HEI scores increased by 22% and 46% respectively (P<.05) with time in these groups. Although different at the start of BCT, HEI scores were similar between the medium and high HEI tertiles at the end of BCT. Study findings suggest that the BCT dining environment elicits positive changes in diet quality for Soldiers who enter military training with lower diet quality, and the HEI appears to be a useful tool to identify military personnel with lower diet quality at the start of training. This may provide the opportunity to target interventions such as diet counseling and education in an effort to improve Soldier health and performance.

Nutrition and training adaptations in aquatic sports.

PubMed

Mujika, Iñigo; Stellingwerff, Trent; Tipton, Kevin

2014-08-01

The adaptive response to training is determined by the combination of the intensity, volume, and frequency of the training. Various periodized approaches to training are used by aquatic sports athletes to achieve performance peaks. Nutritional support to optimize training adaptations should take periodization into consideration; that is, nutrition should also be periodized to optimally support training and facilitate adaptations. Moreover, other aspects of training (e.g., overload training, tapering and detraining) should be considered when making nutrition recommendations for aquatic athletes. There is evidence, albeit not in aquatic sports, that restricting carbohydrate availability may enhance some training adaptations. More research needs to be performed, particularly in aquatic sports, to determine the optimal strategy for periodizing carbohydrate intake to optimize adaptations. Protein nutrition is an important consideration for optimal training adaptations. Factors other than the total amount of daily protein intake should be considered. For instance, the type of protein, timing and pattern of protein intake and the amount of protein ingested at any one time influence the metabolic response to protein ingestion. Body mass and composition are important for aquatic sport athletes in relation to power-to-mass and for aesthetic reasons. Protein may be particularly important for athletes desiring to maintain muscle while losing body mass. Nutritional supplements, such as b-alanine and sodium bicarbonate, may have particular usefulness for aquatic athletes' training adaptation.

Training and the European Working Time Directive: a 7 year review of paediatric anaesthetic trainee caseload data.

PubMed

Fernandez, E; Williams, D G

2009-10-01

The implementation of the European Working Time Directive (WTD) has reduced the hours worked by trainees in the UK to a maximum of 56 h per week. With a further and final reduction to 48 h per week scheduled for August 2009, there is concern amongst doctors about the impact on training and on patient care. Paediatric anaesthesia is one of the specialist areas of anaesthesia for which the Royal College of Anaesthetists (RCoA) recommends a minimum caseload during the period of advanced training. We conducted a retrospective analysis of theatre logbook data from 62 Specialist Registrars (SpRs) who had completed a 12 month period of advanced training in paediatric anaesthesia in our institution between 2000 and 2007. After the implementation of the WTD 56 h week in 2004, the mean total number of cases performed by SpRs per year decreased from 441 to 336, a 24% reduction. We found a statistically significant reduction across all age groups with the largest reduction in the under 1 month of age group. The post-WTD group did not meet the RCoA recommended total minimum caseload or the minimum number of cases of <1 yr of age. Since the implementation of the WTD, there has been a significant reduction in the number of cases performed by SpRs in paediatric anaesthesia and they are no longer achieving the RCoA recommended minimum numbers for advanced training.

Rowing performance, body composition, and bone mineral density outcomes in college-level rowers after a season of concurrent training.

PubMed

Young, Kaelin C; Kendall, Kristina L; Patterson, Kaitlyn M; Pandya, Priyanka D; Fairman, Ciaran M; Smith, Samuel W

2014-11-01

To assess changes in body composition, lumbar-spine bone mineral density (BMD), and rowing performance in college-level rowers over a competition season. Eleven Division I college rowers (mean ± SD 21.4 ± 3.7 y) completed 6 testing sessions throughout the course of their competition season. Testing included measurements of fat mass, bone-free lean mass (BFLM), body fat (%BF), lumbar-spine BMD, and 2000-m time-trial performance. After preseason testing, rowers participated in a periodized training program, with the addition of resistance training to the traditional aerobic-training program. Significant (P < .05) improvements in %BF, total mass, and BFLM were observed at midseason and postseason compared with preseason. Neither lumbar-spine BMD nor BMC significantly changed over the competitive season (P > .05). Finally, rowing performance (as measured by 2000-m time and average watts achieved) significantly improved at midseason and postseason compared with preseason. Our results highlight the efficacy of a seasonal concurrent training program serving to improve body composition and rowing performance, as measured by 2000-m times and average watts, among college-level rowers. Our findings offer practical applications for coaches and athletes looking to design a concurrent strength and aerobic training program to improve rowing performance across a season.

Four Weeks of Off-Season Training Improves Peak Oxygen Consumption in Female Field Hockey Players

PubMed Central

Funch, Lindsey T.; Lind, Erik; Van Langen, Deborah; Hokanson, James F.

2017-01-01

The purpose of the study was to examine the changes in peak oxygen consumption (V˙O2peak) and running economy (RE) following four-weeks of high intensity training and concurrent strength and conditioning during the off-season in collegiate female field hockey players. Fourteen female student-athletes (age 19.29 ± 0.91 years) were divided into two training groups, matched from baseline V˙O2peak: High Intensity Training (HITrun; n = 8) and High Intensity Interval Training (HIIT; n = 6). Participants completed 12 training sessions. HITrun consisted of 30 min of high-intensity running, while HIIT consisted of a series of whole-body high intensity Tabata-style intervals (75–85% of age predicted maximum heart rate) for a total of four minutes. In addition to the interval training, the off-season training included six resistance training sessions, three team practices, and concluded with a team scrimmage. V˙O2peak was measured pre- and post-training to determine the effectiveness of the training program. A two-way mixed (group × time) ANOVA showed a main effect of time with a statistically significant difference in V˙O2peak from pre- to post-testing, F(1, 12) = 12.657, p = 0.004, partial η2 = 0.041. Average (±SD) V˙O2peak increased from 44.64 ± 3.74 to 47.35 ± 3.16 mL·kg−1·min−1 for HIIT group and increased from 45.39 ± 2.80 to 48.22 ± 2.42 mL·kg−1·min−1 for HITrun group. Given the similar improvement in aerobic power, coaches and training staff may find the time saving element of HIIT-type conditioning programs attractive. PMID:29910449

Chicago transit authority train noise exposure.

PubMed

Phan, Linh T; Jones, Rachael M

2017-06-01

To characterize noise exposure of riders on Chicago Transit Authority (CTA) trains, we measured noise levels twice on each segment of 7 of the 8 CTA train lines, which are named after colors, yielding 48 time-series measurements. We found the Blue Line has the highest noise levels compared to other train lines, with mean 76.9 dBA; and that the maximum noise level, 88.9 dBA occurred in the tunnel between the Chicago and Grand stations. Train segments involving travel through a tunnel had significantly higher noise levels than segments with travel on elevated and ground level tracks. While 8-hr doses inside the passenger cars were not estimated to exceed occupational exposure limits, train operators ride in a separate cab with operational windows and may therefore have higher noise exposures than riders. Despite the low risk of hearing loss for riders on CTA trains, in part because transit noise accounts for a small part of total daily noise exposure, 1-min average noise levels exceeded 85 dBA at times. This confirms anecdotal observations of discomfort due to noise levels, and indicates a need for noise management, particularly in tunnels.

Influence of the type of training task on intermanual transfer effects in upper-limb prosthesis training: A randomized pre-posttest study.

PubMed

Romkema, Sietske; Bongers, Raoul M; van der Sluis, Corry K

2017-01-01

Intermanual transfer, the transfer of motor skills from the trained hand to the untrained hand, can be used to train upper limb prosthesis skills. The aim of this study was to determine the relation between the magnitude of the intermanual transfer effect and the type of training task. The used tasks were based on different aspects of prosthetic handling: reaching, grasping, grip-force production and functional tasks. A single-blinded clinical trial, with a pre-posttest design was executed. Seventy-one able-bodied, right-handed participants were randomly assigned to four training and two control groups. The training groups performed a training program with an upper-limb prosthesis simulator. One control group performed a sham training (a dummy training without the prosthesis simulator) and another control group received no training at all. The training groups and sham group trained on five consecutive days. To determine the improvement in skills, a test was administered before, immediately after, and one week after the training. Training was performed with the 'unaffected' arm; tests were performed with the 'affected' arm, with the latter resembling the amputated limb. In this study half of the participants trained with the dominant hand, while the other half trained with the non-dominant hand. Participants executed four tests that corresponded to the different training tasks. The tests measured the reaching (movement time and symmetry ratio), grasping (opening time, duration of maximum hand opening, and closing time), grip-force production (deviation of asked grip-force) and functional (movement time) performance. Half of the participants were tested with their dominant arm and half of the participants with their non-dominant arm. Intermanual transfer effects were not found for reaching, grasping or functional tasks. However, we did find intermanual transfer effects for grip-force production tasks. Possibly, the study design contributed to the negative results due to the duration of the training sessions and test sessions. The positive results of the grip-force production might be an effect of the specificity of the training, that was totally focused on training grip-force production. When using intermanual transfer training in novice amputees, specific training should be devoted to grip-force.

Influence of the type of training task on intermanual transfer effects in upper-limb prosthesis training: A randomized pre-posttest study

PubMed Central

Romkema, Sietske; Bongers, Raoul M.; van der Sluis, Corry K.

2017-01-01

Intermanual transfer, the transfer of motor skills from the trained hand to the untrained hand, can be used to train upper limb prosthesis skills. The aim of this study was to determine the relation between the magnitude of the intermanual transfer effect and the type of training task. The used tasks were based on different aspects of prosthetic handling: reaching, grasping, grip-force production and functional tasks. A single-blinded clinical trial, with a pre-posttest design was executed. Seventy-one able-bodied, right-handed participants were randomly assigned to four training and two control groups. The training groups performed a training program with an upper-limb prosthesis simulator. One control group performed a sham training (a dummy training without the prosthesis simulator) and another control group received no training at all. The training groups and sham group trained on five consecutive days. To determine the improvement in skills, a test was administered before, immediately after, and one week after the training. Training was performed with the ‘unaffected’ arm; tests were performed with the ‘affected’ arm, with the latter resembling the amputated limb. In this study half of the participants trained with the dominant hand, while the other half trained with the non-dominant hand. Participants executed four tests that corresponded to the different training tasks. The tests measured the reaching (movement time and symmetry ratio), grasping (opening time, duration of maximum hand opening, and closing time), grip-force production (deviation of asked grip-force) and functional (movement time) performance. Half of the participants were tested with their dominant arm and half of the participants with their non-dominant arm. Intermanual transfer effects were not found for reaching, grasping or functional tasks. However, we did find intermanual transfer effects for grip-force production tasks. Possibly, the study design contributed to the negative results due to the duration of the training sessions and test sessions. The positive results of the grip-force production might be an effect of the specificity of the training, that was totally focused on training grip-force production. When using intermanual transfer training in novice amputees, specific training should be devoted to grip-force. PMID:29190727

Structuralized box-trainer laparoscopic training significantly improves performance in complex virtual reality laparoscopic tasks.

PubMed

Laski, Dariusz; Stefaniak, Tomasz J; Makarewicz, Wojciech; Proczko, Monika; Gruca, Zbigniew; Sledziński, Zbigniew

2012-03-01

In the era of flowering minimally invasive surgical techniques there is a need for new methods of teaching surgery and supervision of progress in skills and expertise. Virtual and physical box-trainers seem especially fit for this purpose, and allow for improvement of proficiency required in laparoscopic surgery. The study included 34 students who completed the authors' laparoscopic training on physical train-boxes. Progress was monitored by accomplishment of 3 exercises: moving pellets from one place to another, excising and clipping. Analysed parameters included time needed to complete the exercise and right and left hand movement tracks. Students were asked to do assigned tasks prior to, in the middle and after the training. The duration of the course was 28 h in total. Significant shortening of the time to perform each exercise and reduction of the left hand track were achieved. The right hand track was shortened only in exercise number 1. Exercises in the laboratory setting should be regarded as an important element of the process of skills acquisition by a young surgeon. Virtual reality laparoscopic training seems to be a new, interesting educational tool, and at the same time allows for reliable control and assessment of progress.

Issues related to line-oriented flight training

NASA Technical Reports Server (NTRS)

Lauber, J. K.

1981-01-01

The use of a training simulator along with carefully structured, detailed, line trip scenarios was envisioned by NASA as a means of providing a controllable, repeatable way to observe line crews in a highly realistic simulation of their working environment and obtain better understanding operationally significant human factors problems and issues. Relevant research done by the agency and the results of full-mission simulation scenarios revealed potential implications for flight training. Aspects to be considered in creating training programs closely related to the actual line environment with a total crew application in real world incident experiences include: (1) operational, environmental, equipment, and crew problems in scenario design; (2) real time line oriented flight training operation; (3) performance assessment and debriefing; (4) instructor qualification and training; and (5) other issues such as ub un initial, transition, and upgrade training; procedures developent and evaluation, and equipment evaluation.

Advanced real-time multi-display educational system (ARMES): An innovative real-time audiovisual mentoring tool for complex robotic surgery.

PubMed

Lee, Joong Ho; Tanaka, Eiji; Woo, Yanghee; Ali, Güner; Son, Taeil; Kim, Hyoung-Il; Hyung, Woo Jin

2017-12-01

The recent scientific and technologic advances have profoundly affected the training of surgeons worldwide. We describe a novel intraoperative real-time training module, the Advanced Robotic Multi-display Educational System (ARMES). We created a real-time training module, which can provide a standardized step by step guidance to robotic distal subtotal gastrectomy with D2 lymphadenectomy procedures, ARMES. The short video clips of 20 key steps in the standardized procedure for robotic gastrectomy were created and integrated with TilePro™ software to delivery on da Vinci Surgical Systems (Intuitive Surgical, Sunnyvale, CA). We successfully performed the robotic distal subtotal gastrectomy with D2 lymphadenectomy for patient with gastric cancer employing this new teaching method without any transfer errors or system failures. Using this technique, the total operative time was 197 min and blood loss was 50 mL and there were no intra- or post-operative complications. Our innovative real-time mentoring module, ARMES, enables standardized, systematic guidance during surgical procedures. © 2017 Wiley Periodicals, Inc.

Is modified brief assertiveness training for nurses effective? A single-group study with long-term follow-up.

PubMed

Yoshinaga, Naoki; Nakamura, Yohei; Tanoue, Hiroki; MacLiam, Fionnula; Aoishi, Keiko; Shiraishi, Yuko

2018-01-01

To evaluate the long-term effectiveness of modified brief assertiveness training (with cognitive techniques) for nurses. Most assertiveness training takes a long time to conduct; thus, briefer training is required for universal on-the-job training in the workplace. In this single-group study, nurses received two 90-min training sessions with a 1-month interval between sessions. The degree of assertiveness was assessed by using the Rathus Assertiveness Schedule as the primary outcome, at four time points: pre- and post-training, 3-month follow-up and 6-month follow-up. A total of 33 nurses received the training, and the mean Rathus Assertiveness Schedule score improved from -14.2 (SD = 16.5) pre-training to -10.5 (SD = 18.0) post-training (p < .05). These improvements were maintained until the 6-month follow-up. The pre-post effect size of 0.22 (indicating small effect) was larger than the effect sizes ranging from -0.56 to 0.17 (no effect) reported in previous studies that used brief training. Modified brief assertiveness training seems feasible and may achieve long-term favourable outcomes in improving assertiveness among nurses. The ease of implementation of assertiveness training is important because creating an open environment for communication leads to improved job satisfaction, improved nursing care and increased patient safety. © 2017 The Authors. Journal of Nursing Management Published by John Wiley & Sons Ltd.

Artificial neural network with backpropagation learning to predict mean monthly total ozone in Arosa, Switzerland

NASA Astrophysics Data System (ADS)

Chattopadhyay, Surajit; Bandyopadhyay, Goutami

2007-01-01

Present study deals with the mean monthly total ozone time series over Arosa, Switzerland. The study period is 1932-1971. First of all, the total ozone time series has been identified as a complex system and then Artificial Neural Networks models in the form of Multilayer Perceptron with back propagation learning have been developed. The models are Single-hidden-layer and Two-hidden-layer Perceptrons with sigmoid activation function. After sequential learning with learning rate 0.9 the peak total ozone period (February-May) concentrations of mean monthly total ozone have been predicted by the two neural net models. After training and validation, both of the models are found skillful. But, Two-hidden-layer Perceptron is found to be more adroit in predicting the mean monthly total ozone concentrations over the aforesaid period.

Hamstring injuries have increased by 4% annually in men's professional football, since 2001: a 13-year longitudinal analysis of the UEFA Elite Club injury study.

PubMed

Ekstrand, Jan; Waldén, Markus; Hägglund, Martin

2016-06-01

There are limited data on hamstring injury rates over time in football. To analyse time trends in hamstring injury rates in male professional footballers over 13 consecutive seasons and to distinguish the relative contribution of training and match injuries. 36 clubs from 12 European countries were followed between 2001 and 2014. Team medical staff recorded individual player exposure and time-loss injuries. Injuries per 1000 h were compared as a rate ratio (RR) with 95% CI. Injury burden was the number of lay off days per 1000 h. Seasonal trend for injury was analysed using linear regression. A total of 1614 hamstring injuries were recorded; 22% of players sustained at least one hamstring injury during a season. The overall hamstring injury rate over the 13-year period was 1.20 injuries per 1000 h; the match injury rate (4.77) being 9 times higher than the training injury rate (0.51; RR 9.4; 95% CI 8.5 to 10.4). The time-trend analysis showed an annual average 2.3% year on year increase in the total hamstring injury rate over the 13-year period (R(2)=0.431, b=0.023, 95% CI 0.006 to 0.041, p=0.015). This increase over time was most pronounced for training injuries-these increased by 4.0% per year (R(2)=0.450, b=0.040, 95% CI 0.011 to 0.070, p=0.012). The average hamstring injury burden was 19.7 days per 1000 h (annual average increase 4.1%) (R(2)=0.437, b=0.041, 95% CI 0.010 to 0.072, p=0.014). Training-related hamstring injury rates have increased substantially since 2001 but match-related injury rates have remained stable. The challenge is for clubs to reduce training-related hamstring injury rates without impairing match performance. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

The epidemiology of foot injuries in professional rugby union players.

PubMed

Pearce, Christopher J; Brooks, John H M; Kemp, Simon P T; Calder, James D F

2011-09-01

Foot injuries represent a small but important proportion of injuries to professional rugby union players. There are no detailed epidemiological studies regarding these injuries. The aim of this study was to describe the epidemiology of foot injuries sustained by a cohort of professional rugby union players and identify areas that may be targeted for injury prevention in the future. Medical personnel prospectively recorded injuries in professional Premiership rugby union players in England over four seasons. Injuries to the foot were identified and the time away from training and playing was reported. A total of 147 foot injuries were sustained resulting in 3542 days of absence in total. Acute events accounted for 73% of all foot injuries, with chronic, mostly overuse conditions, accounting for 25% (undiagnosed 2%). Chronic conditions led to proportionately more time away from training and playing (p=<0.001). Specifically, stress fractures in the foot accounted for 8% of the total foot injuries but 22% of the absence. Navicular stress fractures had the longest recovery time with the mean return to training and match play of 188 days. In collision sports such as rugby, some injuries may be inevitable but clinicians should always be seeking ways to minimise their occurrence and impact. This study revealed a high proportion of morbidity associated with chronic and overuse foot injuries in these professional athletes. With greater attention paid to risk factors, some of these injuries, and importantly, recurrent injuries may be avoided. Copyright © 2010 European Foot and Ankle Society. Published by Elsevier Ltd. All rights reserved.

Physiological and performance changes from the addition of a sprint interval program to wrestling training.

PubMed

Farzad, Babak; Gharakhanlou, Reza; Agha-Alinejad, Hamid; Curby, David G; Bayati, Mahdi; Bahraminejad, Morteza; Mäestu, Jarek

2011-09-01

Increasing the level of physical fitness for competition is the primary goal of any conditioning program for wrestlers. Wrestlers often need to peak for competitions several times over an annual training cycle. Additionally, the scheduling of these competitions does not always match an ideal periodization plan and may require a modified training program to achieve a high level of competitive fitness in a short-time frame. The purpose of this study was to examine the effects of 4 weeks of sprint-interval training (SIT) program, on selected aerobic and anaerobic performance indices, and hormonal and hematological adaptations, when added to the traditional Iranian training of wrestlers in their preseason phase. Fifteen trained wrestlers were assigned to either an experimental (EXP) or a control (CON) group. Both groups followed a traditional preparation phase consisting of learning and drilling technique, live wrestling and weight training for 4 weeks. In addition, the EXP group performed a running-based SIT protocol. The SIT consisted of 6 35-m sprints at maximum effort with a 10-second recovery between each sprint. The SIT protocol was performed in 2 sessions per week, for the 4 weeks of the study. Before and after the 4-week training program, pre and posttesting was performed on each subject on the following: a graded exercise test (GXT) to determine VO(2)max, the velocity associated with V(2)max (νVO(2)max), maximal ventilation, and peak oxygen pulse; a time to exhaustion test (T(max)) at their νVO(2)max; and 4 successive Wingate tests with a 4-minute recovery between each trial for the determination of peak and mean power output (PPO, MPO). Resting blood samples were also collected at the beginning of each pre and posttesting period, before and after the 4-week training program. The EXP group showed significant improvements in VO(2)max (+5.4%), peak oxygen pulse (+7.7%) and T(max) (+32.2%) compared with pretesting. The EXP group produced significant increases in PPO and MPO during the Wingate testing compared with pretesting (p < 0.05). After the 4-week training program, total testosterone and the total testosterone/cortisol ratio increased significantly in the EXP group, whereas cortisol tended to decrease (p = 0.06). The current findings indicate that the addition of an SIT program with short recovery can improve both aerobic and anaerobic performances in trained wrestlers during the preseason phase. The hormonal changes seen suggest training-induced anabolic adaptations.

Changes in HDL-c concentrations after 16 weeks of combined training in postmenopausal women: characteristics of positive and negative responders.

PubMed

Diniz, Tiego A; Rossi, Fabricio E; Fortaleza, Ana Claudia Souza; Neves, Lucas Melo; Christofaro, Diego Giulliano Destro; Buonani, Camila; Lira, Fabio S; Campos, Eduardo Zapaterra; Prado, Wagner Luiz do; Freitas, Ismael Forte

2018-01-01

This study aimed to investigate the individual characteristics of body composition and metabolic profile that could explain interindividual variation in high-density lipoprotein cholesterol (HDL-c) concentrations in response to 16 weeks of combined strength plus aerobic (combined) training in postmenopausal women. The participants were divided into tertiles based on percentage of changes in HDL-c concentrations after combined training. Only women in the upper tertile (positive responders: Δ > 10.4%; n = 19) and lower tertile (negative responders: Δ < -1.4%; n = 19) were considered for analyses. The total body fat (BF), trunk fat (TF), android fat (AF), gynoid fat, and lean body mass were estimated by dual-energy X-ray absorptiometry. The metabolic profile - glucose, triacylglycerol, total cholesterol, HDL-c, low-density lipoprotein cholesterol, and very-low-density lipoprotein (VLDL) - were assessed. After 16 weeks, both positive and negative responders presented similar improvement in body composition, such as a decrease in percentage and kilograms of BF, TF, and AF, and increase in lean body mass (p value for time < 0.05). As expected, there was an effect of time and also a significant interaction (time vs. group) (p value < 0.001) in the improvement of HDL-c, with higher values for positive responders. Regarding metabolic profile, there were significant interactions (time vs. group) for triacylglycerol (p value = 0.032) and VLDL (p value = 0.027) concentrations, with lower values for positive responders. Our results suggests there is heterogeneity in combined training-induced HDL-c changes in postmenopausal women, and the positive responders were those who presented more pronounced decreases in triacylglycerol and VLDL concentrations.

Investigating the Acquisition, Generalization, and Emergence of Untrained Verbal Operants for Mands Acquired Using the Picture Exchange Communication System in Adults with Severe Developmental Disabilities

ERIC Educational Resources Information Center

Ziomek, M. M.; Rehfeldt, R. A.

2008-01-01

This study compared the total amount of training time and total number of trial blocks for individuals with severe developmental disabilities to acquire mands under control of unconditioned establishing operations and mands under control of transitive conditioned establishing operations for manual sign and for the Picture Exchange Communication…

Wii Fit balance training or progressive balance training in patients with chronic stroke: a randomised controlled trial.

PubMed

Yatar, Gozde Iyigun; Yildirim, Sibel Aksu

2015-04-01

[Purpose] The aim of this study was to compare the effects of Wii Fit balance training (WBT) and progressive balance training (PBT) approaches on balance functions, balance confidence, and activities of daily living in chronic stroke patients. [Subjects] A total of 30 patients were randomized into the WBT (n=15) and PBT (n=15) groups. [Methods] All of the subjects received exercise training based on a neurodevelopemental approach in addition to either Wii Fit or progressive balance training for total of 1 hour a day, 3 days per week for 4 weeks. Primary measurements were static balance function measured with a Wii Balance Board and dynamic balance function assessed with the Berg Balance Scale, Timed Up and Go test, Dynamic Gait Index, and Functional Reach Test. Secondary measures were balance confidence assessed with the Activities-specific Balance Confidence scale and activities of daily living evaluated with the Frenchay Activity Index. [Results] There was not remarkable difference between the two treatments in dynamic balance functions, balance confidence, and activities of daily living. [Conclusion] Although both of the approaches were found to be effective in improving the balance functions, balance confidence, and activities of daily living, neither of them were more preferable than the other for the treatment of balance in patients with chronic stroke.

Is 48 hours enough for Obstetrics and Gynaecology training in Europe?

PubMed Central

Rose, K.; Van de Venne, M.; Abakke, A.J.M.; Romanek, K.; Redecha, M.

2012-01-01

The European Working Time Directive, implemented by the European Union (EU) in 1993, was adopted in the medical profession to improve patient safety as well as the working lives of doctors. The Directive reduced the average amount of hours trainee doctors worked to 48 hours per week. However, its adoption has varied throughout the EU. Its potential effect on both the quality and total amount of hours of training has caused concern. This monograph presents data on Obstetrics and Gynaecology training in Europe obtained from several of the European Network of Trainees in Obstetrics & Gynaecology’s (ENTOG) surveys. The monograph demonstrates large variations in training and explains the difficulties in ascertaining whether 48 hours of training a week is sufficient to become an Obstetrics and Gynaecology specialist in Europe. PMID:24753895

Limited value of haptics in virtual reality laparoscopic cholecystectomy training.

PubMed

Thompson, Jonathan R; Leonard, Anthony C; Doarn, Charles R; Roesch, Matt J; Broderick, Timothy J

2011-04-01

Haptics is an expensive addition to virtual reality (VR) simulators, and the added value to training has not been proven. This study evaluated the benefit of haptics in VR laparoscopic surgery training for novices. The Simbionix LapMentor II haptic VR simulator was used in the study. Randomly, 33 laparoscopic novice students were placed in one of three groups: control, haptics-trained, or nonhaptics-trained group. The control group performed nine basic laparoscopy tasks and four cholecystectomy procedural tasks one time with haptics engaged at the default setting. The haptics group was trained to proficiency in the basic tasks and then performed each of the procedural tasks one time with haptics engaged. The nonhaptics group used the same training protocol except that haptics was disengaged. The proficiency values used were previously published expert values. Each group was assessed in the performance of 10 laparoscopic cholecystectomies (alternating with and without haptics). Performance was measured via automatically collected simulator data. The three groups exhibited no differences in terms of sex, education level, hand dominance, video game experience, surgical experience, and nonsurgical simulator experience. The number of attempts required to reach proficiency did not differ between the haptics- and nonhaptics-training groups. The haptics and nonhaptics groups exhibited no difference in performance. Both training groups outperformed the control group in number of movements as well as path length of the left instrument. In addition, the nonhaptics group outperformed the control group in total time. Haptics does not improve the efficiency or effectiveness of LapMentor II VR laparoscopic surgery training. The limited benefit and the significant cost of haptics suggest that haptics should not be included routinely in VR laparoscopic surgery training.

Effects of combat training on visuomotor performance in children aged 9 to 12 years - an eye-tracking study.

PubMed

Ju, Yan-Ying; Liu, Yen-Hsiu; Cheng, Chih-Hsiu; Lee, Yu-Lung; Chang, Shih-Tsung; Sun, Chi-Chin; Cheng, Hsin-Yi Kathy

2018-02-07

Data on visuomotor performance in combat training and the effects of combat training on visuomotor performance are limited. This study aimed to investigate the effects of a specially designed combat sports (CS) training program on the visuomotor performance levels of children. A pre-post comparative design was implemented. A total of 26 students aged 9-12 years underwent 40-min CS training sessions twice a week for 8 weeks during their physical education classes. The CS training program was designed by a karate coach and a motor control specialist. The other 30 students continued their regular activities and were considered as a control group. Each student's eye movement was monitored using an eye tracker, whereas the motor performance was measured using a target hitting system with a program-controlled microprocessor. The measurements were taken 8 weeks before (baseline), 1 day before (pretest), and 1 week after (posttest) the designated training program. The task used for evaluating these students was hitting or tracking random illuminated targets as rapidly as possible. A two-way analysis of variance [group(2) × time(3)] with repeated measures of time was performed for statistical analysis. For the children who received combat training, although the eye response improvement was not significant, both the primary and secondary saccade onset latencies were significantly earlier compared to the children without combat training. Both groups of students exhibited improvement in their hit response times during the target hitting tasks. The current finding supported the notion that sports training efforts essentially enhance visuomotor function in children aged 9-12 years, and combat training facilitates an earlier secondary saccade onset.

Advanced laparoscopic bariatric surgery Is safe in general surgery training.

PubMed

Kuckelman, John; Bingham, Jason; Barron, Morgan; Lallemand, Michael; Martin, Matthew; Sohn, Vance

2017-05-01

Bariatric surgery makes up an increasing percentage of general surgery training. The safety of resident involvement in these complex cases has been questioned. We evaluated patient outcomes in resident performed laparoscopic bariatric procedures. Retrospective review of patients undergoing a laparoscopic bariatric procedure over seven years at a tertiary care single center. Procedures were primarily performed by a general surgery resident and proctored by an attending surgeon. Primary outcomes included operative volume, operative time and leak rate with perioperative outcomes evaluated as secondary outcomes. A total of 1649 bariatric procedures were evaluated. Operations included laparoscopic bypass (690) and laparoscopic sleeve gastrectomy (959). Average operating time was 136 min. Eighteen leaks (0.67%) were identified. Graduating residents performed an average of 89 laparoscopic bariatric cases during their training. There were no significant differences between resident levels with concern to operative time or leak rate (p 0.97 and p = 0.54). General surgery residents can safely perform laparoscopic bariatric surgery. When proctored by a staff surgeon, a resident's level of training does not significantly impact leak rate. Published by Elsevier Inc.

Changes in healthcare workers' knowledge about tuberculosis following a tuberculosis training programme.

PubMed

Naidoo, S; Taylor, M; Esterhuizen, T M; Nordstrom, D L; Mohamed, O; Knight, S E; Jinabhai, C C

2011-08-01

In resource-limited countries, health policy makers and practitioners need to know whether healthcare workers have sufficient knowledge of tuberculosis and its management. We conducted a study to: (1) measure knowledge changes among healthcare workers who participated in a tuberculosis training programme; and (2) make recommendations about future tuberculosis training for healthcare workers in the KwaZulu-Natal Department of Health. A cross-sectional study conducted in 2007 measured changes in tuberculosis knowledge of doctors, nurses and other healthcare workers after a training programme based on World Health Organization tuberculosis training modules. Data were collected before and after training using a self-administered, 98-item questionnaire covering eight components. A total of 267 healthcare workers, mean age 40.7 years, answered both pre- and post-training questionnaires. Mean total knowledge scores were low despite significant changes (p<0.001) from a pre-training score of 59.5% to a post-training score of 66.5%. Nurses showed significant improvements in mean total knowledge scores (p<0.001) but had the lowest mean total knowledge score post-training, 63.2%. Doctors had significantly better pre-training (p<0.001) and post-training (p<0.001) mean total knowledge scores compared to nurses. Improvement in healthcare workers' overall knowledge of tuberculosis during a training programme was not clinically significant. Periodic field training and supervision should be considered to ensure tuberculosis knowledge improvements.

Inter-session reliability and sex-related differences in hamstrings total reaction time, pre-motor time and motor time during eccentric isokinetic contractions in recreational athlete.

PubMed

Ayala, Francisco; De Ste Croix, Mark; Sainz de Baranda, Pilar; Santonja, Fernando

2014-04-01

The purposes were twofold: (a) to ascertain the inter-session reliability of hamstrings total reaction time, pre-motor time and motor time; and (b) to examine sex-related differences in the hamstrings reaction times profile. Twenty-four men and 24 women completed the study. Biceps femoris and semitendinosus total reaction time, pre-motor time and motor time measured during eccentric isokinetic contractions were recorded on three different occasions. Inter-session reliability was examined through typical percentage error (CVTE), percentage change in the mean (CM) and intraclass correlations (ICC). For both biceps femoris and semitendinosus, total reaction time, pre-motor time and motor time measures demonstrated moderate inter-session reliability (CVTE<10%; CM<3%; ICC>0.7). The results also indicated that, although not statistically significant, women reported consistently longer hamstrings total reaction time (23.5ms), pre-motor time (12.7ms) and motor time (7.5ms) values than men. Therefore, an observed change larger than 5%, 9% and 8% for total reaction time, pre-motor time and motor time respectively from baseline scores after performing a training program would indicate that a real change was likely. Furthermore, while not statistically significant, sex differences were noted in the hamstrings reaction time profile which may play a role in the greater incidence of ACL injuries in women. Copyright © 2013 Elsevier Ltd. All rights reserved.

IGF-I, IGFBPs, and inflammatory cytokine responses during gender-integrated Israeli Army basic combat training.

PubMed

Nindl, Bradley C; Scofield, Dennis E; Strohbach, Cassandra A; Centi, Amanda J; Evans, Rachel K; Yanovich, Ran; Moran, Daniel S

2012-07-01

Insulin-like growth factor 1 (IGF-I) is a robust metabolic and anabolic biomarker that has been demonstrated to be reflective of military training-induced body composition changes and influenced by initial aerobic fitness level. Greater mechanistic insight into the IGF-I response to physical training can potentially be gleaned by also examining other regulatory factors that influence IGF-I biological activity (i.e., insulin-like growth factor-binding proteins [IGFBPs] and inflammatory cytokine responses). The purpose of this study was to assess the influence of sex and initial fitness level on the IGF-I and inflammatory cytokine response to gender-integrated Israeli Defense Forces (IDF) basic combat training (BCT). Recruits (29 men, 19.1 ± 1.3 years; 93 women, 18.8 ± 0.6 years) were recruited from a 4-month gender-integrated BCT of the IDF. Blood was drawn and assayed for total IGF-I, free IGF-I, IGFBPs 1-6, tumor necrosis factor alpha (TNF-α), interleukin 6, and interleukin 1 beta. Body composition was determined via a 4-site skinfold (biceps, triceps, suprailiac, and subscapular) equation. Physical performance was assessed via a maximum volume of oxygen consumption (V[Combining Dot Above]O₂max) test using a treadmill protocol. All measures were obtained pre- and posttraining. A 2-way (sex × time) analysis of variance was used to test for statistical differences (p ≤ 0.05). Additionally, subjects were further partitioned (men and women separately) by tertiles of initial V[Combining Dot Above]O₂max to assess the influence of initial fitness level on the IGF-I system and inflammatory cytokine responses to physical training. Pearson product moment correlational analysis was also used to examine relationships between percent changes in blood measures and physical performance and body composition changes. All data are presented as mean ± SE. Time effects were observed only for total IGF-I, IGFBP-2, TNF-α, V[Combining Dot Above]O₂max, fat-free mass, and fat mass. The only significant (p ≤ 0.05) correlations observed for percent changes were in men between total IGF-I and V[Combining Dot Above]O₂max (r = 0.49) and body mass (r = -0.42) During gender-integrated Israeli Army BCT, men and women generally respond in a similar fashion with regard to blood measures (IGF-I system and inflammatory cytokines) and V[Combining Dot Above]O₂max. Initial fitness level only influenced the IGF-I response to training in women. Although the training-induced changes in total IGF-I (increase), IGFBP-2 (decrease), and TNF-α (decrease) are all indicative of an enhanced circulating anabolic milieu, only total IGF-I for the men was correlated with body composition and fitness improvements.

Training in pathology informatics: implementation at the University of Pittsburgh.

PubMed

Harrison, James H; Stewart, Jimmie

2003-08-01

Pathology informatics is generally recognized as an important component of pathology training, but the scope, form, and goals of informatics training vary substantially between pathology residency programs. The Training and Education Committee of the Association for Pathology Informatics (API TEC) has developed a standard set of knowledge and skills objectives that are recommended for inclusion in pathology informatics training and may serve to standardize and formalize training programs in this area. The University of Pittsburgh (Pittsburgh, Pa) core rotation in pathology informatics includes most of these goals and is offered as an implementation model for pathology informatics training. The core rotation in pathology informatics is a 3-week, full-time rotation including didactic sessions and hands-on laboratories. Topics include general desktop computing and the Internet, but the primary focus of the rotation is vocabulary and concepts related to enterprise and pathology information systems, pathology practice, and research. The total contact time is 63 hours, and a total of 19 faculty and staff contribute. Pretests and posttests are given at the start and end of the rotation. Performance and course evaluation data were collected for 3 years (a total of 21 residents). The rotation implements 84% of the knowledge objectives and 94% of the skills objectives recommended by the API TEC. Residents scored an average of about 20% on the pretest and about 70% on the posttest for an average increase during the course of 50%. Posttest scores did not correlate with pretest scores or self-assessed computer skill level. The size of the pretest/posttest difference correlated negatively with the pretest scores and self-assessed computing skill level. Pretest scores were generally low regardless of whether residents were familiar with desktop computing and productivity applications, indicating that even residents who are computer "savvy" have limited knowledge of pathology informatics topics. Posttest scores showed that all residents' knowledge increased substantially during the course and that residents who were computing novices were not disadvantaged. In fact, novices tended to have higher pretest/posttest differences, indicating that the rotation effectively supported initially less knowledgeable residents in "catching up" to their peers and achieving an appropriate competency level. This rotation provides a formal training model that implements the API TEC recommendations with demonstrated success.

Effectiveness of an interactive telerehabilitation system with home-based exercise training in patients after total hip or knee replacement: study protocol for a multicenter, superiority, no-blinded randomized controlled trial.

PubMed

Eichler, Sarah; Rabe, Sophie; Salzwedel, Annett; Müller, Steffen; Stoll, Josefine; Tilgner, Nina; John, Michael; Wegscheider, Karl; Mayer, Frank; Völler, Heinz

2017-09-21

Total hip or knee replacement is one of the most frequently performed surgical procedures. Physical rehabilitation following total hip or knee replacement is an essential part of the therapy to improve functional outcomes and quality of life. After discharge from inpatient rehabilitation, a subsequent postoperative exercise therapy is needed to maintain functional mobility. Telerehabilitation may be a potential innovative treatment approach. We aim to investigate the superiority of an interactive telerehabilitation intervention for patients after total hip or knee replacement, in comparison to usual care, regarding physical performance, functional mobility, quality of life and pain. This is an open, randomized controlled, multicenter superiority study with two prospective arms. One hundred and ten eligible and consenting participants with total knee or hip replacement will be recruited at admission to subsequent inpatient rehabilitation. After comprehensive, 3-week, inpatient rehabilitation, the intervention group performs a 3-month, interactive, home-based exercise training with a telerehabilitation system. For this purpose, the physiotherapist creates an individual training plan out of 38 different strength and balance exercises which were implemented in the system. Data about the quality and frequency of training are transmitted to the physiotherapist for further adjustment. Communication between patient and physiotherapist is possible with the system. The control group receives voluntary, usual aftercare programs. Baseline assessments are investigated after discharge from rehabilitation; final assessments 3 months later. The primary outcome is the difference in improvement between intervention and control group in 6-minute walk distance after 3 months. Secondary outcomes include differences in the Timed Up and Go Test, the Five-Times-Sit-to-Stand Test, the Stair Ascend Test, the Short-Form 36, the Western Ontario and McMaster Universities Osteoarthritis Index, the International Physical Activity Questionnaire, and postural control as well as gait and kinematic parameters of the lower limbs. Baseline-adjusted analysis of covariance models will be used to test for group differences in the primary and secondary endpoints. We expect the intervention group to benefit from the interactive, home-based exercise training in many respects represented by the study endpoints. If successful, this approach could be used to enhance the access to aftercare programs, especially in structurally weak areas. German Clinical Trials Register (DRKS), ID: DRKS00010009 . Registered on 11 May 2016.

46 CFR 310.3 - Schools and courses.

Code of Federal Regulations, 2013 CFR

2013-10-01

... beyond the control of the School. During a period a school is implementing an approved plan, Cadets may...) months of the total time must be aboard a Training Ship in cruise status. A maximum of two (2) months of...) months of the specified cruise time. For the cadets at the Great Lakes Maritime Academy, six (6) months...

46 CFR 310.3 - Schools and courses.

Code of Federal Regulations, 2012 CFR

2012-10-01

... beyond the control of the School. During a period a school is implementing an approved plan, Cadets may...) months of the total time must be aboard a Training Ship in cruise status. A maximum of two (2) months of...) months of the specified cruise time. For the cadets at the Great Lakes Maritime Academy, six (6) months...

46 CFR 310.3 - Schools and courses.

Code of Federal Regulations, 2014 CFR

2014-10-01

... beyond the control of the School. During a period a school is implementing an approved plan, Cadets may...) months of the total time must be aboard a Training Ship in cruise status. A maximum of two (2) months of...) months of the specified cruise time. For the cadets at the Great Lakes Maritime Academy, six (6) months...

No Correlation Between Work-Hours and Operative Volumes--A Comparison Between United States and Danish Operative Volumes Achieved During Surgical Residency.

PubMed

Kjærgaard, Jane; Sillesen, Martin; Beier-Holgersen, Randi

2016-01-01

Since 2003, United States residents have been limited to an 80-hour workweek. This has prompted concerns of reduced educational quality, especially inadequate operating exposure. In contrast, the Danish surgical specialty-training program mandates a cap on working hours of 37 per week. We hypothesize that there is no direct correlation between work-hours and operative volume achieved during surgical residency. To test the hypothesis, we compare Danish and US operative volumes achieved during surgical residency training. Retrospective comparative study. The data from the US population was extracted from the Accreditation Council for Graduate Medical Education database for General Surgery residents from 2012 to 2013. For Danish residents, a questionnaire with case categories matching the Accreditation Council for Graduate Medical Education categories were sent to all Danish surgeons graduating the national surgical residency program in 2012 or 2013, 54 in total. In all, 30 graduated residents (55%) responded to the Danish survey. We found no significant differences in mean total major procedures (1002.4 vs 976.9, p = 0.28) performed during residency training, but comparing average major procedures per year, the US residents achieve significantly more (132.3 vs 195.4, p <0.01). When factoring in differences in time spent in training, this amounts to a weekly average difference of 1.2 cases throughout training. In this study, we find no difference in overall surgical volumes between Danes and US residents during their surgical training. When time in training was accounted for, differences between weekly surgical volumes achieved were minor, indicating a lack of direct correlation between weekly work-hours and operative volumes achievable. Factors other than work-hours seem to effect on operative volumes achieved during training. Copyright © 2016 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Environmental enrichment facilitates cocaine-cue extinction, deters reacquisition of cocaine self-administration and alters AMPAR GluA1 expression and phosphorylation.

PubMed

Gauthier, Jamie M; Lin, Amy; Nic Dhonnchadha, Bríd Á; Spealman, Roger D; Man, Heng-Ye; Kantak, Kathleen M

2017-01-01

This study investigated the combination of environmental enrichment (EE) with cocaine-cue extinction training on reacquisition of cocaine self-administration. Rats were trained under a second-order schedule for which responses were maintained by cocaine injections and cocaine-paired stimuli. During three weekly extinction sessions, saline was substituted for cocaine but cocaine-paired stimuli were presented. Rats received 4-h periods of EE at strategic time points during extinction training, or received NoEE. Additional control rats received EE or NoEE without extinction training. One week later, reacquisition of cocaine self-administration was evaluated for 15 sessions, and then GluA1 expression, a cellular substrate for learning and memory, was measured in selected brain regions. EE provided both 24 h before and immediately after extinction training facilitated extinction learning and deterred reacquisition of cocaine self-administration for up to 13 sessions. Each intervention by itself (EE alone or extinction alone) was ineffective, as was EE scheduled at individual time points (EE 4 h or 24 h before, or EE immediately or 6 h after, each extinction training session). Under these conditions, rats rapidly reacquired baseline rates of cocaine self-administration. Cocaine self-administration alone decreased total GluA1 and/or pSer845GluA1 expression in basolateral amygdala and nucleus accumbens. Extinction training, with or without EE, opposed these changes and also increased total GluA1 in ventromedial prefrontal cortex and dorsal hippocampus. EE alone increased pSer845GluA1 and EE combined with extinction training decreased pSer845GluA1 in ventromedial prefrontal cortex. EE might be a useful adjunct to extinction therapy by enabling neuroplasticity that deters relapse to cocaine self-administration. © 2015 Society for the Study of Addiction.

The Feasibility of Real-Time Intraoperative Performance Assessment With SIMPL (System for Improving and Measuring Procedural Learning): Early Experience From a Multi-institutional Trial.

PubMed

Bohnen, Jordan D; George, Brian C; Williams, Reed G; Schuller, Mary C; DaRosa, Debra A; Torbeck, Laura; Mullen, John T; Meyerson, Shari L; Auyang, Edward D; Chipman, Jeffrey G; Choi, Jennifer N; Choti, Michael A; Endean, Eric D; Foley, Eugene F; Mandell, Samuel P; Meier, Andreas H; Smink, Douglas S; Terhune, Kyla P; Wise, Paul E; Soper, Nathaniel J; Zwischenberger, Joseph B; Lillemoe, Keith D; Dunnington, Gary L; Fryer, Jonathan P

Intraoperative performance assessment of residents is of growing interest to trainees, faculty, and accreditors. Current approaches to collect such assessments are limited by low participation rates and long delays between procedure and evaluation. We deployed an innovative, smartphone-based tool, SIMPL (System for Improving and Measuring Procedural Learning), to make real-time intraoperative performance assessment feasible for every case in which surgical trainees participate, and hypothesized that SIMPL could be feasibly integrated into surgical training programs. Between September 1, 2015 and February 29, 2016, 15 U.S. general surgery residency programs were enrolled in an institutional review board-approved trial. SIMPL was made available after 70% of faculty and residents completed a 1-hour training session. Descriptive and univariate statistics analyzed multiple dimensions of feasibility, including training rates, volume of assessments, response rates/times, and dictation rates. The 20 most active residents and attendings were evaluated in greater detail. A total of 90% of eligible users (1267/1412) completed training. Further, 13/15 programs began using SIMPL. Totally, 6024 assessments were completed by 254 categorical general surgery residents (n = 3555 assessments) and 259 attendings (n = 2469 assessments), and 3762 unique operations were assessed. There was significant heterogeneity in participation within and between programs. Mean percentage (range) of users who completed ≥1, 5, and 20 assessments were 62% (21%-96%), 34% (5%-75%), and 10% (0%-32%) across all programs, and 96%, 75%, and 32% in the most active program. Overall, response rate was 70%, dictation rate was 24%, and mean response time was 12 hours. Assessments increased from 357 (September 2015) to 1146 (February 2016). The 20 most active residents each received mean 46 assessments by 10 attendings for 20 different procedures. SIMPL can be feasibly integrated into surgical training programs to enhance the frequency and timeliness of intraoperative performance assessment. We believe SIMPL could help facilitate a national competency-based surgical training system, although local and systemic challenges still need to be addressed. Copyright © 2016. Published by Elsevier Inc.

Intermanual transfer in training with an upper-limb myoelectric prosthesis simulator: a mechanistic, randomized, pretest-posttest study.

PubMed

Romkema, Sietske; Bongers, Raoul M; van der Sluis, Corry K

2013-01-01

Intermanual transfer may improve prosthetic handling and acceptance if used in training soon after an amputation. The purpose of this study was to determine whether intermanual transfer effects can be detected after training with a myoelectric upper-limb prosthesis simulator. A mechanistic, randomized, pretest-posttest design was used. A total of 48 right-handed participants (25 women, 23 men) who were able-bodied were randomly assigned to an experimental group or a control group. The experimental group performed a training program of 5 days' duration using the prosthesis simulator. To determine the improvement in skill, a test was administered before, immediately after, and 6 days after training. The control group only performed the tests. Training was performed with the unaffected arm, and tests were performed with the affected arm (the affected arm simulating an amputated limb). Half of the participants were tested with the dominant arm and half with the nondominant arm. Initiation time was defined as the time from starting signal until start of the movement, movement time was defined as the time from the beginning of the movement until completion of the task, and force control was defined as the maximal applied force on a deformable object. The movement time decreased significantly more in the experimental group (F₂,₉₂=7.42, P=.001, η²(G)=.028) when compared with the control group. This finding is indicative of faster handling of the prosthesis. No statistically significant differences were found between groups with regard to initiation time and force control. We did not find a difference in intermanual transfer between the dominant and nondominant arms. The training utilized participants who were able-bodied in a laboratory setting and focused only on transradial amputations. Intermanual transfer was present in the affected arm after training the unaffected arm with a myoelectric prosthesis simulator, and this effect did not depend on laterality. This effect may improve rehabilitation of patients with an upper-limb amputation.

Design, implementation and evaluation of a training programme for school teachers in the use of malaria rapid diagnostic tests as part of a basic first aid kit in southern Malawi.

PubMed

Witek-McManus, Stefan; Mathanga, Don P; Verney, Allison; Mtali, Austin; Ali, Doreen; Sande, John; Mwenda, Reuben; Ndau, Saidi; Mazinga, Charles; Phondiwa, Emmanuel; Chimuna, Tiyese; Melody, David; Roschnik, Natalie; Brooker, Simon J; Halliday, Katherine E

2015-09-17

With increasing levels of enrolment, primary schools present a pragmatic opportunity to improve the access of school children to timely diagnosis and treatment of malaria, increasingly recognised as a major health problem within this age group. The expanded use of malaria rapid diagnostic tests (RDTs) and artemisinin combination therapy (ACT) by community health workers (CHWs) has raised the prospect of whether teachers can provide similar services for school children. We describe and evaluate the training of primary school teachers to use a first aid kit containing malaria RDTs and ACT for the diagnosis and treament of uncomplicated malaria in school children in southern Malawi. We outline the development of the intervention as: (1) conception and design, (2) pilot training, (3) final training, and (4) 7-month follow up. The training materials were piloted at a four-day workshop in July 2013 following their design at national stakeholders meetings. The evaluation of the pilot training and materials were assessed in relation to increased knowledge and skill sets using checklist evaluations and questionnaires, the results of which informed the design of a final seven-day training programme held in December 2013. A follow up of trained teachers was carried out in July 2014 following 7 months of routine implementation. A total of 15 teachers were evaluated at four stages: pilot training, two weeks following pilot, final training and seven months following final training. A total of 15 and 92 teachers were trained at the pilot and final training respectively. An average of 93 % of the total steps required to use RDTs were completed correctly at the final training, declining to 87 % after 7 months. All teachers were observed correctly undertaking safe blood collection and handling, accurate RDT interpretation, and correct dispensing of ACT. The most commonly observed errors were a failure to wait 20 minutes before reading the test result, and adding an incorrect volume of buffer to the test cassette. Following training, teachers are able to competently use RDTs and ACTs test and treat children at school for uncomplicated malaria safely and accurately. Teachers demonstrate a comparable level of RDT use relative to non-health professional users of RDTs, and sustain this competency over a period of seven months during routine implementation.

Functional Mobility Performance and Balance Confidence in Older Adults after Sensorimotor Adaptation Training

NASA Technical Reports Server (NTRS)

Buccello-Stout, Regina R.; Cromwell, Ronita L.; Bloomberg, Jacob J.; Weaver, G. D.

2010-01-01

Research indicates a main contributor of injury in older adults is from falling. The decline in sensory systems limits information needed to successfully maneuver through the environment. The objective of this study was to determine if prolonged exposure to the realignment of perceptual-motor systems increases adaptability of balance, and if balance confidence improves after training. A total of 16 older adults between ages 65-85 were randomized to a control group (walking on a treadmill while viewing a static visual scene) and an experimental group (walking on a treadmill while viewing a rotating visual scene). Prior to visual exposure, participants completed six trials of walking through a soft foamed obstacle course. Participants came in twice a week for 4 weeks to complete training of walking on a treadmill and viewing the visual scene for 20 minutes each session. Participants completed the obstacle course after training and four weeks later. Average time, penalty, and Activity Balance Confidence Scale scores were computed for both groups across testing times. The older adults who trained, significantly improved their time through the obstacle course F (2, 28) = 9.41, p < 0.05, as well as reduced their penalty scores F (2, 28) = 21.03, p < 0.05, compared to those who did not train. There was no difference in balance confidence scores between groups across testing times F (2, 28) = 0.503, p > 0.05. Although the training group improved mobility through the obstacle course, there were no differences between the groups in balance confidence.

Physical and cognitive effects of virtual reality integrated training.

PubMed

Stone, Richard T; Watts, Kristopher P; Zhong, Peihan; Wei, Chen-Shuang

2011-10-01

The objective of this study was to evaluate the cognitive and physical impact of virtual reality (VR) integrated training versus traditional training methods in the domain of weld training. Weld training is very important in various industries and represents a complex skill set appropriate for advanced training intervention. As such, there has been a long search for the most successful and most cost-effective method for training new welders. Participants in this study were randomly assigned to one of two separate training courses taught by sanctioned American Welding Society certified welding instructors; the duration of each course was 2 weeks. After completing the training for a specific weld type, participants were given the opportunity to test for the corresponding certification. Participants were evaluated in terms of their cognitive and physical parameters, total training time exposure, and welding certification awards earned. Each of the four weld types taught in this study represented distinct levels of difficulty and required the development of specialized knowledge and skills. This study demonstrated that participants in the VR integrated training group (VR50) performed as well as, and in some cases, significantly outperformed, the traditional welding (TW) training group.The VR50 group was found to have a 41.6% increase in overall certifications earned compared with the TW group. VR technology is a valuable tool for the production of skilled welders in a shorter time and often with more highly developed skills than their traditionally trained counterparts. These findings strongly support the use ofVR integrated training in the welding industry.

A virtual reality endoscopic simulator augments general surgery resident cancer education as measured by performance improvement.

PubMed

White, Ian; Buchberg, Brian; Tsikitis, V Liana; Herzig, Daniel O; Vetto, John T; Lu, Kim C

2014-06-01

Colorectal cancer is the second most common cause of death in the USA. The need for screening colonoscopies, and thus adequately trained endoscopists, particularly in rural areas, is on the rise. Recent increases in required endoscopic cases for surgical resident graduation by the Surgery Residency Review Committee (RRC) further emphasize the need for more effective endoscopic training during residency to determine if a virtual reality colonoscopy simulator enhances surgical resident endoscopic education by detecting improvement in colonoscopy skills before and after 6 weeks of formal clinical endoscopic training. We conducted a retrospective review of prospectively collected surgery resident data on an endoscopy simulator. Residents performed four different clinical scenarios on the endoscopic simulator before and after a 6-week endoscopic training course. Data were collected over a 5-year period from 94 different residents performing a total of 795 colonoscopic simulation scenarios. Main outcome measures included time to cecal intubation, "red out" time, and severity of simulated patient discomfort (mild, moderate, severe, extreme) during colonoscopy scenarios. Average time to intubation of the cecum was 6.8 min for those residents who had not undergone endoscopic training versus 4.4 min for those who had undergone endoscopic training (p < 0.001). Residents who could be compared against themselves (pre vs. post-training), cecal intubation times decreased from 7.1 to 4.3 min (p < 0.001). Post-endoscopy rotation residents caused less severe discomfort during simulated colonoscopy than pre-endoscopy rotation residents (4 vs. 10%; p = 0.004). Virtual reality endoscopic simulation is an effective tool for both augmenting surgical resident endoscopy cancer education and measuring improvement in resident performance after formal clinical endoscopic training.

Laparoscopic varicocelectomy: virtual reality training and learning curve.

PubMed

Wang, Zheng; Ni, Yuhua; Zhang, Yinan; Jin, Xunbo; Xia, Qinghua; Wang, Hanbo

2014-01-01

To explore the role that virtual reality training might play in the learning curve of laparoscopic varicocelectomy. A total of 1326 laparoscopic varicocelectomy cases performed by 16 participants from July 2005 to June 2012 were retrospectively analyzed. The participants were divided into 2 groups: group A was trained by laparoscopic trainer boxes; group B was trained by a virtual reality training course preoperatively. The operation time curves were drafted, and the learning, improving, and platform stages were divided and statistically confirmed. The operation time and number of cases in the learning and improving stages of both groups were compared. Testicular artery sparing failure and postoperative hydroceles rate were statistically analyzed for the confirmation of the learning curve. The learning curve of laparoscopic varicocelectomy was 15 cases, and with 14 cases more, it came into the platform stage. The number of cases for the learning stages of both groups showed no statistical difference (P=.49), but the operation time of group B for the learning stage was less than that of group A (P<.00001). The number of cases of group B for the improving stage was significantly less than that of group A (P=.005), but the operation time of both groups in the improving stage showed no difference (P=.30). The difference of testicular artery sparing failure rates among these 3 stages was proved significant (P<.0001), the postoperative hydroceles rate showed no statistical difference (P=.60). The virtual reality training shortened the operation time in the learning stage and hastened the trainees' steps in the improving stage, but did not shorten the learning curve as expected to.

Airway inflammation, cough and athlete quality of life in elite female cross-country skiers: A longitudinal study.

PubMed

Kennedy, M D; Davidson, W J; Wong, L E; Traves, S L; Leigh, R; Eves, N D

2016-07-01

The aim of this study was to investigate the effect of a season of cross-country training and racing on airway inflammation, cough symptoms, and athlete quality of life in female skiers. Eighteen elite female skiers performed sputum induction and completed the Leicester Cough Questionnaire (LCQ) and the Recovery-Stress Questionnaire (REST-Q) at three time points (T1 - May/Jun, T2 - Oct/Nov, T3 - Jan-Mar) during the year. No changes were observed between T1 and T2. However, an increase in sputum eosinophils and lymphocytes (P < 0.05) and a significant change in all three domains of the LCQ were observed between T1 and T3 (P < 0.05). A significant association was found between the total yearly hours of training and the change in the total cell count (r(2)  = 0.74; P = 0.006), and a number of other sputum cell counts between T1 and T3. No changes were observed for any domain of the REST-Q. The results of this study demonstrate that airway inflammation and cough symptoms are significantly increased in elite female cross-country skiers across a year of training and racing. The increase in airway inflammation is related to the total amount of training and is worse during the winter months when athletes are training and racing in cold, dry air. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Effects of a short-term whole body vibration intervention on bone mass and structure in elderly people.

PubMed

Gómez-Cabello, Alba; González-Agüero, Alejandro; Morales, Silvia; Ara, Ignacio; Casajús, José A; Vicente-Rodríguez, Germán

2014-03-01

We aimed to clarify whether a short-term whole body vibration training has a beneficial effect on bone mass and structure in elderly men and women. Randomised controlled trial. A total of 49 non-institutionalised elderly (20 men and 29 women) volunteered to participate in the study. Participants who met the inclusion criteria were randomly assigned to one of the study groups (whole body vibration or control). A total of 24 elderly trained squat positioned on a vibration platform 3 times per week for 11 weeks. Bone-related variables were assessed by dual-energy X-ray absorptiometry and peripheral quantitative computed tomography. Two-way repeated measures one-way analysis of variance (group by time) was used to determine the effects of the intervention on the bone-related variables and also to determinate the changes within group throughout the intervention period. Analysis of covariance was used to test the differences between groups for bone-related variables in pre- and post-training assessments and in the percentage of change between groups. All analysis were carried out including age, height, subtotal lean mass and daily calcium intake as covariates. 11 weeks of whole body vibration training led to no changes in none of the bone mineral content and bone mineral density parameters measured by dual-energy X-ray absorptiometry through the skeleton. At the tibia, total, trabecular and cortical volumetric bone mineral density decreased significantly in the whole body vibration group (all P<0.05). A short-term whole body vibration therapy is not enough to cause any changes on bone mineral content or bone mineral density and it only produces a slight variation on bone structure among elderly people. Copyright © 2013 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

Salivary Hormones Response to Preparation and Pre-competitive Training of World-class Level Athletes

PubMed Central

Guilhem, Gaël; Hanon, Christine; Gendreau, Nicolas; Bonneau, Dominique; Guével, Arnaud; Chennaoui, Mounir

2015-01-01

This study aimed to compare the response of salivary hormones of track and field athletes induced by preparation and pre-competitive training periods in an attempt to comment on the physiological effects consistent with the responses of each of the proteins measured. Salivary testosterone, cortisol, alpha-amylase, immunoglobulin A (IgA), chromogranin A, blood creatine kinase activity, and profile of mood state were assessed at rest in 24 world-class level athletes during preparation (3 times in 3 months) and pre-competitive (5 times in 5 weeks) training periods. Total mood disturbance and fatigue perception were reduced, while IgA (+61%) and creatine kinase activity (+43%) increased, and chromogranin A decreased (−27%) during pre-competitive compared to preparation period. A significant increase in salivary testosterone (+9 to +15%) and a decrease in testosterone/cortisol ratio were associated with a progressive reduction in training load during pre-competitive period (P < 0.05). None of the psycho-physiological parameters were significantly correlated to training load during the pre-competitive period. Results showed a lower adrenocortical response and autonomic activity, and an improvement of immunity status, in response to the reduction in training load and fatigue, without significant correlations of salivary hormones with training load. Our findings suggest that saliva composition is sensitive to training contents (season period) but could not be related to workload resulting from track and field athletics training. PMID:26635619

Muscle coordination in healthy subjects during floor walking and stair climbing in robot assisted gait training.

PubMed

Hussein, S; Schmidt, H; Volkmar, M; Werner, C; Helmich, I; Piorko, F; Krüger, J; Hesse, S

2008-01-01

The aim of gait rehabilitation is a restoration of an independent gait and improvement of daily life walking functions. Therefore the specific patterns, that are to be relearned, must be practiced to stimulate the learning process of the central nervous system (CNS). The Walking Simulator HapticWalker allows for the training of arbitrary gait trajectories of daily life. To evaluate the quality of the training a total of 9 subjects were investigated during free floor walking and stair climbing and during the same tasks in two different training modes on the HapticWalker: 1) with and 2) without vertical center of mass (CoM) motion. Electromyograms (EMG) of 8 gait relevant muscles were measured and muscle activation was compared for the various training modes. Besides the muscle activation as an indicator for the quality of rehabilitation training the study investigates if a cancellation of the vertical CoM movement by adaption of the footplate trajectory is feasible i.e. the muscle activation patterns for the two training modes on the HapticWalker agree. Results show no significant differences in activation timing between the training modes. This indicates the feasibility of using a passive patient suspension and emulate the vertical CoM motion by trajectory adaption of the footplates. The muscle activation timing during HapticWalker training shows important characteristics observed in physiological free walking though a few differences can still remain.

Desktop-based computer-assisted orthopedic training system for spinal surgery.

PubMed

Rambani, Rohit; Ward, James; Viant, Warren

2014-01-01

Simulation and surgical training has moved on since its inception during the end of the last century. The trainees are getting more exposed to computers and laboratory training in different subspecialties. More needs to be done in orthopedic simulation in spinal surgery. To develop a training system for pedicle screw fixation and validate its effectiveness in a cohort of junior orthopedic trainees. Fully simulated computer-navigated training system is used to train junior orthopedic trainees perform pedicle screw insertion in the lumbar spine. Real patient computed tomography scans are used to produce the real-time fluoroscopic images of the lumbar spine. The training system was developed to simulate pedicle screw insertion in the lumbar spine. A total of 12 orthopedic senior house officers performed pedicle screw insertion in the lumbar spine before and after the training on training system. The results were assessed based on the scoring system, which included the amount of time taken, accuracy of pedicle screw insertion, and the number of exposures requested to complete the procedure. The result shows a significant improvement in amount of time taken, accuracy of fixation, and the number of exposures after the training on simulator system. This was statistically significant using paired Student t test (p < 0.05). Fully simulated computer-navigated training system is an efficient training tool for young orthopedic trainees. This system can be used to augment training in the operating room, and trainees acquire their skills in the comfort of their study room or in the training room in the hospital. The system has the potential to be used in various other orthopedic procedures for learning of technical skills in a manner aimed at ensuring a smooth escalation in task complexity leading to the better performance of procedures in the operating theater. Copyright © 2014 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Effect of Tai Ji Quan training on self-reported sleep quality in elderly Chinese women with knee osteoarthritis: a randomized controlled trail.

PubMed

Lü, Jiaojiao; Huang, Lingyan; Wu, Xie; Fu, Weijie; Liu, Yu

2017-05-01

The purpose of this study was to explore the effects of a 24-week Tai Ji Quan training program on sleep quality, quality of life, and physical performance among elderly Chinese women with knee osteoarthritis (OA). A 24-week randomized, controlled trial of 46 elderly women with knee OA. Participants were randomly assigned to either a Tai Ji Quan group (n = 23) or a control group (n = 23). Participants in the Tai Ji Quan group completed training sessions three times per week, while those in the control group had bi-weekly educational classes. The primary outcome was total score of the Pittsburgh Sleep Quality of Index (PSQI). Secondary outcomes were: seven subscales of the PSQI; sleep latency; total sleep time; sleep efficiency; physical component summary (PCS) and mental component summary (MCS) of the 36-item Short Form Health Survey (SF-36); Berg Balance Scale (BBS); and Timed Up and Go (TUG). Compared with the control group, participants in the Tai Ji Quan group had significantly improved primary outcome (global PSQI score, p = 0.006) and secondary outcomes, including three PSQI sub-scores (sleep latency, p = 0.031; sleep duration, p = 0.043; daytime dysfunction, p = 0.007), total sleep time (p = 0.033), and SF-36 PCS (p = 0.006). The Tai Ji Quan group also had significant improvements compared with baseline in three PSQI sub-scores (sleep latency, p = 0.031; habitual sleep efficiency, p = 0.049; sleep disturbance, p = 0.016), sleep latency (p = 0.003), BBS (p = 0.001), and TUG (p = 0.006). Tai Ji Quan training is an effective treatment approach to improve sleep quality and quality of life in elderly Chinese women with knee OA. Chinese Clinical Trial Registry (June 16, 2013): ChiCTR-TRC-13003264. Copyright © 2017 Elsevier B.V. All rights reserved.

Physical Exposures, Work Tasks, and OSHA-10 Training Among Temporary and Payroll Construction Workers.

PubMed

Caban-Martinez, Alberto J; Santiago, Katerina M; Stillman, Jordan; Moore, Kevin J; Sierra, Danielle A; Chalmers, Juanita; Baniak, Melissa; Jordan, Melissa M

2018-04-01

We characterize and compare the self-reported physical exposures, work tasks, and OSHA-10 training in a non-probabilistic sample of temporary and payroll construction workers. In June 2016, a total of 250 payroll and temporary general laborers employed at Florida construction sites completed a survey at the job site as part of the falls reported among minority employees (FRAME) study. Workers employed through temp agencies (57.1%) were significantly more likely to report moving or lifting materials more than 100 pounds than payroll workers (38.5%; P < 0.01). Temporary construction workers with 10-hour OSHA training (22.2%) spent significantly less time with intense hand use/awkward hand posture than temporary workers without 10-hour OSHA training (46.9%; P = 0.048). Temp construction workers with OSHA 10-hour training reported less hazardous physical postures than workers without the same training.

Impact of operator experience and training strategy on procedural outcomes with leadless pacing: Insights from the Micra Transcatheter Pacing Study.

PubMed

El-Chami, Mikhael; Kowal, Robert C; Soejima, Kyoko; Ritter, Philippe; Duray, Gabor Z; Neuzil, Petr; Mont, Lluis; Kypta, Alexander; Sagi, Venkata; Hudnall, John Harrison; Stromberg, Kurt; Reynolds, Dwight

2017-07-01

Leadless pacemaker systems have been designed to avoid the need for a pocket and transvenous lead. However, delivery of this therapy requires a new catheter-based procedure. This study evaluates the role of operator experience and different training strategies on procedural outcomes. A total of 726 patients underwent implant attempt with the Micra transcatheter pacing system (TPS; Medtronic, Minneapolis, MN, USA) by 94 operators trained in a teaching laboratory using a simulator, cadaver, and large animal models (lab training) or locally at the hospital with simulator/demo model and proctorship (hospital training). Procedure success, procedure duration, fluoroscopy time, and safety outcomes were compared between training methods and experience (implant case number). The Micra TPS procedure was successful in 99.2% of attempts and did not differ between the 55 operators trained in the lab setting and the 39 operators trained locally at the hospital (P = 0.189). Implant case number was also not a determinant of procedural success (P = 0.456). Each operator performed between one and 55 procedures. Procedure time and fluoroscopy duration decreased by 2.0% (P = 0.002) and 3.2% (P < 0.001) compared to the previous case. Major complication rate and pericardial effusion rate were not associated with case number (P = 0.755 and P = 0.620, respectively). There were no differences in the safety outcomes by training method. Among a large group of operators, implantation success was high regardless of experience. While procedure duration and fluoroscopy times decreased with implant number, complications were low and not associated with case number. Procedure and safety outcomes were similar between distinct training methodologies. © 2017 Wiley Periodicals, Inc.

Time-loss injuries versus non-time-loss injuries in the first team rugby league football: a pooled data analysis.

PubMed

Gissane, Conor; Hodgson, Lisa; Jennings, De

2012-09-01

To describe the injury rates in first team rugby league in terms of those injuries that require missed playing time and those that do not. A pooled data analysis from 2 independent databases. Rugby league match and training environment over several seasons from 1990 to 2003. Injuries were reported as rates per 1000 hours of participation and as percentages with their associated 95% confidence intervals (CIs). A total of 1707 match injuries were recorded. Of these injuries, 257 required players to miss the subsequent match. The remaining 1450 injuries did not require players to miss the next game. They represented 85% (95% CI, 83-87) of all injuries received and recorded. The ratio of non-time-loss (NTL) to time-loss (TL) injuries was 5.64 (95% CI, 4.96-6.42). There were 450 training injuries, of which 81 were TL injuries and 369 NTL injuries. The NTL training injury rate was 4.56 (95% CI, 3.58-5.79) times higher than TL injury rate. Non-time-loss injuries represent the largest proportion of injuries in rugby league. If NTL injuries are not recorded, the workload of practitioners is likely to be severely underestimated.

Application of the Intuitionistic Fuzzy InterCriteria Analysis Method with Triples to a Neural Network Preprocessing Procedure

PubMed Central

Atanassova, Vassia; Sotirova, Evdokia; Doukovska, Lyubka; Bureva, Veselina; Mavrov, Deyan; Tomov, Jivko

2017-01-01

The approach of InterCriteria Analysis (ICA) was applied for the aim of reducing the set of variables on the input of a neural network, taking into account the fact that their large number increases the number of neurons in the network, thus making them unusable for hardware implementation. Here, for the first time, with the help of the ICA method, correlations between triples of the input parameters for training of the neural networks were obtained. In this case, we use the approach of ICA for data preprocessing, which may yield reduction of the total time for training the neural networks, hence, the time for the network's processing of data and images. PMID:28874908

Repetitive cryotherapy attenuates the in vitro and in vivo mononuclear cell activation response.

PubMed

Lindsay, Angus; Othman, Mohd Izani; Prebble, Hannah; Davies, Sian; Gieseg, Steven P

2016-07-01

What is the central question of this study? Acute and repetitive cryotherapy are routinely used to accelerate postexercise recovery, although the effect on resident immune cells and repetitive exposure has largely been unexplored and neglected. What is the main finding and its importance? Using blood-derived mononuclear cells and semi-professional mixed martial artists, we show that acute and repetitive cryotherapy reduces the in vitro and in vivo T-cell and monocyte activation response whilst remaining independent of the physical performance of elite athletes. We investigated the effect of repetitive cryotherapy on the in vitro (cold exposure) and in vivo (cold water immersion) activation of blood-derived mononuclear cells following high-intensity exercise. Single and repeated cold exposure (5°C) of a mixed cell culture (T cells and monocytes) was investigated using in vitro tissue culture experimentation for total neopterin production (neopterin plus 7,8-dihydroneopterin). Fourteen elite mixed martial art fighters were also randomly assigned to either a cold water immersion (15 min at 10°C) or passive recovery protocol, which they completed three times per week during a 6 week training camp. Urine was collected and analysed for neopterin and total neopterin three times per week, and perceived soreness, fatigue, physical performance (broad jump, push-ups and pull-ups) and training performance were also assessed. Single and repetitive cold exposure significantly (P < 0.001) reduced total neopterin production from the mixed cell culture, whereas cold water immersion significantly (P < 0.05) attenuated urinary neopterin and total neopterin during the training camp without having any effect on physical performance parameters. Soreness and fatigue showed little variation between the groups, whereas training session performance was significantly (P < 0.05) elevated in the cold water immersion group. The data suggest that acute and repetitive cryotherapy attenuates in vitro T-cell and monocyte activation. This may explain the disparity in in vivo neopterin and total neopterin between cold water immersion and passive recovery following repetitive exposure during a high-intensity physical impact sport that remains independent of physical performance. © 2016 The Authors. Experimental Physiology © 2016 The Physiological Society.

Effects of isolated or combined carbohydrate and caffeine supplementation between 2 daily training sessions on soccer performance.

PubMed

Andrade-Souza, Victor Amorim; Bertuzzi, Romulo; de Araujo, Gustavo Gomes; Bishop, David; Lima-Silva, Adriano Eduardo

2015-05-01

This study aimed to investigate whether isolated or combined carbohydrate (CHO) and caffeine (CAF) supplementation have beneficial effects on performance during soccer-related tests performed after a previous training session. Eleven male, amateur soccer players completed 4 trials in a randomized, double-blind, and crossover design. In the morning, participants performed the Loughborough Intermittent Shuttle Test (LIST). Then, participants ingested (i) 1.2 g·kg(-1) body mass·h(-1) CHO in a 20% CHO solution immediately after and 1, 2, and 3 h after the LIST; (ii) CAF (6 mg·kg(-1) body mass) 3 h after the LIST; (iii) CHO combined with CAF (CHO+CAF); and (iv) placebo. All drinks were taste-matched and flavourless. After this 4-h recovery, participants performed a countermovement jump (CMJ) test, a Loughborough Soccer Passing Test (LSPT), and a repeated-sprint test. There were no main effects of supplementation for CMJ, LSPT total time, or best sprint and total sprint time from the repeated-sprint test (p>0.05). There were also no main effects of supplementation for heart rate, plasma lactate concentration, rating of perceived exertion (RPE), pleasure-displeasure, and perceived activation (p>0.05). However, there were significant time effects (p<0.05), with heart rate, plasma lactate concentration, RPE, and perceived activation increasing with time, and pleasure-displeasure decreasing with time. In conclusion, isolated and/or combined CHO and CAF supplementation is not able to improve soccer-related performance tests when performed after a previous training session.

Effects of a work injury prevention program for housekeeping in the hotel industry.

PubMed

Landers, Merrill; Maguire, Lynn

2004-01-01

The aim of this retrospective study was to determine the effectiveness of a work injury prevention program in the housekeeping department of a hotel. Studies have validated the use of different injury prevention strategies to decrease the incidence of work-related injuries. Few studies, however, have reported the efficacy of an on-site work injury prevention program by a physical therapist. In 1995, implementation of a work injury prevention program by a physical therapist to 50 housekeeping supervisors, 60 house persons and 340 guest room attendants at a large hotel began. This program included a detailed work risk analysis of the work environment, development of job descriptions, identification of injury-related problematic work situations, and implementation of a job specific supervisor-training program. Supervisor, house person and guest room attendant training was also conducted at the end of 1995 and the beginning of 1997. Data of injury reports in 1995, 1996, and 1997 were analyzed to determine the results of the program. There was a reduction in total injury claims, total medical expenses, total lost work time and total restricted duty time. These results demonstrate the cost effectiveness of implementing a work injury prevention program for housekeeping guest room attendants in the hotel industry. Copyright 2004 IOS Press

What Is the Return on Investment for Implementation of a Crew Resource Management Program at an Academic Medical Center?

PubMed

Moffatt-Bruce, Susan D; Hefner, Jennifer L; Mekhjian, Hagop; McAlearney, John S; Latimer, Tina; Ellison, Chris; McAlearney, Ann Scheck

Crew Resource Management (CRM) training has been used successfully within hospital units to improve quality and safety. This article presents a description of a health system-wide implementation of CRM focusing on the return on investment (ROI). The costs included training, programmatic fixed costs, time away from work, and leadership time. Cost savings were calculated based on the reduction in avoidable adverse events and cost estimates from the literature. Between July 2010 and July 2013, roughly 3000 health system employees across 12 areas were trained, costing $3.6 million. The total number of adverse events avoided was 735-a 25.7% reduction in observed relative to expected events. Savings ranged from a conservative estimate of $12.6 million to as much as $28.0 million. Therefore, the overall ROI for CRM training was in the range of $9.1 to $24.4 million. CRM presents a financially viable way to systematically organize for quality improvement.

Learning by viewing versus learning by doing: A comparative study of observer and participant experiences during an interprofessional simulation training.

PubMed

Reime, Marit Hegg; Johnsgaard, Tone; Kvam, Fred Ivan; Aarflot, Morten; Engeberg, Janecke Merethe; Breivik, Marit; Brattebø, Guttorm

2017-01-01

Larger student groups and pressure on limited faculty time have raised the question of the learning value of merely observing simulation training in emergency medicine, instead of active team participation. The purpose of this study was to examine observers and hands-on participants' self-reported learning outcomes during simulation-based interprofessional team training regarding non-technical skills. In addition, we compared the learning outcomes for different professions and investigated team performance relative to the number of simulations in which they participated. A concurrent mixed-method design was chosen to evaluate the study, using questionnaires, observations, and focus group interviews. Participants included a total of 262 postgraduate and bachelor nursing students and medical students, organised into 44 interprofessional teams. The quantitative data showed that observers and participants had similar results in three of six predefined learning outcomes. The qualitative data emphasised the importance of participating in different roles, training several times, and training interprofessionally to enhance realism. Observing simulation training can be a valuable learning experience, but the students' preferred hands-on participation and learning by doing. For this reason, one can legitimise the observer role, given the large student groups and limited faculty time, as long as the students are also given some opportunity for hands-on participation in order to become more confident in their professional roles.

Sex differences in the effects of 12 weeks sprint interval training on body fat mass and the rates of fatty acid oxidation and VO2max during exercise.

PubMed

Bagley, Liam; Slevin, Mark; Bradburn, Steven; Liu, Donghui; Murgatroyd, Chris; Morrissey, George; Carroll, Michael; Piasecki, Mathew; Gilmore, William S; McPhee, Jamie S

2016-01-01

The purpose of this study was to examine whether very short duration, very high intensity sprint interval training (SIT) leads to loss of body fat mass in association with improvements to VO 2 max and fatty acid oxidation, and to assess the extent of sex dimorphism in these physiological responses. A total of 24 men and 17 women (mean (SEM) age: 39 (±2) years; body mass index 24.6 (0.6)) completed measurements of the maximal rate of oxygen uptake (VO 2 max) and fatty acid oxidation (FATmax). Body fat and lean mass were measured by dual emission x-ray absorptiometry, and fasting blood lipid, glucose and insulin profiles were assessed before and after training. SIT consisted of 4×20 s sprints on a cycle ergometer at approximately 175% VO 2 max, three times per week for 12 weeks. Fat mass decreased by 1.0 kg, although men lost statistically significantly more fat than women both when expressed in Kg and as % body fat. VO 2 max increased by around 9%, but women improved VO 2 max significantly more than men. FATmax improved by around 13%, but fasting plasma glucose, insulin, total triglyceride, total cholesterol and high-density lipoprotein (HDL) did not change after training, while low-density lipoprotein decreased by 8% (p=0.028) and the HDL:Total Cholesterol ratio improved by 6%. There were no sex differences in these metabolic responses to training. These results show lower body fat %, and higher rates of fatty acid oxidation and VO 2 max after 12 weeks of training for just 4 min per week. Notably, women improved VO 2 max more than men, while men lost more fat than women.

Sex differences in the effects of 12 weeks sprint interval training on body fat mass and the rates of fatty acid oxidation and VO2max during exercise

PubMed Central

Bagley, Liam; Slevin, Mark; Bradburn, Steven; Liu, Donghui; Murgatroyd, Chris; Morrissey, George; Carroll, Michael; Piasecki, Mathew; Gilmore, William S; McPhee, Jamie S

2016-01-01

Background The purpose of this study was to examine whether very short duration, very high intensity sprint interval training (SIT) leads to loss of body fat mass in association with improvements to VO2max and fatty acid oxidation, and to assess the extent of sex dimorphism in these physiological responses. Methods A total of 24 men and 17 women (mean (SEM) age: 39 (±2) years; body mass index 24.6 (0.6)) completed measurements of the maximal rate of oxygen uptake (VO2max) and fatty acid oxidation (FATmax). Body fat and lean mass were measured by dual emission x-ray absorptiometry, and fasting blood lipid, glucose and insulin profiles were assessed before and after training. SIT consisted of 4×20 s sprints on a cycle ergometer at approximately 175% VO2max, three times per week for 12 weeks. Results Fat mass decreased by 1.0 kg, although men lost statistically significantly more fat than women both when expressed in Kg and as % body fat. VO2max increased by around 9%, but women improved VO2max significantly more than men. FATmax improved by around 13%, but fasting plasma glucose, insulin, total triglyceride, total cholesterol and high-density lipoprotein (HDL) did not change after training, while low-density lipoprotein decreased by 8% (p=0.028) and the HDL:Total Cholesterol ratio improved by 6%. There were no sex differences in these metabolic responses to training. Conclusions These results show lower body fat %, and higher rates of fatty acid oxidation and VO2max after 12 weeks of training for just 4 min per week. Notably, women improved VO2max more than men, while men lost more fat than women. PMID:27900150

High-frequency resistance training is not more effective than low-frequency resistance training in increasing muscle mass and strength in well-trained men.

PubMed

Gomes, Gederson K; Franco, Cristiane M; Nunes, Paulo Ricardo P; Orsatti, Fábio L

2018-02-27

We studied the effects of two different weekly frequency resistance training (RT) protocols over eight weeks on muscle strength and muscle hypertrophy in well-trained men. Twenty-three subjects (age: 26.2±4.2 years; RT experience: 6.9±3.1 years) were randomly allocated into the two groups: low frequency (LFRT, n = 12) or high frequency (HFRT, n = 11). The LFRT performed a split-body routine, training each specific muscle group once a week. The HFRT performed a total-body routine, training all muscle groups every session. Both groups performed the same number of sets (10-15 sets) and exercises (1-2 exercise) per week, 8-12 repetitions maximum (70-80% of 1RM), five times per week. Muscle strength (bench press and squat 1RM) and lean tissue mass (dual-energy x-ray absorptiometry) were assessed prior to and at the end of the study. Results showed that both groups improved (p<0.001) muscle strength [LFRT and HFRT: bench press = 5.6 kg (95% Confidence Interval (CI): 1.9 - 9.4) and 9.7 kg (95%CI: 4.6 - 14.9) and squat = 8.0 kg (95%CI: 2.7 - 13.2) and 12.0 kg (95%CI: 5.1 - 18.1), respectively] and lean tissue mass (p = 0.007) [LFRT and HFRT: total body lean mass = 0.5 kg (95%CI: 0.0 - 1.1) and 0.8 kg (95%CI: 0.0 - 1.6), respectively] with no difference between groups (bench press, p = 0.168; squat, p = 0.312 and total body lean mass, p = 0.619). Thus, HFRT and LFRT are similar overload strategies for promoting muscular adaptation in well-trained subjects when the sets and intensity are equated per week.

The effect of cognitive-based training for the healthy older people: A meta-analysis of randomized controlled trials

PubMed Central

Chiu, Huei-Ling; Chu, Hsin; Tsai, Jui-Chen; Liu, Doresses; Chen, Ying-Ren; Yang, Hui-Ling

2017-01-01

Background From the perspective of disease prevention, the enhancement of cognitive function among the healthy older people has become an important issue in many countries lately. This study aim to investigate the effect of cognitive-based training on the overall cognitive function, memory, attention, executive function, and visual-spatial ability of the healthy older people. Methods Cochrane, PubMed, EMBASE, MEDLINE, PsycINFO, and CINAHL of selected randomized controlled trials (RCTs), and previous systematic reviews were searched for eligible studies. The population focused on this study were healthy older people who participated in randomized controlled trials that investigated the effectiveness of cognitive-based training. The outcomes including change in overall cognitive function, memory, attention, executive function, and visual-spatial ability. Results We collected a total of 31 RCTs, the results showed that cognitive-based training has a moderate effect on overall cognitive function (g = 0.419; 95%CI = 0.205–0.634) and executive function (g = 0.420; 95%CI = 0.239–0.602), and a small effect on the memory (g = 0.354; 95%CI = 0.244–0.465), attention (g = 0.218; 95%CI = 0.125–0.311), and visual-spatial ability (g = 0.183;95%CI = 0.015–0.352) in healthy older people. Subgroup analysis indicated the intervention characteristics of ≧3 times each week (p = 0.042), ≧8 total training weeks (p = 0.003) and ≧24 total training sessions (p = 0.040) yields a greater effect size. Conclusions Cognitive-based training is effective for the healthy older people. This improvement can represent a clinically important benefit, provide information about the use of cognitive-based training in healthy older people, and help the healthy older people obtain the greatest possible benefit in health promotion and disease prevention. PMID:28459873

Improving balance skills in patients who had stroke through virtual reality treadmill training.

PubMed

Yang, Saiwei; Hwang, Wei-Hsung; Tsai, Yi-Ching; Liu, Fu-Kang; Hsieh, Lin-Fen; Chern, Jen-Suh

2011-12-01

The aim of this study was to evaluate the effects of virtual reality (VR) treadmill training on the balance skills of patients who have had a stroke. A total of 14 patients with strokes were recruited and randomly assigned to receive VR treadmill or traditional treadmill training. The outcome measures that were included for the study were center of pressure (COP) sway excursion, COP maximum sway in anterior-posterior direction, COP maximum sway in medial-lateral direction, COP sway area, bilateral limb-loading symmetric index, the sway excursion values for the paretic foot (sway excursion/P), paretic limb stance time (stance time/P), number of steps of the paretic limb (number of steps/P), and contact area of the paretic foot (contact A/P) during quiet stance, sit-to-stand transfer, and level walking. There were no significant improvements in COP-related measures and symmetric index during the quiet stance, either in the VR treadmill or traditional treadmill training group (P > 0.05). However, the difference between groups after training in COP maximum sway in medial-lateral direction during the quiet stance was significant (P = 0.038). Traditional treadmill training failed to improve sit-to-stand performance, whereas VR treadmill training improved symmetric index (P = 0.028) and sway excursion (P = 0.046) significantly during sit-to-stand transfer. The changes of symmetric index between groups were markedly different (P = 0.045). Finally, both groups improved significantly in stance time/P, but only VR treadmill training increased contact A/P (P = 0.034) after training during level walking. The difference between groups during level walking was not significant. Neither traditional treadmill nor VR treadmill training had any effect on balance skill during quiet stance, but VR treadmill training improved balance skill in the medial-lateral direction better than traditional training did. VR treadmill training also improved balance skill during sit-to-stand transfers and the involvement of paretic limb in level walking more than the traditional one did.

The Reliability of a 5km Run Test on a Motorized Treadmill

ERIC Educational Resources Information Center

Driller, Matthew; Brophy-Williams, Ned; Walker, Anthony

2017-01-01

The purpose of the present study was to determine the reliability of a 5km run test on a motorized treadmill. Over three consecutive weeks, 12 well-trained runners completed three 5km time trials on a treadmill following a standardized warm-up. Runners were partially-blinded to their running speed and distance covered. Total time to complete the…

An Examination of the Teaching Strategies Practiced by the Full-Time Teaching Faculty at Manatee Junior College.

ERIC Educational Resources Information Center

Raines, Roy H.

A random sample (n=25) of full-time faculty at Manatee Junior College (Florida) were surveyed by open-ended questionnaire to determine what instructional techniques were being used and to ascertain if the faculty had acquired minimal training in teaching methods and learning theories. A total of 16 different teaching strategies were identified. Of…

Employees in Nursing and Personal Care Homes: Number, Work Experience, Special Training, and Wages, United States, May-June 1964. Publication No. 1000, Series 12, No. 6.

ERIC Educational Resources Information Center

Taube, Carl A.; Bryant, E. Earl

This report of the findings of a survey of a sample of 1,073 resident institutions which provide nursing or personal care to the aged or chronically ill emphasizes employee work experience, special training, and wages. The median total experience for all nursing and professional employees in the type of job held at the time of the survey was 4.1…

The costs and quality of operative training for residents in tympanoplasty type I.

PubMed

Wang, Mao-Che; Yu, Eric Chen-Hua; Shiao, An-Suey; Liao, Wen-Huei; Liu, Chia-Yu

2009-05-01

A teaching hospital would incur more operation room costs on training surgical residents. To evaluate the increased operation time and the increased operation room costs of operations performed by surgical residents. As a model we used a very common surgical otology procedure -- tympanoplasty type I. From January 1, 2004 to December 31, 2004, we included in this study 100 patients who received tympanoplasty type I in Taipei Veterans General Hospital. Fifty-six procedures were performed by a single board-certified surgeon and 44 procedures were performed by residents. We analyzed the operation time and surgical outcomes in these two groups of patients. The operation room cost per minute was obtained by dividing the total operation room expenses by total operation time in the year 2004. The average operation time of residents was 116.47 min, which was significantly longer (p<0.0001) than that of the board-certified surgeon (average 81.07 min). It cost USD $40.36 more for each operation performed by residents in terms of operation room costs. The surgical success rate of residents was 81.82%, which was significantly lower (p=0.016) than that of the board-certified surgeon (96.43%).

The effect of high-intensity aerobic interval training on markers of systemic inflammation in sedentary populations.

PubMed

Allen, Nicholas G; Higham, Samuel M; Mendham, Amy E; Kastelein, Tegan E; Larsen, Penelope S; Duffield, Rob

2017-06-01

This study examined the effects of high-intensity interval training (HIIT; 30 s sprint, 4-5 min passive recovery) and prolonged intermittent sprint training (PIST; 10 s sprint, 2-3 min moderate exercise) on the systemic inflammatory markers C-reactive protein (CRP) and tumor necrosis factor-α (TNF-α), aerobic capacity, and anthropometry in a middle-aged, sedentary population. Fifty-five sedentary adults (age 49.2 ± 6.1 years) were randomised into HIIT (n = 20), PIST (n = 21), or a sedentary control group (CTRL n = 14). HIIT and PIST performed three training sessions per week for 9 weeks on a cycle ergometer, matched for total high-intensity time, while CTRL continued normal sedentary behaviours. Pre- and post-intervention testing involved measures of anthropometry, peak oxygen consumption (VO 2peak ), and venous blood collection for analyses of CRP and TNF-α. HIIT and PIST increased VO 2peak compared to CTRL (+3.66 ± 2.23 and 3.74 ± 2.62 mL kg min -1 ). A group × time interaction (p = 0.042) and main effect of time (p = 0.026) were evident for waist girth, with only HIIT showing a significant reduction compared to CTRL (-2.1 ± 2.8 cm). TNF-α and CRP showed no group × time interaction or time effect (p > 0.05). In sedentary individuals, 9 weeks of HIIT or PIST were effective to improve aerobic capacity; however, only HIIT significantly reduced waist girth and WHR compared to CTRL. Markers of systemic inflammation remained unchanged across all groups. Accordingly, for inflammation and VO2 peak , the distribution of sprints and the active or passive recovery periods are inconsequential provided that total duration of high-intensity efforts is similar.

Can the learning curve of totally endoscopic robotic mitral valve repair be short-circuited?

PubMed

Yaffee, David W; Loulmet, Didier F; Kelly, Lauren A; Ward, Alison F; Ursomanno, Patricia A; Rabinovich, Annette E; Neuburger, Peter J; Krishnan, Sandeep; Hill, Frederick T; Grossi, Eugene A

2014-01-01

A concern with the initiation of totally endoscopic robotic mitral valve repair (TERMR) programs has been the risk for the learning curve. To minimize this risk, we initiated a TERMR program with a defined team and structured learning approach before clinical implementation. A dedicated team (two surgeons, one cardiac anesthesiologist, one perfusionist, and two nurses) was trained with clinical scenarios, simulations, wet laboratories, and "expert" observation for 3 months. This team then performed a series of TERMRs of varying complexity. Thirty-two isolated TERMRs were performed during the first programmatic year. All operations included mitral valve repair, left atrial appendage exclusion, and annuloplasty device implantation. Additional procedures included leaflet resection, neochordae insertion, atrial ablation, and papillary muscle shortening. Longer clamp times were associated with number of neochordae (P < 0.01), papillary muscle procedures (P < 0.01), and leaflet resection (P = 0.06). Sequential case number had no impact on cross-clamp time (P = 0.3). Analysis of nonclamp time demonstrated a 71.3% learning percentage (P < 0.01; ie, 28.7% reduction in nonclamp time with each doubling of case number). There were no hospital deaths or incidences of stroke, myocardial infarction, unplanned reoperation, respiratory failure, or renal failure. Median length of stay was 4 days. All patients were discharged home. Totally endoscopic robotic mitral valve repair can be safely performed after a pretraining regimen with emphasis on experts' current practice and team training. After a pretraining regimen, cross-clamp times were not subject to learning curve phenomena but were dependent on procedural complexity. Nonclamp times were associated with a short learning curve.

Adaptive Changes After 2 Weeks of 10-s Sprint Interval Training With Various Recovery Times.

PubMed

Olek, Robert A; Kujach, Sylwester; Ziemann, Ewa; Ziolkowski, Wieslaw; Waz, Piotr; Laskowski, Radoslaw

2018-01-01

Purpose: The aim of this study was to compare the effect of applying two different rest recovery times in a 10-s sprint interval training session on aerobic and anaerobic capacities as well as skeletal muscle enzyme activities. Methods: Fourteen physically active but not highly trained male subjects (mean maximal oxygen uptake 50.5 ± 1.0 mlO 2 ·kg -1 ·min -1 ) participated in the study. The training protocol involved a series of 10-s sprints separated by either 1-min (SIT10:1) or 4-min (SIT10:4) of recovery. The number of sprints progressed from four to six over six sessions separated by 1-2 days rest. Pre and post intervention anthropometric measurements, assessment of aerobic, anaerobic capacity and muscle biopsy were performed. In the muscle samples maximal activities of citrate synthase (CS), 3-hydroxyacylCoA dehydrogenase (HADH), carnitine palmitoyl-transferase (CPT), malate dehydrogenase (MDH), and its mitochondrial form (mMDH), as well as lactate dehydrogenase (LDH) were determined. Analysis of variance was performed to determine changes between conditions. Results: Maximal oxygen uptake improved significantly in both training groups, by 13.6% in SIT10:1 and 11.9% in SIT10:4, with no difference between groups. Wingate anaerobic test results indicated main effect of time for total work, peak power output and mean power output, which increased significantly and similarly in both groups. Significant differences between training groups were observed for end power output, which increased by 10.8% in SIT10:1, but remained unchanged in SIT10:4. Both training protocols induced similar increase in CS activity (main effect of time p < 0.05), but no other enzymes. Conclusion: Sprint interval training protocols induce metabolic adaptation over a short period of time, and the reduced recovery between bouts may attenuate fatigue during maximal exercise.

Increase in Cesarean Operative Time Following Institution of the 80-Hour Workweek

PubMed Central

Smrtka, Michael P.; Gunatilake, Ravindu P.; Harris, Benjamin; Yu, Miao; Lan, Lan; Brancazio, Leo R.; Valea, Fidel A.; Grotegut, Chad A.; Brown, Haywood L.

2015-01-01

Background  In 2003, the Accreditation Council for Graduate Medical Education limited resident duty hours to 80 hours per week. More than a decade later, the effect of the limits on resident clinical competence is not fully understood. Objective  We sought to assess the effect of duty hour restrictions on resident performance of an uncomplicated cesarean delivery. Methods  We reviewed unlabored primary cesarean deliveries at Duke University Hospital after 34 weeks gestation, between 2003 and 2011. Descriptive statistics and linear regression were used to compare total operative time with incision to delivery time as a function of years since institution of the 80-hour workweek. Resident training level, subject body mass index, estimated blood loss, and skin closure method were controlled for in the regression model. Results  We identified 444 deliveries that met study criteria. The mean (SD) total operative time in 2003–2004 was 43.3 (14.3) minutes and 59.6 (10.7) minutes in 2010–2011 (P < .001). Multivariable regression demonstrated an increase in total operative time of 1.9 min/y (P < .001) but no change in incision to delivery time (P = .05). The magnitude of increased operative time was seen among junior residents (2.0 min/y, P < .001) compared to that of senior residents (1.2 min/y, P = .06). Conclusions  Since introduction of the 2003 duty hour limits, there has been an increase of nearly 20 minutes in the time required for a routine cesarean delivery. It is unclear if the findings are due to a change in residency duty hours or to another aspect of residency training. PMID:26457141

The Pareto Analysis for Establishing Content Criteria in Surgical Training.

PubMed

Kramp, Kelvin H; van Det, Marc J; Veeger, Nic J G M; Pierie, Jean-Pierre E N

2016-01-01

Current surgical training is still highly dependent on expensive operating room (OR) experience. Although there have been many attempts to transfer more training to the skills laboratory, little research is focused on which technical behaviors can lead to the highest profit when they are trained outside the OR. The Pareto principle states that in any population that contributes to a common effect, a few account for the bulk of the effect. This principle has been widely used in business management to increase company profits. This study uses the Pareto principle for establishing content criteria for more efficient surgical training. A retrospective study was conducted to assess verbal guidance provided by 9 supervising surgeons to 12 trainees performing 64 laparoscopic cholecystectomies in the OR. The verbal corrections were documented, tallied, and clustered according to the aimed change in novice behavior. The corrections were rank ordered, and a cumulative distribution curve was used to calculate which corrections accounted for 80% of the total number of verbal corrections. In total, 253 different verbal corrections were uttered 1587 times and were categorized into 40 different clusters of aimed changes in novice behaviors. The 35 highest-ranking verbal corrections (14%) and the 11 highest-ranking clusters (28%) accounted for 80% of the total number of given verbal corrections. Following the Pareto principle, we were able to identify the aspects of trainee behavior that account for most corrections given by supervisors during a laparoscopic cholecystectomy on humans. This strategy can be used for the development of new training programs to prepare the trainee in advance for the challenges encountered in the clinical setting in an OR. Copyright © 2016 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

In-training factors predictive of choosing and sustaining a productive academic career path in neurological surgery.

PubMed

Crowley, R Webster; Asthagiri, Ashok R; Starke, Robert M; Zusman, Edie E; Chiocca, E Antonio; Lonser, Russell R

2012-04-01

Factors during neurosurgical residency that are predictive of an academic career path and promotion have not been defined. To determine factors associated with selecting and sustaining an academic career in neurosurgery by analyzing in-training factors for all graduates of American College of Graduate Medical Education (ACGME)-accredited programs between 1985 and 1990. Neurological surgery residency graduates (between 1985 and 1990) from ACGME-approved training programs were analyzed to determine factors associated with choosing an academic career path and having academic success. Information was available for 717 of the 720 (99%) neurological surgery resident training graduates (678 male, 39 female). One hundred thirty-eight graduates (19.3%) held full-time academic positions. One hundred seven (14.9%) were professors and 35 (4.9%) were department chairs/chiefs. An academic career path/success was associated with more total (5.1 vs 1.9; P < .001) and first-author publications (3.0 vs 1.0; P < .001) during residency. Promotion to professor or chair/chief was associated with more publications during residency (P < .001). Total publications and first-author publications were independent predictors of holding a current academic position and becoming professor or chair/chief. Although male trainees published more than female trainees (2.6 vs 0.9 publications; P < .004) during training, no significant sex difference was observed regarding current academic position. Program size (≥ 2 graduates a year; P = .02) was predictive of an academic career but not predictive of becoming professor or chair/chief (P > .05). Defined in-training factors including number of total publications, number of first-author publications, and program size are predictive of residents choosing and succeeding in an academic career path.

Balance Training With a Dynamometric Platform Following Total Knee Replacement: A Randomized Controlled Trial.

PubMed

Roig-Casasús, Sergio; María Blasco, José; López-Bueno, Laura; Blasco-Igual, María Clara

2017-03-01

Sensorimotor training has proven to be an efficient approach for recovering balance control following total knee replacement (TKR). The purpose of this trial was to evaluate the influence of specific balance-targeted training using a dynamometric platform on the overall state of balance in older adults undergoing TKR. This was a randomized controlled clinical trial conducted at a university hospital rehabilitation unit. Patients meeting the inclusion criteria were randomly assigned to a control group or an experimental group. Both groups participated in the same 4-week postoperative rehabilitation training protocol. Participants in the experimental group performed additional balance training with a dynamometric platform consisting of tests related to stability challenges, weight-shifting, and moving to the limits of stability. The primary outcome measure was the overall state of balance rated according to the Berg Balance Scale. Secondary outcomes in terms of balance were the Timed Up and Go Test, Functional Reach Test, and Romberg open and closed-eyes tests. Data processing included between-group analysis of covariance, minimal detectable change assessment for the primary outcome measure, and effect size estimation. Confidence intervals (CIs) were set at 95%. Forty-three participants meeting the inclusion criteria and having signed the informed consent were randomly assigned to 2 groups. Thirty-seven completed the training (86.1%). Significant between-group differences in balance performance were found as measured with the Berg Balance Scale (P = .03) and Functional Reach Test (P = .04) with a CI = 95%. Significant differences were not recorded for the Timed Up and Go Test or Romberg open and closed-eyes tests (P > .05). Furthermore, Cohen's effect size resulted in a value of d = 0.97, suggesting a high practical significance of the trial. According to the Berg Balance Scale and Functional Reach Test, participants with TKR who have followed a 4-week training program using a dynamometric platform improved balance performance to a higher extent than a control group training without such a device. The inclusion of this instrument in the functional training protocol may be beneficial for recovering balance following TKR.

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

PubMed

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

2015-03-01

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

Evaluation of distributed practice schedules on retention of a newly acquired surgical skill: a randomized trial.

PubMed

Mitchell, Erica L; Lee, Dae Y; Sevdalis, Nick; Partsafas, Aaron W; Landry, Gregory J; Liem, Timothy K; Moneta, Gregory L

2011-01-01

practice influences new skill acquisition. The aim of this study was to prospectively investigate the impact of practice distribution (weekly vs monthly) on complex motor skill (end-side vascular anastomosis) acquisition and 4-month retention. twenty-four surgical interns were randomly assigned to weekly training for 4 weeks or monthly training for 4 months, with equal total training times. Performance was assessed before training, immediately after training, after the completion of distributed training, and 4 months later. there was no statistical difference in surgical skill acquisition and retention between the weekly and monthly scheduled groups, as measured by procedural checklist scores, global rating scores of operative performance, final product analysis, and overall performance or assessment of operative "competence." distributed practice results in improvement and retention of a newly acquired surgical skill independent of weekly or monthly practice schedules. Flexibility in a surgical skills laboratory curriculum is possible without adversely affecting training. 2011 Elsevier Inc. All rights reserved.

EFFECTS OF STROBOSCOPIC VISUAL TRAINING ON VISUAL ATTENTION, MOTION PERCEPTION, AND CATCHING PERFORMANCE.

PubMed

Wilkins, Luke; Gray, Rob

2015-08-01

It has been shown recently that stroboscopic visual training can improve visual-perceptual abilities, such as central field motion sensitivity and anticipatory timing. Such training should also improve a sports skill that relies on these perceptual abilities, namely ball catching. Thirty athletes (12 women, 18 men; M age=22.5 yr., SD=4.7) were assigned to one of two types of stroboscopic training groups: a variable strobe rate (VSR) group for which the off-time of the glasses was systematically increased (as in previous research) and a constant strobe rate group (CSR) for which the glasses were always set at the shortest off-time. Training involved simple, tennis ball-catching drills (9×20 min.) occurring over a 6-wk. In pre- and post-training, the participants completed a one-handed ball-catching task and the Useful Field of View (UFOV) and the Motion in Depth Sensitivity (MIDS) tests. Since the CSR condition used in the present study has been shown to have no effect on catching performance, it was predicted that the VSR group would show significantly greater improvement pre-post-training. There were no significant differences between the CSR and VSR on any of the tests. However, changes in catching performance (total balls caught) pre-post-training were significantly correlated with changes in scores for the UFOV single-task and MIDS tests. That is, regardless of group, participants whose perceptual-cognitive performance improved in the post-test were significantly more likely to improve their catching performance. This suggests that the perceptual changes observed in previous stroboscopic training studies may be linked to changes in sports skill performance.

Exercise Training and Energy Expenditure following Weight Loss.

PubMed

Hunter, Gary R; Fisher, Gordon; Neumeier, William H; Carter, Stephen J; Plaisance, Eric P

2015-09-01

This study aims to determine the effects of aerobic or resistance training on activity-related energy expenditure (AEE; kcal·d(-1)) and physical activity index (activity-related time equivalent (ARTE)) following weight loss. It was hypothesized that weight loss without exercise training would be accompanied by decreases in AEE, ARTE, and nontraining physical activity energy expenditure (nonexercise activity thermogenesis (NEAT)) and that exercise training would prevent decreases in free-living energy expenditure. One hundred forty premenopausal women had an average weight loss of 25 lb during a diet (800 kcal·d(-1)) of furnished food. One group aerobically trained 3 times per week (40 min·d(-1)), another group resistance-trained 3 times per week (10 exercises/2 sets × 10 repetitions), and the third group did not exercise. Dual-energy x-ray absorptiometry was used to measure body composition, indirect calorimetry was used to measure resting energy expenditure (REE) and walking energy expenditure, and doubly labeled water was used to measure total energy expenditure (TEE). AEE, ARTE, and nontraining physical activity energy expenditure (NEAT) were calculated. TEE, REE, and NEAT all decreased following weight loss for the no-exercise group, but not for aerobic and resistance trainers. Only REE decreased in the two exercise groups. Resistance trainers increased ARTE. HR and oxygen uptake while walking on the flat and up a grade were consistently related to TEE, AEE, NEAT, and ARTE. Exercise training prevents a decrease in energy expenditure, including free-living energy expenditure separate from exercise training, following weight loss. Resistance training increases physical activity, whereas economy/ease of walking is associated with increased TEE, AEE, NEAT, and ARTE.

The effects of flipped learning for bystander cardiopulmonary resuscitation on undergraduate medical students.

PubMed

Nakanishi, Taizo; Goto, Tadahiro; Kobuchi, Taketsune; Kimura, Tetsuya; Hayashi, Hiroyuki; Tokuda, Yasuharu

2017-12-22

To compare bystander cardiopulmonary resuscitation skills retention between conventional learning and flipped learning for first-year medical students. A post-test only control group design. A total of 108 participants were randomly assigned to either the conventional learning or flipped learning. The primary outcome measures of time to the first chest compression and the number of total chest compressions during a 2-minute test period 6 month after the training were assessed with the Mann-Whitney U test. Fifty participants (92.6%) in the conventional learning group and 45 participants (83.3%) in the flipped learning group completed the study. There were no statistically significant differences 6 months after the training in the time to the first chest compression of 33.0 seconds (interquartile range, 24.0-42.0) for the conventional learning group and 31.0 seconds (interquartile range, 25.0-41.0) for the flipped learning group (U=1171.0, p=0.73) or in the number of total chest compressions of 101.5 (interquartile range, 90.8-124.0) for the conventional learning group and 104.0 (interquartile range, 91.0-121.0) for the flipped learning group (U=1083.0, p=0.75). The 95% confidence interval of the difference between means of the number of total chest compressions 6 months after the training did not exceed a clinically important difference defined a priori. There were no significant differences between the conventional learning group and the flipped learning group in our main outcomes. Flipped learning might be comparable to conventional learning, and seems a promising approach which requires fewer resources and enables student-centered learning without compromising the acquisition of CPR skills.

Musical training generalises across modalities and reveals efficient and adaptive mechanisms for reproducing temporal intervals.

PubMed

Aagten-Murphy, David; Cappagli, Giulia; Burr, David

2014-03-01

Expert musicians are able to time their actions accurately and consistently during a musical performance. We investigated how musical expertise influences the ability to reproduce auditory intervals and how this generalises across different techniques and sensory modalities. We first compared various reproduction strategies and interval length, to examine the effects in general and to optimise experimental conditions for testing the effect of music, and found that the effects were robust and consistent across different paradigms. Focussing on a 'ready-set-go' paradigm subjects reproduced time intervals drawn from distributions varying in total length (176, 352 or 704 ms) or in the number of discrete intervals within the total length (3, 5, 11 or 21 discrete intervals). Overall, Musicians performed more veridical than Non-Musicians, and all subjects reproduced auditory-defined intervals more accurately than visually-defined intervals. However, Non-Musicians, particularly with visual stimuli, consistently exhibited a substantial and systematic regression towards the mean interval. When subjects judged intervals from distributions of longer total length they tended to regress more towards the mean, while the ability to discriminate between discrete intervals within the distribution had little influence on subject error. These results are consistent with a Bayesian model that minimizes reproduction errors by incorporating a central tendency prior weighted by the subject's own temporal precision relative to the current distribution of intervals. Finally a strong correlation was observed between all durations of formal musical training and total reproduction errors in both modalities (accounting for 30% of the variance). Taken together these results demonstrate that formal musical training improves temporal reproduction, and that this improvement transfers from audition to vision. They further demonstrate the flexibility of sensorimotor mechanisms in adapting to different task conditions to minimise temporal estimation errors. © 2013.

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

PubMed

Knol, Joep; Keller, Deborah S

2018-04-30

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

Open abdominal surgical training differences experienced by integrated vascular and general surgery residents.

PubMed

Tanious, Adam; Wooster, Mathew; Jung, Andrew; Nelson, Peter R; Armstrong, Paul A; Shames, Murray L

2017-10-01

As the integrated vascular residency program reaches almost a decade of maturity, a common area of concern among trainees is the adequacy of open abdominal surgical training. It is our belief that although their overall exposure to open abdominal procedures has decreased, integrated vascular residents have an adequate and focused exposure to open aortic surgery during training. National operative case log data supplied by the Accreditation Council for Graduate Medical Education were compiled for both graduating integrated vascular surgery residents (IVSRs) and graduating categorical general surgery residents (GSRs) for the years 2012 to 2014. Mean total and open abdominal case numbers were compared between the IVSRs and GSRs, with more in-depth exploration into open abdominal procedures by organ system. Overall, the mean total 5-year case volume of IVSRs was 1168 compared with 980 for GSRs during the same time frame (P < .0001). IVSRs reported nearly double the number of surgeon-chief cases compared with GSRs (452 vs 239; P < .0001). GSRs reported more than double the number of open abdominal procedures compared with IVSRs (205 vs 83; P < .0001). Sixty-five percent of the open abdominal experience for IVSRs was focused on procedures involving the aorta and its branches, with an average of 54 open aortic cases recorded throughout their training. The largest single contributor to open surgical experience for a GSR was alimentary tract surgery, representing 57% of all open abdominal cases. GSRs completed an average of 116 open alimentary tract surgeries during their training. Open abdominal surgery represented an average of 7.1% of the total vascular case volume for the vascular residents, whereas open abdominal surgery represented 21% of a GSR's total surgical experience. IVSRs reported almost double the number of total cases during their training, with double chief-level cases. Sixty-five percent of open abdominal surgeries performed by IVSRs involved the aorta or its renovisceral branches. Whereas open abdominal surgery represented 7.1% of an IVSR's surgical training, GSRs had a far broader scope of open abdominal procedures, completing nearly double those of IVSRs. The differences in open abdominal procedures pertain to the differing diseases treated by GSRs and IVSRs. Copyright © 2017 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved.

Wii Fit balance training or progressive balance training in patients with chronic stroke: a randomised controlled trial

PubMed Central

Yatar, Gozde Iyigun; Yildirim, Sibel Aksu

2015-01-01

[Purpose] The aim of this study was to compare the effects of Wii Fit balance training (WBT) and progressive balance training (PBT) approaches on balance functions, balance confidence, and activities of daily living in chronic stroke patients. [Subjects] A total of 30 patients were randomized into the WBT (n=15) and PBT (n=15) groups. [Methods] All of the subjects received exercise training based on a neurodevelopemental approach in addition to either Wii Fit or progressive balance training for total of 1 hour a day, 3 days per week for 4 weeks. Primary measurements were static balance function measured with a Wii Balance Board and dynamic balance function assessed with the Berg Balance Scale, Timed Up and Go test, Dynamic Gait Index, and Functional Reach Test. Secondary measures were balance confidence assessed with the Activities-specific Balance Confidence scale and activities of daily living evaluated with the Frenchay Activity Index. [Results] There was not remarkable difference between the two treatments in dynamic balance functions, balance confidence, and activities of daily living. [Conclusion] Although both of the approaches were found to be effective in improving the balance functions, balance confidence, and activities of daily living, neither of them were more preferable than the other for the treatment of balance in patients with chronic stroke. PMID:25995576

The influence of training characteristics on the effect of exercise training in patients with coronary artery disease: Systematic review and meta-regression analysis.

PubMed

Kraal, Jos J; Vromen, Tom; Spee, Ruud; Kemps, Hareld M C; Peek, Niels

2017-10-15

Although exercise-based cardiac rehabilitation improves exercise capacity of coronary artery disease patients, it is unclear which training characteristic determines this improvement. Total energy expenditure and its constituent training characteristics (training intensity, session frequency, session duration and programme length) vary considerably among clinical trials, making it hard to compare studies directly. Therefore, we performed a systematic review and meta-regression analysis to assess the effect of total energy expenditure and its constituent training characteristics on exercise capacity. We identified randomised controlled trials comparing continuous aerobic exercise training with usual care for patients with coronary artery disease. Studies were included when training intensity, session frequency, session duration and programme length was described, and exercise capacity was reported in peakVO 2 . Energy expenditure was calculated from the four training characteristics. The effect of training characteristics on exercise capacity was determined using mixed effects linear regression analyses. The analyses were performed with and without total energy expenditure as covariate. Twenty studies were included in the analyses. The mean difference in peakVO 2 between the intervention group and control group was 3.97ml·min -1 ·kg -1 (p<0.01, 95% CI 2.86 to 5.07). Total energy expenditure was significantly related to improvement of exercise capacity (effect size 0.91ml·min -1 ·kg -1 per 100J·kg, p<0.01, 95% CI 0.77 to 1.06), no effect was found for its constituent training characteristics after adjustment for total energy expenditure. We conclude that the design of an exercise programme should primarily be aimed at optimising total energy expenditure rather than on one specific training characteristic. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.

Totally laparoscopic aortic surgery: comparison of the apron and retrocolic techniques in a porcine model.

PubMed

Huynh, Hai; Elkouri, Stephane; Beaudoin, Nathalie; Bruneau, Luc; Guimond, Cathie; Daniel, Véronique; Blair, Jean-François

2007-01-01

This study evaluated the learning curve for a second-year general surgery resident and compared 2 totally laparoscopic aortic surgery techniques in 10 pigs: the transretroperitoneal apron approach and the transperitoneal retrocolic approach. Five end points were compared: success rate, percentage of conversion, time required, laparoscopic anastomosis quality, and learning curve. The first 3 interventions required an open conversion. The last 7 were done without complications. Mean dissection time was significantly higher with the apron approach compared with the retrocolic approach. The total times for operation, clamping, and arteriotomy time were similar. All laparoscopic anastomoses were patent and without stenosis. The initial learning curve for laparoscopic anastomosis was relatively short for a second-year surgery resident. Both techniques resulted in satisfactory exposure of the aorta and similar mean operative and clamping time. Training on an ex vivo laparoscopic box trainer and on an animal model seems to be complementary to decrease laparoscopic anastomosis completion time.

Porcine cadaver organ or virtual-reality simulation training for laparoscopic cholecystectomy: a randomized, controlled trial.

PubMed

Van Bruwaene, Siska; Schijven, Marlies P; Napolitano, Daniel; De Win, Gunter; Miserez, Marc

2015-01-01

As conventional laparoscopic procedural training requires live animals or cadaver organs, virtual simulation seems an attractive alternative. Therefore, we compared the transfer of training for the laparoscopic cholecystectomy from porcine cadaver organs vs virtual simulation to surgery in a live animal model in a prospective randomized trial. After completing an intensive training in basic laparoscopic skills, 3 groups of 10 participants proceeded with no additional training (control group), 5 hours of cholecystectomy training on cadaver organs (= organ training) or proficiency-based cholecystectomy training on the LapMentor (= virtual-reality training). Participants were evaluated on time and quality during a laparoscopic cholecystectomy on a live anaesthetized pig at baseline, 1 week (= post) and 4 months (= retention) after training. All research was performed in the Center for Surgical Technologies, Leuven, Belgium. In total, 30 volunteering medical students without prior experience in laparoscopy or minimally invasive surgery from the University of Leuven (Belgium). The organ training group performed the procedure significantly faster than the virtual trainer and borderline significantly faster than control group at posttesting. Only 1 of 3 expert raters suggested significantly better quality of performance of the organ training group compared with both the other groups at posttesting (p < 0.01). There were no significant differences between groups at retention testing. The virtual trainer group did not outperform the control group at any time. For trainees who are proficient in basic laparoscopic skills, the long-term advantage of additional procedural training, especially on a virtual but also on the conventional organ training model, remains to be proven. Copyright © 2015 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Retraining moderately impaired stroke survivors in driving-related visual attention skills.

PubMed

Akinwuntan, Abiodun E; Devos, Hannes; Verheyden, Geert; Baten, Guido; Kiekens, Carlotte; Feys, Hilde; De Weerdt, Willy

2010-01-01

Visual inattention is a major cause of road accidents and is a problem commonly experienced after stroke. This study investigated the effects of 2 training programs on performance in the Useful Field of View (UFOV), a validated test of driving-related visual attention skills. Data from 69 first-ever, moderately impaired stroke survivors who participated in a randomized controlled trial (RCT) to determine the effects of simulator training on driving after stroke were analyzed. In addition to regular interventions at a rehabilitation center, participants received 15 hours of either simulator-based driving-related training or non-computer-based cognitive training over 5 weeks. Total percentage reduction in UFOV and performance in divided and selective attention and speed of processing subtests were documented at 6 to 9 weeks (pretraining), 11 to 15 weeks (posttraining), and 6 months post stroke (follow-up). Generalized estimating equation (GEE) model revealed neither group effects nor significant interaction effects of group with time in the UFOV total score and the 3 subtests. However, there were significant within-group improvements from pre- through posttraining to follow-up for all the UFOV parameters. Post-hoc GEE analysis revealed that most improvement in both groups occurred from pre- to posttraining. Both training programs significantly improved visual attention skills of moderately impaired stroke survivors after 15 hours of training and retention of benefit lasted up to 6 months after stroke. Neither of the training programs was better than the other.

Effect of web-supported health education on knowledge of health and healthy-living behaviour of female staff in a Turkish university.

PubMed

Nurgul, Keser; Nursan, Cinar; Dilek, Kose; Over, Ozcelik Tijen; Sevin, Altinkaynak

2015-01-01

Once limited with face-to face courses, health education has now moved into the web environment after new developments in information technology This study was carried out in order to give training to the university academic and administrative female staff who have difficulty in attending health education planned for specific times and places. The web-supported training focuses on healthy diet, the importance of physical activity, damage of smoking and stress management. The study was carried out in Sakarya University between the years 2012-2013 as a descriptive and quasi experimental study. The sample consisted of 30 participants who agreed to take part in the survey, filled in the forms and completed the whole training. The data were collected via a "Personel Information Form", "Health Promotion Life-Style Profile (HPLSP)", and "Multiple Choice Questionnaire (MCQ). There was a statistically significant difference between the total points from "Health Promotion Life-Style Profile" and the total points from the sub-scale after and before the training (t=3.63, p=0.001). When the points from the multiple choice questionnaire after and before training were compared, it was seen that the average points were higher after the training (t=8.57, p<0.001). It was found that web-supported health training has a positive effect on the healthy living behaviour of female staff working at a Turkish university and on their knowledge of health promotion.

The general surgery chief resident operative experience: 23 years of national ACGME case logs.

PubMed

Drake, Frederick Thurston; Horvath, Karen D; Goldin, Adam B; Gow, Kenneth W

2013-09-01

The chief resident (CR) year is a pivotal experience in surgical training. Changes in case volume and diversity may impact the educational quality of this important year. To evaluate changes in operative experience for general surgery CRs. Review of Accreditation Council for Graduate Medical Education case logs from 1989-1990 through 2011-2012 divided into 5 periods. Graduates in period 3 were the last to train with unrestricted work hours; those in period 4 were part of a transition period and trained under both systems; and those in period 5 trained fully under the 80-hour work week. Diversity of cases was assessed based on Accreditation Council for Graduate Medical Education defined categories. Total cases and defined categories were evaluated for changes over time. The average total CR case numbers have fallen (271 in period 1 vs 242 in period 5, P < .001). Total CR cases dropped to their lowest following implementation of the 80-hour work week (236 cases), but rebounded in period 5. The percentage of residents' 5-year operative experience performed as CRs has decreased (30% in period 1 vs 25.6% in period 5, P < .001). Regarding case mix: thoracic, trauma, and vascular cases declined steadily, while alimentary and intra-abdominal operations increased. Recent graduates averaged 80 alimentary and 78 intra-abdominal procedures during their CR years. Compared with period 1, in which these 2 categories represented 47.1% of CR experience, in period 5, they represented 65.2% (P < .001). Endocrine experience has been relatively unchanged. Total CR cases declined especially acutely following implementation of the 80-hour work week but have since rebounded. Chief resident cases contribute less to overall experience, although this proportion stabilized before the 80-hour work week. Case mix has narrowed, with significant increases in alimentary and intra-abdominal cases. Broad-based general surgery training may be jeopardized by reduced case diversity. Chief resident cases are crucial in surgical training and educators should consider these findings as surgical training evolves.

The General Surgery Chief Resident Operative Experience

PubMed Central

Drake, Frederick Thurston; Horvath, Karen D.; Goldin, Adam B.; Gow, Kenneth W.

2014-01-01

IMPORTANCE The chief resident (CR) year is a pivotal experience in surgical training. Changes in case volume and diversity may impact the educational quality of this important year. OBJECTIVE To evaluate changes in operative experience for general surgery CRs. DESIGN, SETTING, AND PARTICIPANTS Review of Accreditation Council for Graduate Medical Education case logs from 1989–1990 through 2011–2012 divided into 5 periods. Graduates in period 3 were the last to train with unrestricted work hours; those in period 4 were part of a transition period and trained under both systems; and those in period 5 trained fully under the 80-hour work week. Diversity of cases was assessed based on Accreditation Council for Graduate Medical Education defined categories. MAIN OUTCOMES AND MEASURES Total cases and defined categories were evaluated for changes over time. RESULTS The average total CR case numbers have fallen (271 in period 1 vs 242 in period 5, P < .001). Total CR cases dropped to their lowest following implementation of the 80-hour work week (236 cases), but rebounded in period 5. The percentage of residents’ 5-year operative experience performed as CRs has decreased (30% in period 1 vs 25.6% in period 5, P < .001). Regarding case mix: thoracic, trauma, and vascular cases declined steadily, while alimentary and intra-abdominal operations increased. Recent graduates averaged 80 alimentary and 78 intra-abdominal procedures during their CR years. Compared with period 1, in which these 2 categories represented 47.1% of CR experience, in period 5, they represented 65.2% (P < .001). Endocrine experience has been relatively unchanged. CONCLUSIONS AND RELEVANCE Total CR cases declined especially acutely following implementation of the 80-hour work week but have since rebounded. Chief resident cases contribute less to overall experience, although this proportion stabilized before the 80-hour work week. Case mix has narrowed, with significant increases in alimentary and intra-abdominal cases. Broad-based general surgery training may be jeopardized by reduced case diversity. Chief resident cases are crucial in surgical training and educators should consider these findings as surgical training evolves. PMID:23864049

The Grapefruit: An Alternative Arthroscopic Tool Skill Platform.

PubMed

Molho, David A; Sylvia, Stephen M; Schwartz, Daniel L; Merwin, Sara L; Levy, I Martin

2017-08-01

To establish the construct validity of an arthroscopic training model that teaches arthroscopic tool skills including triangulation, grasping, precision biting, implant delivery and ambidexterity and uses a whole grapefruit for its training platform. For the grapefruit training model (GTM), an arthroscope and arthroscopic instruments were introduced through portals cut in the grapefruit skin of a whole prepared grapefruit. After institutional review board approval, participants performed a set of tasks inside the grapefruit. Performance for each component was assessed by recording errors, achievement of criteria, and time to completion. A total of 19 medical students, orthopaedic surgery residents, and fellowship-trained orthopaedic surgeons were included in the analysis and were divided into 3 groups based on arthroscopic experience. One-way analysis of variance (ANOVA) and the post hoc Tukey test were used for statistical analysis. One-way ANOVA showed significant differences in both time to completion and errors between groups, F(2, 16) = 16.10, P < .001; F(2, 16) = 17.43, P < .001. Group A had a longer time to completion and more errors than group B (P = .025, P = .019), and group B had a longer time to completion and more errors than group C (P = .023, P = .018). The GTM is an easily assembled and an alternative arthroscopic training model that bridges the gap between box trainers, cadavers, and virtual reality simulators. Our findings suggest construct validity when evaluating its use for teaching the basic arthroscopic tool skills. As such, it is a useful addition to the arthroscopic training toolbox. There is a need for validated low-cost arthroscopic training models that are easily accessible. Copyright © 2017 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

Blood Volume: Its Adaptation to Endurance Training

NASA Technical Reports Server (NTRS)

Convertino, Victor A.

1991-01-01

Expansion of blood volume (hypervolemia) has been well documented in both cross-sectional and longitudinal studies as a consequence of endurance exercise training. Plasma volume expansion can account for nearly all of the exercise-induced hypervolemia up to 2-4 wk; after this time expansion may be distributed equally between plasma and red cell volumes. The exercise stimulus for hypervolemia has both thermal and nonthermal components that increase total circulating plasma levels of electrolytes and proteins. Although protein and fluid shifts from the extravascular to intravascular space may provide a mechanism for rapid hypervolemia immediately after exercise, evidence supports the notion that chronic hypervolemia associated with exercise training represents a net expansion of total body water and solutes. This net increase of body fluids with exercise training is associated with increased water intake and decreased urine volume output. The mechanism of reduced urine output appears to be increased renal tubular reabsorption of sodium through a more sensitive aldosterone action in man. Exercise training-induced hypervolemia appears to be universal among most animal species, although the mechanisms may be quite different. The hypervolemia may provide advantages of greater body fluid for heat dissipation and thermoregulatory stability as well as larger vascular volume and filling pressure for greater cardiac stroke volume and lower heart rates during exercise.

Effect of 8 Weeks Soccer Training on Health and Physical Performance in Untrained Women.

PubMed

Ortiz, Jaelson G; da Silva, Juliano F; Carminatti, Lorival J; Guglielmo, Luiz G A; Diefenthaeler, Fernando

2018-03-01

This study aims to analyze the physiological, neuromuscular, and biochemical responses in untrained women after eight weeks of regular participation in small-sided soccer games compared to aerobic training. Twenty-seven healthy untrained women were divided into two groups [soccer group (SG = 17) and running group (RG = 10)]. Both groups trained three times per week for eight weeks. The variables measured in this study were maximal oxygen uptake (VO 2 max), relative velocity at VO 2 max (vVO 2 max), peak velocity, relative intensity at lactate threshold (vLT), relative intensity at onset of blood lactate accumulation (vOBLA), peak force, total cholesterol, HDL, LDL, triglycerides, and cholesterol ratio (LDL/HDL). VO 2 max, vLT, and vOBLA increased significantly in both groups (12.8 and 16.7%, 11.1 and 15.3%, 11.6 and 19.8%, in SG and RG respectively). However, knee extensors peak isometric strength and triglyceride levels, total cholesterol, LDL, and HDL did not differ after eight weeks of training in both groups. On the other hand, the LDL/HDL ratio significantly reduced in both groups. In conclusion, eight weeks of regular participation in small-sided soccer games was sufficient to increase aerobic performance and promote health benefits related to similar aerobic training in untrained adult women.

Total cost of ownership: the role of clinical engineering.

PubMed

Hockel, Dale; Kintner, Michael

2014-06-01

Hospitals often incur substantial hidden costs associated with service agreements that they enter into with original equipment manufacturers at the time of equipment purchase. Hospitals should perform an analysis of the total cost of ownership (TCO) of their organizations' medical equipment to identify opportunities for performance improvement and savings. The findings of the TCO analysis can point to areas where clinical engineering service management can be improved through investments in technology, training, and teamwork.

Impact of the European Working Time Directive (EWTD) on the operative experience of surgery residents.

PubMed

Hopmans, Cornelis J; den Hoed, Pieter T; van der Laan, Lijckle; van der Harst, Erwin; van der Elst, Maarten; Mannaerts, Guido H H; Dawson, Imro; Timman, Reinier; Wijnhoven, Bas P L; IJzermans, Jan N M

2015-04-01

In Europe and the United States, work hour restrictions are considered to be particularly burdensome for residents in surgery specialties. The aim of this study was to examine whether reduction of the work week to 48 hours resulting from the implementation of the European Working Time Directive has affected the operative experience of surgery residents. This study was conducted in a general surgery training region in the Netherlands, consisting of 1 university hospital and 6 district training hospitals. Operating records summarizing the surgical procedures performed as "primary surgeon" in the operating theater for different grades of surgeons were retrospectively analyzed for the period 2005-2012 by the use of linear regression models. Operative procedures performed by residents were considered the main outcome measure. In total, 235,357 operative procedures were performed, including 47,458 (20.2%) in the university hospital and 187,899 (79.8%) in the district training hospitals (n = 5). For residents in the university hospital, the mean number of operative procedures performed per 1.0 full-time equivalent increased from 128 operations in 2005 to 204 operations in 2012 (P = .001), whereas for residents in district training hospitals, no substantial differences were found over time. The mean (±SD) operative caseload of 64 residents who completed the 6-year training program between 2005 and 2012 was 1,391 ± 226 (range, 768-1856). A comparison of the operative caseload according to year of board-certification showed no difference. Implementation of the European Working Time Directive has not affected adversely the number of surgical procedures performed by residents within a general surgical training region in the Netherlands. Copyright © 2015 Elsevier Inc. All rights reserved.

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

PubMed

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

2011-03-01

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

Residency training in physiatry during a time of change: funding of graduate medical education and other issues.

PubMed

DeLisa, J A; Jain, S S; Kirshblum, S

1998-01-01

Decision makers at the federal and state level are considering, and some states have enacted, a reduction in total United States residency positions, a shift in emphasis from specialist to generalist training, a need for programs to join together in training consortia to determine local residency position allocation strategy, a reduction in funding of international medical graduates, and a reduction in funding beyond the first certificate or a total of five years. A 5-page, 24-item questionnaire was sent to all physiatry residency training directors. The objective was to discern a descriptive database of physiatry training programs and how their institutions might respond to cuts in graduate medical education funding. Fifty-eight (73%) of the questionnaires were returned. Most training directors believe that their primary mission is to train general physiatrists and, to a much lesser extent, to train subspecialty or research fellows. Directors were asked how they might handle reductions in house staff such as using physician extenders, shifting clinical workload to faculty, hiring additional faculty, and funding physiatry residents from practice plans and endowments. Physiatry has had little experience (29%; 17/58) with voluntary graduate medical education consortiums, but most (67%; 34/58) seem to feel that if a consortium system is mandated, they would favor a local or regional over a national body because they do not believe the specialty has a strong enough national stature. The major barriers to a consortium for graduate medical education allocation were governance, academic, fiscal, bureaucratic, and competition.

The influence of training characteristics on the effect of aerobic exercise training in patients with chronic heart failure: A meta-regression analysis.

PubMed

Vromen, T; Kraal, J J; Kuiper, J; Spee, R F; Peek, N; Kemps, H M

2016-04-01

Although aerobic exercise training has shown to be an effective treatment for chronic heart failure patients, there has been a debate about the design of training programs and which training characteristics are the strongest determinants of improvement in exercise capacity. Therefore, we performed a meta-regression analysis to determine a ranking of the individual effect of the training characteristics on the improvement in exercise capacity of an aerobic exercise training program in chronic heart failure patients. We focused on four training characteristics; session frequency, session duration, training intensity and program length, and their product; total energy expenditure. A systematic literature search was performed for randomized controlled trials comparing continuous aerobic exercise training with usual care. Seventeen unique articles were included in our analysis. Total energy expenditure appeared the only training characteristic with a significant effect on improvement in exercise capacity. However, the results were strongly dominated by one trial (HF-action trial), accounting for 90% of the total patient population and showing controversial results compared to other studies. A repeated analysis excluding the HF-action trial confirmed that the increase in exercise capacity is primarily determined by total energy expenditure, followed by session frequency, session duration and session intensity. These results suggest that the design of a training program requires high total energy expenditure as a main goal. Increases in training frequency and session duration appear to yield the largest improvement in exercise capacity. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Exercise Training and Energy Expenditure following Weight Loss

PubMed Central

Hunter, Gary R.; Fisher, Gordon; Neumeier, William H.; Carter, Stephen J.; Plaisance, Eric P.

2015-01-01

Purpose Determine the effects of aerobic or resistance training on activity related energy expenditure (AEE, kcal/d) and physical activity index (ARTE) following weight loss. It was hypothesized that weight loss without exercise training would be accompanied by a decrease in AEE, ARTE, and non-training physical activity energy expenditure (NEAT) and that exercise training would prevent decreases in free living energy expenditure. Methods 140 pre-menopausal women underwent an average of 25 pound weight loss during an 800 kcal/day diet of furnished food. One group aerobically trained 3 times/wk (40 min/d), another resistance trained 3 times/wk (10 exercises/2 sets x10 repetitions) and the third group did not exercise. DXA was used to measure body composition, indirect calorimetry to measure resting (REE) and walking energy expenditure, and doubly labeled water to measure total energy expenditure (TEE). AEE, ARTE, and non-training physical activity energy expenditure (NEAT) were calculated. Results TEE, REE, and NEAT all decreased following weight loss for the no exercise group, but not for the aerobic and resistance trainers. Only REE decreased in the two exercise groups. The resistance trainers increased ARTE. Heart rate and oxygen uptake while walking on the flat and up a grade were consistently related to TEE, AEE, NEAT, and ARTE. Conclusion Exercise training prevents a decrease in energy expenditure, including free living energy expenditure separate from the exercise training, following weight loss. Resistance training increased physical activity, while ease and economy in walking associates with increased TEE, AEE, NEAT, and ARTE. PMID:25606816

Blood markers of recovery from Ironman distance races in an elite triathlete.

PubMed

Mujika, Iñigo; Pereira da Silveira, Felipe; Nosaka, Kazunori

2017-01-01

To understand the recovery of a top triathlete from Ironman distance triathlon races and the timing of training resumption, this study followed an elite male triathlete for 4 years and examined blood parameters after 6 Ironman triathlon races, in which he finished either first (3 races) or second (3 races), with finishing times of 8:00:21 to 8:49:38 (hours:minutes:seconds). The blood was taken either 5, 6 or 8 days after each triathlon race without any training sessions or recovery interventions after the race until the blood sampling. The blood analyses consisted of full hematology including red cell count and differential leucocyte counts (neutrophils, lymphocytes, monocytes, eosinophils, basophils), full iron status (serum iron, total serum capacity, transferrin, saturation index, and ferritin) and general biochemistry (glucose, urea, creatinine, total proteins, aspartate transaminase [AST], alanine transaminase [AST], creatine kinase [CK]). No abnormal values were found for hematology and full iron status. CK activity exceeded the normal reference range (32-162 IU/L) after 3 races that he finished second (Roth 2007: 255 IU/L; Frankfurt 2008: 413 IU/L; Frankfurt 2009: 308 IU/L), but the blood samples were taken at 5 days after the two Frankfurt races and were not different from the athlete's normal training values. AST and ALT activities were also slightly elevated after the two Frankfurt races (2008: 57 IU/L, 61 IU/L; 2009: 43 IU/L, 46 IU/L). It appears that despite slightly elevated CK activity, this elite triathlete recovered from Ironman distance triathlon races within approximately one week and could therefore resume full training within that time frame.

Accreditation Council for Graduate Medical Education Case Log: General Surgery Resident Thoracic Surgery Experience

PubMed Central

Kansier, Nicole; Varghese, Thomas K.; Verrier, Edward D.; Drake, F. Thurston; Gow, Kenneth W.

2014-01-01

Background General surgery resident training has changed dramatically over the past 2 decades, with likely impact on specialty exposure. We sought to assess trends in general surgery resident exposure to thoracic surgery using the Accreditation Council for Graduate Medical Education (ACGME) case logs over time. Methods The ACGME case logs for graduating general surgery residents were reviewed from academic year (AY) 1989–1990 to 2011–2012 for defined thoracic surgery cases. Data were divided into 5 eras of training for comparison: I, AY89 to 93; II, AY93 to 98; III, AY98 to 03; IV, AY03 to 08; V, AY08 to 12. We analyzed quantity and types of cases per time period. Student t tests compared averages among the time periods with significance at a p values less than 0.05. Results A total of 21,803,843 general surgery cases were reviewed over the 23-year period. Residents averaged 33.6 thoracic cases each in period I and 39.7 in period V. Thoracic cases accounted for nearly 4% of total cases performed annually (period I 3.7% [134,550 of 3,598,574]; period V 4.1% [167,957 of 4,077,939]). For the 3 most frequently performed procedures there was a statistically significant increase in thoracoscopic approach from period II to period V. Conclusions General surgery trainees today have the same volume of thoracic surgery exposure as their counterparts over the last 2 decades. This maintenance in caseload has occurred in spite of work-hour restrictions. However, general surgery graduates have a different thoracic surgery skill set at the end of their training, due to the predominance of minimally invasive techniques. Thoracic surgery educators should take into account these differences when training future cardiothoracic surgeons. PMID:24968766

Effects of 8-Week Hatha Yoga Training on Metabolic and Inflammatory Markers in Healthy, Female Chinese Subjects: A Randomized Clinical Trial.

PubMed

Chen, Neng; Xia, Xianghou; Qin, Liqiang; Luo, Li; Han, Shufen; Wang, Guiping; Zhang, Ru; Wan, Zhongxiao

2016-01-01

We aimed to determine the effects of an 8 wk Hatha yoga training on blood glucose, insulin, lipid profiles, endothelial microparticles (EMPs), and inflammatory status in healthy, lean, and female Chinese subjects. A total of 30 healthy, female Chinese subjects were recruited and randomized into control or yoga practice group. The yoga practice included 8 wks of yoga practice (2 times/wk) for a total of 16 times. Fasting blood samples were collected before and after yoga training. Plasma was isolated for the measurement of lipid profiles, glucose, insulin, EMPs, and inflammatory cytokines. Whole blood was cultured ex vivo and stimulated with lipopolysaccharide (LPS) and Pam3Cys-SK4. Peripheral blood mononuclear cells (PBMCs) were isolated for the measurement of TLR2 and TLR4 protein expression. Yoga practice significantly reduced plasma cholesterol, LDL-cholesterol, insulin levels, and CD31+/CD42b- EMPs. Cultured whole blood from the yoga group has reduced proinflammatory cytokines secretion both at unstimulated condition and when stimulated with Pam3Cys-SK4; this might be associated with reduced TLR2 protein expression in PBMCs after yoga training. Hatha yoga practice in healthy Chinese female subjects could improve hallmarks related to MetS; thus it can be considered as an ancillary intervention in the primary MetS prevention for the healthy population. This trial is registered with ChiCTR-IOR-14005747.

Development and validation of a high-fidelity phonomicrosurgical trainer.

PubMed

Klein, Adam M; Gross, Jennifer

2017-04-01

To validate the use of a high-fidelity phonomicrosurgical trainer. A high-fidelity phonomicrosurgical trainer, based on a previously validated model by Contag et al., 1 was designed with multilayered vocal folds that more closely mimic the consistency of true vocal folds, containing intracordal lesions to practice phonomicrosurgical removal. A training module was developed to simulate the true phonomicrosurgical experience. A validation study with novice and expert surgeons was conducted. Novices and experts were instructed to remove the lesion from the synthetic vocal folds, and novices were given four training trials. Performances were measured by the amount of time spent and tissue injury (microflap, superficial, deep) to the vocal fold. An independent Student t test and Fisher exact tests were used to compare subjects. A matched-paired t test and Wilcoxon signed rank tests were used to compare novice performance on the first and fourth trials and assess for improvement. Experts completed the excision with less total errors than novices (P = .004) and made less injury to the microflap (P = .05) and superficial tissue (P = .003). Novices improved their performance with training, making less total errors (P = .002) and superficial tissue injuries (P = .02) and spending less time for removal (P = .002) after several practice trials. This high-fidelity phonomicrosurgical trainer has been validated for novice surgeons. It can distinguish between experts and novices; and after training, it helped to improve novice performance. N/A. Laryngoscope, 127:888-893, 2017. © 2016 The American Laryngological, Rhinological and Otological Society, Inc.

76 FR 39981 - Agency Information Collection Activities; Submission for OMB Review; Joint Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-07

... for the first year to convert systems and conduct training. Estimated Total Annual Burden: National... 124,832 burden hours for the first year to convert systems and conduct training. Total: 571,302 burden... 188 burden hours for the first year to convert systems and conduct training. Estimated Total Annual...

The effect of preoperative training on functional recovery in patients undergoing total knee arthroplasty: A systematic review and meta-analysis.

PubMed

Ma, Jian-Xiong; Zhang, Lu-Kai; Kuang, Ming-Jie; Zhao, Jie; Wang, Ying; Lu, Bin; Sun, Lei; Ma, Xin-Long

2018-03-01

A meta-analysis to evaluate the efficacy of preoperative training on functional recovery in patients undergoing total knee arthroplasty. Randomized controlled trials (RCTs) about relevant studies were searched from PubMed (1996-2017.4), Embase (1980-2017.4), and the Cochrane Library (CENTRAL 2017.4). Nine studies which evaluated the effect of preoperative training on functional recovery in patients undergoing TKA were included in our meta-analysis. Meta-analysis results were collected and analyzed by Review Manager 5.3 (Copenhagen: The Nordic Cochrane Center the Collaboration 2014). Nine studies containing 777 patients meet the inclusion criteria. Our pooled data analysis indicated that preoperative training was as effective as the control group in terms of visual analogue scale(VAS) score at ascend stairs (P = 0.41) and descend stars (P = 0.80), rang of motion (ROM) of flexion (P = 0.86) and extension (P = 0.60), short form 36 (SF-36) of physical function score (P = 0.07) and bodily pain score (P = 0.39), western Ontario and Macmaster universities osteoarthritis index (WOMAC) function score (P = 0.10), and time up and go (P = 0.28). While differences were found in length of stay (P < 0.05). Our meta-analysis demonstrated that preoperative training have the similar efficacy on functional recovery in patients following total knee arthroplasty compared with control group. However, high quality studies with more patients were needed in future. Copyright © 2018 IJS Publishing Group Ltd. Published by Elsevier Ltd. All rights reserved.

Chemotherapy Order Entry by a Clinical Support Pharmacy Technician in an Outpatient Medical Day Unit

PubMed Central

Neville, Heather; Broadfield, Larry; Harding, Claudia; Heukshorst, Shelley; Sweetapple, Jennifer; Rolle, Megan

2016-01-01

Background: Pharmacy technicians are expanding their scope of practice, often in partnership with pharmacists. In oncology, such a shift in responsibilities may lead to workflow efficiencies, but may also cause concerns about patient risk and medication errors. Objectives: The primary objective was to compare the time spent on order entry and order-entry checking before and after training of a clinical support pharmacy technician (CSPT) to perform chemotherapy order entry. The secondary objectives were to document workflow interruptions and to assess medication errors. Methods: This before-and-after observational study investigated chemotherapy order entry for ambulatory oncology patients. Order entry was performed by pharmacists before the process change (phase 1) and by 1 CSPT after the change (phase 2); order-entry checking was performed by a pharmacist during both phases. The tasks were timed by an independent observer using a personal digital assistant. A convenience sample of 125 orders was targeted for each phase. Data were exported to Microsoft Excel software, and timing differences for each task were tested with an unpaired t test. Results: Totals of 143 and 128 individual orders were timed for order entry during phase 1 (pharmacist) and phase 2 (CSPT), respectively. The mean total time to perform order entry was greater during phase 1 (1:37 min versus 1:20 min; p = 0.044). Totals of 144 and 122 individual orders were timed for order-entry checking (by a pharmacist) in phases 1 and 2, respectively, and there was no difference in mean total time for order-entry checking (1:21 min versus 1:20 min; p = 0.69). There were 33 interruptions not related to order entry (totalling 39:38 min) during phase 1 and 25 interruptions (totalling 30:08 min) during phase 2. Three errors were observed during order entry in phase 1 and one error during order-entry checking in phase 2; the errors were rated as having no effect on patient care. Conclusions: Chemotherapy order entry by a trained CSPT appeared to be just as safe and efficient as order entry by a pharmacist. Changes in pharmacy technicians’ scope of practice could increase the amount of time available for pharmacists to provide direct patient care in the oncology setting. PMID:27402999

Chemotherapy Order Entry by a Clinical Support Pharmacy Technician in an Outpatient Medical Day Unit.

PubMed

Neville, Heather; Broadfield, Larry; Harding, Claudia; Heukshorst, Shelley; Sweetapple, Jennifer; Rolle, Megan

2016-01-01

Pharmacy technicians are expanding their scope of practice, often in partnership with pharmacists. In oncology, such a shift in responsibilities may lead to workflow efficiencies, but may also cause concerns about patient risk and medication errors. The primary objective was to compare the time spent on order entry and order-entry checking before and after training of a clinical support pharmacy technician (CSPT) to perform chemotherapy order entry. The secondary objectives were to document workflow interruptions and to assess medication errors. This before-and-after observational study investigated chemotherapy order entry for ambulatory oncology patients. Order entry was performed by pharmacists before the process change (phase 1) and by 1 CSPT after the change (phase 2); order-entry checking was performed by a pharmacist during both phases. The tasks were timed by an independent observer using a personal digital assistant. A convenience sample of 125 orders was targeted for each phase. Data were exported to Microsoft Excel software, and timing differences for each task were tested with an unpaired t test. Totals of 143 and 128 individual orders were timed for order entry during phase 1 (pharmacist) and phase 2 (CSPT), respectively. The mean total time to perform order entry was greater during phase 1 (1:37 min versus 1:20 min; p = 0.044). Totals of 144 and 122 individual orders were timed for order-entry checking (by a pharmacist) in phases 1 and 2, respectively, and there was no difference in mean total time for order-entry checking (1:21 min versus 1:20 min; p = 0.69). There were 33 interruptions not related to order entry (totalling 39:38 min) during phase 1 and 25 interruptions (totalling 30:08 min) during phase 2. Three errors were observed during order entry in phase 1 and one error during order-entry checking in phase 2; the errors were rated as having no effect on patient care. Chemotherapy order entry by a trained CSPT appeared to be just as safe and efficient as order entry by a pharmacist. Changes in pharmacy technicians' scope of practice could increase the amount of time available for pharmacists to provide direct patient care in the oncology setting.

The effects of Crew Resource Mangement (CRM) training in airline maintenance: Results following three years' experience

NASA Technical Reports Server (NTRS)

Taylor, J. C.; Robertson, M. M.

1995-01-01

This report describes three years' evaluation of the effects of one airline's Crew Resources Management (CRM) training operation for maintenance. This evaluation focuses on the post-training attitudes of maintenance managers' and technical support professionals, their reported behaviors, and the safety, efficiency and dependable maintenance performance of their units. The results reveal a strong positive effect of the training. The overall program represents the use of CRM training as a long-term commitment to improving performance through effective communication at all levels in airline maintenance operations. The initial findings described in our previous progress reports are reinforced and elaborated here. The current results benefit from the entire pre-post training survey, which now represents total attendance of all managers and staff professionals. Additionally there are now full results from the two-month, six-month, and 12-month follow-up questionnaires, together with as many as 33 months of post-training performance data, using several indicators. In this present report, we examine participants' attitudes, their reported behaviors following the training, the performance of their work units, and the relationships among these variables. Attitudes include those measured immediately before and after the training as well as participants' attitudes months after their training. Performance includes measures, by work units, of on-time flight departures, on-schedule maintenance releases, occupational and aircraft safety, and efficient labor costs. We report changes in these performance measures following training, as well their relationships with the training participants' attitudes. Highlights of results from this training program include increased safety and improved costs associated with positive attitudes about the use of more assertive communication, and the improved management of stress. Improved on-time performance is also related to those improved attitudes, as well as favorable attitudes about participative management.

Strength and Power Training Effects on Lower Limb Force, Functional Capacity, and Static and Dynamic Balance in Older Female Adults.

PubMed

Lopes, Paula Born; Pereira, Gleber; Lodovico, Angélica; Bento, Paulo C B; Rodacki, André L F

2016-03-03

It has been proposed that muscle power is more effective to prevent falls than muscle force production capacity, as rapid reactions are required to allow the postural control. This study aimed to compare the effects of strength and power training on lower limb force, functional capacity, and static and dynamic balance in older female adults. Thirty-seven volunteered healthy women had been allocated into the strength-training group (n = 14; 69 ± 7.3 years, 155 ± 5.6 cm, 72 ± 9.7 kg), the power-training group (n = 12; 67 ± 7.4 years, 153 ± 5.5 cm, 67.2 ± 7 kg), and control group (n = 11; 65 ± 3.1 years, 154 ± 5.6 cm, 70.9 ± 3 kg). After 12 weeks of training, the strength-training and power-training groups increased significantly maximum dynamic strength (29% and 27%), isometric strength (26% and 37%), and step total time (13% and 14%, dynamic balance), respectively. However, only the power-training group increased the rate of torque development (55%) and the functional capacity in 30-second chair stand (22%) and in time up and go tests (-10%). Empirically, power training may reduce the risk of injuries due to lower loads compared to strength training, and consequently, the physical effort demand during the training session is lower. Therefore, power training should be recommended as attractive training stimuli to improve lower limb force, functional capacity, and postural control of older female adults.

Notebook input devices put to the age test: the usability of trackpoint and touchpad for middle-aged adults.

PubMed

Armbrüster, C; Sutter, C; Ziefle, M

2007-03-01

In two experiments, the usability of input devices integrated into computer notebooks was under study. The most common input devices, touchpad (experiment 1) and trackpoint (experiment 2) were examined. So far, the evaluation of mobile input devices has been restricted to younger users. However, due to ongoing demographic change, the main target group of mobile devices will be older users. Therefore, the present study focused on ageing effects. A total of 14 middle-aged (40-65 years) and 20 younger (20-32 years) users were compared regarding speed and accuracy of cursor control in a point-click and a point-drag-drop task. Moreover, the effects of training were addressed by examining the performance increase over time. In total, 640 trials per task and input device were executed. The results show that ageing is a central factor to be considered in input device design. Middle-aged users were significantly slower than younger users when executing the different tasks. Over time, a significant training effect was observed for both devices and both age groups, although the benefit of training was greater for the middle-aged group. Generally, the touchpad performance was higher than the trackpoint performance in both age groups, but the age-related performance decrements were less distinct when using the touchpad.

Individuals with severely impaired vision can learn useful orientation and mobility skills in virtual streets and can use them to improve real street safety.

PubMed

Bowman, Ellen Lambert; Liu, Lei

2017-01-01

Virtual reality has great potential in training road safety skills to individuals with low vision but the feasibility of such training has not been demonstrated. We tested the hypotheses that low vision individuals could learn useful skills in virtual streets and could apply them to improve real street safety. Twelve participants, whose vision was too poor to use the pedestrian signals were taught by a certified orientation and mobility specialist to determine the safest time to cross the street using the visual and auditory signals made by the start of previously stopped cars at a traffic-light controlled street intersection. Four participants were trained in real streets and eight in virtual streets presented on 3 projection screens. The crossing timing of all participants was evaluated in real streets before and after training. The participants were instructed to say "GO" at the time when they felt the safest to cross the street. A safety score was derived to quantify the GO calls based on its occurrence in the pedestrian phase (when the pedestrian sign did not show DON'T WALK). Before training, > 50% of the GO calls from all participants fell in the DON'T WALK phase of the traffic cycle and thus were totally unsafe. 20% of the GO calls fell in the latter half of the pedestrian phase. These calls were unsafe because one initiated crossing this late might not have sufficient time to walk across the street. After training, 90% of the GO calls fell in the early half of the pedestrian phase. These calls were safer because one initiated crossing in the pedestrian phase and had at least half of the pedestrian phase for walking across. Similar safety changes occurred in both virtual street and real street trained participants. An ANOVA showed a significant increase of the safety scores after training and there was no difference in this safety improvement between the virtual street and real street trained participants. This study demonstrated that virtual reality-based orientation and mobility training could be as efficient as real street training in improving street safety in individuals with severely impaired vision.

Home-based resistance training improves femoral bone mineral density in women on hormone therapy.

PubMed

Judge, James Oat; Kleppinger, Alison; Kenny, Anne; Smith, Jo-Anne; Biskup, Brad; Marcella, Glenn

2005-09-01

This study tested whether moderate resistance training would improve femoral bone mineral density (BMD) in long-term users of hormone therapy with low BMD. The study was a 2-year randomized, controlled, trial (RCT) of moderate resistance training of either the lower extremity or the upper extremity. Eighty-five women participated in a 6-month observation period. The setting was center-based and home-based training. The participants were 189 women aged 59-78 years, with total femur T-scores from -0.8 to -2.8 and on hormone therapy (HT) for a minimum of 2 years (mean 11.8 years); 153 completed the trial. Lower extremity training used weight belts (mean 7.8 kg) in step-ups and chair rises; upper extremity training used elastic bands and dumbbells. Measurements were BMD and body composition [dual-energy X-ray absorptiometry (DXA)], bone turnover markers. Total femoral BMD showed a downward trend during the observation period: 0.35%+/-0.18% (P=0.14). The response to training was similar in the upper and lower groups in the primary outcomes. At 2 years, total femoral BMD increased 1.5% (95% CI 0.8%-2.2%) in the lower group and 1.8% (95% CI 1.1%-2.5%) in the upper group. Trochanter BMD increased 2.4% (95% CI 1.3%-3.5%) in the lower group and 2.5% (95% CI 1.4%-3.6%) in the upper group (for both analyses time effect P<0.001). At 1 year, a bone resorption marker (C-telopeptide) decreased 9% (P=0.04). Bone formation markers, bone-specific alkaline phosphatase, decreased 5% (P<0.001), and N-terminal type I procollagen peptide decreased 7% (P=0.01). Body composition (percent lean and percent body fat) was maintained in both groups. We concluded that long-term moderate resistance training reversed bone loss, decreased bone turnover, increased femur BMD, and maintained body composition. The similarity of response in upper and lower groups supports a systemic response rather than a site-specific response to moderate resistance training.

A randomised placebo-exercise controlled trial of Kung Fu training for improvements in body composition in overweight/obese adolescents: the “Martial Fitness” study

PubMed Central

Tsang, Tracey W.; Kohn, Michael; Chow, Chin Moi; Singh, M Fiatarone

2009-01-01

The purpose of the study was to investigate if Chinese martial arts (Kung Fu, KF) might be effective for improving body composition, as well as being an appealing form of physical activity for inexperienced, sedentary, overweight/obese adolescents. Twenty subjects (age: 13.3 ± 1.8 y; BMI percentile: 98.6(86.5 - 99.8); 60% girls) were randomly-assigned to the supervised KF or placebo (Tai Chi, TC) control group 3 d.wk-1 for 6 months. We assessed body composition, including total and regional fat and lean mass, total and regional bone mineral density (BMD), percent lean and fat mass, body mass index and waist circumference, at baseline and after 6 months of training using anthropometry and dual-energy X-ray absorptiometry (DXA). Habitual physical activity and dietary intake were recorded as covariates via self-report at each time-point. As expected due to natural growth, significant increases in height, weight, total and lumbar BMD, and lean mass were seen in the cohort over time, with a trend for increased whole body fat mass, with no difference between groups. By contrast, percent fat and android fat mass via DXA did not increase in either group over time. The absence of a similar expected increase in central adiposity over 6 months could indicate a positive effect of participation in both programs on the metabolically critical abdominal adiposity in this cohort. Further research in this area is warranted to determine ways to increase uptake and compliance, and to see if longer-term martial arts training not only maintains, but improves abdominal fat mass and related metabolic health indices in overweight/ obese adolescents. Key points Participation in our martial arts trial attenuated the increases in body fat mass expected due to growth in our overweight/obese adolescent group. All subjects allocated to the Kung Fu intervention were satisfied with their Kung Fu training, in contrast to our placebo-exercise (Tai Chi) subjects, suggesting that this form of exercise is worth investigating further for adherence and efficacy. This was the first randomized, placebo-exercise controlled trial to be conducted, examining the effects of martial arts training alone on body composition in sedentary overweight/obese adolescents. Larger, longer-term trials are required to confirm our findings. PMID:24150562

A retrospective study of anaesthetic caseload of Specialist Registrars following the introduction of new working patterns in the Wessex region.

PubMed

Al-Rawi, S; Spargo, P

2009-03-01

The impact of implementing the European Working Time Directive (EWTD) and the consequent reduction in hours of work has led to concerns about training. This retrospective study compared total caseload, obstetric caseload, out-of-hours caseload and supervision levels of trainee anaesthetists in one region of the UK (Wessex) before and after the implementation of EWTD compliant rotas. Anaesthetic trainee logbooks submitted at the annual Record of In-Training Assessment were compared between the years 1999 and 2006. The logbook data was divided into two groups, group A (13-h shift) and group B (24-h on-call rota). There was no difference in total caseload, obstetric caseload or supervision. Out-of-hours caseload was greater in group A (p < 0.01).

Making working memory work: a meta-analysis of executive-control and working memory training in older adults.

PubMed

Karbach, Julia; Verhaeghen, Paul

2014-11-01

This meta-analysis examined the effects of process-based executive-function and working memory training (49 articles, 61 independent samples) in older adults (> 60 years). The interventions resulted in significant effects on performance on the trained task and near-transfer tasks; significant results were obtained for the net pretest-to-posttest gain relative to active and passive control groups and for the net effect at posttest relative to active and passive control groups. Far-transfer effects were smaller than near-transfer effects but were significant for the net pretest-to-posttest gain relative to passive control groups and for the net gain at posttest relative to both active and passive control groups. We detected marginally significant differences in training-induced improvements between working memory and executive-function training, but no differences between the training-induced improvements observed in older adults and younger adults, between the benefits associated with adaptive and nonadaptive training, or between the effects in active and passive control conditions. Gains did not vary with total training time. © The Author(s) 2014.

SLO blind data set inversion and classification using physically complete models

NASA Astrophysics Data System (ADS)

Shamatava, I.; Shubitidze, F.; Fernández, J. P.; Barrowes, B. E.; O'Neill, K.; Grzegorczyk, T. M.; Bijamov, A.

2010-04-01

Discrimination studies carried out on TEMTADS and Metal Mapper blind data sets collected at the San Luis Obispo UXO site are presented. The data sets included four types of targets of interest: 2.36" rockets, 60-mm mortar shells, 81-mm projectiles, and 4.2" mortar items. The total parameterized normalized magnetic source (NSMS) amplitudes were used to discriminate TOI from metallic clutter and among the different hazardous UXO. First, in object's frame coordinate, the total NSMS were determined for each TOI along three orthogonal axes from the training data provided by the Strategic Environmental Research and Development Program (SERDP) along with the referred blind data sets. Then the inverted total NSMS were used to extract the time-decay classification features. Once our inversion and classification algorithms were tested on the calibration data sets then we applied the same procedure to all blind data sets. The combined NSMS and differential evolution algorithm is utilized for determine the NSMS strengths for each cell. The obtained total NSMS time-decay curves were used to extract the discrimination features and perform classification using the training data as reference. In addition, for cross validation, the inverted locations and orientations from NSMS-DE algorithm were compared against the inverted data that obtained via the magnetic field, vector and scalar potentials (HAP) method and the combined dipole and Gauss-Newton approach technique. We examined the entire time decay history of the total NSMS case-by-case for classification purposes. Also, we use different multi-class statistical classification algorithms for separating the dangerous objects from non hazardous items. The inverted targets were ranked by target ID and submitted to SERDP for independent scoring. The independent scoring results are presented.

Training, executive, attention and motor skills (TEAMS) training versus standard treatment for preschool children with attention deficit hyperactivity disorder: a randomised clinical trial.

PubMed

Vibholm, Helle Annette; Pedersen, Jesper; Faltinsen, Erlend; Marcussen, Michael H; Gluud, Christian; Storebø, Ole Jakob

2018-06-08

This study compared the effectiveness of manualised training, executive, attention, and motor skills (TEAMS) training versus standard treatment in preschool children with attention deficit hyperactivity disorder (ADHD). We conducted a randomised parallel group, single-blinded, superiority trial. The primary outcome was ADHD symptoms and the secondary outcome was functionality. Parents and primary school teachers assessed outcomes at pretreatment, posttreatment, and at one, three, and 6 months follow-up. In total, 67 children (aged 3-6 years) were randomised. In the TEAMS group, 32 out of 33 (97%) participants completed the total 8-week program, compared with only 7 out of 26 (27%) in the control group. The repeated-model analyses showed no significant change between the two interventions for ADHD symptoms and functionality levels over time. The mean difference in ADHD symptoms between TEAMS versus standard treatment at posttreatment was 2.18 points (95% confidence interval - 8.62 to 13.0; trial sequential analysis-adjusted confidence interval - 19.3 to 23.7). Trial registration Clinical Trials identifier: NCT01918436 (Retrospectively registered). Registered on 7 August 2013.

Resistance exercise countermeasures for space flight: implications of training specificity

NASA Technical Reports Server (NTRS)

Bamman, M. M.; Caruso, J. F.

2000-01-01

While resistance exercise should be a logical choice for prevention of strength loss during unloading, the principle of training specificity cannot be overlooked. Our purpose was to explore training specificity in describing the effect of our constant load exercise countermeasure on isokinetic strength performance. Twelve healthy men (mean +/- SD: 28.0 +/- 5.2 years, 179.4 +/- 3.9 cm, 77.5 +/- 13.6 kg) were randomly assigned to no exercise or resistance exercise (REX) during 14 days of bed rest. REX performed five sets of leg press exercise to volitional fatigue (6-10 repetitions) every other day. Unilateral isokinetic concentric-eccentric knee extension testing performed before and on day 15 prior to reambulation included torque-velocity and power-velocity relationships at four velocities (0.52, 1.75, 2.97, and 4.19 rad s-1), torque-position relationship, and contractile work capacity (10 repetitions at 1.05 rad s-1). Two (group) x 2 (time) ANOVA revealed no group x time interactions; thus, groups were combined. Across velocities, angle-specific torque fell 18% and average power fell 20% (p < 0.05). No velocity x time or mode (concentric/eccentric) x time interactions were noted. Torque x position decreased on average 24% (p < 0.05). Total contractile work dropped 27% (p < 0.05). Results indicate bed rest induces rapid and marked reductions in strength and our constant load resistance training protocol did not prevent isokinetic strength losses. Differences between closed-chain training and open-chain testing may explain the lack of protection.

Effects of Physical Training and Fitness on Running Injuries in Physically Active Young Men.

PubMed

Grier, Tyson L; Canham-Chervak, Michelle; Anderson, Morgan K; Bushman, Timothy T; Jones, Bruce H

2017-01-01

Grier, TL, Canham-Chervak, M, Anderson, MK, Bushman, TT, and Jones, BH. Effects of physical training and fitness on running injuries in physically active young men. J Strength Cond Res 31(1): 207-216, 2017-The purpose of this investigation was to determine the effects of physical training (PT) and fitness on risks for running-related injuries (RRIs) in physically active young men. Personal characteristics, PT, Army Physical Fitness Test scores, and injury data were obtained by survey. Army Physical Fitness Test variables (push-ups, sit-ups, and 2-mile run) were converted into quartiles (Q), where Q1 = lowest performance and Q4 = highest performance. Odds ratios (OR) and 95% confidence intervals (95% CI) were calculated using multivariate logistic regression. Over 4,000 (n = 4,236) soldiers were surveyed. Running injury incidence was 14%. A greater risk of an RRI was associated with older age (OR31+/<22 years = 1.62, 95% CI, 1.21-2.18), higher BMI ((Equation is included in full-text article.)), and total distance ran per week during unit PT (OR16.1+/1-5 miles = 1.66, 95% CI, 1.15-2.41). A lower risk of an RRI was associated with total distance run per week during personal PT (OR5.1-10/1-5 miles = 0.70, 95% CI, 0.53-0.91, OR10.1-16 +/1-5 miles = 0.58, 95% CI, 0.35-0.97, OR16.1+/1-5 miles = 0.54, 95% CI, 0.30-0.98), higher aerobic endurance as measured by 2-mile run performance (ORQ4/Q1 = 0.50, 95% CI, 0.35-0.72), and unit resistance training ≥3 times a week (OR≥3 times per week/none = 0.46, 95% CI, 0.29-0.73). Greater personal PT running mileage decreased injuries in this population suggesting that the increased protective effect of higher aerobic fitness outweighed the injurious effect of running more miles during personal PT. Countermeasures to prevent RRIs could entail enhancing aerobic endurance, providing opportunities for personal aerobic training, monitoring for excessive unit PT running mileage and encouraging unit resistance training ≥3 times per week.

Changes in aerobic capacity and glycaemic control in response to reduced-exertion high-intensity interval training (REHIT) are not different between sedentary men and women.

PubMed

Metcalfe, Richard S; Tardif, Nicolas; Thompson, Dylan; Vollaard, Niels B J

2016-11-01

Previously it has been reported that reduced-exertion high-intensity interval training (REHIT; total training time of 3 × 10 min per week) improves maximal aerobic capacity in both sedentary men and women, but improves insulin sensitivity in men only. The aim of the present study was to determine whether there is a true sex difference in response to REHIT, or that these findings can be explained by the large interindividual variability in response inherent to all exercise training. Thirty-five sedentary participants (18 women; mean ± SD age for men and women, respectively: age, 33 ± 9 and 36 ± 9 years; body mass index, 25.1 ± 2.1 and 24.1 ± 3.5 kg·m -2 ; maximal aerobic capacity, 38.6 ± 8.3 and 31.6 ± 4.6 mL·kg -1 ·min -1 ) completed a 6-week REHIT programme consisting of eighteen 10-min unloaded cycling sessions with 1 (first session) or 2 (all other sessions) "all-out" 10-20-s sprints against a resistance of 5% of body mass. Maximal aerobic capacity and oral glucose tolerance test-derived insulin sensitivity were determined before and after training. REHIT was associated with an increase in maximal aerobic capacity (2.54 ± 0.65 vs. 2.78 ± 0.68 L·min -1 , main effect of time: p < 0.01), a trend toward reduced plasma insulin area-under-the-curve (AUC; 6.7 ± 4.8 vs. 6.1 ± 4.0 IU·min -1 ·mL -1 , p = 0.096), but no significant change in plasma glucose AUC or the Cederholm index of insulin sensitivity. Substantial interindividual variability in response to REHIT was observed for all variables, but there was no significant effect of sex. In conclusion, REHIT improves the key health marker of aerobic capacity within a minimal total training time-commitment. There is large interindividual variability in responses to REHIT, but sex differences in the responses are not apparent.

An Evaluation of a Multicomponent Mental Competency and Stress Management Training for Entrants in Surgery Medicine.

PubMed

Mache, Stefanie; Danzer, Gerhard; Klapp, Burghard; Groneberg, David A

2015-01-01

Stress occurs in surgeons with a significantly higher prevalence than in the general population. At the same time, learning of coping techniques and improving personal skills how to handle the daily workload are not integral parts of the medical education or during adjustment to the job as a surgeon. In this pilot study, we developed a training course to teach different stress management and coping techniques and analyzed individual conditions of the surgeons before and after the course. In total, 68 junior surgeons in their first year at work participated in the training and were randomized in an intervention (n = 35) or a control group (n = 33). At the beginning and the end of the training, the intervention and the comparison group answered a standardized, validated questionnaire on job satisfaction, perceived stress, and personal skills (such as self-efficacy). The surgeons showed a significant decline in perceived stress. Furthermore, they showed an improvement in self-reported resilience and self-efficacy. Job satisfaction increased at the same time. The comparison cohort of surgeons showed comparable scores for the specified outcome variables at the beginning but showed no progressive changes during time. The study findings indicate that the training for junior surgeons in their first year at work is suitable to implement as a group training program. Moreover, the training provides statistically significant improvement in perceptions of distress and strengthens individual protective factors and job satisfaction. Copyright © 2015 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

When should we perform a repeat training on adrenaline auto-injector use for physician trainees?

PubMed

Topal, E; Bakirtas, A; Yilmaz, O; Karagol, I H E; Arga, M; Demirsoy, M S; Turktas, I

2014-01-01

Studies demonstrate that both doctors and patients may use adrenaline auto-injector improperly and the usage skills are improved by training. In this study, we aimed to determine the appropriate frequency of training to maintain skills for adrenaline auto-injector use. We invited all interns of 2011-2012 training period. At baseline, all participants were given theoretical and practical training on adrenaline auto-injector use. The participants were randomly assigned into two groups. We asked those in group 1 to demonstrate the use of adrenaline auto-injector trainer in the third month and those in group 2 in the sixth month. One hundred and sixty interns were enrolled. Compared with the beginning score, demonstration of skills at all the steps and total scores did not change for the group tested in the third month (p=0.265 and p=0.888, respectively). However; for the group examined in the sixth month; the demonstration of skills for proper use of the auto-injector at all steps and the mean time to administer adrenaline decreased (p=0.018 and p<0.001, respectively). Besides, the group which was tested in the third month was better than the group which was tested in the sixth month in terms of demonstrating all steps (p=0.014), the total score (p=0.019), mean time of change to administer adrenaline (p<0.001) and presumptive self-injection into thumb (p=0.029). Auto-injector usage skills of physician trainees decrease after the sixth month and are better in those who had skill reinforcement at 3 months, suggesting continued education and skill reinforcement may be useful. Copyright © 2013 SEICAP. Published by Elsevier Espana. All rights reserved.

A Secure and High-Fidelity Live Animal Model for Off-Pump Coronary Bypass Surgery Training.

PubMed

Liu, Xiaopeng; Yang, Yan; Meng, Qiang; Sun, Jiakang; Luo, Fuliang; Cui, Yongchun; Zhang, Hong; Zhang, Dong; Tang, Yue

2016-01-01

Existing simulators for off-pump coronary artery (CA) bypass grafting training are unable to provide cardiac surgery residents all necessary skills they need entering the operation room. In this study, we introduced a secure and high-fidelity live animal model to supplement the in vitro simulators for off-pump CA bypass grafting training. The left internal thoracic artery (ITA) of 3 Chinese miniature pigs was grafted to the left anterior descending CA using an end-to-side anastomosis. The free segment of the ITA was fixed on the ventricle surface, making it a simulative CA beating in synchrony with the heart. A total of 6 to 8 training anastomoses were made on each ITA. Animal Experiment Center in Fuwai Hospital. In total, 19 resident surgeons with at least 3 years of cardiac surgery work experience were trained using the new model. Their performances were recorded and reviewed. Simulative coronary arteries were successfully constructed in all 3 animals with no adverse event observed. A total of 19 anastomoses were then completed, 1 pig of 7 anastomoses and the other 2 animals of 6 anastomoses. Time consumption for the anastomosis was 782 ± 107 seconds. Anastomotic leakage was observed in 10/19 procedures. The most frequency site (7/10) was at the toe of the anastomosis. Further, the most common cause was uneven spacing or small margin of the stitches or both. Emergencies occurred during the training process included hypotension (7 procedures), tachyarrhythmia (4 procedures), and low blood oxygen saturation (1 procedure). This study demonstrated the safety and feasibility of our new live pig model in training resident surgeons. The simulative arteries can be easily accomplished and were long enough to place at least 6 anastomoses. Both on lumen diameter and motion status, they were proven to be a good substitution of the CA. Copyright © 2016. Published by Elsevier Inc.

Maternal blood pressure and heart rate response to pelvic floor muscle training during pregnancy.

PubMed

Ferreira, Cristine H; Naldoni, Luciane M V; Ribeiro, Juliana Dos Santos; Meirelles, Maria Cristina C C; Cavalli, Ricardo de Carvalho; Bø, Kari

2014-07-01

To assess whether maternal blood pressure (BP) and heart rate (HR) change significantly in response to pelvic floor muscle training during pregnancy. Longitudinal exploratory study with repeated measurements. Twenty-seven nulliparous healthy women of mean age 23.3 years (range 18-36) and mean body mass index 23.4 (range 23.1-29.5). Individual supervised pelvic floor muscle training from gestational week 20 till 36 with assessment of BP and HR at gestational weeks 20, 24, 28, 32 and 36. Systolic and diastolic BP was measured before and after each training session and HR was monitored during each session. Pelvic floor muscle training did not change BP. 77% (n = 21) of participants exceeded 70% of estimated maximum HR during at least one session. The time for exceeding 70% of estimated maximum HR was between 2.2 and 3.2 % of the total exercise session. Increases in BP and HR from gestational weeks 20 till 36 were within normal limits for pregnant women. Pelvic floor muscle training in nulliparous sedentary pregnant women does not increase BP. It significantly increases HR during the exercise sessions, but only for a limited period of time and with no negative long-term effect on BP or HR. © 2014 Nordic Federation of Societies of Obstetrics and Gynecology.

Mental Transformation Skill in Young Children: The Role of Concrete and Abstract Motor Training.

PubMed

Levine, Susan C; Goldin-Meadow, Susan; Carlson, Matthew T; Hemani-Lopez, Naureen

2018-05-01

We examined the effects of three different training conditions, all of which involve the motor system, on kindergarteners' mental transformation skill. We focused on three main questions. First, we asked whether training that involves making a motor movement that is relevant to the mental transformation-either concretely through action (action training) or more abstractly through gestural movements that represent the action (move-gesture training)-resulted in greater gains than training using motor movements irrelevant to the mental transformation (point-gesture training). We tested children prior to training, immediately after training (posttest), and 1 week after training (retest), and we found greater improvement in mental transformation skill in both the action and move-gesture training conditions than in the point-gesture condition, at both posttest and retest. Second, we asked whether the total gain made by retest differed depending on the abstractness of the movement-relevant training (action vs. move-gesture), and we found that it did not. Finally, we asked whether the time course of improvement differed for the two movement-relevant conditions, and we found that it did-gains in the action condition were realized immediately at posttest, with no further gains at retest; gains in the move-gesture condition were realized throughout, with comparable gains from pretest-to-posttest and from posttest-to-retest. Training that involves movement, whether concrete or abstract, can thus benefit children's mental transformation skill. However, the benefits unfold differently over time-the benefits of concrete training unfold immediately after training (online learning); the benefits of more abstract training unfold in equal steps immediately after training (online learning) and during the intervening week with no additional training (offline learning). These findings have implications for the kinds of instruction that can best support spatial learning. Copyright © 2018 Cognitive Science Society, Inc.

The Relationship of a Pilot's Educational Background, Aeronautical Experience and Recency of Experience to Performance In Initial Training at a Regional Airline

NASA Astrophysics Data System (ADS)

Shane, Nancy R.

The purpose of this study was to determine how a pilot's educational background, aeronautical experience and recency of experience relate to their performance during initial training at a regional airline. Results show that variables in pilots' educational background, aeronautical experience and recency of experience do predict performance in training. The most significant predictors include years since graduation from college, multi-engine time, total time and whether or not a pilot had military flying experience. Due to the pilot shortage, the pilots entering regional airline training classes since August 2013 have varied backgrounds, aeronautical experience and recency of experience. As explained by Edward Thorndike's law of exercise and the law of recency, pilots who are actively using their aeronautical knowledge and exercising their flying skills should exhibit strong performance in those areas and pilots who have not been actively using their aeronautical knowledge and exercising their flying skills should exhibit degraded performance in those areas. Through correlation, chi-square and multiple regression analysis, this study tests this theory as it relates to performance in initial training at a regional airline.

Effects of in-season short-term aerobic and high-intensity interval training program on repeated sprint ability and jump performance in handball players.

PubMed

Hermassi, Souhail; Ingebrigtsen, Jørgen; Schwesig, René; Fieseler, Georg; Delank, Karl-Stefan; Chamari, Karim; Shephard, Roy J; Chelly, Mohamed-Souhaiel

2018-01-01

This study examined the effects of a 7-week in-season aerobic and high-intensity interval-training program on performance tests linked to successful handball play (e.g., repeated sprint and jumping ability). Thirty participants (age 17.0±1.2 years, body mass 81.1±3.4 kg, height 1.82±0.07 m) performed a Yo-Yo Intermittent Recovery Test level 1 (Yo-Yo IR1), a squat (SJ) and a Countermovement Jump Test (CMJ), as well as a repeated Sprint Ability Test (RSA). From this, maximal aerobic speed (MAS, reached at the end of the Yo-Yo IR1), jumping ability, best time in a single sprint trial (RSAbest), total time (RSATT) and the performance decrement (RSAdec) during all sprints were calculated. Later, subjects were randomly assigned to a control group (CG; N.=15) performing their normal training schedule (5 weekly sessions of ~90 minutes of handball training) or an experimental group (EG; N.=15). The EG performed two 30 min sessions per week of high-intensity aerobic exercises at 100-130% of MAS in addition to their normal training schedule. A significant improvement in MAS (d=4.1), RSAbest (d=1.9), RSATT (d=1.5) and RSAdec (d=2.3) after the training period was demonstrated. Also, significant interaction effects (time x group) were found for all parameters as the EG significantly improved performances in all tests after training. The greatest interaction effects were observed in MAS (η2=0.811) and CMJ (η2=0.759). No relevant changes in test performances were found in the CG (mean d=-0.02). These results indicate that individually speed-controlled aerobic and interval training is effective for improving specific handball performance.

Unsupervised progressive elastic band exercises for frail geriatric inpatients objectively monitored by new exercise-integrated technology-a feasibility trial with an embedded qualitative study.

PubMed

Rathleff, C R; Bandholm, T; Spaich, E G; Jorgensen, M; Andreasen, J

2017-01-01

Frailty is a serious condition frequently present in geriatric inpatients that potentially causes serious adverse events. Strength training is acknowledged as a means of preventing or delaying frailty and loss of function in these patients. However, limited hospital resources challenge the amount of supervised training, and unsupervised training could possibly supplement supervised training thereby increasing the total exercise dose during admission. A new valid and reliable technology, the BandCizer, objectively measures the exact training dosage performed. The purpose was to investigate feasibility and acceptability of an unsupervised progressive strength training intervention monitored by BandCizer for frail geriatric inpatients. This feasibility trial included 15 frail inpatients at a geriatric ward. At hospitalization, the patients were prescribed two elastic band exercises to be performed unsupervised once daily. A BandCizer Datalogger enabling measurement of the number of sets, repetitions, and time-under-tension was attached to the elastic band. The patients were instructed in performing strength training: 3 sets of 10 repetitions (10-12 repetition maximum (RM)) with a separation of 2-min pauses and a time-under-tension of 8 s. The feasibility criterion for the unsupervised progressive exercises was that 33% of the recommended number of sets would be performed by at least 30% of patients. In addition, patients and staff were interviewed about their experiences with the intervention. Four (27%) out of 15 patients completed 33% of the recommended number of sets. For the total sample, the average percent of performed sets was 23% and for those who actually trained ( n  = 12) 26%. Patients and staff expressed a general positive attitude towards the unsupervised training as an addition to the supervised training sessions. However, barriers were also described-especially constant interruptions. Based on the predefined criterion for feasibility, the unsupervised training was not feasible, although the criterion was almost met. The patients and staff mainly expressed positive attitudes towards the unsupervised training. As even a small training dosage has been shown to improve the physical performance of geriatric inpatients, the proposed intervention might be relevant if the interruptions are decreased in future large-scale trials and if the adherence is increased. ClinicalTrials.gov: NCT02702557, February 29, 2016. Data Protection Agency: 2016-42, February 25, 2016. Ethics Committee: No registration needed, December 8, 2015 (e-mail correspondence).

The effects of initial participation motivations on learning engagement in transition training for future general practitioners in rural China: perceived deterrents as mediator

PubMed Central

Cui, Guan-yu; Yao, Mei-lin; Zhang, Xia; Guo, Yan-kui; Li, Hui-min; Yao, Xiu-ping

2016-01-01

Background For the shortage of high-quality general practitioners (GPs) in China's rural areas, Chinese government has taken steps to encourage rural specialists to participate in transition training for future GPs. Specialists’ initial participation motivations and their perceived deterrents during training may play important roles for their learning engagement in the transition training. This study aimed at revealing the relationships among the variables of initial participation motivations, perceived deterrents in training, and learning engagement. Methods A questionnaire survey was used in this study. A total of 156 rural specialists who participated in transition training for future GPs filled out the questionnaire, which consisted of the measurements of initial participation motivations, perceived deterrents, and learning engagement in training. The data about specialists’ demographic variables were collected at the same time. Results The variance of initial escape/stimulations motivation significantly predicted the variance of learning engagement through the full mediating role of perceived deterrents in training. In addition, initial educational preparation motivations predicted the variance of learning engagement directly. Conclusions Specialists’ initial participation motivations and perceived deterrents in training played important roles for learning engagement in the transition training. PMID:27340086

Computerized Cognitive Training in Children With Autism and Intellectual Disabilities: Feasibility and Satisfaction Study

PubMed Central

Benyakorn, Songpoom; Calub, Catrina A; Riley, Steven J; Schneider, Andrea; Iosif, Ana-Maria; Solomon, Marjorie; Hessl, David

2018-01-01

Background Researchers are increasingly interested in testing and developing computerized cognitive training interventions for individuals with autism spectrum disorder due to the limited accessibility of treatments for this disorder. Understanding the feasibility of testing cognitive interventions for this population is critical, especially for individuals with ASD who have low to moderate intellectual ability. Objective The aim of the study was to evaluate the feasibility of computerized cognitive training as measured by attrition rate and a parent satisfaction survey. Methods A total of 26 participants aged 8-17 years with an autism spectrum disorder diagnosis and significant intellectual impairment were enrolled (mean age 11.1 years). They were instructed to complete 25 sessions of Cogmed Working Memory Training in 5 to 6 weeks with coach assistance. Attrition rate and parent satisfaction surveys were measured after the completion of training. Results Most participants (96%, 25/26) completed the training and indicated high satisfaction (>88%). However, among the participants who completed the training, 5 participants (19%) were unable to finish in 6 weeks, the recommended training period by Cogmed. Parents noted various positive (eg, voice-overs) and negative (eg, particular graphic and sounds associated with a stimulus) features of the game that they thought affected their child’s response. Conclusions Children with autism spectrum disorder and intellectual impairments can successfully participate in computerized cognitive training interventions but may require additional weeks to complete the training beyond the time needed for children without intellectual impairments. The overall completion rate, with extended time to complete the training, was high. Developers of cognitive training programs for this population should take into account potential issues regarding the noise level of stimuli and characteristics of the visual graphics. PMID:29802090

An International Survey on Taking Up a Career in Cardiovascular Research: Opportunities and Biases toward Would-Be Physician-Scientists.

PubMed

Biondi-Zoccai, Giuseppe; Cerrato, Enrico; Peruzzi, Mariangela; D'Ascenzo, Fabrizio; De Falco, Elena; Chimenti, Isotta; Sciarretta, Sebastiano; Marullo, Antonino G M; Cavarretta, Elena; Greco, Ernesto; Benedetto, Umberto; Pompilio, Giulio; Escaned, Javier; Abbate, Antonio; Carpentier, Alain; Chachques, Juan Carlos; Frati, Giacomo

2015-01-01

Cardiovascular research is the main shaper of clinical evidence underpinning decision making, with its cyclic progression of junior researchers to mature faculty members. Despite efforts at improving cardiovascular research training, several unmet needs persist. We aimed to appraise current perceptions on cardiovascular research training with an international survey. We administered a 20-closed-question survey to mentors and mentees belonging to different international institutions. A total of 247 (12%) surveys were available (out of 2,000 invitations). Overall, mentees and mentors were reasonably satisfied with the educational and research resources. Significant differences were found analyzing results according to gender, geographic area, training and full-time researcher status. Specifically, women proved significantly less satisfied than men, disclosed access to fewer resources and less support from mentors (all P<0.05). People working in institutions not located in North America or Northern/Central Europe were significantly less satisfied and disclosed much less support (both P<0.05). Those in training reported limited opportunities for collaboration (P = 0.009), and non-full-time researchers disclosed more limited access to tutors and formal grant writing training (both P<0.05). Several potential biases appear to be present in the way training in cardiovascular research is provided worldwide, including one against women. If confirmed, these data require proactive measures to decrease discriminations and improve the cardiovascular research training quality.

Effects of 6-week Nordic walking training on body composition and antioxidant status for women > 55 years of age.

PubMed

Cebula, Agata; Tyka, Anna Katarzyna; Pilch, Wanda; Szyguła, Zbigniew; Pałka, Tomasz; Sztafa-Cabała, Katarzyna; Frączek, Barbara; Tyka, Aleksander

2017-05-08

This study examined the effects of 6-week Nordic walking (NW) workout with individually customized intensity, on the body composition, and oxidative stress biomarkers for women > 55 years of age. Sixteen sedentary women (age 58.1±2.02 years old, body mass index (BMI) 26.74±2.72 kg/m2) worked out the NW 3 times/week over the 6-week period. Training intensity, which reflected the dominance of oxygen metabolism, was determined based on changes in physiological indicators during graded exercise on a treadmill (walking with poles). The body composition and oxidative stress biomarkers in blood were measured before and after the exercise routine. After the training period, body weight, body fat percentage, body mass index and uric acid levels in serum decreased significantly (p < 0.05). At the same time the plasma total antioxidant status increased considerably (p < 0.05), while the total oxidative status and the oxidized low-density lipoproteins concentration levels did not change significantly (p > 0.05). Within a relatively short time, the Nordic walking with the customized intensity level focused on the dominance of fat metabolism, decreased body fat and improved the blood antioxidant defense system for previously sedentary women. Int J Occup Med Environ Health 2017;30(3):445-454. This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.

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

DTIC Science & Technology

2016-03-01

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

Stakeholders' views of shared learning models in general practice: a national survey.

PubMed

van de Mortel, Thea; Silberberg, Peter; Ahern, Christine; Pit, Sabrina

2014-09-01

The number of learners requiring general practice placements creates supervisory capacity constraints. This research examined how a shared learning model may affect training capacity. The number of learners requiring general practice placements creates supervisory capacity constraints. This research examined how a shared learning model may affect training capacity. A total of 1122 surveys were completed: 75% of learners had participated in shared learning; 25% of multi-level learner practices were not using shared learning. Learners were positive about shared learning (4.3-4.4/5), considering it an effective way to learn that created training capacity (4.1-4.2/5). 79-88% of learners preferred a mixture of one-to-one teaching and shared learning. Supervisors thought shared learning was more cost- and time-efficient, and created training capacity (4.3-4.4/5). Shared learning models have the potential to increase GP training capacity. Many practices are not utilising shared learning, representing capacity loss. Regional training providers should emphasise positive aspects of shared learning to facilitate uptake.

Effects of 12-week brisk walking training on exercise blood pressure in elderly patients with essential hypertension: a pilot study.

PubMed

He, L I; Wei, Wang Ren; Can, Zhao

2018-01-24

Essential hypertension (EP) is characterized by blood pressure (BP) elevations, which often lead to target organ damage and cardiovascular illness. The following study investigates whether aerobic exercise programs with different intensities could reduce the magnitude of BP rise. Patients with essential hypertension were recruited from the Baoshan Community Health Service Center. A total of 46 patients were finally selected and randomly assigned into two groups: control group (CON) included patients who did not participate in exercise intervention training; treatment group (TRG) included patients who participated in 12-week brisk walking training (60-min of brisk walking, three times a week for a total of 12 weeks). 3-minute step tests of low and high intensity were conducted pre- and post-intervention. To compare the effects of exercise intervention, 23 subjects with normal blood pressure (NBP) who did not participate in 12-week brisk walking training, were recruited. After 12 weeks of brisk walking, SBP of TRG during resting, low and high-intensity exercise was significantly reduced by 8.3mmHg, 15.6mmHg, and 22.6mmHg, respectively; while HR of TRG's during resting, low and high intensity was significantly reduced by 3.6beats/minute, 8.7beats/minute and 11.3beats/minute, respectively. Meanwhile, after 12 weeks of brisk walking, TRG's steps per day, [Formula: see text]o 2max , moderate physical activity time and physical activity energy expenditure significantly increased by 6000 steps, 2.4 ml/kg/m, 40 minutes and 113 kcal, respectively. At the same time, TRG's body fat rate and sedentary time significantly reduced by 2% and 60 minutes per day. Brisk walking can reduce the magnitude of BP rise during exercise of different intensities and may be reduced the risk of acute cardiovascular incidents in elderly patients with essential hypertension. EP: Essential hypertension; BP: blood pressure; CON: control group; TRG: treatment group; NBP: normal blood pressure; PA: physical activity.

Weaving a Stronger Fabric for Improved Outcomes

ERIC Educational Resources Information Center

Lobry de Bruyn, Lisa; Prior, Julian; Lenehan, Jo

2014-01-01

Purpose: To explain how training and education events (TEEs) can be designed to increase the likelihood of achieving behavioural objectives. Approach: The approach combined both a quantitative review of evaluation surveys undertaken at the time of the TEE, and qualitative telephone interviews with selected attendees (2025% of the total population…

An Assessment of the Child Development Associate Competencies.

ERIC Educational Resources Information Center

Butler, Florence; And Others

Competencies for the Child Development Associates is a comprehensive, developmental training program for teachers of preschool children, in which the total design is to help children acquire the basic competencies and skills for full development, while at the same time assuring that the quality of the child's experiences is emotionally satisfying…

Identifying Efficiencies in the Supply Chain for Training Ammunition: Methods, Models, and Recommendations

DTIC Science & Technology

2016-01-01

Standard Army Ammunition System–Modernized ( SAAS -MOD), Total Army Munitions Information System (TAMIS), and the Worldwide Ammunition Reporting System...activities do your ASP personnel execute that are not captured in the Workload Report accessible in SAAS ? How much time would you estimate each of these

Use of the RSA/RCOD Index to Identify Training Priority in Soccer Players.

PubMed

Wong, Del P; Hjelde, Geir H; Cheng, Ching-Feng; Ngo, Jake K

2015-10-01

The use of RSA/RCOD index indicates the repeated change-of-direction (RCOD) performance relative to the repeated-sprint ability (RSA) and provides a standardized approach to prioritize training needs for RSA and RCOD. To compare the RSA/RCOD index among different age groups, RSA and RCOD were measured from 20 under-16 players (U16), 20 under-19 players (U19), and 17 first-team professional players (PRO) from a football (soccer) club that has regular participation in the UEFA Champions League. Each player performed the RSA and RCOD tests, during which the fastest time (FT), average time (AT), total time (TT), and percentage decrement score (%Dec) were recorded. No significant differences were found in RSA/RCOD index-FT, AT, TT, and %Dec among the 3 groups (p > 0.05) and between U19 and PRO in all RSA and RCOD measures (p > 0.05). Most values of RSA/RCOD index were 0.51 among the U16, U19, and PRO groups. Moreover, we concluded that the RSA/RCOD index might not be further changed after 16 years of age unless specific training programs for RSA and RCOD are prescribed. Therefore, this study provides an empirical case, and coaches can establish the RSA/RCOD index value relevant to their training system and monitor players' training needs of RSA and RCOD in a longer term.

Implementation of automated external defibrillators on merchant ships.

PubMed

Oldenburg, Marcus; Baur, Xaver; Schlaich, Clara

2011-01-01

In contrast to cruise ships, ferries and merchant ships are rarely equipped with automated external defibrillators (AEDs). Germany is the first flag state worldwide that legally requires to carry AEDs on seagoing merchant vessels by September 2012 at the latest. The aim of this study was to investigate the effect of training ship officers in the handling of AEDs and to explore their perceptions concerning the user-friendliness of currently available defibrillators. Using four different AEDs, 130 nautical officers performed a total of 400 resuscitation drills. One group (n = 60) used only one device before and after resuscitation training; the other group (n = 70) used all four AEDs in comparison after training. The officers' performances were timed and they were asked by questionnaire about the user-friendliness of each AED. Without resuscitation training, 81.7% of the first mentioned group delivered an effective defibrillation shock. After a 7-hour resuscitation training with special regard to defibrillation, all ship officers (n = 130) used the AED correctly. Among all AEDs, the mean time until start of analysis decreased from 72.4 seconds before to 60.4 seconds after resuscitation training (Wilcoxon test; p < 0.001). The results of the questionnaire and the differences in time to first shock indicated a different user-friendliness of the AEDs. The voice prompts and the screen messages of all AEDs were well understood by all participants. In the second mentioned group, 57.1% regarded feedback information related to depths and frequency of thorax compression as helpful. Nautical officers are able to use AEDs in a timely and effective way with proper training. However, to take advantage of all wanted features of the device (monitoring and resuscitation), the ship management has to observe practical questions of storage, maintenance, signing, training, data management, and transmission. Thus, implementation of the regulations requires proper instructions for the maritime industry by responsible bodies. © 2011 International Society of Travel Medicine.

Effectiveness of short-term endoscopic surgical skill training for young pediatric surgeons: a validation study using the laparoscopic fundoplication simulator.

PubMed

Jimbo, Takahiro; Ieiri, Satoshi; Obata, Satoshi; Uemura, Munenori; Souzaki, Ryota; Matsuoka, Noriyuki; Katayama, Tamotsu; Masumoto, Kouji; Hashizume, Makoto; Taguchi, Tomoaki

2015-10-01

Pediatric surgeons require highly advanced skills when performing endoscopic surgery; however, their experience is often limited in comparison to general surgeons. The aim of this study was to evaluate the effectiveness of endoscopic surgery training for less-experienced pediatric surgeons and then compare their skills before and after training. Young pediatric surgeons (n = 7) who participated in this study underwent a 2-day endoscopic skill training program, consisting of lectures, box training and live tissue training. The trainees performed the Nissen construction tasks before and after training using our objective evaluation system. A statistical analysis was conducted using the two-tailed paired Student's t tests. The time for task was 984 ± 220 s before training and 645 ± 92.8 s after training (p < 0.05). The total path length of both forceps was 37855 ± 10586 mm before training and 22582 ± 3045 mm after training (p < 0.05). The average velocity of both forceps was 26.1 ± 3.68 mm/s before training and 22.9 ± 2.47 mm/sec after training (p < 0.1). The right and left balance of suturing was improved after training (p < 0.05). Pediatric surgery trainees improved their surgical skills after receiving short-term training. We demonstrated the effectiveness of our training program, which utilized a new laparoscopic fundoplication simulator.

A study evaluating if targeted training for startle effect can improve pilot reactions in handling unexpected situations in a flight simulator

NASA Astrophysics Data System (ADS)

Gillen, Michael William

Recent airline accidents point to a crew's failure to make correct and timely decisions following a sudden and unusual event that startled the crew. This study sought to determine if targeted training could augment decision making during a startle event. Following a startle event cognitive function is impaired for a short duration of time (30-90 seconds). In aviation, critical decisions are often required to be made during this brief, but critical, time frame. A total of 40 volunteer crews (80 individual pilots) were solicited from a global U.S. passenger airline. Crews were briefed that they would fly a profile in the simulator but were not made aware of what the profile would entail. The study participants were asked to complete a survey on their background and flying preferences. Every other crew received training on how to handle a startle event. The training consisted of a briefing and simulator practice. Crew members (subjects) were either presented a low altitude or high altitude scenario to fly in a full-flight simulator. The maneuver scenarios were analyzed using a series of one-way ANOVAs, t-tests and regression for the main effect of training on crew performance. The data indicated that the trained crews flew the maneuver profiles significantly better than the untrained crews and significantly better than the Federal Aviation Administration (FAA) Airline Transport Pilot (ATP) standards. Each scenario's sub factors were analyzed using regression to examine for specific predictors of performance. The results indicate that in the case of the high altitude profile, problem diagnosis was a significant factor, in the low altitude profile, time management was also a significant factor. These predicators can be useful in further targeting training. The study's findings suggest that targeted training can help crews manage a startle event, leading to a potential reduction of inflight loss of control accidents. The training was broad and intended to cover an overall aircraft handling approach rather than being aircraft specific. Inclusion of this type of training by airlines has the potential to better aid crews in handling sudden and unusual events.

Effects of Two Training Modalities on Body Fat and Insulin Resistance in Postmenopausal Women.

PubMed

Henríquez, Sandra; Monsalves-Alvarez, Matías; Jimenez, Teresa; Barrera, Gladys; Hirsch, Sandra; de la Maza, María Pia; Leiva, Laura; Rodriguez, Juan Manuel; Silva, Claudio; Bunout, Daniel

2017-11-01

Henríquez, S, Monsalves-Alvarez, M, Jimenez, T, Barrera, G, Hirsch, S, de la Maza, MP, Leiva, L, Rodriguez, JM, Silva, C, and Bunout, D. Effects of two training modalities on body fat and insulin resistance in postmenopausal women. J Strength Cond Res 31(11): 2955-2964, 2017-Our objective was to compare the effects of a low-load circuit resistance training protocol and usual aerobic training in postmenopausal women. Postmenopausal women with at least 1 feature of the metabolic syndrome were randomly allocated to a low-load circuit resistance training protocol or traditional aerobic training in a braked cycle ergometer. The intervention consisted in supervised sessions lasting 40 minutes, 3 times per week, during 6 months. At baseline and at the end of the intervention, fasting serum lipid levels, serum interleukin 6, C-reactive protein, 8 isoprostanes, and insulin resistance (assessed through QUICKI and HOMA-IR) were measured. Body fat was measured by double-beam X-ray absorptiometry and by computed tomography densitometric quantification at lumbar 3 vertebral level. Twenty-one women aged 58 (54-59) years were allocated to aerobic training and 21 women aged 55 (52-61) years were allocated to the low-load circuit resistance training protocol. Eighteen and 16 women in each group completed the 6 months training period. Women in both groups experienced significant reductions in blood pressure, total body, subcutaneous, and intraabdominal body fat. Reductions in total cholesterol and triacylglycerol levels were also observed. No changes in insulin resistance indexes, 8 isoprostanes, C-reactive protein, or interleukin 6 were observed in either group. No significant differences between treatment groups were observed in any of the measured parameters. We conclude that low-load circuit resistance training and aerobic training resulted in the same reductions in body fat and serum lipid levels.

Increases in Emotional Intelligence After an Online Training Program Are Associated With Better Decision-Making on the Iowa Gambling Task.

PubMed

Alkozei, Anna; Smith, Ryan; Demers, Lauren A; Weber, Mareen; Berryhill, Sarah M; Killgore, William D S

2018-01-01

Higher levels of emotional intelligence have been associated with better inter and intrapersonal functioning. In the present study, 59 healthy men and women were randomized into either a three-week online training program targeted to improve emotional intelligence ( n = 29), or a placebo control training program targeted to improve awareness of nonemotional aspects of the environment ( n = 30). Compared to placebo, participants in the emotional intelligence training group showed increased performance on the total emotional intelligence score of the Mayer-Salovey-Caruso Emotional Intelligence Test, a performance measure of emotional intelligence, as well as subscales of perceiving emotions and facilitating thought. Moreover, after emotional intelligence training, but not after placebo training, individuals displayed the ability to arrive at optimal performance faster (i.e., they showed a faster learning rate) during an emotion-guided decision-making task (i.e., the Iowa Gambling Task). More specifically, although both groups showed similar performance at the start of the Iowa Gambling Task from pre- to posttraining, the participants in the emotional intelligence training group learned to choose more advantageous than disadvantageous decks than those in the placebo training group by the time they reached the "hunch" period of the task (i.e., the point in the task when implicit task learning is thought to have occurred). Greater total improvements in performance on the Iowa Gambling Task from pre- to posttraining in the emotional intelligence training group were also positively correlated with pre- to posttraining changes in Mayer-Salovey-Caruso Emotional Intelligence Test scores, in particular with changes in the ability to perceive emotions. The present study provides preliminary evidence that emotional intelligence can be trained with the help of an online training program targeted at adults; it also suggests that changes in emotional intelligence, as a result of such a program, can lead to improved emotion-guided decision-making.

The development and application of an injury prediction model for noncontact, soft-tissue injuries in elite collision sport athletes.

PubMed

Gabbett, Tim J

2010-10-01

Limited information exists on the training dose-response relationship in elite collision sport athletes. In addition, no study has developed an injury prediction model for collision sport athletes. The purpose of this study was to develop an injury prediction model for noncontact, soft-tissue injuries in elite collision sport athletes. Ninety-one professional rugby league players participated in this 4-year prospective study. This study was conducted in 2 phases. Firstly, training load and injury data were prospectively recorded over 2 competitive seasons in elite collision sport athletes. Training load and injury data were modeled using a logistic regression model with a binomial distribution (injury vs. no injury) and logit link function. Secondly, training load and injury data were prospectively recorded over a further 2 competitive seasons in the same cohort of elite collision sport athletes. An injury prediction model based on planned and actual training loads was developed and implemented to determine if noncontact, soft-tissue injuries could be predicted and therefore prevented in elite collision sport athletes. Players were 50-80% likely to sustain a preseason injury within the training load range of 3,000-5,000 units. These training load 'thresholds' were considerably reduced (1,700-3,000 units) in the late-competition phase of the season. A total of 159 noncontact, soft-tissue injuries were sustained over the latter 2 seasons. The percentage of true positive predictions was 62.3% (n = 121), whereas the total number of false positive and false negative predictions was 20 and 18, respectively. Players that exceeded the training load threshold were 70 times more likely to test positive for noncontact, soft-tissue injury, whereas players that did not exceed the training load threshold were injured 1/10 as often. These findings provide information on the training dose-response relationship and a scientific method of monitoring and regulating training load in elite collision sport athletes.

Somatotype, training and performance in Ironman athletes.

PubMed

Kandel, Michel; Baeyens, Jean Pierre; Clarys, Peter

2014-01-01

The aim of this study was to describe the physiques of Ironman athletes and the relationship between Ironman's performance, training and somatotype. A total of 165 male and 22 female competitors of the Ironman Switzerland volunteered in this study. Ten anthropometric dimensions were measured, and 12 training and history variables were recorded with a questionnaire. The variables were compared with the race performance. The somatotype was a strong predictor of Ironman performance (R=0.535; R(2)=0.286; sign. p<0.001) in male athletes. The endomorphy component was the most substantial predictor. Reductions in endomorphy by one standard deviation as well as an increased ectomorphy value by one standard deviation lead to significant and substantial improvement in Ironman performance (28.1 and 29.8 minutes, respectively). An ideal somatotype of 1.7-4.9-2.8 could be established. Age and quantitative training effort were not significant predictors on Ironman performance. In female athletes, no relationship between somatotype, training and performance was found. The somatotype of a male athlete defines for 28.6% variance in Ironman performance. Athletes not having an ideal somatotype of 1.7-4.9-2.8 could improve their performance by altering their somatotype. Lower rates in endomorphy, as well as higher rates in ectomorphy, resulted in a significant better race performance. The impact of somatotype was the most distinguished on the run discipline and had a much greater impact on the total race time than the quantitative training effort. These findings could not be found in female athletes.

Comparable Effects of High-Intensity Interval Training and Prolonged Continuous Exercise Training on Abdominal Visceral Fat Reduction in Obese Young Women.

PubMed

Zhang, Haifeng; Tong, Tom K; Qiu, Weifeng; Zhang, Xu; Zhou, Shi; Liu, Yang; He, Yuxiu

2017-01-01

This study compared the effect of prolonged moderate-intensity continuous training (MICT) on reducing abdominal visceral fat in obese young women with that of work-equivalent (300 kJ/training session) high-intensity interval training (HIIT). Forty-three participants received either HIIT ( n = 15), MICT ( n = 15), or no training (CON, n = 13) for 12 weeks. The abdominal visceral fat area (AVFA) and abdominal subcutaneous fat area (ASFA) of the participants were measured through computed tomography scans preintervention and postintervention. Total fat mass and the fat mass of the android, gynoid, and trunk regions were assessed through dual-energy X-ray absorptiometry. Following HIIT and MICT, comparable reductions in AVFA (-9.1, -9.2 cm 2 ), ASFA (-35, -28.3 cm 2 ), and combined AVFA and ASFA (-44.7, -37.5 cm 2 , p > 0.05) were observed. Similarly, reductions in fat percentage (-2.5%, -2.4%), total fat mass (-2.8, -2.8 kg), and fat mass of the android (-0.3, -0.3 kg), gynoid (-0.5, -0.7 kg), and trunk (-1.6, -1.2 kg, p > 0.05) regions did not differ between HIIT and MICT. No variable changed in CON. In conclusion, MICT consisting of prolonged sessions has no quantitative advantage, compared with that resulting from HIIT, in abdominal visceral fat reduction. HIIT appears to be the predominant strategy for controlling obesity because of its time efficiency.

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

Jager, Yetta; Bevelhimer, Mark S; al., et.

Military landscapes represent a mixture of undisturbed natural ecosystems, developed areas, and lands that support different types and intensities of military training. Research to understand water-quality influences of military landscapes usually involves intensive sampling in a few watersheds. In this study, we developed a survey design of accessible headwater watersheds intended to improve our ability to distinguish land water relationships in general, and training influences, in particular, on Fort Stewart, GA. We sampled and analyzed water from watershed outlets. We successfully developed correlative models for total suspended solids (TSS), total nitrogen (TN), organic carbon (OC), and organic nitrogen (ON), whichmore » dominated in this blackwater ecosystem. TSS tended to be greater in samples after rainfall and during the growing season, and models that included %Wetland suggested a build-and-flush relationship. We also detected a positive association between TSS and tank-training, which suggests a need to intercept sediment-laden runoff from training areas. Models for OC showed a negative association with %Grassland. TN and ON both showed negative associations with %Grassland, %Wetland, and %Forest. Unexpected positive associations were observed between OC and equipmenttraining activity and between ON and %Bare ground ? Roads. Future studies that combine our survey-based approach with more intensive monitoring of the timing and intensity of training would be needed to better understand the mechanisms for these empirical relationships involving military training. Looking beyond local effects on Fort Stewart streams, we explore questions about how exports of OC and nitrogen from coastal military installations ultimately influence estuaries downstream.« less

Best practice for motor imagery: a systematic literature review on motor imagery training elements in five different disciplines

PubMed Central

2011-01-01

Background The literature suggests a beneficial effect of motor imagery (MI) if combined with physical practice, but detailed descriptions of MI training session (MITS) elements and temporal parameters are lacking. The aim of this review was to identify the characteristics of a successful MITS and compare these for different disciplines, MI session types, task focus, age, gender and MI modification during intervention. Methods An extended systematic literature search using 24 databases was performed for five disciplines: Education, Medicine, Music, Psychology and Sports. References that described an MI intervention that focused on motor skills, performance or strength improvement were included. Information describing 17 MITS elements was extracted based on the PETTLEP (physical, environment, timing, task, learning, emotion, perspective) approach. Seven elements describing the MITS temporal parameters were calculated: study duration, intervention duration, MITS duration, total MITS count, MITS per week, MI trials per MITS and total MI training time. Results Both independent reviewers found 96% congruity, which was tested on a random sample of 20% of all references. After selection, 133 studies reporting 141 MI interventions were included. The locations of the MITS and position of the participants during MI were task-specific. Participants received acoustic detailed MI instructions, which were mostly standardised and live. During MI practice, participants kept their eyes closed. MI training was performed from an internal perspective with a kinaesthetic mode. Changes in MI content, duration and dosage were reported in 31 MI interventions. Familiarisation sessions before the start of the MI intervention were mentioned in 17 reports. MI interventions focused with decreasing relevance on motor-, cognitive- and strength-focused tasks. Average study intervention lasted 34 days, with participants practicing MI on average three times per week for 17 minutes, with 34 MI trials. Average total MI time was 178 minutes including 13 MITS. Reporting rate varied between 25.5% and 95.5%. Conclusions MITS elements of successful interventions were individual, supervised and non-directed sessions, added after physical practice. Successful design characteristics were dominant in the Psychology literature, in interventions focusing on motor and strength-related tasks, in interventions with participants aged 20 to 29 years old, and in MI interventions including participants of both genders. Systematic searching of the MI literature was constrained by the lack of a defined MeSH term. PMID:21682867

Web-Based Therapist Training in Interpersonal Psychotherapy for Depression: Pilot Study

PubMed Central

Lipsitz, Joshua D; Markowitz, John C; Bleiberg, Kathryn L

2017-01-01

Background Training mental health professionals to deliver evidence-based therapy (EBT) is now required by most academic accreditation bodies, and evaluating the effectiveness of such training is imperative. However, shortages of time, money, and trained EBT clinician teachers make these challenges daunting. New technologies may help. The authors have developed the first empirically evaluated comprehensive Internet therapist training program for interpersonal psychotherapy (IPT). Objective The aim of this study was to examine whether (1) the training protocol would increase clinicians’ knowledge of IPT concepts and skills and (2) clinicians would deem the training feasible as measured by satisfaction and utility ratings. Methods A total of 26 clinicians enrolled in the training, consisting of (1) a Web-based tutorial on IPT concepts and techniques; (2) live remote training via videoconference, with trainees practicing IPT techniques in a role-play using a case vignette; and (3) a Web-based portal for therapists posttraining use to help facilitate implementation of IPT and maintain adherence over time. Results Trainees’ knowledge of IPT concepts and skills improved significantly (P<.001). The standardized effect size for the change was large: d=2.53, 95% CI 2.23-2.92. Users found the technical features easy to use, the content useful for helping them treat depressed clients, and felt the applied training component enhanced their professional expertise. Mean rating of applied learning was 3.9 (scale range from 1=very little to 5=a great deal). Overall satisfaction rating was 3.5 (range from 1=very dissatisfied to 4=very satisfied). Conclusions Results support the efficacy and feasibility of this technology in training clinicians in EBTs and warrant further empirical evaluation. PMID:28716769

Web-Based Therapist Training in Interpersonal Psychotherapy for Depression: Pilot Study.

PubMed

Kobak, Kenneth A; Lipsitz, Joshua D; Markowitz, John C; Bleiberg, Kathryn L

2017-07-17

Training mental health professionals to deliver evidence-based therapy (EBT) is now required by most academic accreditation bodies, and evaluating the effectiveness of such training is imperative. However, shortages of time, money, and trained EBT clinician teachers make these challenges daunting. New technologies may help. The authors have developed the first empirically evaluated comprehensive Internet therapist training program for interpersonal psychotherapy (IPT). The aim of this study was to examine whether (1) the training protocol would increase clinicians' knowledge of IPT concepts and skills and (2) clinicians would deem the training feasible as measured by satisfaction and utility ratings. A total of 26 clinicians enrolled in the training, consisting of (1) a Web-based tutorial on IPT concepts and techniques; (2) live remote training via videoconference, with trainees practicing IPT techniques in a role-play using a case vignette; and (3) a Web-based portal for therapists posttraining use to help facilitate implementation of IPT and maintain adherence over time. Trainees' knowledge of IPT concepts and skills improved significantly (P<.001). The standardized effect size for the change was large: d=2.53, 95% CI 2.23-2.92. Users found the technical features easy to use, the content useful for helping them treat depressed clients, and felt the applied training component enhanced their professional expertise. Mean rating of applied learning was 3.9 (scale range from 1=very little to 5=a great deal). Overall satisfaction rating was 3.5 (range from 1=very dissatisfied to 4=very satisfied). Results support the efficacy and feasibility of this technology in training clinicians in EBTs and warrant further empirical evaluation. ©Kenneth A Kobak, Joshua D Lipsitz, John C Markowitz, Kathryn L Bleiberg. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 17.07.2017.

Training-specific functional, neural, and hypertrophic adaptations to explosive- vs. sustained-contraction strength training.

PubMed

Balshaw, Thomas G; Massey, Garry J; Maden-Wilkinson, Thomas M; Tillin, Neale A; Folland, Jonathan P

2016-06-01

Training specificity is considered important for strength training, although the functional and underpinning physiological adaptations to different types of training, including brief explosive contractions, are poorly understood. This study compared the effects of 12 wk of explosive-contraction (ECT, n = 13) vs. sustained-contraction (SCT, n = 16) strength training vs. control (n = 14) on the functional, neural, hypertrophic, and intrinsic contractile characteristics of healthy young men. Training involved 40 isometric knee extension repetitions (3 times/wk): contracting as fast and hard as possible for ∼1 s (ECT) or gradually increasing to 75% of maximum voluntary torque (MVT) before holding for 3 s (SCT). Torque and electromyography during maximum and explosive contractions, torque during evoked octet contractions, and total quadriceps muscle volume (QUADSVOL) were quantified pre and post training. MVT increased more after SCT than ECT [23 vs. 17%; effect size (ES) = 0.69], with similar increases in neural drive, but greater QUADSVOL changes after SCT (8.1 vs. 2.6%; ES = 0.74). ECT improved explosive torque at all time points (17-34%; 0.54 ≤ ES ≤ 0.76) because of increased neural drive (17-28%), whereas only late-phase explosive torque (150 ms, 12%; ES = 1.48) and corresponding neural drive (18%) increased after SCT. Changes in evoked torque indicated slowing of the contractile properties of the muscle-tendon unit after both training interventions. These results showed training-specific functional changes that appeared to be due to distinct neural and hypertrophic adaptations. ECT produced a wider range of functional adaptations than SCT, and given the lesser demands of ECT, this type of training provides a highly efficient means of increasing function. Copyright © 2016 the American Physiological Society.

Benefits of exercise training and the correlation between aerobic capacity and functional outcomes and quality of life in elderly patients with coronary artery disease.

PubMed

Chen, Chia-Hsin; Chen, Yi-Jen; Tu, Hung-Pin; Huang, Mao-Hsiung; Jhong, Jing-Hui; Lin, Ko-Long

2014-10-01

Cardiopulmonary exercise training is beneficial to people with coronary artery disease (CAD). Nevertheless, the correlation between aerobic capacity, and functional mobility and quality of life in elderly CAD patients is less addressed. The purpose of the current study is to investigate the beneficial effects of exercise training in elderly people with CAD, integrating exercise stress testing, functional mobility, handgrip strength, and health-related quality of life. Elderly people with CAD were enrolled from the outpatient clinic of a cardiac rehabilitation unit in a medical center. Participants were assigned to the exercise training group (N = 21) or the usual care group (N = 15). A total of 36 sessions of exercise training, completed in 12 weeks, was prescribed. Echocardiography, exercise stress testing, the 6-minute walking test, Timed Up and Go test, and handgrip strength testing were performed, and the Short-Form 36 questionnaire (SF-36) was administered at baseline and at 12-week follow-up. Peak oxygen consumption improved significantly after training. The heart rate recovery improved from 13.90/minute to 16.62/minute after exercise training. Functional mobility and handgrip strength also improved after training. Significant improvements were found in SF-36 physical function, social function, role limitation due to emotional problems, and mental health domains. A significant correlation between dynamic cardiopulmonary exercise testing parameters, the 6-minute walking test, Timed Up and Go test, handgrip strength, and SF-36 physical function and general health domains was also detected. Twelve-week, 36-session exercise training, including moderate-intensity cardiopulmonary exercise training, strengthening exercise, and balance training, is beneficial to elderly patients with CAD, and cardiopulmonary exercise testing parameters correlate well with balance and quality of life. Copyright © 2014. Published by Elsevier Taiwan.

Gait mechanics and tibiofemoral loading in men of the ACL-SPORTS randomized control trial.

PubMed

Capin, Jacob J; Khandha, Ashutosh; Zarzycki, Ryan; Arundale, Amelia J H; Ziegler, Melissa L; Manal, Kurt; Buchanan, Thomas S; Snyder-Mackler, Lynn

2018-03-25

The risk for post-traumatic osteoarthritis is elevated after anterior cruciate ligament reconstruction (ACLR), and may be especially high among individuals with aberrant walking mechanics, such as medial tibiofemoral joint underloading 6 months postoperatively. Rehabilitation training programs have been proposed as one strategy to address aberrant gait mechanics. We developed the anterior cruciate ligament specialized post-operative return-to-sports (ACL-SPORTS) randomized control trial to test the effect of 10 post-operative training sessions consisting of strength, agility, plyometric, and secondary prevention exercises (SAPP) or SAPP plus perturbation (SAPP + PERT) training on gait mechanics after ACLR. A total of 40 male athletes (age 23 ± 7 years) after primary ACLR were randomized to SAPP or SAPP + PERT training and tested at three distinct, post-operative time points: 1) after impairment resolution (Pre-training); 2) following 10 training sessions (Post-training); and 3) 2 years after ACLR. Knee kinematic and kinetic variables as well as muscle and joint contact forces were calculated via inverse dynamics and a validated electromyography-informed musculoskeletal model. There were no significant improvements from Pre-training to Post-training in either intervention group. Smaller peak knee flexion angles, extension moments, extensor muscle forces, medial compartment contact forces, and tibiofemoral contact forces were present across group and time, however the magnitude of interlimb differences were generally smaller and likely not meaningful 2 years postoperatively. Neither SAPP nor SAPP + PERT training appears effective at altering gait mechanics in men in the short-term; however, meaningful gait asymmetries mostly resolved between post-training and 2 years after ACLR regardless of intervention group. © 2018 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res. © 2018 Orthopaedic Research Society. Published by Wiley Periodicals, Inc.

Evaluation of a community-based training to promote responsible self-medication in East Java, Indonesia.

PubMed

Setiadi, Adji P; Wibowo, Yosi; Setiawan, Eko; Presley, Bobby; Mulyono, Ika; Wardhani, Ari S; Sunderland, Bruce

2018-05-24

To explore pharmacist/pharmacy staff trainers' perspectives on conducting community-based training to promote responsible self-medication, and to evaluate knowledge gained among community representatives participating in the training. Training was conducted in four districts/cities in East Java, Indonesia in 2016. A pre-test/post-test study was used to evaluate the knowledge of 129 community representatives (participants) before/after the training; pre-test and post-test scores as well as absolute gain were determined. Four focus group discussions with 20 pharmacist/pharmacy staff (trainers) were conducted after the training, and the data were thematically analysed. Overall mean test scores for community representatives significantly improved from 14.11 to 15.70 after the training (P < 0.001). The average total absolute gain was 1.85 (95% CI 1.29 to 2.39). To reach local communities, trainers suggested improvements to the content and structure of the module, training aids, trainer competency, approach and time allocation. Community-based training provides a potential strategy to improve community knowledge of medications. Findings from this study should inform strategies for a broader uptake amongst local communities in Indonesia. © 2018 Royal Pharmaceutical Society.

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

The NLstart2run study: Training-related factors associated with running-related injuries in novice runners.

PubMed

Kluitenberg, Bas; van der Worp, Henk; Huisstede, Bionka M A; Hartgens, Fred; Diercks, Ron; Verhagen, Evert; van Middelkoop, Marienke

2016-08-01

The incidence of running-related injuries is high. Some risk factors for injury were identified in novice runners, however, not much is known about the effect of training factors on injury risk. Therefore, the purpose of this study was to examine the associations between training factors and running-related injuries in novice runners, taking the time varying nature of these training-related factors into account. Prospective cohort study. 1696 participants completed weekly diaries on running exposure and injuries during a 6-week running program for novice runners. Total running volume (min), frequency and mean intensity (Rate of Perceived Exertion) were calculated for the seven days prior to each training session. The association of these time-varying variables with injury was determined in an extended Cox regression analysis. The results of the multivariable analysis showed that running with a higher intensity in the previous week was associated with a higher injury risk. Running frequency was not significantly associated with injury, however a trend towards running three times per week being more hazardous than two times could be observed. Finally, lower running volume was associated with a higher risk of sustaining an injury. These results suggest that running more than 60min at a lower intensity is least injurious. This finding is contrary to our expectations and is presumably the result of other factors. Therefore, the findings should not be used plainly as a guideline for novices. More research is needed to establish the person-specific training patterns that are associated with injury. Copyright © 2015 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

Skill acquisition while operating in-vehicle information systems: interface design determines the level of safety-relevant distractions.

PubMed

Jahn, Georg; Krems, Josef F; Gelau, Christhard

2009-04-01

This study tested whether the ease of learning to use human-machine interfaces of in-vehicle information systems (IVIS) can be assessed at standstill. Assessing the attentional demand of IVIS should include an evaluation of ease of learning, because the use of IVIS at low skill levels may create safety-relevant distractions. Skill acquisition in operating IVIS was quantified by fitting the power law of practice to training data sets collected in a driving study and at standstill. Participants practiced manual destination entry with two route guidance systems differing in cognitive demand. In Experiment 1, a sample of middle-aged participants was trained while steering routes of varying driving demands. In Experiment 2, another sample of middle-aged participants was trained at standstill. In Experiment 1, display glance times were less affected by driving demands than by total task times and decreased at slightly higher speed-up rates (0.02 higher on average) than task times collected at standstill in Experiment 2. The system interface that minimized cognitive demand was operated more quickly and was easier to learn. Its system delays increased static task times, which still predicted 58% of variance in display glance times compared with even 76% for the second system. The ease of learning to use an IVIS interface and the decrease in attentional demand with training can be assessed at standstill. Fitting the power law of practice to static task times yields parameters that predict display glance times while driving, which makes it possible to compare interfaces with regard to ease of learning.

Developing web-based training for public health practitioners: what can we learn from a review of five disciplines?

PubMed Central

Ballew, Paula; Castro, Sarah; Claus, Julie; Kittur, Nupur; Brennan, Laura; Brownson, Ross C.

2013-01-01

During a time when governmental funding, resources and staff are decreasing and travel restrictions are increasing, attention to efficient methods of public health workforce training is essential. A literature review was conducted to inform the development and delivery of web-based trainings for public health practitioners. Literature was gathered and summarized from five disciplines: Information Technology, Health, Education, Business and Communications, following five research themes: benefits, barriers, retention, promotion and evaluation. As a result, a total of 138 articles relevant to web-based training design and implementation were identified. Key recommendations emerged, including the need to conduct formative research and evaluation, provide clear design and layout, concise content, interactivity, technical support, marketing and promotion and incentives. We conclude that there is limited application of web-based training in public health. This review offers an opportunity to learn from other disciplines. Web-based training methods may prove to be a key training strategy for reaching our public health workforce in the environment of limited resources. PMID:22987862

Evaluation of the breast cancer train the trainer program for nurses in Turkey.

PubMed

Karayurt, Ozgul; Gürsoy, Ayla Akkaş; Taşçi, Sultan; Gündoğdu, Fatma

2010-09-01

The Breast Cancer Train the Trainer (TTT) program was designed to increase breast cancer awareness, improve knowledge about breast cancer among nurses, and provide quality care for breast cancer patients by trained nurses. A total of three programs were held and 82 nurses from different regions of Turkey attended this training. The educational activities employed several teaching and learning strategies. After completion, we determined that the participating nurses' knowledge on breast cancer had increased significantly, and they were satisfied with the training received. The Breast Cancer TTT program is a unique educational endeavor for nurses in Turkey, and our results showed that the training achieved its goal. Trained nurses in Breast Cancer TTT programs can help educate women about the importance of breast health and the measures they need to take to protect themselves against breast cancer. At the same time, nurses can also increase and enhance the quality of life in patients with breast cancer. This is an example of a program that can easily be spread throughout the world as it was done from England and Australia to Turkey.

Video-game-assisted physiotherapeutic scoliosis-specific exercises for idiopathic scoliosis: case series and introduction of a new tool to increase motivation and precision of exercise performance.

PubMed

Wibmer, Christine; Groebl, Petra; Nischelwitzer, Alexander; Salchinger, Beate; Sperl, Matthias; Wegmann, Helmut; Holzer, Hans-Peter; Saraph, Vinay

2016-01-01

It is important to monitor how patients with juvenile and adolescent idiopathic scoliosis comply with their physiotherapeutic scoliosis-specific exercises (PSSE). Physiogame, a newly developed video game using the Game-Trak 3D interactive game controller, combines correct PSSE performance with gaming. It tracks the position of the working limb in 3D space during the exercises as participants aim to hit certain targets and avoid others, and gives direct feedback by stopping the game if the working limb leaves the target 3D space, which is chosen to secure the corrective position according to the Schroth method. Physiogame records the quality and frequency of the exercises performed. We aimed to investigate the influence of this tool on motivation to perform regularly and, correctly, and with self-assessment of performance quality. This case series included 8 consecutive patients with idiopathic scoliosis (thoracolumbar 7, lumbar 1), ages 7-13 years, all female and treated according to SOSORT guidelines; the COBB angle of primary curve at the start of brace therapy was 22-34°. In addition to Full Time Rigid Bracing (FTRB, Cheneau) and PSSE (Schroth), the participants were to perform two standardized Schroth exercises (muscle cylinder in standing position, mainly addressing the thoracic curve, and in side-lying position, mainly addressing the lumbar curve) with video game assistance every day for 6 months. The development (first to last month) of the following parameters was analyzed with descriptive methods: the actual training time to assess motivation, the ratio of the actual playing time versus total playing time to assess exercise improvement, and self-assessment of quality of performance. The average number of sessions with Physiogame was 217 per study participant (range 24 to 572, the study protocol targeted at least 180); actual training time decreased from 79 to 52 min (first to last month). Actual playing time increased from 73% of the total playing time to 83% (first to last month), and positive hits per second from 0.33 to 0.56. Self-assessment increased from "good" to "very good". The curve angles (°Cobb) were maintained over the study period (upper thoracic mean -1.3°, median -1°; lower thoracic mean 3°, median 2°; lumbar mean 0.5, median 0). The improvement we saw in exercise performance, is thought to result primarily from the direct given feedback during the game, as the exercises themselves were already familiar to the patients. The synchronous recording of actual training time allows evaluation of Schroth therapy for idiopathic scoliosis, since both prescribed training time and actual training time are captured. No comparable tool was found in literature.

Effect of low-flow anesthesia education on knowledge, attitude and behavior of the anesthesia team.

PubMed

Hanci, Volkan; Yurtlu, Serhan; Ayoğlu, Hilal; Okyay, Rahşan Dilek; Erdoğan, Gülay; Abduşoğlu, Mustafa; Sayin, Esin; Turan, Işil Ozkoçak

2010-08-01

The aim of this study was to evaluate the effect of education on the knowledge, attitude and behavior of anesthesiology staff and residents towards low-flow anesthesia. The staff and residents in the Department of Anesthesia and Reanimation, Zonguldak Karaelmas University were given theoretical and practical training in delivering low-flow anesthesia. To evaluate their attitudes and behaviors toward low-flow anesthesia, we collected data during the 6 months before training, during the first 3 months after training, and at 4-6 months after training. Anesthesia follow-up records, operation time, volatile anesthetic agent used, and the amount (in liters) of fresh gas low mid-anesthesia were recorded in all three stages. A total of 3,158 patients received general anesthesia and inhalation anesthesia was used in 3,115 of these patients. Our study group consisted of 2,752 patients who had no absolute or relative contraindications to low-flow anesthesia. While the mean fresh gas flow was 4.00 +/- 0.00 L/min before training, this level dropped to 2.98 L/min in the first 3 months after training, and to 3.26 L/min in the following 3 months. The mean fresh gas flow was significantly lower at the two post-training assessments than before training (p < 0.05). In conclusion, low-flow anesthesia may be used more frequently if educational seminars are provided to anesthetists. The use of low-flow anesthesia may increase further by allocating more time to this technique in anesthesia training programs provided at regular intervals. Copyright 2010 Elsevier. Published by Elsevier B.V. All rights reserved.

Reserve Component Personnel Issues: Questions and Answers

DTIC Science & Technology

2017-01-18

100 per month (not to exceed $1,200 total), a one- time relocation and travel assistance payment of $500, a payment of up to $2,000 for each licensure...provide trained units and qualified persons available for active duty in the armed forces, in time of war or national emergency, and at such other... times as the national security may require, to fill the needs of the armed forces whenever more units and persons are needed than are in the regular

Determination of sensation threshold from small pulse trains of 2.01μm laser light

NASA Astrophysics Data System (ADS)

Dugan, Daniel C.; Johnson, Thomas E.

2009-02-01

The determination of sensation thresholds has applications ranging from uses in the medical community such as neural pathway mapping and for the diagnosis of diabetic neuropathy, to potential uses in determining safety standards. This study sought to determine the sensation threshold, and the distribution of sensation probabilities, for pulse trains ranging from two 10 ms pulses to nine 10 ms pulses from 2.01 μm laser light incident on a human forearm and chest. Threshold was defined as the energy density that would elicit sensation 50% of the time (ED50). A method of levels approach was used in conjunction with a monovariate binary response model to determine the ED50. We determined the ED50 and also a distribution of threshold probabilities. Threshold was found to be largely dependant on total energy deposited for smaller pulse trains, and thus independent of the number of pulses. Total energy becomes less important as the number of pulses increases however, and a decrease in threshold was measured for a nine pulse train as compared to one through four pulse trains. Thus we have demonstrated that this method is a useful and easy way for determining sensation thresholds from a 2.01 μm laser for possible clinical use. We have also demonstrated that lower power lasers when pulsed can elicit sensation at comparable levels to higher power single pulse lasers.

Influence of changing work patterns on training in anaesthesia: an analysis of activity in a UK teaching hospital from 1996 to 2004.

PubMed

Underwood, S M; McIndoe, A K

2005-11-01

We aimed to assess the influence of reduced working hours on training in a UK teaching hospital as the specialist registrar grade was introduced in 1996, the New Deal was implemented in 2001 and the Working Time Directive (WTD) took effect for doctors in training in 2004. We analysed data from operating theatres in our hospital looking at grade of anaesthetist, time of day, emergency category, and specialty for more than 50,000 cases. Although direct supervision of trainees increased from 32 to 37 to 47%, senior house officer (SHO) and specialist registrar (SpR) caseload reduced by 20 and 21%, respectively, while that of the consultants rose. The reduction in total operating theatre cases for our trainees was evident across the epochs analysed, case numbers fell after introduction of the New Deal as well as more recently following the WTD, particularly for SHOs who are now doing a larger proportion of their work at night. SHOs and SpRs are doing more obstetric cases than in previous times but these are regional and not general anaesthetics.

Subspeciality training in hematology and oncology, 2003: results of a survey of training program directors conducted by the American Society of Hematology.

PubMed

Todd, Robert F; Gitlin, Scott D; Burns, Linda J

2004-06-15

A survey of directors of adult and pediatric hematology/oncology subspecialty training programs in the United States and Canada was conducted to assess the environment in which recruitment and training is conducted in these medical disciplines. A total of 107 program directors responded to the survey, representing 66% of internal medicine and 47% of pediatric subspecialty programs in hematology or hematology/oncology. Specific areas covered in the web-based questionnaire included the type and demographics of the training program, profile of the training program director, characteristics of the applicant pool and existing trainee recruits, characteristics of the training program environment and curricula, research productivity of trainees, and the career pathways taken by recent training program graduates (including dominant areas of clinical interest). The results of this survey show considerable heterogeneity in the recruiting practices and the environment in which subspecialty training occurs, leading the authors to recommend improvements in or a heightened attention to issues, including recruitment of minority trainees, flexibility to recruit international medical school graduates, timing of trainee acceptance, maintaining the financial support of Medicare graduation medical education (GME), training of physician scientists, organization of the continuity clinic experience, visibility of nonmalignant hematology as a career path, and level of training program director support.

Disseminating cardiopulmonary resuscitation training by distributing 9,200 personal manikins.

PubMed

de Paiva, Edison Ferreira; Padilha, Roberto de Queiroz; Sgobero, Jenny Karol Gomes Sato; Ganem, Fernando; Cardoso, Luiz Francisco

2014-08-01

Community members should be trained so that witnesses of cardiac arrests are able to trigger the emergency system and perform adequate resuscitation. In this study, the authors evaluated the results of cardiopulmonary resuscitation (CPR) training of communities in four Brazilian cities, using personal resuscitation manikins. In total, 9,200 manikins were distributed in Apucarana, Itanhaém, Maringá, and São Carlos, which are cities where the populations range from 80,000 to 325,000 inhabitants. Elementary and secondary school teachers were trained on how to identify a cardiac arrest, trigger the emergency system, and perform chest compressions. The teachers were to transfer the training to their students, who would then train their families and friends. In total, 49,131 individuals were trained (6.7% of the population), but the original strategy of using teachers and students as multipliers was responsible for only 27.9% of the training. A total of 508 teachers were trained, and only 88 (17.3%) transferred the training to the students. Furthermore, the students have trained only 45 individuals of the population. In Maringá and São Carlos, the strategy was changed and professionals in the primary health care system were prepared and used as multipliers. This strategy proved extremely effective, especially in Maringá, where 39,041 individuals were trained (79.5% of the total number of trainings). Community health care providers were more effective in passing the training to students than the teachers (odds ratio [OR] = 7.12; 95% confidence interval [CI] = 4.74 to 10.69; p < 0.0001). Instruction of CPR using personal manikins by professionals in the primary health care system seems to be a more efficient strategy for training the community than creating a training network in the schools. © 2014 by the Society for Academic Emergency Medicine.

Mobile Simulation Unit: taking simulation to the surgical trainee.

PubMed

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

2015-05-01

Simulation-based training has become an increasingly accepted part of surgical training. However, simulators are still not widely available to surgical trainees. Some factors that hinder the widespread implementation of simulation-based training are the lack of standardized methods and equipment, costs and time constraints. We have developed a Mobile Simulation Unit (MSU) that enables trainees to access modern simulation equipment tailored to the needs of the learner at the trainee's workplace. From July 2012 to December 2012, the MSU visited six hospitals in South Australia, four in metropolitan and two in rural areas. Resident Medical Officers, surgical trainees, Fellows and International Medical Graduates were invited to voluntarily utilize a variety of surgical simulators on offer. Participants were asked to complete a survey about the accessibility of simulation equipment at their workplace, environment of the MSU, equipment available and instruction received. Utilization data were collected. The MSU was available for a total of 303 h over 52 days. Fifty-five participants were enrolled in the project and each spent on average 118 min utilizing the simulators. The utilization of the total available time was 36%. Participants reported having a poor access to simulation at their workplace and overwhelmingly gave positive feedback regarding their experience in the MSU. The use of the MSU to provide simulation-based education in surgery is feasible and practical. The MSU provides consistent simulation training at the surgical trainee's workplace, regardless of geographic location, and it has the potential to increase participation in simulation programmes. © 2014 Royal Australasian College of Surgeons.

Fast dictionary-based reconstruction for diffusion spectrum imaging.

PubMed

Bilgic, Berkin; Chatnuntawech, Itthi; Setsompop, Kawin; Cauley, Stephen F; Yendiki, Anastasia; Wald, Lawrence L; Adalsteinsson, Elfar

2013-11-01

Diffusion spectrum imaging reveals detailed local diffusion properties at the expense of substantially long imaging times. It is possible to accelerate acquisition by undersampling in q-space, followed by image reconstruction that exploits prior knowledge on the diffusion probability density functions (pdfs). Previously proposed methods impose this prior in the form of sparsity under wavelet and total variation transforms, or under adaptive dictionaries that are trained on example datasets to maximize the sparsity of the representation. These compressed sensing (CS) methods require full-brain processing times on the order of hours using MATLAB running on a workstation. This work presents two dictionary-based reconstruction techniques that use analytical solutions, and are two orders of magnitude faster than the previously proposed dictionary-based CS approach. The first method generates a dictionary from the training data using principal component analysis (PCA), and performs the reconstruction in the PCA space. The second proposed method applies reconstruction using pseudoinverse with Tikhonov regularization with respect to a dictionary. This dictionary can either be obtained using the K-SVD algorithm, or it can simply be the training dataset of pdfs without any training. All of the proposed methods achieve reconstruction times on the order of seconds per imaging slice, and have reconstruction quality comparable to that of dictionary-based CS algorithm.

Fast Dictionary-Based Reconstruction for Diffusion Spectrum Imaging

PubMed Central

Bilgic, Berkin; Chatnuntawech, Itthi; Setsompop, Kawin; Cauley, Stephen F.; Yendiki, Anastasia; Wald, Lawrence L.; Adalsteinsson, Elfar

2015-01-01

Diffusion Spectrum Imaging (DSI) reveals detailed local diffusion properties at the expense of substantially long imaging times. It is possible to accelerate acquisition by undersampling in q-space, followed by image reconstruction that exploits prior knowledge on the diffusion probability density functions (pdfs). Previously proposed methods impose this prior in the form of sparsity under wavelet and total variation (TV) transforms, or under adaptive dictionaries that are trained on example datasets to maximize the sparsity of the representation. These compressed sensing (CS) methods require full-brain processing times on the order of hours using Matlab running on a workstation. This work presents two dictionary-based reconstruction techniques that use analytical solutions, and are two orders of magnitude faster than the previously proposed dictionary-based CS approach. The first method generates a dictionary from the training data using Principal Component Analysis (PCA), and performs the reconstruction in the PCA space. The second proposed method applies reconstruction using pseudoinverse with Tikhonov regularization with respect to a dictionary. This dictionary can either be obtained using the K-SVD algorithm, or it can simply be the training dataset of pdfs without any training. All of the proposed methods achieve reconstruction times on the order of seconds per imaging slice, and have reconstruction quality comparable to that of dictionary-based CS algorithm. PMID:23846466

The state of the service: a survey of psychiatry resident education in psychosomatic medicine.

PubMed

Heinrich, Thomas W; Schwartz, Ann C; Zimbrean, Paula C; Wright, Mark T

2013-01-01

Although required by the Accreditation Council for Graduate Medical Education, training of general psychiatry residents in Psychosomatic Medicine (PM) varies significantly between programs. In 1996, the Academy of Psychosomatic Medicine (APM) developed guidelines for residency training in PM. Since then, there has been no assessment of the status of PM training during psychiatry residency. Assessment of the current state of PM training in U.S. psychiatry residency programs. A 46-item questionnaire was sent via e-mail to 206 residency directors. Four major areas were assessed: the timing and duration of the PM rotation, level of faculty supervision, didactic curriculum, and role (or potential role) of the APM in residency education. Ninety-two surveys were returned (response rate 45%). Forty-four (54%) of the general psychiatry residencies reported the total duration of the C-L rotation as being between 3 and 6 months (including both full- and part-time rotation). Only 38 (46%) programs' residents complete their PM experience in 1 year of residency. The average Full-Time Equivalent of teaching faculty per service was 1.74 (standard deviation 0.92). Sixty-four (77%) programs have a formal didactic curriculum in C-L. Eighty-one (98%) respondents were aware of the APM. Fifty-eight (70%) had APM members among faculty. The most popular responses on how the APM could best serve training programs were the creation of a subspecialty curriculum (73%) as well as the development of a competency-based evaluation tool (66%). There is significant variation in how residents are taught PM during their training. The APM is a well-recognized organization that may define what constitutes adequate residency training in PM and may help programs fulfill the educational needs of residents. © 2013 The Academy of Psychosomatic Medicine. Published by Elsevier Inc. All rights reserved.

How balance task-specific training contributes to improving physical function in older subjects undergoing rehabilitation following hip fracture: a randomized controlled trial.

PubMed

Monticone, Marco; Ambrosini, Emilia; Brunati, Roberto; Capone, Antonio; Pagliari, Giulia; Secci, Claudio; Zatti, Giovanni; Ferrante, Simona

2018-03-01

To evaluate the efficacy of a rehabilitation programme including balance task-specific training in improving physical function, pain, activities of daily living (ADL), balance and quality of life in subjects after a hip fracture. Randomized controlled trial. A total of 52 older subjects selected for internal fixation due to extra-capsular hip fracture were randomized to be included in an experimental ( n = 26) and control group ( n = 26). The experimental group underwent a rehabilitation programme based on balance task-specific training. The control group underwent general physiotherapy, including open kinetic chain exercises and walking training. Both groups individually followed programmes of 90-minute sessions five times/week for three weeks. The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), a Pain Numerical Rating Scale, the Berg Balance Scale, the Functional Independence Measure and the 36-item Short-Form Health Survey. The participants were evaluated before and after training, and after 12 months. Significant effects of time, group and time × group were found for all outcome measures in favour of the experimental group. A clinically important between-group difference of 25 points was achieved after training and at follow-up in terms of the primary outcome (WOMAC function before treatment, after treatment and at follow-up was 84.8 (3.7), 39.8 (4.9) and 35.7 (6.2) for the experimental group and 80.9 (5.7), 65.2 (7.1) and 61.0 (11.1) for the control group). An inpatient rehabilitation programme based on balance task-specific training is useful in improving physical function, pain, ADL and quality of life in older patients after hip fracture.

The effects of combining elastic and free weight resistance on strength and power in athletes.

PubMed

Anderson, Corey E; Sforzo, Gary A; Sigg, John A

2008-03-01

This study was undertaken to determine whether combined elastic and free weight resistance (CR) provides different strength and power adaptations than free weight resistance (FWR) training alone. Forty-four young (age 20 +/- 1 years), resistance-trained (4 +/- 2 years' experience) subjects were recruited from men's basketball and wrestling teams and women's basketball and hockey teams at Cornell University. Subjects were stratified according to team, then randomly assigned to the control (C; n = 21) or experimental group (E; n = 23). Before and after 7 weeks of resistance training, subjects were tested for lean body mass, 1 repetition maximum back squat and bench press, and peak and average power. Both C and E groups performed identical workouts except that E used CR (i.e., elastic resistance) for the back squat and bench press, whereas the C group used FWR alone. CR was performed using an elastic bungee cord attached to a standard barbell loaded with plates. Elastic tension was accounted for in an attempt to equalize the total work done by each group. Statistical analyses revealed significant (P < 0.05) between-group differences after training. Compared with C, improvement for E was nearly three times greater for back squat (16.47 +/- 5.67 vs. 6.84 +/- 4.42 kg increase), two times greater for bench press (6.68 +/- 3.41 vs. 3.34 +/- 2.67 kg increase), and nearly three times greater for average power (68.55 +/- 84.35 vs. 23.66 +/- 40.56 watt increase). Training with CR may be better than FWR alone for developing lower and upper body strength, and lower body power in resistance-trained individuals. Long-term effects are unclear, but CR training makes a meaningful contribution in the short term to performance adaptations of experienced athletes.

Looking at graduates of Title V MCHB-funded training programs through the lens of the MCH pyramid.

PubMed

Margolis, Lewis H; Rosenberg, Angela; Umble, Karl; Chewning, Linda

2013-10-01

To examine the distribution of professional responsibilities as reflected in each level of the MCH Pyramid for 208 graduates of five Maternal and Child Health Bureau (MCHB)-funded training programs-Leadership Education in Neurodevelopmental and Related Disabilities, nutrition, pediatric dentistry, public health, and social work-at the University of North Carolina at Chapel Hill. Graduates completed a web-based survey, 1-8 years after graduation. For each program, we constructed means of the reported percentages of total work time spent in infrastructure-building, population-based, enabling, and direct health care services. Although generally consistent with the goals of the training programs, the percentages of time spent in each level of the Pyramid varied substantially among the five programs. For example, for a clinically focused program like pediatric dentistry, 80.2 % of time is spent in direct care services in contrast to 14.8 % for public health graduates. For each program, however, graduates report responsibilities among the different levels of the Pyramid. Reporting job responsibilities within the MCH Pyramid provides a more informative picture of the contributions of training program graduates than do conventional metrics such as institutional or agency appointments. The fact that graduates from all five programs engage multiple roles is consistent with the MCHB workforce training goal to develop leaders in the field of MCH. Given the central role of the MCH Pyramid in planning and reporting for the MCH Services Block Grant, MCH training programs should include metrics such as graduates' roles according to the MCH Pyramid to assure that training goals are more closely aligned with workforce needs.

Exercise Training Reduces Intrathoracic Fat Regardless of Defective Glucose Tolerance.

PubMed

Honkala, Sanna M; Motiani, Kumail K; Eskelinen, Jari-Joonas; Savolainen, Anna; Saunavaara, Virva; Virtanen, Kirsi A; Löyttyniemi, Eliisa; Kapanen, Jukka; Knuuti, Juhani; Kalliokoski, Kari K; Hannukainen, Jarna C

2017-07-01

Epicardial (EAT) and pericardial (PAT) fat masses and myocardial triglyceride content (MTC) are enlarged in obesity and insulin resistance. We studied whether the high-intensity interval training (HIIT) and moderate-intensity continuous training (MICT) similarly decrease ectopic fat in and around the heart and whether the decrease is similar in healthy subjects and subjects with defective glucose tolerance (DGT). A total of 28 healthy men (body mass index = 20.7-30.0 kg·m, age = 40-55 yr) and 16 men with DGT (body mass index = 23.8-33.5 kg·m, age = 43-53 yr) were randomized into HIIT and MICT interventions for 2 wk. EAT and PAT were determined by computed tomography and MTC by H-MRS. At baseline, DGT subjects had impaired aerobic capacity and insulin sensitivity and higher levels of whole body fat, visceral fat, PAT, and EAT (P < 0.05, all) compared with healthy subjects. In the whole group, HIIT increased aerobic capacity (HIIT = 6%, MICT = 0.3%; time × training P = 0.007) and tended to improve insulin sensitivity (HIIT = 24%, MICT = 8%) as well as reduce MTC (HIIT = -42%, MICT = +23%) (time × training P = 0.06, both) more efficiently compared with MICT, and without differences in the training response between the healthy and the DGT subjects. However, both training modes decreased EAT (-5%) and PAT (-6%) fat (time P < 0.05) and not differently between the healthy and the DGT subjects. Whole body fat, visceral fat, PAT, and EAT masses are enlarged in DGT. Both HIIT and MICT effectively reduce EAT and PAT in healthy and DGT subjects, whereas HIIT seems to be superior as regards improving aerobic capacity, whole-body insulin sensitivity, and MTC.

Accommodating Adolescent Sleep-Wake Patterns: The Effects of Shifting the Timing of Sleep on Training Effectiveness

PubMed Central

Miller, Nita Lewis; Tvaryanas, Anthony P.; Shattuck, Lawrence G.

2012-01-01

Study Objective: This study evaluated the effect of accommodating adolescent sleep-wake patterns by altering the timing of the major sleep period of US Army recruits. Design: The quasi-experimental study compared recruits assigned to one of two training companies: one with a customary sleep regimen (20:30 to 04:30) while the other employed a phase-delayed sleep regimen (23:00 to 07:00), the latter aligning better with biologically driven sleep-wake patterns of adolescents. Setting: The study was conducted during Basic Combat Training (BCT) at Fort Leonard Wood, Missouri. Trainees: The study included 392 trainees: 209 received the intervention, while 183 composed the Comparison group. Measurements and Results: Demographic and psychophysiological measures were collected on all trainees. Weekly assessments of subjective fatigue and mood, periodic physical fitness, marksmanship scores, and attrition rates from BCT were studied. Actigraphy was collected on approximately 24% of trainees. Based on actigraphy, trainees on the phase-delayed sleep schedule obtained 31 m more sleep/night than trainees on the customary sleep schedule. The Intervention group reported less total mood disturbance relative to baseline. Improvements in marksmanship correlated positively with average nightly sleep during the preceding week when basic marksmanship skills were taught. No differences were seen in physical fitness or attrition rates. In contrast to the Intervention group, the Comparison group was 2.3 times more likely to experience occupationally significant fatigue and 5.5 times more likely to report poor sleep quality. Conclusions: Accommodating adolescent sleep patterns significantly improves mental health and performance in the training environment. Citation: Miller NL; Tvaryanas AP; Shattuck LG. Accommodating adolescent sleep-wake patterns: the effects of shifting the timing of sleep on training effectiveness. SLEEP 2012;35(8):1123-1136. PMID:22851808

19 CFR 351.524 - Allocation of benefit to a particular time period.

Code of Federal Regulations, 2010 CFR

2010-04-01

... percent of relevant sales (e.g., total sales, export sales, the sales of a particular product, or the sales to a particular market) of the firm in question during the year in which the subsidy was approved... promotion assistance; early retirement payments; worker assistance; worker training; wage subsidies; and...

The Timing of Training

DTIC Science & Technology

1992-12-01

Report are the most athorftat~v and modi carefully cousideredl products IDA publishes. They normnally embody recults of mijor projects which (a) hov a...promising approaches to maintaining strong military manpower capability during a period of declining budgets and force levels. This is one of a total ...9 B. Productivity Issues ................................................................................ 12 C. Recruitm ent Issues

Dynamic Sensorimotor Planning during Long-Term Sequence Learning: The Role of Variability, Response Chunking and Planning Errors

PubMed Central

Verstynen, Timothy; Phillips, Jeff; Braun, Emily; Workman, Brett; Schunn, Christian; Schneider, Walter

2012-01-01

Many everyday skills are learned by binding otherwise independent actions into a unified sequence of responses across days or weeks of practice. Here we looked at how the dynamics of action planning and response binding change across such long timescales. Subjects (N = 23) were trained on a bimanual version of the serial reaction time task (32-item sequence) for two weeks (10 days total). Response times and accuracy both showed improvement with time, but appeared to be learned at different rates. Changes in response speed across training were associated with dynamic changes in response time variability, with faster learners expanding their variability during the early training days and then contracting response variability late in training. Using a novel measure of response chunking, we found that individual responses became temporally correlated across trials and asymptoted to set sizes of approximately 7 bound responses at the end of the first week of training. Finally, we used a state-space model of the response planning process to look at how predictive (i.e., response anticipation) and error-corrective (i.e., post-error slowing) processes correlated with learning rates for speed, accuracy and chunking. This analysis yielded non-monotonic association patterns between the state-space model parameters and learning rates, suggesting that different parts of the response planning process are relevant at different stages of long-term learning. These findings highlight the dynamic modulation of response speed, variability, accuracy and chunking as multiple movements become bound together into a larger set of responses during sequence learning. PMID:23056630

A tale of two trainers: virtual reality versus a video trainer for acquisition of basic laparoscopic skills.

PubMed

Debes, Anders J; Aggarwal, Rajesh; Balasundaram, Indran; Jacobsen, Morten B

2010-06-01

This study aimed to assess the transferability of basic laparoscopic skills between a virtual reality simulator (MIST-VR) and a video trainer box (D-Box). Forty-six medical students were randomized into 2 groups, training on MIST-VR or D-Box. After training with one modality, a crossover assessment on the other was performed. When tested on MIST-VR, the MIST-VR group showed significantly shorter time (90.3 seconds vs 188.6 seconds, P <.001), better economy of movements (4.40 vs 7.50, P <.001), and lower score (224.7 vs 527.0, P <.001). However, when assessed on the D-Box, there was no difference between the groups for time (402.0 seconds vs 325.6 seconds, P = .152), total hand movements (THC) (289 vs 262, P = .792), or total path length (TPL) (34.9 m vs 34.6 m, P = .388). Both simulators provide significant improvement in performance. Our results indicate that skills learned on the MIST-VR are transferable to the D-Box, but the opposite cannot be demonstrated. Copyright 2010 Elsevier Inc. All rights reserved.

Team Training in Family Medicine Residency Programs and Its Impact on Team-Based Practice Post-Graduation.

PubMed

Carney, Patricia A; Waller, Elaine; Dexter, Eve; Marino, Miguel; Morton, Kelly; Green, Larry; Fogarty, Colleen T; Jones, Samuel; Eiff, M Patrice

2017-05-01

Our objective was to examine perceptions of adequacy in team-based care training during residency and whether this influences practice choice post- residency training. We analyzed self-administered survey data from recent residency graduates collected as part of the Preparing Personal Physicians for Practice (P4) Project to characterize residents' perceptions of adequacy of training they received on team-based care. Multivariable logistic regression was used to assess the association between adequacy of team-based care training and joining practices that use team-based care after residency graduation, adjusting for differences in demographics. A total of 241 residency graduates were included in these analyses with response rates to surveys of 80.8%-98.1%. They reported practicing in 31 different US states or districts and four other countries. Over 82% of residency graduates reported being adequately trained in team-based care, 9.5% reported being overtrained, and 7.9% reported receiving no team-based care training over the study period. Seventy-six percent of P4 graduates joined practices that used team-based care in 2011, which increased to 86% (81/94) in 2013. The adjusted odds of practicing in settings with team-based care was 5.7 times higher for residents who reported being adequately prepared for team-based care compared to those who reported receiving no team-based care training and was 12.5 times higher for those who reported being over-prepared compared to those who reported no training/under-prepared. The majority of residency graduates perceive they were well trained in team-based care, which is significantly associated with joining practices that use team-based care post graduation.

A comparison of injuries in elite male and female football players: A five-season prospective study.

PubMed

Larruskain, J; Lekue, J A; Diaz, N; Odriozola, A; Gil, S M

2018-01-01

The aim was to compare the epidemiology of injuries between elite male and female football players from the same club. Injuries and individual exposure time in a male team and a female team, both playing in the Spanish first division, were prospectively recorded by the club's medical staff for five seasons (2010-2015) following the FIFA consensus statement. Total, training, and match exposure hours per player-season were 20% higher for men compared to women (P<.01). Total, training, and match injury incidence were 30%-40% higher in men (P≤.04) mainly due to a 4.82 (95% confidence interval [CI] 2.30-10.08) times higher incidence of contusions, as there were no differences in the incidence of muscle and joint/ligament injuries (P≥.44). The total number of absence days was 21% larger in women owing to a 5.36 (95% CI 1.11-25.79) times higher incidence of severe knee and ankle ligament injuries. Hamstring strains and pubalgia cases were 1.93 (95% CI 1.16-3.20) and 11.10 (95% CI 1.48-83.44) times more frequent in men, respectively; whereas quadriceps strains, anterior cruciate ligament ruptures, and ankle syndesmosis injuries were 2.25 (95% CI 1.22-4.17), 4.59 (95% CI 0.93-22.76), and 5.36 (95% CI 1.11-25.79) times more common in women, respectively. In conclusion, prevention strategies should be tailored to the needs of male and female football players, with men more predisposed to hamstring strains and hip/groin injuries, and women to quadriceps strains and severe knee and ankle ligament injuries. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Lessons from the Hot Seat: NASA Scientists in Live Broadcast and Documentary Television (Invited)

NASA Astrophysics Data System (ADS)

Thaller, M.

2013-12-01

NASA sends hundreds of scientists a year to media training, where they are taught to stick to their talking points, resist off-topic questions, and stand up to bullying. In over 15 years of television work representing NASA, I have yet to put any of the practices I learned in these sessions into action. Honestly, in over 99% of cases, reporters and documentarians are looking for totally different things from scientists on their programs. For most TV interviews, there are two or three minutes to get a few points across (and it is *amazing* how fast that time goes), show an animation, and smile engagingly to give the impression that NASA scientists are not arrogant jerks and might even be worth some tax money. But we are never trained to do this! In this session, I'll talk about some of my television experiences (good, bad, and totally embarrassing), show some examples of the short video segments we film, and discuss why most science organizations, including NASA, aren't training their scientists to give the media what they really want.

Investigating the Acquisition, Generalization, and Emergence of Untrained Verbal Operants for Mands Acquired Using the Picture Exchange Communication System in Adults With Severe Developmental Disabilities

PubMed Central

Ziomek, Megan M; Rehfeldt, Ruth Anne

2008-01-01

This study compared the total amount of training time and total number of trial blocks for individuals with severe developmental disabilities to acquire mands under control of unconditioned establishing operations and mands under control of transitive conditioned establishing operations for manual sign and for the Picture Exchange Communication System (PECS). Also examined was the generalization of mands across settings and communicative partners, as well as the emergence of untrained tacts and intraverbals for mands acquired using PECS. Mands for preferred items and for items needed to complete a chained task were acquired more rapidly and in fewer training blocks for PECS than for manual sign. Moreover, mands established using PECS generalized across settings and communicative partners. Finally, untrained tacts and intraverbals using PECS were shown to emerge for some of the participants following PECS training. These results suggest that PECS may be a viable alternative communication system for adults with severe developmental disabilities who have little or no history of systematic instruction and limited imitative repertoires. PMID:22477401

Investigating the acquisition, generalization, and emergence of untrained verbal operants for mands acquired using the picture exchange communication system in adults with severe developmental disabilities.

PubMed

Ziomek, Megan M; Rehfeldt, Ruth Anne

2008-01-01

This study compared the total amount of training time and total number of trial blocks for individuals with severe developmental disabilities to acquire mands under control of unconditioned establishing operations and mands under control of transitive conditioned establishing operations for manual sign and for the Picture Exchange Communication System (PECS). Also examined was the generalization of mands across settings and communicative partners, as well as the emergence of untrained tacts and intraverbals for mands acquired using PECS. Mands for preferred items and for items needed to complete a chained task were acquired more rapidly and in fewer training blocks for PECS than for manual sign. Moreover, mands established using PECS generalized across settings and communicative partners. Finally, untrained tacts and intraverbals using PECS were shown to emerge for some of the participants following PECS training. These results suggest that PECS may be a viable alternative communication system for adults with severe developmental disabilities who have little or no history of systematic instruction and limited imitative repertoires.

Training cardiovascular outcomes researchers: A survey of mentees and mentors to identify critical training gaps and needs.

PubMed

Khazanie, Prateeti; Al-Khatib, Sana M; Wang, Tracy Y; Crowley, Matthew J; Kressin, Nancy R; Krumholz, Harlan M; Kiefe, Catarina I; Wells, Barbara L; O'Brien, Sean M; Peterson, Eric D; Sanders, Gillian D

2018-02-01

Many young investigators are interested in cardiovascular (CV) outcomes research; however, the current training experience of early investigators across the United States is uncertain. From April to November 2014, we surveyed mentees and mentors of early-stage CV outcomes investigators across the United States. We contacted successful grantees of government agencies, members of professional organizations, and trainees in CV outcomes training programs. A total of 185 (of 662) mentees and 76 (of 541) mentors completed the survey. Mentees were equally split by sex; most had completed training >3 years before completing the survey and were clinicians. Mentors were more likely women, mostly ≥20 years posttraining, and at an associate/full professor rank. Mentors reported devoting more time currently to clinical work than when they were early in their career and mentoring 2-4 people simultaneously. More than 80% of mentees started training to become academicians and completed training with the same goal. More than 70% of mentees desired at least 50% research time in future jobs. More than 80% of mentors believed that future investigators would need more than 50% time dedicated to research. Most mentees (80%) were satisfied with their relationship with their mentor and reported having had opportunities to develop independently. Mentors more frequently than mentees reported that funding cutbacks had negatively affected mentees' ability to succeed (84% vs 58%). Across funding mechanisms, mentees were more optimistic than mentors about securing funding. Both mentees and mentors reported greatest preparedness for job/career satisfaction (79% for both) and publications (84% vs 92%) and least preparedness for future financial stability (48% vs 46%) and work-life balance (47% vs 42%). Survey findings may stimulate future discourse and research on how best to attract, train, and retain young investigators in CV outcomes research. Insights may help improve existing training programs and inform the design of new ones. Copyright © 2017. Published by Elsevier Inc.

Heart rate-based training intensity and its impact on injury incidence among elite-level professional soccer players.

PubMed

Owen, Adam L; Forsyth, Jacky J; Wong, Del P; Dellal, Alexandre; Connelly, Sean P; Chamari, Karim

2015-06-01

Elite-level professional soccer players are suggested to have increased physical, technical, tactical, and psychological capabilities when compared with their subelite counterparts. Ensuring these players remain at the elite level generally involves training many different bodily systems to a high intensity or level within a short duration. This study aimed to examine whether an increase in training volume at high-intensity levels was related to injury incidence, or increased the odds of sustaining an injury. Training intensity was monitored through time spent in high-intensity (T-HI) and very high-intensity (T-VHI) zones of 85-<90% and ≥90% of maximal heart rate (HRmax), and all injuries were recorded over 2 consecutive seasons. Twenty-three, elite professional male soccer players (mean ± SD age, 25.6 ± 4.6 years; stature, 181.8 ± 6.8 cm; and body mass, 79.3 ± 8.1 kg) were studied throughout the 2-years span of the investigation. The results showed a mean total injury incidence of 18.8 (95% confidence interval [CI], 14.7-22.9) injuries per 1,000 hours of exposure. Significant correlations were found between training volume at T-HI and injury incidence (r = 0.57, p = 0.005). Further analysis revealed how players achieving more time in the T-VHI zone during training increased the odds of sustaining a match injury (odds ratio = 1.87; 95% CI, 1.12-3.12, p = 0.02) but did not increase the odds of sustaining a training injury. Reducing the number of competitive match injuries among elite-level professional players may be possible if greater focus is placed on the training intensity and volume over a period of time ensuring the potential reduction of fatigue or overuse injuries. In addition, it is important to understand the optimal training load at which adaptation occurs without raising the risk of injury.

Maturity status and injury risk in youth soccer players.

PubMed

Malina, Robert M

2010-03-01

To investigate the association of relative skeletal age and other risk factors with injury in elite schoolboy footballers (soccer players). Prospective cohort study, with players participating for varying numbers of years. Manchester United Football Club Academy, 2001 to 2007. Players were recruited to the club by scouts. At intake, the boys were medically screened to ensure they could be fully involved in the training and games program. Computerized medical records for the boys were maintained for the entire study period. The investigation included boys 9 to 16 years of age. Numbers varied between 98 and 144 per year (mean n/y = 130) over 6 years. Overall, 292 players were represented in the sample. Mean drop out per season was 21%. Each year consenting players had a radiograph of the left wrist and hand for the assessment of skeletal age (SA), using the Fels method. Eighty-five players had at least 1 radiograph and 12 players had 6 radiographs, 1 in each year of the study. Early and late maturers were those with an SA >1 year older or younger, respectively, than their chronologic age (CA). Information on demographics, height and weight, playing and training times, and position played was collected. The main outcome measure was the relation of maturity status to the occurrence of injuries. For the total sample across all the age groups the incidence of injuries was 1.44 per 1000 hours of training (n = 244 injuries), and 10.5 per 1000 match hours (n = 169 injuries). The mean number of injuries per season was 79.3, with a mean loss of 12.5 injury days per player per season. Boys aged <14 years were most vulnerable. Most injuries resulted from overuse rather than from trauma. Most common injury type and location were, respectively, soft tissue and knee joint. Mean SA for the total sample was in advance of mean CA (12.08y vs 11.74y; P < 0.05). Injury incidence did not differ significantly among late, normal, and early maturing players (1.4, 1.5, and 1.8, respectively) when training time, playing time, height, and playing position were statistically controlled as covariates (P = 0.73). However, results of general log linear analysis of mean data over the 6 seasons indicated a relationship between injury occurrence and training time, match-play time, and the CA-SA difference (P < 0.05). The 3 variables together explained 48% of the variance in injury incidence. Position played, foot dominance, and mean height gain were not related to injury occurrence. Maturity status and time spent in match play and training were significant predictors of injuries in 9- to 16-year-old elite male soccer players.

Short-term heat acclimation improves the determinants of endurance performance and 5-km running performance in the heat.

PubMed

James, Carl A; Richardson, Alan J; Watt, Peter W; Willmott, Ashley G B; Gibson, Oliver R; Maxwell, Neil S

2017-03-01

This study investigated the effect of 5 days of controlled short-term heat acclimation (STHA) on the determinants of endurance performance and 5-km performance in runners, relative to the impairment afforded by moderate heat stress. A control group (CON), matched for total work and power output (2.7 W·kg -1 ), differentiated thermal and exercise contributions of STHA on exercise performance. Seventeen participants (10 STHA, 7 CON) completed graded exercise tests (GXTs) in cool (13 °C, 50% relative humidity (RH), pre-training) and hot conditions (32 °C, 60% RH, pre- and post-training), as well as 5-km time trials (TTs) in the heat, pre- and post-training. STHA reduced resting (p = 0.01) and exercising (p = 0.04) core temperature alongside a smaller change in thermal sensation (p = 0.04). Both groups improved the lactate threshold (LT, p = 0.021), lactate turnpoint (LTP, p = 0.005) and velocity at maximal oxygen consumption (vV̇O 2max ; p = 0.031) similarly. Statistical differences between training methods were observed in TT performance (STHA, -6.2(5.5)%; CON, -0.6(1.7)%, p = 0.029) and total running time during the GXT (STHA, +20.8(12.7)%; CON, +9.8(1.2)%, p = 0.006). There were large mean differences in change in maximal oxygen consumption between STHA +4.0(2.2) mL·kg -1 ·min -1 (7.3(4.0)%) and CON +1.9(3.7) mL·kg -1 ·min -1 (3.8(7.2)%). Running economy (RE) deteriorated following both training programmes (p = 0.008). Similarly, RE was impaired in the cool GXT, relative to the hot GXT (p = 0.004). STHA improved endurance running performance in comparison with work-matched normothermic training, despite equality of adaptation for typical determinants of performance (LT, LTP, vV̇O 2max ). Accordingly, these data highlight the ergogenic effect of STHA, potentially via greater improvements in maximal oxygen consumption and specific thermoregulatory and associated thermal perception adaptations absent in normothermic training.

Use of an Anti-Gravity Treadmill for Early Postoperative Rehabilitation After Total Knee Replacement: A Pilot Study to Determine Safety and Feasibility.

PubMed

Bugbee, William D; Pulido, Pamela A; Goldberg, Timothy; D'Lima, Darryl D

2016-01-01

The objective was to determine the safety, feasibility, and effects of anti-gravity gait training on functional outcomes (Knee Injury and Osteoarthritis Outcome Score [KOOS], the Timed Up and Go test [TUG], Numerical Rating Scale [NRS] for pain) with the AlterG® Anti-Gravity Treadmill® device for total knee arthroplasty (TKA) rehabilitation. Subjects (N = 30) were randomized to land-based vs anti-gravity gait training over 4 weeks of physical therapy after TKA. Adverse events, complications, and therapist satisfaction were recorded. All patients completed rehabilitation protocols without adverse events. KOOS, TUG, and NRS scores improved in both groups with no significant differences between groups. For the AlterG group, Sports/Recreation and Quality of Life subscales of the KOOS had the most improvement. At the end of physical therapy, TUG and NRS pain scores improved from 14 seconds to 8 seconds and from 2.8 to 1.1, respectively. Subjectively, therapists reported 100% satisfaction with the AlterG. This initial pilot study demonstrated that the AlterG Anti-Gravity Treadmill device was safe and feasible. While functional outcomes improved over time with use of the anti-gravity gait training, further studies are needed to define the role of this device as an alternative or adjunct to established rehabilitation protocols.

Effects of low-dose ibuprofen supplementation and resistance training on bone and muscle in postmenopausal women: A randomized controlled trial.

PubMed

Duff, Whitney R D; Kontulainen, Saija A; Candow, Darren G; Gordon, Julianne J; Mason, Riley S; Taylor-Gjevre, Regina; Nair, Bindu; Szafron, Michael; Baxter-Jones, Adam D G; Zello, Gordon A; Chilibeck, Philip D

2016-12-01

To compare the effects of nine months of exercise training and ibuprofen supplementation (given immeditately after exercise sessions) on bone and muscle in postmenopausal women. In a double-blind randomized trial, participants (females: n = 90, mean age 64.8, SD 4.3 years) were assigned (computer generated, double blind) to receive supervised resistance training or stretching 3 days/week, and ibuprofen (400 mg, post-exercise) or placebo (i.e. 4 groups) for 9 months. In this proof-of-concept study the sample size was halved from required 200 identified via 90% power calculation. Baseline and post-intervention testing included: Dual energy x-ray absorptiometry (DXA) for lumbar spine, femoral neck, and total body areal bone mineral density (aBMD); geometry of proximal femur; total body lean tissue and fat mass; predicted 1-repetition maximum muscle strength testing (1RM; biceps curl, hack squat). Exercise training or ibuprofen supplementation had no effects on aBMD of the lumbar spine, femoral neck, and total body. There was a significant exercise × supplement × time interaction for aBMD of Ward's region of the femoral neck (p = 0.015) with post hoc comparison showing a 6% decrease for stretching with placebo vs. a 3% increase for stretching with ibuprofen (p = 0.017). Resistance training increased biceps curl and hack squat strength vs. stretching (22% vs. 4% and 114% vs. 12%, respectively) (p < 0.01) and decreased percent body fat compared to stretching (2% vs. 0%) (p < 0.05). Ibuprofen supplementation provided some benefits to bone when taken independent of exercise training in postmenopausal women. This study provides evidence towards a novel, easily accessible stimulus for enhancing bone health [i.e. ibuprofen].

Comparison of the effects of virtual reality-based balance exercises and conventional exercises on balance and fall risk in older adults living in nursing homes in Turkey.

PubMed

Yeşilyaprak, Sevgi Sevi; Yıldırım, Meriç Şenduran; Tomruk, Murat; Ertekin, Özge; Algun, Z Candan

2016-01-01

There is limited information on effective balance training techniques including virtual reality (VR)-based balance exercises in residential settings and no studies have been designed to compare the effects of VR-based balance exercises with conventional balance exercises in older adults living in nursing homes in Turkey. The objective of our study was to investigate the effects of VR-based balance exercises on balance and fall risk in comparison to conventional balance exercises in older adults living in nursing homes. A total sample of 18 subjects (65-82 years of age) with fall history who were randomly assigned to either the VR group (Group 1, n = 7) or the conventional exercise group (Group 2, n = 11) completed the exercise training. In both groups, Berg balance score (BBS), timed up & go duration, and left leg stance and tandem stance duration with eyes closed significantly improved with time (p < 0.05), but changes were similar in both groups (p > 0.05) after training, indicating that neither the exercise method was superior. Similar improvements were found in balance and fall risk with VR-based balance training and conventional balance training in older adults living in the nursing home. Both exercise trainings can be preferable by health care professionals considering fall prevention. Appropriate patient selection is essential.

Martial arts: time needed for training.

PubMed

Burke, David T; Protopapas, Marina; Bonato, Paolo; Burke, John T; Landrum, Rpbert F

2011-03-01

To measure the time needed to teach a series of martial arts techniques to proficiency. Fifteen volunteer subjects without any prior martial arts or self-defense experience were recruited. A panel of martial arts experts selected 21 different techniques including defensive stances, arm blocks, elbow strikes, palm strikes, thumbs to eyes, instep kicks and a carotid neck restraint. The critical elements of each technique were identified by the panel and incorporated into a teaching protocol, and then into a scoring system. Two black belt martial arts instructors directed a total of forty-five 45-minute training sessions. Videotaped proficiency testing was performed weekly. The videotapes were reviewed by the investigators to determine the proficiency levels of each subject for each technique. The techniques were rated by the average number of training sessions needed for an individual to develop proficiency in that technique. The mean number of sessions necessary to train individuals to proficiency ranged from 27 to 38.3. Using this system, the most difficult techniques seemed to be elbow strikes to the rear, striking with thumbs to the eyes and arm blocking. In this study 29 hours of training was necessary to train novice students to be proficient in 21 offensive and defensive martial arts techniques. To our knowledge, this is the first study that attempts to measure the learning curves involved when teaching martial arts techniques.

Martial Arts: Time Needed for Training

PubMed Central

Burke, David T.; Protopapas, Marina; Bonato, Paolo; Burke, John T.; Landrum, Rpbert F.

2011-01-01

Purpose To measure the time needed to teach a series of martial arts techniques to proficiency. Methods Fifteen volunteer subjects without any prior martial arts or self-defense experience were recruited. A panel of martial arts experts selected 21 different techniques including defensive stances, arm blocks, elbow strikes, palm strikes, thumbs to eyes, instep kicks and a carotid neck restraint. The critical elements of each technique were identified by the panel and incorporated into a teaching protocol, and then into a scoring system. Two black belt martial arts instructors directed a total of forty-five 45-minute training sessions. Videotaped proficiency testing was performed weekly. The videotapes were reviewed by the investigators to determine the proficiency levels of each subject for each technique. Results The techniques were rated by the average number of training sessions needed for an individual to develop proficiency in that technique. The mean number of sessions necessary to train individuals to proficiency ranged from 27 to 38.3. Using this system, the most difficult techniques seemed to be elbow strikes to the rear, striking with thumbs to the eyes and arm blocking. Conclusions In this study 29 hours of training was necessary to train novice students to be proficient in 21 offensive and defensive martial arts techniques. To our knowledge, this is the first study that attempts to measure the learning curves involved when teaching martial arts techniques. PMID:22375215

Effectiveness of a computerised working memory training in adolescents with mild to borderline intellectual disabilities.

PubMed

Van der Molen, M J; Van Luit, J E H; Van der Molen, M W; Klugkist, I; Jongmans, M J

2010-05-01

The goal of this study is to evaluate the effectiveness of a computerised working memory (WM) training on memory, response inhibition, fluid intelligence, scholastic abilities and the recall of stories in adolescents with mild to borderline intellectual disabilities attending special education. A total of 95 adolescents with mild to borderline intellectual disabilities were randomly assigned to either a training adaptive to each child's progress in WM, a non-adaptive WM training, or to a control group. Verbal short-term memory (STM) improved significantly from pre- to post-testing in the group who received the adaptive training compared with the control group. The beneficial effect on verbal STM was maintained at follow-up and other effects became clear at that time as well. Both the adaptive and non-adaptive WM training led to higher scores at follow-up than at post-intervention on visual STM, arithmetic and story recall compared with the control condition. In addition, the non-adaptive training group showed a significant increase in visuo-spatial WM capacity. The current study provides the first demonstration that WM can be effectively trained in adolescents with mild to borderline intellectual disabilities.

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.

General practice--reflection on five years of multidisciplinary training at Medical Centre Gütersloh.

PubMed

van den Heuvel, H G J

2011-12-01

Medical Centre Gütersloh is a primary care setting which provides the full range of general practice care for British Forces Germany Health Service (BFG HS). The aim of this article is to evaluate the multidisciplinary training organised by the author there, to exchange information and to provide suggestions for improvement and development. Description of the training scheme and analysis of routinely collected management data. The training scheme is based on adult education principles with a focus on interactive learning. Over the period November 2005-July 2010 a total of 1201 members of staff from various disciplines participated in 86 documented training sessions. The majority of the attending staff considered the training to be relevant, interesting and well presented. A substantial proportion indicated that they would change their practice as a result of the training. These views remained stable over time. The majority of facilitators consisted of medical centre employees. This article provides an overview onfive years of multidisciplinary training in a general practice setting. Overall feedback from staff suggests that the training has been highly valued over those years. However, it is recognised that this evaluation has its limitations and suggestions are made regarding how these types of training schemes can be improved and developed further.

Multineuronal vectorization is more efficient than time-segmental vectorization for information extraction from neuronal activities in the inferior temporal cortex.

PubMed

Kaneko, Hidekazu; Tamura, Hiroshi; Tate, Shunta; Kawashima, Takahiro; Suzuki, Shinya S; Fujita, Ichiro

2010-08-01

In order for patients with disabilities to control assistive devices with their own neural activity, multineuronal spike trains must be efficiently decoded because only limited computational resources can be used to generate prosthetic control signals in portable real-time applications. In this study, we compare the abilities of two vectorizing procedures (multineuronal and time-segmental) to extract information from spike trains during the same total neuron-seconds. In the multineuronal vectorizing procedure, we defined a response vector whose components represented the spike counts of one to five neurons. In the time-segmental vectorizing procedure, a response vector consisted of components representing a neuron's spike counts for one to five time-segment(s) of a response period of 1 s. Spike trains were recorded from neurons in the inferior temporal cortex of monkeys presented with visual stimuli. We examined whether the amount of information of the visual stimuli carried by these neurons differed between the two vectorizing procedures. The amount of information calculated with the multineuronal vectorizing procedure, but not the time-segmental vectorizing procedure, significantly increased with the dimensions of the response vector. We conclude that the multineuronal vectorizing procedure is superior to the time-segmental vectorizing procedure in efficiently extracting information from neuronal signals. Copyright (c) 2010 Elsevier Ltd. All rights reserved.

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

PubMed

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

2017-06-01

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

Preparations for Integrating Space-Based Total Lightning Observations into Forecast Operations

NASA Technical Reports Server (NTRS)

Stano, Geoffrey T.; Fuell, Kevin K.; Molthan, Andrew L.

2016-01-01

NASA's Short-term Prediction Research and Transition (SPoRT) Center has been a leader in collaborating with the United States National Weather Service (NWS) offices to integrate ground-based total lightning (intra-cloud and cloud-to-ground) observations into the real-time operational environment. For much of these collaborations, the emphasis has been on training, dissemination of data to the NWS AWIPS system, and focusing on the utility of these data in the warning decision support process. A shift away from this paradigm has occurred more recently for several reasons. For one, SPoRT's collaborations have expanded to new partners, including emergency managers and the aviation community. Additionally, and most importantly, is the impending launch of the GOES-R Geostationary Lightning Mapper (GLM). This has led to collaborative efforts to focus on additional forecast needs, new data displays, develop training for GLM uses based on the lessons learned from ground-based lightning mapping arrays, and ways to better relate total lightning data to other meteorological parameters. This presentation will focus on these efforts to prepare the operational end user community for GLM with an eye towards sharing lessons learned as EUMETSAT prepares for the Meteosat Third Generation Lightning Imager. This will focus on both software and training needs. In particular, SPoRT has worked closely with the Meteorological Development Laboratory to create the total lightning tracking tool. This software allows for NWS forecasters to manually track storms of interest and display a time series trend of observations. This tool also has been expanded to work on any gridded data set allowing for easy visual comparisons of multiple parameters in addition to total lightning. A new web display has been developed for the ground-based observations that can be easily extended to satellite observations. This paves the way for new collaborations outside of the NWS, both domestically and internationally, as the web display will be functional on PCs and mobile devices. Furthermore, SPoRT has helped developed the software plug-in to visualize GLM data. Examples using the official GLM proxy product will be used to provide a glimpse as to what real-time GLM and likely MTG-LI data will be in the near future.

The effect of cognitive-motor dual task training with the biorescue force platform on cognition, balance and dual task performance in institutionalized older adults: a randomized controlled trial

PubMed Central

Delbroek, Tom; Vermeylen, Wietse; Spildooren, Joke

2017-01-01

[Purpose] This study investigates whether cognition, balance and dual task performance in institutionalized older adults improves by a virtual reality dual task training. [Subjects and Methods] Randomized controlled trial; Twenty institutionalized older adults with mild cognitive impairment (13 female, 7 male; average age, 87.2 ± 5.96 years) were randomized to the intervention (i.e. Virtual reality dual-task training using the BioRescue) or control group (no additional training). The intervention group took part in a 6-week training program while the elderly in the control group maintained their daily activities. Balance was measured with the Instrumented Timed Up-and-Go Test with and without a cognitive task. The Observed Emotion Rating Scale and Intrinsic Motivation Inventory were administered to evaluate the emotions and motivation regarding the exergaming program. [Results] The intervention group improved significantly on the total Timed Up-and-Go duration and the turn-to-sit duration during single-task walking in comparison to the control group who received no additional training. Participants found the virtual reality dual task training pleasant and useful for their concentration, memory and balance. Pleasure and alertness were the two emotions which were mostly seen during the intervention. [Conclusion] The BioRescue is a pleasant and interesting treatment method, well suited for institutionalized older adults in need of lifelong physical therapy. PMID:28744033

Adapted low intensity ergometer aerobic training for early and severely impaired stroke survivors: a pilot randomized controlled trial to explore its feasibility and efficacy.

PubMed

Wang, Zun; Wang, Lei; Fan, Hongjuan; Jiang, Wenjun; Wang, Sheng; Gu, Zhaohua; Wang, Tong

2014-09-01

[Purpose] To evaluate the feasibility and efficacy of adapted low intensity ergometer aerobic training for early and severely impaired stroke survivors. [Subjects] The subjects were forty-eight early stroke survivors. [Methods] Eligible subjects were recruited and randomly assigned to an experimental group and a control group. Both groups participated in comprehensive rehabilitation training. Low intensity aerobic training was only performed by the experimental group. Outcome measures were the Fugl-Meyer motor score, Barthel index, exercise test time, peak heart rate, plasma glucose level and serum lipid profiles. [Results] Patients in the experimental group finished 88.6% of the total aerobic training sessions prescribed. In compliant participants (adherence≥80%), aerobic training significantly improved the Barthel index (from 40.1±21.1 to 79.2±14.2), Fugl-Meyer motor score (from 26.4±19.4 to 45.4±12.7), exercise test time (from 12.2±3.62 min to 13.9±3.6 min), 2-hour glucose level (from 9.22±1.16 mmol/L to 7.21±1.36 mmol/L) and homeostasis model of assessment for insulin resistence index (from 1.72±1.01 to 1.28±0.88). [Conclusion] Preliminary findings suggest that early and severely impaired stroke patients may benefit from low intensity ergometer aerobic training.

The effects of interday rest on adaptation to 6 weeks of plyometric training in young soccer players.

PubMed

Ramírez-Campillo, Rodrigo; Meylan, César M P; Álvarez-Lepín, Cristian; Henriquez-Olguín, Carlos; Martinez, Cristian; Andrade, David C; Castro-Sepúlveda, Mauricio; Burgos, Carlos; Baez, Eduardo I; Izquierdo, Mikel

2015-04-01

The purpose of this study was to determine the effects of short-term plyometric training interposed with 24 or 48 hours of rest between training sessions on explosive and endurance adaptations in young soccer players. A total of 166 players, between 10 and 17 years of age, were randomly divided into 3 groups: a control group (CG; n = 55) and 2 plyometric training groups with 24 hours (PT24; n = 54) and 48 hours (PT48; n = 57) of rest between training sessions. Before and after intervention, players were measured in squat jump, countermovement jump, 20 (RSI20) cm drop jump reactive strength index, broad long jump, 20-m sprint time, 10 × 5-m agility time, 20-m multistage shuttle run test, and sit-and-reach test. The plyometric training program was applied during 6 weeks, 2 sessions per week, with a load from 140 to 260 jumps per session, replacing some soccer-specific drills. After intervention, the CG did not show significant performance changes. PT24 and PT48 groups showed a small-to-moderate significant improvement in all performance tests (p < 0.001), with no differences between treatments. Although it has been recommended that plyometric drills should not be conducted on consecutive days, the study shows that plyometric training applied twice weekly on consecutive or nonconsecutive days results in similar explosive and endurance adaptations in young male soccer players.

Jump frequency may contribute to risk of jumper's knee: a study of interindividual and sex differences in a total of 11,943 jumps video recorded during training and matches in young elite volleyball players.

PubMed

Bahr, Martin A; Bahr, Roald

2014-09-01

Male sex, total training volume (number of hours per week) and match exposure (number of sets played per week) are risk factors for jumper's knee among young elite volleyball players. However, it is not known whether jump frequency differs among players on the same squad. To examine interindividual and sex differences in jump frequency during training and matches in young elite volleyball players. Observational study. Norwegian elite volleyball boarding school training programme. Student-athletes (26 boys and 18 girls, 16-18 years). Individual jump counts were recorded based on visual analysis of video recordings obtained from 1 week of volleyball training (9 training sessions for boys and 10 for girls, 14.1 h and 17.8 h of training, respectively) and 10 matches (5.9 h for boys (16 sets) and 7.7 h for girls (21 sets). A total of 11,943 jumps were recorded, 4138 during matches and 7805 during training. As training attendance and jump frequency varied substantially between players, the total exposure in training ranged from 50 to 666 jumps/week among boys and from 11 to 251 jumps/week among girls. On average, this corresponded to 35.7 jumps/h for boys and 13.7 jumps/h for girls (Student t test, p=0.002). Total jump exposure during matches ranged between 1 and 339 jumps among boys and between 0 and 379 jumps among girls, corresponding to an average jump frequency of 62.2 jumps/h for boys and 41.9 jumps/h for girls (Student t test, p<0.039). The interindividual differences in jump frequency were substantially greater than any differences observed among player functions. Jump frequency has substantial interindividual and sex differences during training and matches in young elite volleyball players. Total jump volume may represent a more important risk factor for jumper's knee than total training volume, warranting further research attention. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Supervised Balance Training and Wii Fit-Based Exercises Lower Falls Risk in Older Adults With Type 2 Diabetes.

PubMed

Morrison, Steven; Simmons, Rachel; Colberg, Sheri R; Parson, Henri K; Vinik, Aaron I

2018-02-01

This study examined the benefits of and differences between 12 weeks of thrice-weekly supervised balance training and an unsupervised at-home balance activity (using the Nintendo Wii Fit) for improving balance and reaction time and lowering falls risk in older individuals with type 2 diabetes mellitus (T2DM). Before-after trial. University research laboratory, home environment. Sixty-five older adults with type 2 diabetes were recruited for this study. Participants were randomly allocated to either supervised balance training (mean age 67.8 ± 5.2) or unsupervised training using the Nintendo Wii Fit balance board (mean age 66.1 ± 5.6). The training period for both groups lasted for 12 weeks. Individuals were required to complete three 40-minute sessions per week for a total of 36 sessions. The primary outcome measure was falls risk, which was as derived from the physiological profile assessment. In addition, measures of simple reaction time, lower limb proprioception, postural sway, knee flexion, and knee extension strength were also collected. Persons also self-reported any falls in the previous 6 months. Both training programs resulted in a significant lowering of falls risk (P < .05). The reduced risk was attributable to significant changes in reaction times for the hand (P < .05), foot (P < .01), lower-limb proprioception (P < .01), and postural sway (P < .05). Overall, training led to a decrease in falls risk, which was driven by improvements in reaction times, lower limb proprioception, and general balance ability. Interestingly, the reduced falls risk occurred without significant changes in leg strength, suggesting that interventions to reduce falls risk that target intrinsic risk factors related to balance control (over muscle strength) may have positive benefits for the older adult with T2DM at risk for falls. Copyright © 2017 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

Effect of balance training on postural balance control and risk of fall in children with diplegic cerebral palsy.

PubMed

El-Shamy, Shamekh Mohamed; Abd El Kafy, Ehab Mohamed

2014-01-01

The purpose of this study was to evaluate the effects of balance training on postural control and fall risk in children with diplegic cerebral palsy. Thirty spastic diplegic cerebral palsied children (10-12 years) were included in this study. Children were randomly assigned into two equal-sized groups: control and study groups. Participants in both groups received a traditional physical therapy exercise program. The study group additionally received balance training on the Biodex balance system. Treatment was provided 30 min/d, 3 d/week for 3 successive months. To evaluate the limit of stability and fall risk, participated children received baseline and post-treatment assessments using the Biodex balance system. Overall directional control, total time to complete the test, overall stability index of the fall risk test and total score of the pediatric balance scale were measured. Children in both groups showed significant improvements in the mean values of all measured variables post-treatment (p < 0.05). The results also showed significantly better improvement in the measured parameters for the study group, as compared to the control group (p < 0.05). Balance training on Biodex system is a useful tool that can be used in improving postural balance control in children with diplegic cerebral palsy.

Functional electrical stimulation cycling improves body composition, metabolic and neural factors in persons with spinal cord injury.

PubMed

Griffin, L; Decker, M J; Hwang, J Y; Wang, B; Kitchen, K; Ding, Z; Ivy, J L

2009-08-01

Persons with spinal cord injury (SCI) are at a heightened risk of developing type II diabetes and cardiovascular disease. The purpose of this investigation was to conduct an analysis of metabolic, body composition, and neurological factors before and after 10 weeks of functional electrical stimulation (FES) cycling in persons with SCI. Eighteen individuals with SCI received FES cycling 2-3 times per week for 10 weeks. Body composition was analyzed by dual X-ray absorptiometry. The American Spinal Injury Association (ASIA) neurological classification of SCI test battery was used to assess motor and sensory function. An oral glucose tolerance (OGTT) and insulin-response test was performed to assess blood glucose control. Additional metabolic variables including plasma cholesterol (total-C, HDL-C, LDL-C), triglyceride, and inflammatory markers (IL-6, TNF-alpha, and CRP) were also measured. Total FES cycling power and work done increased with training. Lean muscle mass also increased, whereas, bone and adipose mass did not change. The ASIA motor and sensory scores for the lower extremity significantly increased with training. Blood glucose and insulin levels were lower following the OGTT after 10 weeks of training. Triglyceride levels did not change following training. However, levels of IL-6, TNF-alpha, and CRP were all significantly reduced.

Training emotional intelligence improves both emotional intelligence and depressive symptoms in inpatients with borderline personality disorder and depression.

PubMed

Jahangard, Leila; Haghighi, Mohammad; Bajoghli, Hafez; Ahmadpanah, Mohammad; Ghaleiha, Ali; Zarrabian, Mohammad Kazem; Brand, Serge

2012-09-01

Borderline personality disorder (BPD) is defined as a pervasive pattern of instability in emotion, mood and interpersonal relationships, with a comorbidity between PBD and depressive disorders (DD). A key competence for successful management of interpersonal relationships is emotional intelligence (EI). Given the low EI of patients suffering from BPD, the present study aimed at investigating the effect on both emotional intelligence and depression of training emotional intelligence in patients with BPD and DD. A total of 30 inpatients with BPD and DD (53% females; mean age 24.20 years) took part in the study. Patients were randomly assigned either to the treatment or to the control group. Pre- and post-testing 4 weeks later involved experts' rating of depressive disorder and self-reported EI. The treatment group received 12 sessions of training in components of emotional intelligence. Relative to the control group, EI increased significantly in the treatment group over time. Depressive symptoms decreased significantly over time in both groups, though improvement was greater in the treatment than the control group. For inpatients suffering from BPD and DD, regular skill training in EI can be successfully implemented and leads to improvements both in EI and depression. Results suggest an additive effect of EI training on both EI and depressive symptoms.

The potential of real-time fMRI neurofeedback for stroke rehabilitation: A systematic review.

PubMed

Wang, Tianlu; Mantini, Dante; Gillebert, Celine R

2017-09-18

Real-time functional magnetic resonance imaging (rt-fMRI) neurofeedback aids the modulation of neural functions by training self-regulation of brain activity through operant conditioning. This technique has been applied to treat several neurodevelopmental and neuropsychiatric disorders, but its effectiveness for stroke rehabilitation has not been examined yet. Here, we systematically review the effectiveness of rt-fMRI neurofeedback training in modulating motor and cognitive processes that are often impaired after stroke. Based on predefined search criteria, we selected and examined 33 rt-fMRI neurofeedback studies, including 651 healthy individuals and 15 stroke patients in total. The results of our systematic review suggest that rt-fMRI neurofeedback training can lead to a learned modulation of brain signals, with associated changes at both the neural and the behavioural level. However, more research is needed to establish how its use can be optimized in the context of stroke rehabilitation. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

Nutrition education practices of primary school teachers in a resource-constrained community in Gauteng, South Africa.

PubMed

Kupolati, Mojisola D; Gericke, Gerda J; MacIntyre, Una E; Ferreira, Ronel; Fraser, William; Du Toit, Peet

2016-01-01

We investigated the nutrition education (NE) practices of teachers of grade 4‒7 learners in 11 primary schools (85% of total number) of the Bronkhorstspruit district (Gauteng Province) to identify opportunities for improving NE in these schools. A descriptive cross-sectional survey was carried out among a convenient sample of the teachers (N = 73) using a structured nutrition education practice questionnaire. Descriptive data analysis was done. Results showed that the majority of the teachers taught nutrition in about 10% to 20% of their teaching time. Thirty percent had no training to teach nutrition, and most teachers (86%) would like to receive training in nutrition. Teachers mostly taught nutrition as part of the curriculum (67%) and very few (18%) integrated nutrition into other subjects. Needing improvement were adequate classroom time for nutrition education delivery, continuing training in nutrition for teachers, and provision of up-to-date instructional materials for teaching nutrition.

Individuals with severely impaired vision can learn useful orientation and mobility skills in virtual streets and can use them to improve real street safety

PubMed Central

Liu, Lei

2017-01-01

Virtual reality has great potential in training road safety skills to individuals with low vision but the feasibility of such training has not been demonstrated. We tested the hypotheses that low vision individuals could learn useful skills in virtual streets and could apply them to improve real street safety. Twelve participants, whose vision was too poor to use the pedestrian signals were taught by a certified orientation and mobility specialist to determine the safest time to cross the street using the visual and auditory signals made by the start of previously stopped cars at a traffic-light controlled street intersection. Four participants were trained in real streets and eight in virtual streets presented on 3 projection screens. The crossing timing of all participants was evaluated in real streets before and after training. The participants were instructed to say “GO” at the time when they felt the safest to cross the street. A safety score was derived to quantify the GO calls based on its occurrence in the pedestrian phase (when the pedestrian sign did not show DON’T WALK). Before training, > 50% of the GO calls from all participants fell in the DON’T WALK phase of the traffic cycle and thus were totally unsafe. 20% of the GO calls fell in the latter half of the pedestrian phase. These calls were unsafe because one initiated crossing this late might not have sufficient time to walk across the street. After training, 90% of the GO calls fell in the early half of the pedestrian phase. These calls were safer because one initiated crossing in the pedestrian phase and had at least half of the pedestrian phase for walking across. Similar safety changes occurred in both virtual street and real street trained participants. An ANOVA showed a significant increase of the safety scores after training and there was no difference in this safety improvement between the virtual street and real street trained participants. This study demonstrated that virtual reality-based orientation and mobility training could be as efficient as real street training in improving street safety in individuals with severely impaired vision. PMID:28445540

The evaluation of a food allergy and epinephrine autoinjector training program for personnel who care for children in schools and community settings.

PubMed

Wahl, Ann; Stephens, Hilary; Ruffo, Mark; Jones, Amanda L

2015-04-01

With the dramatic increase in the incidence of food allergies, nurses and other school personnel are likely to encounter a child with food allergies. The objectives of this study were to assess the effectiveness of in-person training on enhancing knowledge about food allergies and improving self-confidence in preventing, recognizing, and treating food allergy reactions and to collect information about prior training and participation in response to food allergy incidents. A total of 4,818 individuals at 247 schools and community sites participated in the training program, which was delivered by a licensed registered nurse. Written evaluations, online surveys, and phone interviews were used to measure the impact including content retention, confidence, and behavior changes. The results of this study show that in-person training can increase participant's knowledge about food allergies and improve self-confidence in preventing, recognizing, and treating allergic reactions and that these gains were sustained over time. © The Author(s) 2014.

Pelvic floor muscle exercises utilizing trunk stabilization for treating postpartum urinary incontinence: randomized controlled pilot trial of supervised versus unsupervised training.

PubMed

Kim, Eun-Young; Kim, Suhn-Yeop; Oh, Duck-Won

2012-02-01

To investigate the effect of supervised and unsupervised pelvic floor muscle exercises utilizing trunk stabilization for treating postpartum urinary incontinence and to compare the outcomes. Randomized, single-blind controlled study. Outpatient rehabilitation hospital. Eighteen subjects with postpartum urinary incontinence. Subjects were randomized to either a supervised training group with verbal instruction from a physiotherapist, or an unsupervised training group after undergoing a supervised demonstration session. Bristol Female Lower Urinary Tract Symptom questionnaire (urinary symptoms and quality of life) and vaginal function test (maximal vaginal squeeze pressure and holding time) using a perineometer. The change values for urinary symptoms (-27.22 ± 6.20 versus -18.22 ± 5.49), quality of life (-5.33 ± 2.96 versus -1.78 ± 3.93), total score (-32.56 ± 8.17 versus -20.00 ± 6.67), maximal vaginal squeeze pressure (18.96 ± 9.08 versus 2.67 ± 3.64 mmHg), and holding time (11.32 ± 3.17 versus 5.72 ± 2.29 seconds) were more improved in the supervised group than in the unsupervised group (P < 0.05). In the supervised group, significant differences were found for all variables between pre- and post-test values (P < 0.01), whereas the unsupervised group showed significant differences for urinary symptom score, total score and holding time between the pre- and post-test results (P < 0.05). These findings suggest that exercising the pelvic floor muscles by utilizing trunk stabilization under physiotherapist supervision may be beneficial for the management of postpartum urinary incontinence.

Deep learning with domain adaptation for accelerated projection-reconstruction MR.

PubMed

Han, Yoseob; Yoo, Jaejun; Kim, Hak Hee; Shin, Hee Jung; Sung, Kyunghyun; Ye, Jong Chul

2018-09-01

The radial k-space trajectory is a well-established sampling trajectory used in conjunction with magnetic resonance imaging. However, the radial k-space trajectory requires a large number of radial lines for high-resolution reconstruction. Increasing the number of radial lines causes longer acquisition time, making it more difficult for routine clinical use. On the other hand, if we reduce the number of radial lines, streaking artifact patterns are unavoidable. To solve this problem, we propose a novel deep learning approach with domain adaptation to restore high-resolution MR images from under-sampled k-space data. The proposed deep network removes the streaking artifacts from the artifact corrupted images. To address the situation given the limited available data, we propose a domain adaptation scheme that employs a pre-trained network using a large number of X-ray computed tomography (CT) or synthesized radial MR datasets, which is then fine-tuned with only a few radial MR datasets. The proposed method outperforms existing compressed sensing algorithms, such as the total variation and PR-FOCUSS methods. In addition, the calculation time is several orders of magnitude faster than the total variation and PR-FOCUSS methods. Moreover, we found that pre-training using CT or MR data from similar organ data is more important than pre-training using data from the same modality for different organ. We demonstrate the possibility of a domain-adaptation when only a limited amount of MR data is available. The proposed method surpasses the existing compressed sensing algorithms in terms of the image quality and computation time. © 2018 International Society for Magnetic Resonance in Medicine.

Effectiveness of locomotion training in a home visit preventive care project: one-group pre-intervention versus post-intervention design study.

PubMed

Ito, Shinya; Hashimoto, Mari; Aduma, Saori; Yasumura, Seiji

2015-11-01

Locomotion training in a home visit-type preventive-care program has been reported elsewhere. However, continuation of appropriate exercises in a home setting is difficult, and few reports are available on locomotion training in a home setting. The objective of this study was to evaluate the effectiveness of locomotion training over 3 months in a home visit-type preventive-care program for improvement of motor function among elderly people. Nine hundred and fifty-eight elderly people in Tendo City in Japan who were not currently attending any preventive-care program were invited to participate in the study, and 87 were enrolled. In the pre-intervention and post-intervention assessments, we administered an interview survey (the Kihon Checklist), the timed one-leg standing test with eyes open and the sit-to-stand test, at the participants' homes. The intervention involved one set of training exercises with the participants standing on each leg for 1 min and squatting five or six times. The participants were asked to repeat one set of the exercises three times a day at home. In addition, the participants were regularly asked over the telephone about their performance of the exercises. Physical strength, cognitive function, and total scores of the Kihon Checklist were significantly lower after the intervention than before. In addition, the one-leg standing test time was significantly longer after the intervention (mean ± SD, 23.9 ± 35.4) than before (15.7 ± 20.5), and the sit-to-stand test time was significantly shorter after the intervention (13.0 ± 6.2) than before (14.8 ± 8.3). Locomotion training in a home-visit preventive-care program with telephone support effectively improved the motor function of elderly people who were not currently attending any preventive-care program organized by the long-term care insurance system.

Differential basal and exercise-induced IGF-I system responses to resistance vs. calisthenic-based military readiness training programs.

PubMed

Nindl, Bradley C; Alemany, Joseph A; Rarick, Kevin R; Eagle, Shawn R; Darnell, Mathew E; Allison, Katelyn F; Harman, Everett A

2017-02-01

The purpose of this study was to: 1) evaluate differential responses of the IGF-I system to either a calisthenic- or resistance exercise-based program and 2) determine if this chronic training altered the IGF-I system during an acute resistance exercise protocol. Thirty-two volunteers were randomly assigned into a resistance exercise-based training (RT) group (n=15, 27±5y, 174±6cm, 81±12kg) or a calisthenic-based training group (CT) (n=17, 29±5y, 179±8cm, 85±10kg) and all underwent 8weeks of exercise training (1.5h/d, 5d/wk). Basal blood was sampled pre- (Week 0), mid- (Week 4) and post-training (Week 8) and assayed for IGF-I system analytes. An acute resistance exercise protocol (AREP) was conducted preand post-training consisting of 6 sets of 10 repetitions in the squat with two minutes of rest in between sets and the IGF-I system analytes measured. A repeated measures ANOVA (p≤0.05) was used for statistical analysis. No interaction or within-subject effects were observed for basal total IGF-I, free IGF-I, or IGFBP-1. IGFBP-2 (pre; 578.6±295.7post-training; 14.3±1.9μg/mL; p=0.01). An interaction was observed for the RT group as IGFBP-3 increased from pre to mid (3462.4±216.4 vs. 3962.2±227.9ng/mL), but was not significant at the post-training time point (3770.3±228.7ng/mL). AREP caused all analytes except free IGF-I (40% decrease) to increase (17-27%; p=0.001) during exercise, returning to baseline concentration into recovery. Post-training, bioavailable IGF-I recovered more rapidly post-exercise. 8wks of chronic physical training resulted in increased basal IGFBP-2 and IGFBP-3, decreased ALS, increased pre-AREP free IGF-I and a more rapid free IGF-I recovery post-AREP. While total IGF-I was insensitive to chronic physical training, changes were observed with circulating IGFBPs and bioavailable IGF-I. To glean the most robust information on the effects of exercise training, studies must move beyond relying solely on total IGF-I measures and should consider IGFBPs and bioavailable IGF-I as these components of the circulating IGF-I system are essential determinants of IGF-I physiological action. Copyright © 2016 Elsevier Ltd. All rights reserved.

Automatic control of negative emotions: evidence that structured practice increases the efficiency of emotion regulation.

PubMed

Christou-Champi, Spyros; Farrow, Tom F D; Webb, Thomas L

2015-01-01

Emotion regulation (ER) is vital to everyday functioning. However, the effortful nature of many forms of ER may lead to regulation being inefficient and potentially ineffective. The present research examined whether structured practice could increase the efficiency of ER. During three training sessions, comprising a total of 150 training trials, participants were presented with negatively valenced images and asked either to "attend" (control condition) or "reappraise" (ER condition). A further group of participants did not participate in training but only completed follow-up measures. Practice increased the efficiency of ER as indexed by decreased time required to regulate emotions and increased heart rate variability (HRV). Furthermore, participants in the ER condition spontaneously regulated their negative emotions two weeks later and reported being more habitual in their use of ER. These findings indicate that structured practice can facilitate the automatic control of negative emotions and that these effects persist beyond training.

A Novel Perforator Flap Training Model Using a Chicken Leg.

PubMed

Cifuentes, Ignacio J; Yañez, Ricardo A; Salisbury, Maria C; Rodriguez, José R; Varas, Julian E; Dagnino, Bruno L

2016-04-01

Living animal models are frequently used for perforator flap dissection training, but no ex vivo models have been described. The aim of this study is to present a novel nonliving model for perforator flap training based on a constant perforator in the chicken leg. A total of 15 chicken legs were used in this study. Anatomical dissection of the perforator was performed after its identification using ink injection, and in four of these specimens a perforator-based flap was raised. The anatomical dissection revealed a constant intramuscular perforator with a median length of 5.7 cm. Median proximal and distal vessel diameters were 0.93 and 0.4 mm, respectively. The median dissection time was 77.5 minutes. This study introduces a novel, affordable, and reproducible model for the intramuscular dissection of a perforator-based flap using an ex vivo animal model. Its consistent perforator and appropriate-sized vessels make it useful for training.

Evaluation of a parallel implementation of the learning portion of the backward error propagation neural network: experiments in artifact identification.

PubMed Central

Sittig, D. F.; Orr, J. A.

1991-01-01

Various methods have been proposed in an attempt to solve problems in artifact and/or alarm identification including expert systems, statistical signal processing techniques, and artificial neural networks (ANN). ANNs consist of a large number of simple processing units connected by weighted links. To develop truly robust ANNs, investigators are required to train their networks on huge training data sets, requiring enormous computing power. We implemented a parallel version of the backward error propagation neural network training algorithm in the widely portable parallel programming language C-Linda. A maximum speedup of 4.06 was obtained with six processors. This speedup represents a reduction in total run-time from approximately 6.4 hours to 1.5 hours. We conclude that use of the master-worker model of parallel computation is an excellent method for obtaining speedups in the backward error propagation neural network training algorithm. PMID:1807607

Eccentric exercise training as a countermeasure to non-weight-bearing soleus muscle atrophy

NASA Technical Reports Server (NTRS)

Kirby, Christopher R.; Ryan, Mirelle J.; Booth, Frank W.

1992-01-01

This investigation tested whether eccentric resistance training could prevent soleus muscle atrophy during non-weight bearing. Adult female rats were randomly assigned to either weight bearing +/- intramuscular electrodes or non-weight bearing +/- intramuscular electrodes groups. Electrically stimulated maximal eccentric contractions were performed on anesthetized animals at 48-h intervals during the 10-day experiment. Non-weight bearing significantly reduced soleus muscle wet weight (28-31 percent) and noncollagenous protein content (30-31 percent) compared with controls. Eccentric exercise training during non-weight bearing attenuated but did not prevent the loss of soleus muscle wet weight and noncollagenous protein by 77 and 44 percent, respectively. The potential of eccentric exercise training as an effective and highly efficient counter-measure to non-weight-bearing atrophy is demonstrated in the 44 percent attenuation of soleus muscle noncollagenous protein loss by eccentric exercise during only 0.035 percent of the total non-weight-bearing time period.

[Part-time residency training in Israel].

PubMed

Fishbain, Dana; Levi, Baruch; Borow, Malke; Ashkenazi, Shai; Lindner, Arie

2012-08-01

Full-time work has long been perceived as a cornerstone of medical residency, the consensus being that a resident must apply the bulk of his time and attention to his professional training. Demographic and cultural changes that have taken place over the last several years, specifically the rise in the number of female doctors and the importance of leisure time to the younger generation, have intensified the need to find new and innovative ways to deal with the plight of the resident population. One idea, already in effect in many Western countries, is the institution of part-time residency programs. The possibility of fulfilling residency requirements on a part-time basis is intended to assist medical residents in integrating their professional development with their personal and family life, without compromising the quality of their training. A number of research studies conducted over the last several years in countries that allow part-time residency, among them the United States, England and Switzerland, aimed to examine the quality of part-time training. The various studies evinced a high level of satisfaction from the program both by the residents themselves and their supervisors, and in many aspects those doing residency part-time received higher appraisals than their full-time colleagues. Some of the residents polled noted that they would have totally foregone the practice of medicine had there not been an option to complete residency part-time. In light of the experience throughout the world and the changing landscape in Israel, the Scientific Council of the Israeli Medical Association decided to examine the issue and its various aspects, and weighed all the considerations in favor and against part-time residency. Recently, the Scientific Council approved the launch of a pilot program to allow part-time residency in several fields that were carefully selected according to specific criteria. Once the Ministry of Health completes the LegisLation process, part-time residency will officially begin in Israel.

The first cut is the deepest: basic surgical training in ophthalmology.

PubMed

Gibson, A; Boulton, M G; Watson, M P; Moseley, M J; Murray, P I; Fielder, A R

2005-12-01

To examine the basic surgical training received by Senior House Officers (SHOs) in ophthalmology and the influence on training of sociodemographic and organisational factors. Cross-sectional survey of SHOs in recognised UK surgical training posts asking about laboratory training and facilities, surgical experience, demographic details, with the opportunity to add comments. A total of 314/466 (67%) questionnaires were returned. In all, 67% had attended a basic surgical course, 40% had access to wet labs and 39% had spent time in a wet lab in the previous 6 months. The mean number of part phakoemulsification (phako) procedures performed per week was 0.79; the mean number of full phakos performed per week was 0.74. The number of part phakos performed was negatively correlated, and the number of full phakos completed was positively correlated, with length of time as an SHO. Respondents who had larger operating lists performed more full phakos per week (P<0.001). Compared to men, women were less likely to have access to a wet lab (P=0.013), had completed fewer full phakos per week (P=0.003), and were less likely to have completed 50 full phakos (P=0003). SHOs' comments revealed concerns about their limited 'hands on' experience. There are significant shortcomings in the basic surgical training SHOs receive, particularly in relation to wet lab experience and opportunities to perform full intraocular procedures. SHOs themselves perceive their training as inadequate. Women are disadvantaged in both laboratory and patient-based training, but minority ethnic groups and those who qualified overseas are not.

Effect of nordic walking and water aerobics training on body composition and the blood flow in lower extremities in elderly women.

PubMed

Jasiński, Ryszard; Socha, Małgorzata; Sitko, Ludmiła; Kubicka, Katarzyna; Woźniewski, Marek; Sobiech, Krzysztof A

2015-03-29

Nordic walking and water aerobics are very popular forms of physical activity in the elderly population. The aim of the study was to evaluate the influence of regular health training on the venous blood flow in lower extremities and body composition in women over 50 years old. Twenty-four women of mean age 57.9 (± 3.43) years, randomly divided into three groups (Nordic walking, water aerobics, and non-training), participated in the study. The training lasted 8 weeks, with one-hour sessions twice a week. Dietary habits were not changed. Before and after training vein refilling time and the function of the venous pump of the lower extremities were measured by photoplethysmography. Body composition was determined by bioelectrical impedance. Eight weeks of Nordic walking training improved the venous blood flow in lower extremities and normalized body composition in the direction of reducing chronic venous disorder risk factors. The average values of the refilling time variable (p = 0.04, p = 0.02, respectively) decreased in both the right and the left leg. After training a statistically significant increase in the venous pump function index was found only in the right leg (p = 0.04). A significant increase in fat-free mass, body cell mass and total body water was observed (p = 0.01), whereas body mass, the body mass index, and body fat decreased (p < 0.03). With regard to water aerobic training, no similar changes in the functions of the venous system or body composition were observed.

Assessment of neuromuscular function after different strength training protocols using tensiomyography.

PubMed

de Paula Simola, Rauno Á; Harms, Nico; Raeder, Christian; Kellmann, Michael; Meyer, Tim; Pfeiffer, Mark; Ferrauti, Alexander

2015-05-01

The purpose of the study was to analyze tensiomyography (TMG) sensitivity to changes in muscle force and neuromuscular function of the muscle rectus femoris (RF) using TMG muscle properties after 5 different lower-limb strength training protocols (multiple sets; DS = drop sets; eccentric overload; FW = flywheel; PL = plyometrics). After baseline measurements, 14 male strength trained athletes completed 1 squat training protocol per week over a 5-week period in a randomized controlled order. Maximal voluntary isometric contraction (MVIC), TMG measurements of maximal radial displacement of the muscle belly (Dm), contraction time between 10 and 90% of Dm (Tc), and mean muscle contraction velocities from the beginning until 10% (V10) and 90% of Dm (V90) were analyzed up to 0.5 (post-train), 24 (post-24), and 48 hours (post-48) after the training interventions. Significant analysis of variance main effects for measurement points were found for all TMG contractile properties and MVIC (p < 0.01). Dm and V10 post-train values were significantly lower after protocols DS and FW compared with protocol PL (p = 0.032 and 0.012, respectively). Dm, V10, and V90 decrements correlated significantly to the decreases in MVIC (r = 0.64-0.67, p ≤ 0.05). Some TMG muscle properties are sensitive to changes in muscle force, and different lower-limb strength training protocols lead to changes in neuromuscular function of RF. In addition, those protocols involving high and eccentric load and a high total time under tension may induce higher changes in TMG muscle properties.

Improving access to services and interactions with clients in Guatemala: the value of distance learning.

PubMed

Brambila, Carlos; Lopez, Felipe; Garcia-Colindres, Julio; Donis, Marco Vinicio

2005-04-01

To develop and test a distance-learning programme to improve the quality and efficiency of family planning services in Guatemala. The setting was rural family planning services in Guatemala. The study design was quasi-experimental with one intervention and one control group and with pre- and post-intervention measures. Two staff members from each of 20 randomly selected health districts were trained as leaders of the training programme. In turn, the 40 trainers trained a total of 240 service providers, under the supervision of four health area facilitators. The results were compared with 20 randomly selected control health districts. The intervention was a distance-learning programme including 40 in-class hours followed by 120 inservice practice hours spread over a 4-month period. Distinctively, the programme used a cascade approach to training, intensive supervision, and close monitoring and evaluation. Patient flow analysis was used to determine number of contacts, waiting times, and the interaction time between service providers and clients. Consultation observations were used to assess the quality and completeness of reproductive health information and services received by clients. The intervention showed a positive impact on reducing the number of contacts before the consultation and client waiting times. More complete services and better quality services were provided at intervention clinics. Some, but not all, of the study objectives were attained. The long-term impact of the intervention is as yet unknown. Distance-learning programmes are an effective methodology for training health professionals in rural areas.

Is it All About the Money? Not All Surgical Subspecialization Leads to Higher Lifetime Revenue when Compared to General Surgery.

PubMed

Baimas-George, Maria; Fleischer, Brian; Slakey, Douglas; Kandil, Emad; Korndorffer, James R; DuCoin, Christopher

It is believed that spending additional years gaining expertise in surgical subspecialization leads to higher lifetime revenue. Literature shows that more surgeons are pursuing fellowship training and dedicated research years; however, there are no data looking at the aggregate economic impact when training time is accounted for. It is hypothesized that there will be a discrepancy in lifetime income when delay to practice is considered. Data were collected from the Medical Group Management Association's 2015 report of average annual salaries. Fixed time of practice was set at 30 years, and total adjusted revenue was calculated based on variable years spent in research and fellowship. All total revenue outcomes were compared to general surgery and calculated in US dollars. The financial data on general surgeons and 9 surgical specialties (vascular, pediatric, plastic, breast, surgical oncology, cardiothoracic, thoracic primary, transplant, and trauma) were examined. With fellowship and no research, breast and surgical oncology made significantly less than general surgery (-$1,561,441, -$1,704,958), with a difference in opportunity cost equivalent to approximately 4 years of work. Pediatric and cardiothoracic surgeons made significantly more than general surgeons, with an increase of opportunity cost equivalent to $5,301,985 and $3,718,632, respectively. With 1 research year, trauma surgeons ended up netting less than a general surgeon by $325,665. With 2 research years, plastic and transplant surgeons had total lifetime revenues approximately equivalent to that of a general surgeon. Significant disparities exist in lifetime total revenue between surgical subspecialties and in comparison, to general surgery. Although most specialists do gross more than general surgeons, breast and surgical oncologists end up netting significantly less over their lifetime as well as trauma surgeons if they do 1 year of research. Thus, the economic advantage of completing additional training is dependent on surgical field and duration of research. Copyright © 2017 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Geographically Distributed Citizen Scientist Training for the 2017 Citizen CATE Experiment

NASA Astrophysics Data System (ADS)

Gelderman, Richard; Penn, Matt; Baer, Robert; Isberner, Fred; Pierce, Michael; Walter, Donald K.; Yanamandra-Fisher, Padma; Sheeley, Neil R.

2016-01-01

The solar eclipse of 21 August 2017 will be visible to over a half billion people across the entire North American continent. The roughly 100-mile wide path of totality, stretching from Oregon to South Carolina, will be the destination for tens of millions of people. In the decades since 1979, when the last total solar eclipse was visible from the continental USA, the phenomenon of Internet enabled citizen science has grown to be an accepted mode for science. The Citizen Continental-America Telescopic Eclipse (Citizen CATE) experiment has been funded as one of the three 2017 eclipse related NASA STEM agreements to engage citizen scientists in a unique, cutting-edge solar physics experiment. Teams across the USA will be trained to use standardized refracting telescope and digital imager set-ups to observe the solar corona during the eclipse, acquiring multiple exposures to create one high dynamic range image. After observing during the eclipse, the CATE volunteers will upload the combined image to a cloud-storage site and the CATE team will then work to properly orient and align all the images collected from across the continent to produce a continuous 90-minutes movie. A time-compressed first cut of the entire sequence will be made available to media outlets on the same afternoon of the eclipse, with hope that high quality images will encourage the most accurate coverage of this Great American Eclipse. We discuss overall the project, as well as details of the initial tests of the prototype set-up (including in the Faroe Islands during the March 2015 total solar eclipse) and plans for the future night-time and day-time observing campaigns, and for a handful of observing teams positioned for overlapping observations of the March 2016 total solar eclipse in the South Pacific.

The effect of interruptions during training on the time to the first trial and race start in Thoroughbred racehorses.

PubMed

Bolwell, C F; Rogers, C W; French, N P; Firth, E C

2013-02-01

Few studies have investigated the effect of having interruptions during training on future training and racing performance in Thoroughbred racehorses. The aim of this paper was to investigate the effect of having an interruption before the first trial on starting in a trial or a race. A prospective cohort study was used to record the training activity of a cohort of Thoroughbred racehorses, over two racing seasons. Fourteen racehorse trainers recorded information on the distances worked at canter and at fast speeds (<15s/200 m) and provided reasons for horses not training, or for having interruptions (break from training). Trial and racing results were obtained from the New Zealand Thoroughbred Racing online database. A Cox proportional hazards regression model was used to investigate two outcome measures of performance: (1) time to the first trial and (2) time to the first race. The type of interruption that had occurred before the first trial was the main exposure of interest, and was grouped into: no interruption, voluntary (no known condition or disease present) and involuntary interruptions (due to the presence of a condition or disease). A total of 160/200 (80%) horses started in at least one trial and 100/205 (48%) horses started in at least one race during the study period. The median time to starting in a trial or a race differed significantly (p<0.001) with the type of interruption. The hazard of starting in a trial was lower for horses experiencing voluntary and involuntary interruptions (p<0.001) but there was no association with starting in a race, after adjusting for confounding variables. As age at the start of training increased the hazard of starting in a trial decreased. Horses accumulating longer distances at 15s/200 m had a higher hazard of starting in a trial, whilst horses accumulating fewer events at high speed and fewer trials had a reduced hazard of starting in a race. There was significant clustering at the trainer level for both the outcomes investigated. Interruptions to training had an effect on the time to, and hazard of, a trial but not a race start. The timing of these interruptions may have implications for future racing success and career longevity. Copyright © 2012 Elsevier B.V. All rights reserved.

Organisational Change and the Management of Training in Australian Enterprises.

ERIC Educational Resources Information Center

Smith, Andrew; Oczkowski, Edward; Macklin, Robert; Noble, Charles

2003-01-01

A survey of 584 Australian companies investigated the impact of 5 management practices (total quality management, teamwork, lean production, reengineering, learning organizations) in relation to 8 training practices. New management practices had significant but differing effects on the organization of training: total quality management had the…

The short-term effect of high versus moderate protein intake on recovery after strength training in resistance-trained individuals.

PubMed

Roberts, Justin; Zinchenko, Anastasia; Suckling, Craig; Smith, Lee; Johnstone, James; Henselmans, Menno

2017-01-01

Dietary protein intakes up to 2.9 g.kg -1 .d -1 and protein consumption before and after resistance training may enhance recovery, resulting in hypertrophy and strength gains. However, it remains unclear whether protein quantity or nutrient timing is central to positive adaptations. This study investigated the effect of total dietary protein content, whilst controlling for protein timing, on recovery in resistance trainees. Fourteen resistance-trained individuals underwent two 10-day isocaloric dietary regimes with a protein content of 1.8 g.kg -1 .d -1 (PRO MOD ) or 2.9 g.kg -1 .d -1 (PRO HIGH ) in a randomised, counterbalanced, crossover design. On days 8-10 (T1-T3), participants undertook resistance exercise under controlled conditions, performing 3 sets of squat, bench press and bent-over rows at 80% 1 repetition maximum until volitional exhaustion. Additionally, participants consumed a 0.4 g.kg -1 whey protein concentrate/isolate mix 30 min before and after exercise sessions to standardise protein timing specific to training. Recovery was assessed via daily repetition performance, muscle soreness, bioelectrical impedance phase angle, plasma creatine kinase (CK) and tumor necrosis factor-α (TNF-α). No significant differences were reported between conditions for any of the performance repetition count variables ( p  > 0.05). However, within PRO MOD only, squat performance total repetition count was significantly lower at T3 (19.7 ± 6.8) compared to T1 (23.0 ± 7.5; p  = 0.006). Pre and post-exercise CK concentrations significantly increased across test days ( p  ≤ 0.003), although no differences were reported between conditions. No differences for TNF-α or muscle soreness were reported between dietary conditions. Phase angle was significantly greater at T3 for PRO HIGH (8.26 ± 0.82°) compared with PRO MOD (8.08 ± 0.80°; p  = 0.012). When energy intake and peri-exercise protein intake was controlled for, a short term PRO HIGH diet did not improve markers of muscle damage or soreness in comparison to a PRO MOD approach following repeated days of intensive training. Whilst it is therefore likely that moderate protein intakes (1.8 g.kg -1 .d -1 ) may be sufficient for resistance-trained individuals, it is noteworthy that both lower body exercise performance and bioelectrical phase angle were maintained with PRO HIGH . Longer term interventions are warranted to determine whether PRO MOD intakes are sufficient during prolonged training periods or when extensive exercise (e.g. training twice daily) is undertaken.

Effect of 8 Weeks Soccer Training on Health and Physical Performance in Untrained Women

PubMed Central

Ortiz, Jaelson G.; da Silva, Juliano F.; Carminatti, Lorival J.; Guglielmo, Luiz G.A.; Diefenthaeler, Fernando

2018-01-01

This study aims to analyze the physiological, neuromuscular, and biochemical responses in untrained women after eight weeks of regular participation in small-sided soccer games compared to aerobic training. Twenty-seven healthy untrained women were divided into two groups [soccer group (SG = 17) and running group (RG = 10)]. Both groups trained three times per week for eight weeks. The variables measured in this study were maximal oxygen uptake (VO2max), relative velocity at VO2max (vVO2max), peak velocity, relative intensity at lactate threshold (vLT), relative intensity at onset of blood lactate accumulation (vOBLA), peak force, total cholesterol, HDL, LDL, triglycerides, and cholesterol ratio (LDL/HDL). VO2max, vLT, and vOBLA increased significantly in both groups (12.8 and 16.7%, 11.1 and 15.3%, 11.6 and 19.8%, in SG and RG respectively). However, knee extensors peak isometric strength and triglyceride levels, total cholesterol, LDL, and HDL did not differ after eight weeks of training in both groups. On the other hand, the LDL/HDL ratio significantly reduced in both groups. In conclusion, eight weeks of regular participation in small-sided soccer games was sufficient to increase aerobic performance and promote health benefits related to similar aerobic training in untrained adult women. Key points Regular participation in soccer small sided-games increase aerobic performance and promote health benefits related to similar aerobic training in untrained women. 8 weeks soccer training is enough to promote positive physiological and biochemical adaptations in untrained women. Soccer small sided-games have the potential to be more pleasurable and effective among women as other modalities as running and cycling. PMID:29535574

A 3-week multimodal intervention involving high-intensity interval training in female cancer survivors: a randomized controlled trial.

PubMed

Schmitt, Joachim; Lindner, Nathalie; Reuss-Borst, Monika; Holmberg, Hans-Christer; Sperlich, Billy

2016-02-01

To compare the effects of a 3-week multimodal rehabilitation involving supervised high-intensity interval training (HIIT) on female breast cancer survivors with respect to key variables of aerobic fitness, body composition, energy expenditure, cancer-related fatigue, and quality of life to those of a standard multimodal rehabilitation program. A randomized controlled trial design was administered. Twenty-eight women, who had been treated for cancer were randomly assigned to either a group performing exercise of low-to-moderate intensity (LMIE; n = 14) or a group performing high-intensity interval training (HIIT; n = 14) as part of a 3-week multimodal rehabilitation program. No adverse events related to the exercise were reported. Work economy improved following both HIIT and LMIE, with improved peak oxygen uptake following LMIE. HIIT reduced mean total body fat mass with no change in body mass, muscle or fat-free mass (best P < 0.06). LMIE increased muscle and total fat-free body mass. Total energy expenditure (P = 0.45) did not change between the groups, whereas both improved quality of life to a similar high extent and lessened cancer-related fatigue. This randomized controlled study demonstrates that HIIT can be performed by female cancer survivors without adverse health effects. Here, HIIT and LMIE both improved work economy, quality of life and cancer-related fatigue, body composition or energy expenditure. Since the outcomes were similar, but HIIT takes less time, this may be a time-efficient strategy for improving certain aspects of the health of female cancer survivors. © 2016 The Authors. Physiological Reports published by Wiley Periodicals, Inc. on behalf of the American Physiological Society and The Physiological Society.

Influence of compressive gear on powerlifting performance: role of blood flow restriction training.

PubMed

Godawa, Travis M; Credeur, Daniel P; Welsch, Michael A

2012-05-01

This study investigated the effects of powerlifting gear on training volume and performance, defined by the squat, bench press, and deadlift. Eighteen powerlifters (18-26 years) were randomized into either a group that trained and competed using compressive gear (CG) or without the gear (NON). Training volume, volume progression, and powerlifting performance were assessed before and after 10 weeks of training. Training volume increased in the first 4 weeks for both groups. Volume lifted for squat and the totals were greater in the CG. There was an increase in squat (19.05 ± 30.97 lb, p = 0.02), deadlift (19.05 ± 21.17 lb, p = 0.001), and the total score (44.00 ± 60.44 lb, p = 0.005) for both the groups. The improvements in squat (CG = 33.85 vs. NON = 5.74, p = 0.07) and totals (CG = 66.59 vs. NON = 23.67, p = 0.15) were greater in the CG. Both groups showed a significant and similar increase in the Wilks scores (+13.54 points, p = 0.03). There was a trend toward greater volume progression in those wearing CG during the initial stages of training. Both the groups significantly improved performance for the squat, and deadlift, and had higher totals, and Wilks scores, indicating significant strength gains. The greater magnitude of improvements in the squat and totals for the CG lifters suggests an ergogenic potential of training with powerlifting gear.

Improving fluid intelligence with training on working memory: a meta-analysis.

PubMed

Au, Jacky; Sheehan, Ellen; Tsai, Nancy; Duncan, Greg J; Buschkuehl, Martin; Jaeggi, Susanne M

2015-04-01

Working memory (WM), the ability to store and manipulate information for short periods of time, is an important predictor of scholastic aptitude and a critical bottleneck underlying higher-order cognitive processes, including controlled attention and reasoning. Recent interventions targeting WM have suggested plasticity of the WM system by demonstrating improvements in both trained and untrained WM tasks. However, evidence on transfer of improved WM into more general cognitive domains such as fluid intelligence (Gf) has been more equivocal. Therefore, we conducted a meta-analysis focusing on one specific training program, n-back. We searched PubMed and Google Scholar for all n-back training studies with Gf outcome measures, a control group, and healthy participants between 18 and 50 years of age. In total, we included 20 studies in our analyses that met our criteria and found a small but significant positive effect of n-back training on improving Gf. Several factors that moderate this transfer are identified and discussed. We conclude that short-term cognitive training on the order of weeks can result in beneficial effects in important cognitive functions as measured by laboratory tests.

Effect of dietary antioxidants, training, and performance correlates on antioxidant status in competitive rowers.

PubMed

Braakhuis, Andrea J; Hopkins, Will G; Lowe, Timothy E

2013-09-01

The beneficial effects of exercise and a healthy diet are well documented in the general population but poorly understood in elite athletes. Previous research in subelite athletes suggests that regular training and an antioxidant-rich diet enhance antioxidant defenses but not performance. To investigate whether habitual diet and/or exercise (training status or performance) affect antioxidant status in elite athletes. Antioxidant blood biomarkers were assessed before and after a 30-min ergometer time trial in 28 male and 34 female rowers. The antioxidant blood biomarkers included ascorbic acid, uric acid, total antioxidant capacity (TAC), erythrocyte- superoxide dismutase, glutathione peroxidase (GPx), and catalase. Rowers completed a 7-d food diary and an antioxidant-intake questionnaire. Effects of diet, training, and performance on resting biomarkers were assessed with Pearson correlations, and their effect on exercise-induced changes in blood biomarkers was assessed by a method of standardization. With the exception of GPx, there were small to moderate increases with exercise for all markers. Blood resting TAC had a small correlation with total antioxidant intake (correlation .29; 90% confidence limits, ±.27), and the exercise-induced change in TAC had a trivial to small association with dietary antioxidant intake from vitamin C (standardized effect .19; ±.22), vegetables (.20; ±.23), and vitamin A (.25; ±.27). Most other dietary intakes had trivial associations with antioxidant biomarkers. Years of training had a small inverse correlation with TAC (-.32; ±.19) and a small association with the exercise-induced change in TAC (.27; ±.24). Training status correlates more strongly with antioxidant status than diet does.

Comparable Effects of High-Intensity Interval Training and Prolonged Continuous Exercise Training on Abdominal Visceral Fat Reduction in Obese Young Women

PubMed Central

Zhang, Haifeng; Tong, Tom K.; Qiu, Weifeng; Zhang, Xu; Zhou, Shi

2017-01-01

This study compared the effect of prolonged moderate-intensity continuous training (MICT) on reducing abdominal visceral fat in obese young women with that of work-equivalent (300 kJ/training session) high-intensity interval training (HIIT). Forty-three participants received either HIIT (n = 15), MICT (n = 15), or no training (CON, n = 13) for 12 weeks. The abdominal visceral fat area (AVFA) and abdominal subcutaneous fat area (ASFA) of the participants were measured through computed tomography scans preintervention and postintervention. Total fat mass and the fat mass of the android, gynoid, and trunk regions were assessed through dual-energy X-ray absorptiometry. Following HIIT and MICT, comparable reductions in AVFA (−9.1, −9.2 cm2), ASFA (−35, −28.3 cm2), and combined AVFA and ASFA (−44.7, −37.5 cm2, p > 0.05) were observed. Similarly, reductions in fat percentage (−2.5%, −2.4%), total fat mass (−2.8, −2.8 kg), and fat mass of the android (−0.3, −0.3 kg), gynoid (−0.5, −0.7 kg), and trunk (−1.6, −1.2 kg, p > 0.05) regions did not differ between HIIT and MICT. No variable changed in CON. In conclusion, MICT consisting of prolonged sessions has no quantitative advantage, compared with that resulting from HIIT, in abdominal visceral fat reduction. HIIT appears to be the predominant strategy for controlling obesity because of its time efficiency. PMID:28116314

Survey of the incidence and effect of major life events on graduate medical education trainees

PubMed Central

Grimm, Lars J.; Nagler, Alisa; Maxfield, Charles M.

2015-01-01

Purpose This study aims to assess the incidence of major life events during graduate medical education (GME) training and to establish any associations with modifiable activities and career planning. Methods The authors surveyed graduating GME trainees from their parent institution in June 2013. Demographic information (clinical department, gender, training duration) and major life events (marriage, children, death/illness, home purchase, legal troubles, property loss) were surveyed. Respondents were queried about the relationship between life events and career planning. A multivariable logistic regression model tested for associations. Results A total of 53.2% (166/312) of graduates responded to the survey. 50% (83/166) of respondents were female. Major life events occurred in 96.4% (160/166) of respondents. Male trainees were more likely (56.1% [46/82] vs. 30.1% [25/83]) to have a child during training (p=0.01). A total of 41.6% (69/166) of responders consciously engaged or avoided activities during GME training, while 31.9% (53/166) of responders reported that life events influenced their career plans. Trainees in lifestyle residencies (p=0.02), those who experienced the death or illness of a close associate (p=0.01), and those with legal troubles (p=0.04) were significantly more likely to consciously control life events. Conclusion Major life events are very common and changed career plans in nearly a third of GME trainees. Furthermore, many trainees consciously avoided activities due to their responsibilities during training. GME training programs should closely assess the institutional support systems available to trainees during this difficult time. PMID:26070948

Time-course effects of aerobic physical training in the prevention of cigarette smoke-induced COPD.

PubMed

Toledo-Arruda, Alessandra C; Vieira, Rodolfo P; Guarnier, Flávia A; Suehiro, Camila L; Caleman-Neto, Agostinho; Olivo, Clarice R; Arantes, Petra M M; Almeida, Francine M; Lopes, Fernanda D T Q S; Ramos, Ercy M C; Cecchini, Rubens; Lin, Chin Jia; Martins, Milton Arruda

2017-09-01

A previous study by our group showed that regular exercise training (ET) attenuated pulmonary injury in an experimental model of chronic exposure to cigarette smoke (CS) in mice, but the time-course effects of the mechanisms involved in this protection remain poorly understood. We evaluated the temporal effects of regular ET in an experimental model of chronic CS exposure. Male C57BL/6 mice were divided into four groups: Control (sedentary + air), Exercise (aerobic training + air), Smoke (sedentary + smoke), and Smoke + Exercise (aerobic training + smoke). Mice were exposed to CS and ET for 4, 8, or 12 wk. Exercise protected mice exposed to CS from emphysema and reductions in tissue damping and tissue elastance after 12 wk ( P < 0.01). The total number of inflammatory cells in the bronchoalveolar lavage increased in the Smoke group, mainly due to the recruitment of macrophages after 4 wk, neutrophils and lymphocytes after 8 wk, and lymphocytes and macrophages after 12 wk ( P < 0.01). Exercise attenuated this increase in mice exposed to CS. The protection conferred by exercise was mainly observed after exercise adaptation. Exercise increased IL-6 and IL-10 in the quadriceps and lungs ( P < 0.05) after 12 wk. Total antioxidant capacity and SOD was increased and TNF-α and oxidants decreased in lungs of mice exposed to CS after 12 wk ( P < 0.05). The protective effects of exercise against lung injury induced by cigarette smoke exposure suggests that anti-inflammatory mediators and antioxidant enzymes play important roles in chronic obstructive pulmonary disease development mainly after the exercise adaptation. NEW & NOTEWORTHY These experiments investigated for the first time the temporal effects of regular moderate exercise training in cigarette smoke-induced chronic obstructive pulmonary disease. We demonstrate that aerobic conditioning had a protective effect in emphysema development induced by cigarette smoke exposure. This effect was most likely secondary to an effect of exercise on oxidant-antioxidant balance and anti-inflammatory mediators. Copyright © 2017 the American Physiological Society.

Exercise training improves endothelial function in resistance arteries of young prehypertensives.

PubMed

Beck, D T; Martin, J S; Casey, D P; Braith, R W

2014-05-01

Prehypertension is associated with reduced conduit artery endothelial function and perturbation of oxidant/antioxidant status. It is unknown whether endothelial dysfunction persists to resistance arteries and whether exercise training affects oxidant/antioxidant balance in young prehypertensives. We examined resistance artery function using venous occlusion plethysmography measurement of forearm (FBF) and calf blood flow (CBF) at rest and during reactive hyperaemia (RH), as well as lipid peroxidation (8-iso-PGF2α) and antioxidant capacity (Trolox-equivalent antioxidant capacity; TEAC) before and after exercise intervention or time control. Forty-three unmedicated prehypertensive and 15 matched normotensive time controls met screening requirements and participated in the study (age: 21.1±0.8 years). Prehypertensive subjects were randomly assigned to resistance exercise training (PHRT; n=15), endurance exercise training (PHET; n=13) or time-control groups (PHTC; n=15). Treatment groups exercised 3 days per week for 8 weeks. Peak and total FBF were lower in prehypertensives than normotensives (12.7±1.2 ml min(-1) per100 ml tissue and 89.1±7.7 ml min(-1) per 100 ml tissue vs 16.3±1.0 ml min(-1) per 100 ml tissue and 123.3±6.4 ml min(-1) per 100 ml tissue, respectively; P<0.05). Peak and total CBF were lower in prehypertensives than normotensives (15.3±1.2 ml min(-1) per 100 ml tissue and 74±8.3 ml min(-1) per 100 ml tissue vs 20.9±1.4 ml min(-1) per 100 ml tissue and 107±9.2 ml min(-1) per 100 ml tissue, respectively; P<0.05). PHRT and PHET improved humoral measures of TEAC (+24 and +30%) and 8-iso-PGF2α (-43 and -40%, respectively; P < or = 0.05). This study provides evidence that young prehypertensives exhibit reduced resistance artery endothelial function and that short-term (8 weeks) resistance or endurance training are effective in improving resistance artery endothelial function and oxidant/antioxidant balance in young prehypertensives.

Optimizing Preseason Training Loads in Australian Football.

PubMed

Carey, David L; Crow, Justin; Ong, Kok-Leong; Blanch, Peter; Morris, Meg E; Dascombe, Ben J; Crossley, Kay M

2018-02-01

To investigate whether preseason training plans for Australian football can be computer generated using current training-load guidelines to optimize injury-risk reduction and performance improvement. A constrained optimization problem was defined for daily total and sprint distance, using the preseason schedule of an elite Australian football team as a template. Maximizing total training volume and maximizing Banister-model-projected performance were both considered optimization objectives. Cumulative workload and acute:chronic workload-ratio constraints were placed on training programs to reflect current guidelines on relative and absolute training loads for injury-risk reduction. Optimization software was then used to generate preseason training plans. The optimization framework was able to generate training plans that satisfied relative and absolute workload constraints. Increasing the off-season chronic training loads enabled the optimization algorithm to prescribe higher amounts of "safe" training and attain higher projected performance levels. Simulations showed that using a Banister-model objective led to plans that included a taper in training load prior to competition to minimize fatigue and maximize projected performance. In contrast, when the objective was to maximize total training volume, more frequent training was prescribed to accumulate as much load as possible. Feasible training plans that maximize projected performance and satisfy injury-risk constraints can be automatically generated by an optimization problem for Australian football. The optimization methods allow for individualized training-plan design and the ability to adapt to changing training objectives and different training-load metrics.

Surgical simulation tasks challenge visual working memory and visual-spatial ability differently.

PubMed

Schlickum, Marcus; Hedman, Leif; Enochsson, Lars; Henningsohn, Lars; Kjellin, Ann; Felländer-Tsai, Li

2011-04-01

New strategies for selection and training of physicians are emerging. Previous studies have demonstrated a correlation between visual-spatial ability and visual working memory with surgical simulator performance. The aim of this study was to perform a detailed analysis on how these abilities are associated with metrics in simulator performance with different task content. The hypothesis is that the importance of visual-spatial ability and visual working memory varies with different task contents. Twenty-five medical students participated in the study that involved testing visual-spatial ability using the MRT-A test and visual working memory using the RoboMemo computer program. Subjects were also trained and tested for performance in three different surgical simulators. The scores from the psychometric tests and the performance metrics were then correlated using multivariate analysis. MRT-A score correlated significantly with the performance metrics Efficiency of screening (p = 0.006) and Total time (p = 0.01) in the GI Mentor II task and Total score (p = 0.02) in the MIST-VR simulator task. In the Uro Mentor task, both the MRT-A score and the visual working memory 3-D cube test score as presented in the RoboMemo program (p = 0.02) correlated with Total score (p = 0.004). In this study we have shown that some differences exist regarding the impact of visual abilities and task content on simulator performance. When designing future cognitive training programs and testing regimes, one might have to consider that the design must be adjusted in accordance with the specific surgical task to be trained in mind.

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.

Effects of strength training on muscle strength characteristics, functional capabilities, and balance in middle-aged and older women.

PubMed

Holviala, Jarkko H S; Sallinen, Janne M; Kraemer, William J; Alen, Markku J; Häkkinen, Keijo K T

2006-05-01

Progressive strength training can lead to substantial increases in maximal strength and mass of trained muscles, even in older women and men, but little information is available about the effects of strength training on functional capabilities and balance. Thus, the effects of 21 weeks of heavy resistance training--including lower loads performed with high movement velocities--twice a week on isometric maximal force (ISOmax) and force-time curve (force produced in 500 milliseconds, F0-500) and dynamic 1 repetition maximum (1RM) strength of the leg extensors, 10-m walking time (10WALK) and dynamic balance test (DYN.D) were investigated in 26 middle-aged (MI; 52.8 +/- 2.4 years) and 22 older women (O; 63.8 +/- 3.8 years). 1RM, ISOmax, and F0-500 increased significantly in MI by 28 +/- 10%, 20 +/- 19%, 31 +/- 34%, and in O by 27 +/- 8%, 20 +/- 16%, 18 +/- 45%, respectively. 10WALK (MI and O, p < 0.001) shortened and DYN.D improved (MI and O, p < 0.001). The present strength-training protocol led to large increases in maximal and explosive strength characteristics of leg extensors and in walking speed, as well to an improvement in the present dynamic balance test performance in both age groups. Although training-induced increase in explosive strength is an important factor for aging women, there are other factors that contribute to improvements in dynamic balance capacity. This study indicates that total body heavy resistance training, including explosive dynamic training, may be applied in rehabilitation or preventive exercise protocols in aging women to improve dynamic balance capabilities.

Perceptions of the Inpatient Training Experience: A Nationwide Survey of Gastroenterology Program Directors and Fellows.

PubMed

Kumar, Navin L; Perencevich, Molly L; Trier, Jerry S

2017-10-01

Inpatient training is a key component of gastroenterology (GI) fellowship programs nationwide, yet little is known about perceptions of the inpatient training experience. To compare the content, objectives and quality of the inpatient training experience as perceived by program directors (PD) and fellows in US ACGME-accredited GI fellowship programs. We conducted a nationwide, online-based survey of GI PDs and fellows at the conclusion of the 2016 academic year. We queried participants about (1) the current models of inpatient training, (2) the content, objectives, and quality of the inpatient training experience, and (3) the frequency and quality of educational activities on the inpatient service. We analyzed five-point Likert items and rank assessments as continuous variables by an independent t test and compared proportions using the Chi-square test. Survey response rate was 48.4% (75/155) for PDs and a total of 194 fellows completed the survey, with both groups reporting the general GI consult team (>90%) as the primary model of inpatient training. PDs and fellows agreed on the ranking of all queried responsibilities of the inpatient fellow to develop during the inpatient service. However, fellows indicated that attendings spent less time teaching and provided less formal feedback than that perceived by PDs (p < 0.0001). PDs rated the overall quality of the inpatient training experience (p < 0.0001) and education on the wards (p = 0.0003) as better than overall ratings by fellows. Although GI fellows and PDs agree on the importance of specific fellow responsibilities on the inpatient service, fellows report experiencing less teaching and feedback from attendings than that perceived by PDs. Committing more time to education and assessment may improve fellows' perceptions of the inpatient training experience.

Characteristics predicting laparoscopic skill in medical students: nine years' experience in a single center.

PubMed

Nomura, Tsutomu; Matsutani, Takeshi; Hagiwara, Nobutoshi; Fujita, Itsuo; Nakamura, Yoshiharu; Kanazawa, Yoshikazu; Makino, Hiroshi; Mamada, Yasuhiro; Fujikura, Terumichi; Miyashita, Masao; Uchida, Eiji

2018-01-01

We introduced laparoscopic simulator training for medical students in 2007. This study was designed to identify factors that predict the laparoscopic skill of medical students, to identify intergenerational differences in abilities, and to estimate the variability of results in each training group. Our ultimate goal was to determine the optimal educational program for teaching laparoscopic surgery to medical students. Between 2007 and 2015, a total of 270 fifth-year medical students were enrolled in this observational study. Before training, the participants were asked questions about their interest in laparoscopic surgery, experience with playing video games, confidence about driving, and manual dexterity. After the training, aspects of their competence (execution time, instrument path length, and economy of instrument movement) were assessed. Multiple regression analysis identified significant effects of manual dexterity, gender, and confidence about driving on the results of the training. The training results have significantly improved over recent years. The variability among the results in each training group was relatively small. We identified the characteristics of medical students with excellent laparoscopic skills. We observed educational benefits from interactions between medical students within each training group. Our study suggests that selection and grouping are important to the success of modern programs designed to train medical students in laparoscopic surgery.

Effect of exercise training on Ca2+ release units of left ventricular myocytes of spontaneously hypertensive rats.

PubMed

Carneiro-Júnior, M A; Quintão-Júnior, J F; Drummond, L R; Lavorato, V N; Drummond, F R; Amadeu, M A; Oliveira, E M; Felix, L B; Cruz, J S; Mill, J G; Natali, A J; Prímola-Gomes, T N

2014-08-29

In cardiomyocytes, calcium (Ca2+) release units comprise clusters of intracellular Ca2+ release channels located on the sarcoplasmic reticulum, and hypertension is well established as a cause of defects in calcium release unit function. Our objective was to determine whether endurance exercise training could attenuate the deleterious effects of hypertension on calcium release unit components and Ca2+ sparks in left ventricular myocytes of spontaneously hypertensive rats. Male Wistar and spontaneously hypertensive rats (4 months of age) were divided into 4 groups: normotensive (NC) and hypertensive control (HC), and normotensive (NT) and hypertensive trained (HT) animals (7 rats per group). NC and HC rats were submitted to a low-intensity treadmill running protocol (5 days/week, 1 h/day, 0% grade, and 50-60% of maximal running speed) for 8 weeks. Gene expression of the ryanodine receptor type 2 (RyR2) and FK506 binding protein (FKBP12.6) increased (270%) and decreased (88%), respectively, in HC compared to NC rats. Endurance exercise training reversed these changes by reducing RyR2 (230%) and normalizing FKBP12.6 gene expression (112%). Hypertension also increased the frequency of Ca2+ sparks (HC=7.61±0.26 vs NC=4.79±0.19 per 100 µm/s) and decreased its amplitude (HC=0.260±0.08 vs NC=0.324±0.10 ΔF/F0), full width at half-maximum amplitude (HC=1.05±0.08 vs NC=1.26±0.01 µm), total duration (HC=11.51±0.12 vs NC=14.97±0.24 ms), time to peak (HC=4.84±0.06 vs NC=6.31±0.14 ms), and time constant of decay (HC=8.68±0.12 vs NC=10.21±0.22 ms). These changes were partially reversed in HT rats (frequency of Ca2+ sparks=6.26±0.19 µm/s, amplitude=0.282±0.10 ΔF/F0, full width at half-maximum amplitude=1.14±0.01 µm, total duration=13.34±0.17 ms, time to peak=5.43±0.08 ms, and time constant of decay=9.43±0.15 ms). Endurance exercise training attenuated the deleterious effects of hypertension on calcium release units of left ventricular myocytes.

Low Volume Aerobic Training Heightens Muscle Deoxygenation in Early Post-Angina Pectoris Patients.

PubMed

Takagi, Shun; Murase, Norio; Kime, Ryotaro; Niwayama, Masatsugu; Osada, Takuya; Katsumura, Toshihito

2016-01-01

The aim of this study was to investigate the effect of low volume aerobic exercise training on muscle O2 dynamics during exercise in early post-angina pectoris (AP) patients, as a pilot study. Seven AP patients (age: 72 ± 6 years) participated in aerobic exercise training for 12 weeks. Training consisted of continuous cycling exercise for 30 min at the individual's estimated lactate threshold, and the subjects trained for 15 ± 5 exercise sessions over 12 weeks. Before and after training, the subjects performed ramp cycling exercise until exhaustion. Muscle O2 saturation (SmO2) and relative changes from rest in deoxygenated hemoglobin concentration (∆Deoxy-Hb) and total hemoglobin concentration (∆Total-Hb) were monitored at the vastus lateralis by near infrared spatial resolved spectroscopy during exercise. The SmO2 was significantly lower and ∆Deoxy-Hb was significantly higher after training than before training, while there were no significant changes in ∆Total-Hb. These results indicated that muscle deoxygenation and muscle O2 extraction were potentially heightened by aerobic exercise training in AP patients, even though the exercise training volume was low.

Tai Chi for People with Visual Impairments: A Pilot Study

ERIC Educational Resources Information Center

Miszko, Tanya A.; Ramsey, Vincent K.; Blasch, Bruce B.

2004-01-01

This pilot study assessed the physical and psychological outcomes of a tai chi exercise program for eight adults with visual impairments. It found that after eight weeks of orientation and mobility training and tai chi practice, the participants' single leg-stance time and total knee flexion work and power improved, as did their frequency of,…

Sanitation in School Housekeeping, A Training Course for School Custodians.

ERIC Educational Resources Information Center

Florida State Dept. of Education, Tallahassee. School Plant Management Section.

The most efficient and modern methods for cleaning and sanitizing school facilities are presented for the benefit of school custodians. Careful attention to the total school environment can be supportive of the general education program and at the same time make a sound contribution to the health and health education. Topics discussed include--(1)…

77 FR 12373 - Pilot Certification and Qualification Requirements for Air Carrier Operations

Federal Register 2010, 2011, 2012, 2013, 2014

2012-02-29

... section of this document. Privacy: We will post all comments we receive, without change, to http://www... Certification rating, pass a Training Program knowledge test before taking the and practical ATP knowledge test, test, and have and have a minimum at least 1,500 of 50 hours in class hours total time of airplane. as...

Significance of Linguistics in Translation Education at the University Level

ERIC Educational Resources Information Center

Erton, Ismail; Tanbi, Yasemin

2016-01-01

Translation studies--that is translation and Interpretation, is a field that evolved as a sub-discipline of Linguistics and its related subjects. In the course of time, it developed as a separate area of study with roots still attached to its origins. Hence, the training of translator and the interpreter cannot be totally separated from…

Robotic surgery basic skills training: Evaluation of a pilot multidisciplinary simulation-based curriculum

PubMed Central

Foell, Kirsten; Finelli, Antonio; Yasufuku, Kazuhiro; Bernardini, Marcus Q.; Waddell, Thomas K.; Pace, Kenneth T.; Honey, R. John D.’A.; Lee, Jason Y.

2013-01-01

Purpose: Simulation-based training improves clinical skills, while minimizing the impact of the educational process on patient care. We present results of a pilot multidisciplinary, simulation-based robotic surgery basic skills training curriculum (BSTC) for robotic novices. Methods: A 4-week, simulation-based, robotic surgery BSTC was offered to the Departments of Surgery and Obstetrics & Gynecology (ObGyn) at the University of Toronto. The course consisted of various instructional strategies: didactic lecture, self-directed online-training modules, introductory hands-on training with the da Vinci robot (dVR) (Intuitive Surgical Inc., Sunnyvale, CA), and dedicated training on the da Vinci Skills Simulator (Intuitive Surgical Inc., Sunnyvale, CA) (dVSS). A third of trainees participated in competency-based dVSS training, all others engaged in traditional time-based training. Pre- and post-course skill testing was conducted on the dVR using 2 standardized skill tasks: ring transfer (RT) and needle passing (NP). Retention of skills was assessed at 5 months post-BSTC. Results: A total of 37 participants completed training. The mean task completion time and number of errors improved significantly post-course on both RT (180.6 vs. 107.4 sec, p < 0.01 and 3.5 vs. 1.3 sec, p < 0.01, respectively) and NP (197.1 vs. 154.1 sec, p < 0.01 and 4.5 vs. 1.8 sec, p = 0.04, respectively) tasks. No significant difference in performance was seen between specialties. Competency-based training was associated with significantly better post-course performance. The dVSS demonstrated excellent face validity. Conclusions: The implementation of a pilot multidisciplinary, simulation-based robotic surgery BSTC revealed significantly improved basic robotic skills among novice trainees, regardless of specialty or level of training. Competency-based training was associated with significantly better acquisition of basic robotic skills. PMID:24381662

Effect of Different Training Methods on Stride Parameters in Speed Maintenance Phase of 100-m Sprint Running.

PubMed

Cetin, Emel; Hindistan, I Ethem; Ozkaya, Y Gul

2018-05-01

Cetin, E, Hindistan, IE, Ozkaya, YG. Effect of different training methods on stride parameters in speed maintenance phase of 100-m sprint running. J Strength Cond Res 32(5): 1263-1272, 2018-This study examined the effects of 2 different training methods relevant to sloping surface on stride parameters in speed maintenance phase of 100-m sprint running. Twenty recreationally active students were assigned into one of 3 groups: combined training (Com), horizontal training (H), and control (C) group. Com group performed uphill and downhill training on a sloping surface with an angle of 4°, whereas H group trained on a horizontal surface, 3 days a week for 8 weeks. Speed maintenance and deceleration phases were divided into distances with 10-m intervals, and running time (t), running velocity (RV), step frequency (SF), and step length (SL) were measured at preexercise, and postexercise period. After 8 weeks of training program, t was shortened by 3.97% in Com group, and 2.37% in H group. Running velocity also increased for totally 100 m of running distance by 4.13 and 2.35% in Com, and H groups, respectively. At the speed maintenance phase, although t and maximal RV (RVmax) found to be statistically unaltered during overall phase, t was found to be decreased, and RVmax was preceded by 10 m in distance in both training groups. Step length was increased at 60-70 m, and SF was decreased at 70-80 m in H group. Step length was increased with concomitant decrease in SF at 80-90 m in Com group. Both training groups maintained the RVmax with a great percentage at the speed maintenance phase. In conclusion, although both training methods resulted in an increase in running time and RV, Com training method was more prominently effective method in improving RV, and this improvement was originated from the positive changes in SL during the speed maintaining phase.

Sexual health education in U.S. physician assistant programs.

PubMed

Seaborne, Lori A; Prince, Ronald J; Kushner, David M

2015-05-01

Since the 1950s, sexual health education in medical schools has been evaluated and reported upon, but there has never been an assessment published about sexual health curricula in U.S. physician assistant (PA) programs. The aim of this study was to gain better understanding of how PA programs cover sexual health topics. Between January and March 2014, 181 accredited PA programs received a mailed survey inquiring about their sexual health curriculum. The survey assessed general sexual health topics; lesbian, gay, bisexual, transgender (LGBT) topics; teaching methods; and the amount of time spent on sexual health education. A total of 106 programs responded (59%). Ten programs offered a required, discrete course on human sexuality. The majority incorporated training into other coursework, which is consistent with most medical schools. LGBT topics were covered less thoroughly than the general sexual health topics. Total amount of time spent on sexual health topics varied widely among programs, from a minimum of 2-4 hours to a maximum of 60 hours, with a median of 12 hours. PA programs in the United States appear to compare favorably with the training offered to medical students in regard to time spent on sexual health education. Transgender issues were least well-covered of all the topics queried. © 2015 International Society for Sexual Medicine.

Training-induced neuroplasticity in young children.

PubMed

Schlaug, Gottfried; Forgeard, Marie; Zhu, Lin; Norton, Andrea; Norton, Andrew; Winner, Ellen

2009-07-01

As the main interhemispheric fiber tract, the corpus callosum (CC) is of particular importance for musicians who simultaneously engage parts of both hemispheres to process and play music. Professional musicians who began music training before the age of 7 years have larger anterior CC areas than do nonmusicians, which suggests that plasticity due to music training may occur in the CC during early childhood. However, no study has yet demonstrated that the increased CC area found in musicians is due to music training rather than to preexisting differences. We tested the hypothesis that approximately 29 months of instrumental music training would cause a significant increase in the size of particular subareas of the CC known to have fibers that connect motor-related areas of both hemispheres. On the basis of total weekly practice time, a sample of 31 children aged 5-7 was divided into three groups: high-practicing, low-practicing, and controls. No CC size differences were seen at base line, but differences emerged after an average of 29 months of observation in the high-practicing group in the anterior midbody of the CC (which connects premotor and supplementary motor areas of the two hemispheres). Total weekly music exposure predicted degree of change in this subregion of the CC as well as improvement on a motor-sequencing task. Our results show that it is intense musical experience/practice, not preexisting differences, that is responsible for the larger anterior CC area found in professional adult musicians.

The efficacy of a whole body sprint-interval training intervention in an office setting: A feasibility study.

PubMed

Gurd, Brendon J; Patel, Jugal; Edgett, Brittany A; Scribbans, Trisha D; Quadrilatero, Joe; Fischer, Steven L

2018-05-28

Whole body sprint-interval training (WB-SIT) represents a mode of exercise training that is both time-efficient and does not require access to an exercise facility. The current study examined the feasibility of implementing a WB-SIT intervention in a workplace setting. A total of 747 employees from a large office building were invited to participate with 31 individuals being enrolled in the study. Anthropometrics, aerobic fitness, core and upper body strength, and lower body mobility were assessed before and after a 12-week exercise intervention consisting of 2-4 training sessions per week. Each training session required participants to complete 8, 20-second intervals (separated by 10 seconds of rest) of whole body exercise. Proportion of participation was 4.2% while the response rate was 35% (11/31 participants completed post training testing). In responders, compliance to prescribed training was 83±17%, and significant (p <  0.05) improvements were observed for aerobic fitness, push-up performance and lower body mobility. These results demonstrate the efficacy of WB-FIT for improving fitness and mobility in an office setting, but highlight the difficulties in achieving high rates of participation and response in this setting.

Effect of complex training on carbon monoxide, cardiorespiratory function, and body mass among college students at the initial stage of stopping smoking.

PubMed

Kim, Seungsuk

2017-08-01

[Purpose] This study aimed to analyze the effects of complex training on carbon monoxide, cardiorespiratory function, and body mass among college students with the highest smoking rate among all age group. [Subjects and Methods] A total of 40 college students voluntarily participated in this study. All subjects smoked and were randomly divided into two groups: the experimental group (N=20) and the control group (N=20). The experimental group underwent complex training (30 min of training five times a week for 12 weeks) while the control group did not participate in such training. The complex training consisted of two parts: aerobic exercise (walking and running) and resistance exercise (weight training). [Results] Two-way ANOVA with repeated measures revealed significant interactions among CO, VO2max, HRmax, VEmax, body fat, and skeletal muscle mass, indicating that the changes were significantly different among groups. [Conclusion] A 12 week of complex physical exercise program would be an effective way to support a stop-smoking campaign as it quickly eliminates CO from the body and improves cardiorespiratory function and body condition.

Traditional birth attendants in Malawi.

PubMed

Smit, J J

1994-06-01

Traditional Birth Attendants (TBAs) and traditional healers form an important link in the chain of health personnel providing primary health care in Malawi. In spite of the establishment of hospitals and health centres, it is to these traditional healers and TBAs that the majority of people turn in times of sickness and child-birth. Approximately 60 per cent of all deliveries in Malawi occur in the villages. It is therefore important that due regard be paid to the activities of these traditional practitioners in order to ensure the achievement of the goal--"Health for all by the year 2000". The training of TBAs is seen as part of the Maternal and Child Health Services in the country. The Ministry of Health is responsible for the training and control of Traditional Birth Attendants and in 1976 opened a register in order to list all those trained. In early 1978 a training course for selected TBAs was conducted at the Kamuzu Central Hospital, Lilongwe and from 1982 the training programme evolved into a national training programme for TBAs. By February 1987, a total of 841 Traditional birth Attendants had been trained and the programme is still continuing.

A simulator for training in endovascular aneurysm repair: The use of three dimensional printers.

PubMed

Torres, I O; De Luccia, N

2017-08-01

To develop an endovascular aneurysm repair (EVAR) simulation system using three dimensional (3D) printed aneurysms, and to evaluate the impact of patient specific training prior to EVAR on the surgical performance of vascular surgery residents in a university hospital in Brazil. This was a prospective, controlled, single centre study. During 2015, the aneurysms of patients undergoing elective EVAR at São Paulo University Medical School were 3D printed and used in training sessions with vascular surgery residents. The 3D printers Stratasys-Connex 350, Formlabs-Form1+, and Makerbot were tested. Ten residents were enrolled in the control group (five residents and 30 patients in 2014) or the training group (five residents and 25 patients in 2015). The control group performed the surgery under the supervision of a senior vascular surgeon (routine procedure, without simulator training). The training group practised the surgery in a patient specific simulator prior to the routine procedure. Objective parameters were analysed, and a subjective questionnaire addressing training utility and realism was answered. Patient specific training reduced fluoroscopy time by 30% (mean 48 min, 95% confidence interval [CI] 40-58 vs. 33 min, 95% CI 26-42 [p < .01]), total procedure time by 29% (mean 292 min [95% CI 235-336] vs. 207 [95% CI 173-247]; p < .01), and volume of contrast used by 25% (mean 87 mL [95% CI 73-103] vs. 65 mL [95% CI 52-81]; p = .02). The residents considered the training useful and realistic, and reported that it increased their self confidence. The 3D printers Form1+ (using flexible resin) and Makerbot (using silicone) provided the best performance based on simulator quality and cost. An EVAR simulation system using 3D printed aneurysms was feasible. The best results were obtained with the 3D printers Form1+ (using flexible resin) and Makerbot (using silicone). Patient specific training prior to EVAR at a university hospital in Brazil improved residents' surgical performance (based on fluoroscopy time, surgery time, and volume of contrast used) and increased their self confidence. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

Effect of timing of protein and carbohydrate intake after resistance exercise on nitrogen balance in trained and untrained young men.

PubMed

Mori, Hiroyasu

2014-08-06

Resistance exercise alters the post-exercise response of anabolic and catabolic hormones. A previous study indicated that the turnover of muscle protein in trained individuals is reduced due to alterations in endocrine factors caused by resistance training, and that muscle protein accumulation varies between trained and untrained individuals due to differences in the timing of protein and carbohydrate intake. We investigated the effect of the timing of protein and carbohydrate intake after resistance exercise on nitrogen balance in trained and untrained young men. Subjects were 10 trained healthy men (mean age, 23 ± 4 years; height, 173.8 ± 3.1 cm; weight, 72.3 ± 4.3 kg) and 10 untrained healthy men (mean age, 23 ± 1 years; height, 171.8 ± 5.0 cm; weight, 64.5 ± 5.0 kg). All subjects performed four sets of 8 to 10 repetitions of a resistance exercise (comprising bench press, shoulder press, triceps pushdown, leg extension, leg press, leg curl, lat pulldown, rowing, and biceps curl) at 80% one-repetition maximum. After each resistance exercise session, subjects were randomly divided into two groups with respect to intake of protein (0.3 g/kg body weight) and carbohydrate (0.8 g/kg body weight) immediately after (P0) or 6 h (P6) after the session. All subjects were on an experimental diet that met their individual total energy requirement. We assessed whole-body protein metabolism by measuring nitrogen balance at P0 and P6 on the last 3 days of exercise training. The nitrogen balance was significantly lower in the trained men than in the untrained men at both P0 (P <0.05) and P6 (P <0.01). The nitrogen balance in trained men was significantly higher at P0 than at P6 (P <0.01), whereas that in the untrained men was not significantly different between the two periods. The timing of protein and carbohydrate intake after resistance exercise influences nitrogen balance differently in trained and untrained young men.

Effect of timing of protein and carbohydrate intake after resistance exercise on nitrogen balance in trained and untrained young men

PubMed Central

2014-01-01

Background Resistance exercise alters the post-exercise response of anabolic and catabolic hormones. A previous study indicated that the turnover of muscle protein in trained individuals is reduced due to alterations in endocrine factors caused by resistance training, and that muscle protein accumulation varies between trained and untrained individuals due to differences in the timing of protein and carbohydrate intake. We investigated the effect of the timing of protein and carbohydrate intake after resistance exercise on nitrogen balance in trained and untrained young men. Methods Subjects were 10 trained healthy men (mean age, 23 ± 4 years; height, 173.8 ± 3.1 cm; weight, 72.3 ± 4.3 kg) and 10 untrained healthy men (mean age, 23 ± 1 years; height, 171.8 ± 5.0 cm; weight, 64.5 ± 5.0 kg). All subjects performed four sets of 8 to 10 repetitions of a resistance exercise (comprising bench press, shoulder press, triceps pushdown, leg extension, leg press, leg curl, lat pulldown, rowing, and biceps curl) at 80% one-repetition maximum. After each resistance exercise session, subjects were randomly divided into two groups with respect to intake of protein (0.3 g/kg body weight) and carbohydrate (0.8 g/kg body weight) immediately after (P0) or 6 h (P6) after the session. All subjects were on an experimental diet that met their individual total energy requirement. We assessed whole-body protein metabolism by measuring nitrogen balance at P0 and P6 on the last 3 days of exercise training. Results The nitrogen balance was significantly lower in the trained men than in the untrained men at both P0 (P <0.05) and P6 (P <0.01). The nitrogen balance in trained men was significantly higher at P0 than at P6 (P <0.01), whereas that in the untrained men was not significantly different between the two periods. Conclusion The timing of protein and carbohydrate intake after resistance exercise influences nitrogen balance differently in trained and untrained young men. PMID:25096224

AMPA receptor phosphorylation and recognition memory: learning-related, time-dependent changes in the chick brain following filial imprinting.

PubMed

Solomonia, Revaz O; Meparishvili, Maia; Mikautadze, Ekaterine; Kunelauri, Nana; Apkhazava, David; McCabe, Brian J

2013-04-01

There is strong evidence that a restricted part of the chick forebrain, the intermediate medial mesopallium (IMM), stores information acquired through the learning process of visual imprinting. We have previously demonstrated that at 1 h but not 24 h after imprinting training, a learning-specific increase in the amount of membrane Thr286-autophosphorylated α-calcium/calmodulin-dependent protein kinase II (αCaMKII), and in the proportion of total αCaMKII that is phosphorylated, occurs in the IMM but not in a control brain region, the posterior pole of the nidopallium (PPN). αCaMKII directly phosphorylates Ser831 in the GluA1 subunit of the α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid receptor. In the present study we have inquired whether the learning-related increase in αCaMKII autophosphorylation is followed by changes in the Ser831 phosphorylation of GluA1 (P-GluA1) and in the total amount of this subunit (T-GluA1). Trained chicks together with untrained control chicks were killed either 1 or 24 h after training. Tissue was removed from the IMM together with tissue from the PPN as a control. Amounts of P-GluA1 and T-GluA1 were measured. In the left IMM of the 1 h group the P-GluA1/T-GluA1 ratio increased in a learning-specific way. No learning-related changes were observed in other brain regions at 1 h or in any region 24 h after training. The results indicate that a time- and regionally-dependent, learning-specific increase in GluA1 phosphorylation occurs early in recognition memory formation.

The effect of exercise intensity on postresistance exercise hypotension in trained men.

PubMed

Duncan, Michael J; Birch, Samantha L; Oxford, Samuel W

2014-06-01

The occurrence of postresistance exercise hypotension (PEH) after resistance exercise remains unknown. This study examined blood pressure and heart rate (HR) responses to an acute bout of low- and high-intensity resistance exercise, matched for total work, in trained males. Sixteen resistance-trained males (23.1 ± 5.9 years) performed an acute bout of low- (40% of 1 repetition maximum [1RM]) and high-intensity resistance exercise (80% 1RM), matched for total work, separated by 7 days and performed in a counterbalanced order. Systolic blood pressure (SBP) and diastolic blood pressure (DBP), mean arterial pressure (MAP), and HR were assessed before exercise, after completion of each exercise resistance exercise (3 sets of back squat, bench press, and deadlift) and every 10 minutes after resistance exercise for a period of 60 minutes. Results indicated a significant intensity × time interaction for SBP (p = 0.034, partial η(2) = 0.122) and MAP (p = 0.047, partial η(2) = 0.116) whereby SBP and MAP at 50-minute recovery and 60-minute recovery were significantly lower after high-intensity exercise (p = 0.01 for SBP and p = 0.05 for MAP in both cases) compared with low-intensity exercise. There were no significant main effects or interactions in regard to DBP (all p > 0.05). Heart rate data indicated a significant main effect for time (F(9, 135) = 2.479, p = 0.0001, partial η(2) = 0.344). Post hoc multiple comparisons indicated that HR was significantly higher after squat, bench press, and deadlift exercise compared with resting HR and HR at 40-, 50-, and 60-minute recovery (all p = 0.03). The present findings suggest that an acute bout of high intensity, but not low intensity, resistance exercise using compound movements can promote PEH in trained men.

Development of a curriculum and training program in Woman Veterans Health for Internal Medical Residents.

PubMed

Ceylony, Manju; Porhomayon, Jahan; Pourafkari, Leili; Nader, Nader D

2017-09-26

Internal Medicine residents must develop competency as Primary Care Providers, but a gap exists in their curriculum and training with regard to women's reproductive health. With increasing need in VA due to new influx of women veterans it poses problems in recruitment of competent physicians trained in Women's health. An intensive, one-month women's reproductive health curriculum with hands on experience for Internal Medicine residents was provided. Curriculum was taught to the residents who rotated at the Women's Health Clinic for one month. Pre-test and post-test exams were administered. Increase in knowledge of residents in providing gender specific evaluations and management was objectively assessed by changes in post-test scores. Data were analyzed for statistically significant improvement in written tests scores. Total of 47 Internal Medicine residents rotated through Women's Health Center during the evaluation period. All residents completed both pre-test and post-test exams. The average time to complete the pre-test was 20.5 ± 5.4 min and 19.5 ± 4.8 min for post-test. There was no correlation between the time to complete the pre-test exam and the post-test exam. The total score was significantly improved from 8.5 ± 1.6 to 13.2 ± 1.8 (p < 0.0001). This study shows how to equip physicians in training with information on women's health that enables them to provide safe and gender appropriate care in primary care settings. This practice will reduce the need for frequent referrals for specialized care and thus provide cost saving for patient and health care on the whole.

Individualized Internal and External Training Load Relationships in Elite Wheelchair Rugby Players.

PubMed

Paulson, Thomas A W; Mason, Barry; Rhodes, James; Goosey-Tolfrey, Victoria L

2015-01-01

The quantification and longitudinal monitoring of athlete training load (TL) provides a scientific explanation for changes in performance and helps manage injury/illness risk. Therefore, accurate and reliable monitoring tools are essential for the optimization of athletic performance. The aim of the present study was to establish the relationship between measures of internal [heart rate (HR) and session RPE (sRPE)] and external TL specific to wheelchair rugby (WR). Fourteen international WR athletes (age = 29 ± 7 years; body mass = 58.9 ± 10.9 kg) were monitored during 18 training sessions over a 3 month period during the competitive phase of the season. Activity profiles were collected during each training session using a radio-frequency based indoor tracking system (ITS). External TL was quantified by total distance (m) covered as well as time spent and distance covered in a range of classification-specific arbitrary speed zones. Banister's TRIMP, Edwards's summated HR zone (SHRZ), and Lucia's TRIMP methods were used to quantify physiological internal TL. sRPE was calculated as the product of session duration multiplied by perceived exertion using the Borg CR10 scale. Relationships between external and internal TL were examined using correlation coefficients and the 90% confidence intervals (90% CI). sRPE (r = 0.59) and all HR-based (r > 0.80) methods showed large and very large relationships with the total distance covered during training sessions, respectively. Large and very large correlations (r = 0.56 - 0.82) were also observed between all measures of internal TL and times spent and distances covered in low and moderate intensity speed zones. HR-based methods showed very large relationships with time (r = 0.71-0.75) and distance (r = 0.70-0.73) in the very high speed zone and a large relationship with the number of high intensity activities (HIA) performed (r = 0.56-0.62). Weaker relationships (r = 0.32-0.35) were observed between sRPE and all measures of high intensity activity. A large variation of individual correlation co-efficient was observed between sRPE and all external TL measures. The current findings suggest that sRPE and HR-based internal TL measures provide a valid tool for quantifying volume of external TL during WR training but may underestimate HIA. It is recommended that both internal and external TL measures are employed for the monitoring of overall TL during court-based training in elite WR athletes.

Individualized Internal and External Training Load Relationships in Elite Wheelchair Rugby Players

PubMed Central

Paulson, Thomas A. W.; Mason, Barry; Rhodes, James; Goosey-Tolfrey, Victoria L.

2015-01-01

Aim: The quantification and longitudinal monitoring of athlete training load (TL) provides a scientific explanation for changes in performance and helps manage injury/illness risk. Therefore, accurate and reliable monitoring tools are essential for the optimization of athletic performance. The aim of the present study was to establish the relationship between measures of internal [heart rate (HR) and session RPE (sRPE)] and external TL specific to wheelchair rugby (WR). Methods: Fourteen international WR athletes (age = 29 ± 7 years; body mass = 58.9 ± 10.9 kg) were monitored during 18 training sessions over a 3 month period during the competitive phase of the season. Activity profiles were collected during each training session using a radio-frequency based indoor tracking system (ITS). External TL was quantified by total distance (m) covered as well as time spent and distance covered in a range of classification-specific arbitrary speed zones. Banister's TRIMP, Edwards's summated HR zone (SHRZ), and Lucia's TRIMP methods were used to quantify physiological internal TL. sRPE was calculated as the product of session duration multiplied by perceived exertion using the Borg CR10 scale. Relationships between external and internal TL were examined using correlation coefficients and the 90% confidence intervals (90% CI). Results: sRPE (r = 0.59) and all HR-based (r > 0.80) methods showed large and very large relationships with the total distance covered during training sessions, respectively. Large and very large correlations (r = 0.56 − 0.82) were also observed between all measures of internal TL and times spent and distances covered in low and moderate intensity speed zones. HR-based methods showed very large relationships with time (r = 0.71−0.75) and distance (r = 0.70−0.73) in the very high speed zone and a large relationship with the number of high intensity activities (HIA) performed (r = 0.56−0.62). Weaker relationships (r = 0.32−0.35) were observed between sRPE and all measures of high intensity activity. A large variation of individual correlation co-efficient was observed between sRPE and all external TL measures. Conclusion: The current findings suggest that sRPE and HR-based internal TL measures provide a valid tool for quantifying volume of external TL during WR training but may underestimate HIA. It is recommended that both internal and external TL measures are employed for the monitoring of overall TL during court-based training in elite WR athletes. PMID:26733881

Total quality assurance

NASA Astrophysics Data System (ADS)

Louzon, E.

1989-12-01

Quality, cost, and schedule are three factors affecting the competitiveness of a company; they require balancing so that products of acceptable quality are delivered, on time and at a competitive cost. Quality costs comprise investment in quality maintenance and failure costs which arise from failure to maintain standards. The basic principle for achieving the required quality at minimum cost is that of prevention of failures, etc., through production control, attention to manufacturing practices, and appropriate management and training. Total quality control involves attention to the product throughout its life cycle, including in-service performance evaluation, servicing, and maintenance.

Management strategies of iron accumulation in a captive population of black rhinoceroses (Diceros bicornis minor).

PubMed

Mylniczenko, Natalie D; Sullivan, Kathleen E; Corcoran, Michelle E; Fleming, Gregory J; Valdes, Eduardo V

2012-09-01

During routine health screens for black rhinoceroses (Diceros bicornis minor) in a captive setting, serum iron and ferritin were analyzed as well as total iron binding capacity and total iron saturation. Trends for ferritin and percent iron saturation showed steady increases since 2003 in four of four animals (three males; one female) with two animals (one male; one female) consistently showing higher elevations over conspecifics. The historical diet had been comprised of a commercial or in-house complete pelleted feed; several species of fresh browse, Bermuda grass, alfalfa and timothy hays, as well as enrichment and training items (apples, carrots, sweet potatoes, and a small amount of leafy greens and vegetables). In 2009, one of the three male rhinoceroses showed a threefold increase in ferritin and concurrently exhibited clinical signs of lethargy, decreased appetite, and disinterest in training. The lone female showed a twofold increase; she also became reproductively acyclic in the prior year. The male was immobilized for examination and phlebotomy. During the same time period, a new version of the complete pelleted feed, with a reduced amount of iron, was introduced. Subsequent to the diet change, the male's ferritin levels have consistently declined, and the female started cycling again. Even with these corrective steps to reduce iron levels, levels of iron saturation remained high, and ferritin levels were still above 1,500 ng/ml. Therapeutic phlebotomy was instituted via a rigorous training program that allowed phlebotomies over a 30-min time frame. This was possible because of a long-term training program for the animals, consistent training personnel, routine collection of samples on a monthly basis, and general comfort level of the animals in the restraint chute. The results of this integrated approach showed some significant improvements and an overall positive impact on the animals.

A Novel Application of Machine Learning Methods to Model Microcontroller Upset Due to Intentional Electromagnetic Interference

NASA Astrophysics Data System (ADS)

Bilalic, Rusmir

A novel application of support vector machines (SVMs), artificial neural networks (ANNs), and Gaussian processes (GPs) for machine learning (GPML) to model microcontroller unit (MCU) upset due to intentional electromagnetic interference (IEMI) is presented. In this approach, an MCU performs a counting operation (0-7) while electromagnetic interference in the form of a radio frequency (RF) pulse is direct-injected into the MCU clock line. Injection times with respect to the clock signal are the clock low, clock rising edge, clock high, and the clock falling edge periods in the clock window during which the MCU is performing initialization and executing the counting procedure. The intent is to cause disruption in the counting operation and model the probability of effect (PoE) using machine learning tools. Five experiments were executed as part of this research, each of which contained a set of 38,300 training points and 38,300 test points, for a total of 383,000 total points with the following experiment variables: injection times with respect to the clock signal, injected RF power, injected RF pulse width, and injected RF frequency. For the 191,500 training points, the average training error was 12.47%, while for the 191,500 test points the average test error was 14.85%, meaning that on average, the machine was able to predict MCU upset with an 85.15% accuracy. Leaving out the results for the worst-performing model (SVM with a linear kernel), the test prediction accuracy for the remaining machines is almost 89%. All three machine learning methods (ANNs, SVMs, and GPML) showed excellent and consistent results in their ability to model and predict the PoE on an MCU due to IEMI. The GP approach performed best during training with a 7.43% average training error, while the ANN technique was most accurate during the test with a 10.80% error.

Residency program trainee-satisfaction correlate with results of the European board examination in neurosurgery.

PubMed

Stienen, Martin N; Netuka, David; Demetriades, Andreas K; Ringel, Florian; Gautschi, Oliver P; Gempt, Jens; Kuhlen, Dominique; Schaller, Karl

2016-10-01

Substantial country differences in neurosurgical training throughout Europe have recently been described, ranging from subjective rating of training quality to objective working hours per week. The aim of this study was to analyse whether these differences translate into the results of the written and oral part of the European Board Examination in Neurological Surgery (EBE-NS). Country-specific composite scores for satisfaction with quality of theoretical and practical training, as well as working hours per week, were obtained from an electronic survey distributed among European neurosurgical residents between June 2014 and March 2015. These were related to anonymous country-specific results of the EBE-NS between 2009 and 2016, using uni- and multivariate linear regression analysis. A total of n = 1025 written and n = 63 oral examination results were included. There was a significant linear relationship between the country-specific EBE-NS result in the written part and the country-specific composite score for satisfaction with quality of theoretical training [adjusted regression coefficient (RC) -3.80, 95 % confidence interval (CI) -5.43-7 -2.17, p < 0.001], but not with practical training or working time. For the oral part, there was a linear relationship between the country-specific EBE-NS result and the country-specific composite score for satisfaction with quality of practical training (RC 9.47, 95 % CI 1.47-17.47, p = 0.021), however neither with satisfaction with quality of theoretical training nor with working time. With every one-step improvement on the country-specific satisfaction score for theoretical training, the score in the EBE-NS Part 1 increased by 3.8 %. With every one-step improvement on the country-specific satisfaction score for practical training, the score in the EBE-NS Part 2 increased by 9.47 %. Improving training conditions is likely to have a direct positive influence on the knowledge level of trainees, as measured by the EBE-NS. The effect of the actual working time on the theoretical and practical knowledge of neurosurgical trainees appears to be insignificant.

COMPARISON OF LAPAROSCOPIC SKILLS PERFORMANCE USING SINGLE-SITE ACCESS (SSA) DEVICES VS. AN INDEPENDENT-PORT SSA APPROACH

PubMed Central

Schill, Matthew R.; Varela, J. Esteban; Frisella, Margaret M.; Brunt, L. Michael

2015-01-01

Background We compared performance of validated laparoscopic tasks on four commercially available single site access (SSA) access devices (AD) versus an independent port (IP) SSA set-up. Methods A prospective, randomized comparison of laparoscopic skills performance on four AD (GelPOINT™, SILS™ Port, SSL Access System™, TriPort™) and one IP SSA set-up was conducted. Eighteen medical students (2nd–4th year), four surgical residents, and five attending surgeons were trained to proficiency in multi-port laparoscopy using four laparoscopic drills (peg transfer, bean drop, pattern cutting, extracorporeal suturing) in a laparoscopic trainer box. Drills were then performed in random order on each IP-SSA and AD-SSA set-up using straight laparoscopic instruments. Repetitions were timed and errors recorded. Data are mean ± SD, and statistical analysis was by two-way ANOVA with Tukey HSD post-hoc tests. Results Attending surgeons had significantly faster total task times than residents or students (p< 0.001), but the difference between residents and students was NS. Pair-wise comparisons revealed significantly faster total task times for the IP-SSA set-up compared to all four AD-SSA’s within the student group only (p<0.05). Total task times for residents and attending surgeons showed a similar profile, but the differences were NS. When data for the three groups was combined, the total task time was less for the IP-SSA set-up than for each of the four AD-SSA set-ups (p < 0.001). Similarly,, the IP-SSA set-up was significantly faster than 3 of 4 AD-SSA set-ups for peg transfer, 3 of 4 for pattern cutting, and 2 of 4 for suturing. No significant differences in error rates between IP-SSA and AD-SSA set-ups were detected. Conclusions When compared to an IP-SSA laparoscopic set-up, single site access devices are associated with longer task performance times in a trainer box model, independent of level of training. Task performance was similar across different SSA devices. PMID:21993938

Prevalence and Cost of Full-Time Research Fellowships During General Surgery Residency – A National Survey

PubMed Central

Robertson, Charles M.; Klingensmith, Mary E.; Coopersmith, Craig M.

2009-01-01

Structured Abstract Objective To quantify the prevalence, outcomes, and cost of surgical resident research. Summary Background Data General surgery is unique among graduate medical education programs because a large percentage of residents interrupt their clinical training to spend 1-3 years performing full-time research. No comprehensive data exists on the scope of this practice. Methods Survey sent to all 239 program directors of general surgery residencies participating in the National Resident Matching Program. Results Response rate was 200/239 (84%). A total of 381 out of 1052 trainees (36%) interrupt residency to pursue full-time research. The mean research fellowship length is 1.7 years, with 72% of trainees performing basic science research. A significant association was found between fellowship length and post-residency activity, with a 14.7% increase in clinical fellowship training and a 15.2% decrease in private practice positions for each year of full-time research (p<0.0001). Program directors at 31% of programs reported increased clinical duties for research fellows as a result of ACGME work hour regulations for clinical residents, while a further 10% of programs are currently considering such changes. It costs $41.5 million to pay the 634 trainees who perform research fellowships each year, the majority of which is paid for by departmental funds (40%) and institutional training grants (24%). Conclusions Interrupting residency to perform a research fellowship is a common and costly practice among general surgery residents. While performing a research fellowship is associated with clinical fellowship training after residency, it is unclear to what extent this practice leads to the development of surgical investigators after post-graduate training. PMID:19106692

Prevalence and cost of full-time research fellowships during general surgery residency: a national survey.

PubMed

Robertson, Charles M; Klingensmith, Mary E; Coopersmith, Craig M

2009-01-01

To quantify the prevalence, outcomes, and cost of surgical resident research. General surgery is unique among graduate medical education programs because a large percentage of residents interrupt their clinical training to spend 1 to 3 years performing full-time research. No comprehensive data exists on the scope of this practice. Survey sent to all 239 program directors of general surgery residencies participating in the National Resident Matching Program. Response rate was 200 of 239 (84%). A total of 381 of 1052 trainees (36%) interrupt residency to pursue full-time research. The mean research fellowship length is 1.7 years, with 72% of trainees performing basic science research. A significant association was found between fellowship length and postresidency activity, with a 14.7% increase in clinical fellowship training and a 15.2% decrease in private practice positions for each year of full-time research (P < 0.0001). Program directors at 31% of programs reported increased clinical duties for research fellows as a result of Accreditation Council for Graduate Medical Education work hour regulations for clinical residents, whereas a further 10% of programs are currently considering such changes. It costs $41.5 million to pay the 634 trainees who perform research fellowships each year, the majority of which is paid for by departmental funds (40%) and institutional training grants (24%). Interrupting residency to perform a research fellowship is a common and costly practice among general surgery residents. Although performing a research fellowship is associated with clinical fellowship training after residency, it is unclear to what extent this practice leads to the development of surgical investigators after postgraduate training.

Establishing a community pharmacy residency at an independent pharmacy: Time allocation and valuation.

PubMed

Shugart, Katherine; Bryant, Jason; Kress, Dean; Ziegler, Bryan; Connelly, Lynn; Brittain, Kristy

2015-12-01

The value of a first-year community pharmacy residency program (CPRP) at an independent pharmacy was estimated based on time allocation for resident responsibilities. Predefined time allocation categories for the pharmacy resident were used to consistently classify and document time completing residency activities. Benefit-to-cost ratio was determined by tabulating total costs and total benefits of the residency program. A retrospective-prospective comparison of overall change in revenue, operating expense, and prescription volume was performed between the preresident time period (July 2012 to June 2013) and the postresident time period (July 2013 to June 2014). This comparison accounted for resident activities that did not directly generate revenue. Time allocations for the resident out of 2,221 total hours logged were dispensing (40%), clinical setup (16%), research (8%), professional meetings (7%), clinical activities (5%), resident education (5%), site precepting (4%), residency meetings (4%), didactic teaching (3%), miscellaneous (3%), marketing (2%), training (2%), and public health promotion (1%). Total costs were $77,422, and total benefits were $118,410. The benefit-to-cost ratio was 1.53. The postresident time interval had $172,451 more revenue and $6,622 more in operating expenses than the preresident time interval, and prescription volume decreased by 2,000 prescriptions compared to the previous year. The benefit-to-cost analysis indicated a $1.53 return for every $1.00 invested into a CPRP. An increase in revenue and operating expenses for the pharmacy was observed after implementation of the CPRP compared to the previous year. Copyright © 2015 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

[The hardware techniques for the restoration of the gait stereotype in the patients following total hip replacement: the personalized approach].

PubMed

Koneva, E S; Lyadov, K V; Shapovalenko, T V; Zhukova, E V; Polushkin, V G

2018-04-09

total hip replacement has long ago become the «golden standard» for the treatment of dysplastic coxarthrosis in thousands of the patients receiving it every year. In the meantime, the analysis of the specialized literature gives evidence of the lack of a systematic and personified approach to the rehabilitation treatment. The objective of the present study was to improve medical rehabilitation of the patients following the total hip replacement and to develop the personalized programs for walking modality reconstruction taking into consideration the age and the body weight of the patients. A total of 240 patients were available for the observation including 184 women and 56 men. They were divided into three study groups and one control group, with the differentiation into the following three subgroups: one comprised of the patients of moderate acerage age and body weight, the other containing the obese patients (BMI>35), and the third one involving the elderly patients (age >70 years); each subgroup consisted of 20 patients. All the patients received the early basic rehabilitation treatment, those in the study groups had to perform in addition the robotic training based on the use of hardware techniques supplemented by passive mechanotherapy and electromyostimulation designed to restore the walking stereotype with three types of devices: body weight unloading, video-reconstruction associated with biological feedback and robototherapy. The comparative analysis of the effectiveness of various methods of gait reconstruction has demonstrated the high effectiveness of the application of the hardware technique in the patients of moderate acerage age and body weight. At the same time, the elderly patients had a significantly higher rate of successful walking reconstruction efficiency under the influence of the video-associated training with biological feedback (3 times that achieved with training using the device for unloading the body weight and 4 times compared with the result of a course of robotic walk. The evaluation of the application of the techniques for the gait stereotype reconstruction in the obese patients gave evidence of the advantage of the Lokomat robotic trainings that produced 6 times better results than unloading of the body weight and 5 times better ones than the video-associated training with biological feedback. The results of the present study are on the whole comparable with the data reported by other authors although its design was different from that of the majority of the published studies in that our patients were allocated to different subgroups for the further personalization of the methods applied to restore the gait stereotype. The factors limiting the use of the results of this study include the medium-high level of the patients' welfare most of whom are residents of the city of Moscow and Moscow region characterized by a relatively high quality and accessibility of health care. It means that the results of such studies as the one described in the present article are directly related to the quality and accessibility of health care and can be extrapolated only to the socially safe and well-to-do patients. All the hardware techniques are equally effective in the patients of moderate average age and body weight. The elderly patients showed the best results using the video-reconstruction associated with biological feedback, while the Locomat technique was especially useful for the obese patients.

Initial validation of a virtual-reality robotic simulator.

PubMed

Lendvay, Thomas S; Casale, Pasquale; Sweet, Robert; Peters, Craig

2008-09-01

Robotic surgery is an accepted adjunct to minimally invasive surgery, but training is restricted to console time. Virtual-reality (VR) simulation has been shown to be effective for laparoscopic training and so we seek to validate a novel VR robotic simulator. The American Urological Association (AUA) Office of Education approved this study. Subjects enrolled in a robotics training course at the 2007 AUA annual meeting underwent skills training in a da Vinci dry-lab module and a virtual-reality robotics module which included a three-dimensional (3D) VR robotic simulator. Demographic and acceptability data were obtained, and performance metrics from the simulator were compared between experienced and nonexperienced roboticists for a ring transfer task. Fifteen subjects-four with previous robotic surgery experience and 11 without-participated. Nine subjects were still in urology training and nearly half of the group had reported playing video games. Overall performance of the da Vinci system and the simulator were deemed acceptable by a Likert scale (0-6) rating of 5.23 versus 4.69, respectively. Experienced subjects outperformed nonexperienced subjects on the simulator on three metrics: total task time (96 s versus 159 s, P < 0.02), economy of motion (1,301 mm versus 2,095 mm, P < 0.04), and time the telemanipulators spent outside of the center of the platform's workspace (4 s versus 35 s, P < 0.02). This is the first demonstration of face and construct validity of a virtual-reality robotic simulator. Further studies assessing predictive validity are ultimately required to support incorporation of VR robotic simulation into training curricula.

Randomized control trial of computer-based training targeting alertness in older adults: the ALERT trial protocol.

PubMed

VanVleet, Thomas; Voss, Michelle; Dabit, Sawsan; Mitko, Alex; DeGutis, Joseph

2018-05-03

Healthy aging is associated with a decline in multiple functional domains including perception, attention, short and long-term memory, reasoning, decision-making, as well as cognitive and motor control functions; all of which are significantly modulated by an individual's level of alertness. The control of alertness also significantly declines with age and contributes to increased lapses of attention in everyday life, ranging from minor memory slips to a lack of vigilance and increased risk of falls or motor-vehicle accidents. Several experimental behavioral therapies designed to remediate age-related cognitive decline have been developed, but differ widely in content, method and dose. Preliminary studies demonstrate that Tonic and Phasic Alertness Training (TAPAT) can improve executive functions in older adults and may be a useful adjunct treatment to enhance benefits gained in other clinically validated treatments. The purpose of the current trial (referred to as the Attention training for Learning Enhancement and Resilience Trial or ALERT) is to compare TAPAT to an active control training condition, include a larger sample of patients, and assess both cognitive and functional outcomes. We will employ a multi-site, longitudinal, blinded randomized controlled trial (RCT) design with a target sample of 120 patients with age-related cognitive decline. Patients will be asked to complete 36 training sessions remotely (30 min/day, 5 days a week, over 3 months) of either the experimental TAPAT training program or an active control computer games condition. Patients will be assessed on a battery of cognitive and functional outcomes at four time points, including: a) immediately before training, b) halfway through training, c) within forty-eight hours post completion of total training, and d) after a three-month no-contact period post completion of total training, to assess the longevity of potential training effects. The strengths of this protocol are that it tests an innovative, in-home administered treatment that targets a fundamental deficit in adults with age-related cognitive decline; employs highly sensitive computer-based assessments of cognition as well as functional abilities, and incorporates a large sample size in an RCT design. ClinicalTrials.gov identifier: NCT02416401.

Content analysis of medical students' seminars: a unique method of analyzing clinical thinking.

PubMed

Takata, Yukari; Stein, Gerald H; Endo, Kuniyuki; Arai, Akiko; Kohsaka, Shun; Kitano, Yuka; Honda, Hitoshi; Kitazono, Hidetaka; Tokunaga, Hironobu; Tokuda, Yasuharu; Obika, Mikako; Miyoshi, Tomoko; Kataoka, Hitomi; Terasawa, Hidekazu

2013-12-01

The study of communication skills of Asian medical students during structured Problem-based Learning (PBL) seminars represented a unique opportunity to assess their critical thinking development. This study reports the first application of the health education technology, content analysis (CA), to a Japanese web-based seminar (webinar). The authors assigned twelve randomly selected medical students from two universities and two clinical instructors to two virtual classrooms for four PBL structured tutoring sessions that were audio-video captured for CA. Both of the instructors were US-trained physicians. This analysis consisted of coding the students' verbal comments into seven types, ranging from trivial to advanced knowledge integration comments that served as a proxy for clinical thinking. The most basic level of verbal simple responses accounted for a majority (85%) of the total students' verbal comments. Only 15% of the students' comments represented more advanced types of critical thinking. The male students responded more than the female students; male students attending University 2 responded more than male students from University 1. The total mean students' verbal response time for the four sessions with the male instructor was 6.9%; total mean students' verbal response time for the four sessions with the female instructor was 19% (p < 0.05). This report is the first to describe the application of CA to a multi-university real time audio and video PBL medical student clinical training webinar in two Japanese medical schools. These results are preliminary, mostly limited by a small sample size (n = 12) and limited time frame (four sessions). CA technology has the potential to improve clinical thinking for medical students. This report may stimulate improvements for implementation.

Content analysis of medical students’ seminars: a unique method of analyzing clinical thinking

PubMed Central

2013-01-01

Background The study of communication skills of Asian medical students during structured Problem-based Learning (PBL) seminars represented a unique opportunity to assess their critical thinking development. This study reports the first application of the health education technology, content analysis (CA), to a Japanese web-based seminar (webinar). Methods The authors assigned twelve randomly selected medical students from two universities and two clinical instructors to two virtual classrooms for four PBL structured tutoring sessions that were audio-video captured for CA. Both of the instructors were US-trained physicians. This analysis consisted of coding the students’ verbal comments into seven types, ranging from trivial to advanced knowledge integration comments that served as a proxy for clinical thinking. Results The most basic level of verbal simple responses accounted for a majority (85%) of the total students’ verbal comments. Only 15% of the students’ comments represented more advanced types of critical thinking. The male students responded more than the female students; male students attending University 2 responded more than male students from University 1. The total mean students’ verbal response time for the four sessions with the male instructor was 6.9%; total mean students’ verbal response time for the four sessions with the female instructor was 19% (p < 0.05). Conclusions This report is the first to describe the application of CA to a multi-university real time audio and video PBL medical student clinical training webinar in two Japanese medical schools. These results are preliminary, mostly limited by a small sample size (n = 12) and limited time frame (four sessions). CA technology has the potential to improve clinical thinking for medical students. This report may stimulate improvements for implementation. PMID:24289320

Effects of computer-based stress management training on psychological well-being and work performance in japanese employees: a cluster randomized controlled trial.

PubMed

Umanodan, Rino; Shimazu, Akihito; Minami, Masahide; Kawakami, Norito

2014-01-01

This study evaluated the effectiveness of a computer-based stress management training (SMT) program in improving employees' psychological well-being and work performance. A total of 12 work units (N=263) were randomly assigned to either an intervention group (8 work units, n=142) or to a wait-list control group (4 work units, n=121). All participants were requested to answer online questionnaires assessing psychological well-being as a primary outcome, and coping style, social support, and knowledge about stress management as secondary outcomes at baseline (T0), immediately after the intervention (T1), and 2 months after the intervention (T2). The group × time interaction was tested using a mixed-model repeated measures ANOVA. Results showed a group × time interaction for "knowledge about stress management" in the entire sample. Among participants who had more than 3 d of training, a significant group × time interaction was observed for "problem-solving" and "avoidance and suppression" as well as "knowledge about stress management." Our computer-based stress management program was effective for improving knowledge about stress management. It was also effective for improving coping skills in instances where participants had enough time (at least 3 d) to complete all sessions.

Effects of Sport-Specific Training Intensity on Sleep Patterns and Psychomotor Performance in Adolescent Athletes.

PubMed

Suppiah, Haresh T; Low, Chee Yong; Chia, Michael

2016-11-01

Adolescent student-athletes face time constraints due to athletic and scholastic commitments, resulting in habitually shortened nocturnal sleep durations. However, there is a dearth of research on the effects of sleep debt on student-athlete performance. The study aimed to (i) examine the habitual sleep patterns (actigraphy) of high-level student-athletes during a week of training and academic activities, (ii) ascertain the effects of habitual sleep durations experienced by high-level student-athletes on psychomotor performance, and (iii) examine the impact of sport training intensities on the sleep patterns of high-level student-athletes that participate in low and high intensity sports. Sleep patterns of 29 high-level student-athletes (14.7 ± 1.3 yrs) were monitored over 7 days. A psychomotor vigilance task was administered on weekdays to ascertain the effects of habitual sleep durations. Weekend total sleep time was longer than weekdays along with a delay in bedtime, and waketimes. Psychomotor vigilance reaction times on Monday were faster than on Thursday and Friday, with reaction times on Tuesday also faster than on Friday. False starts and lapses were greater on Friday compared with Monday. There was a negative impact of sleep debt on student-athletes' psychomotor performance.

In vivo porcine training model for laparoscopic Roux-en-Y choledochojejunostomy.

PubMed

Lee, Jun Suh; Hong, Tae Ho

2015-06-01

The purpose of this study was to develop a porcine training model for laparoscopic choledochojejunostomy (CJ) that can act as a bridge between simulation models and actual surgery for novice surgeons. The feasibility of this model was evaluated. Laparoscopic CJ using intracorporeal sutures was performed on ten animals by a surgical fellow with no experience in human laparoscopic CJ. A single layer of running sutures was placed in the posterior and anterior layers. Jejunojejunostomy was performed using a linear stapler, and the jejunal opening was closed using absorbable unidirectional sutures (V-Loc 180). The average operation time was 131.3 ± 36.4 minutes, and the CJ time was 57.5 ± 18.4 minutes. Both the operation time and CJ time showed a steady decrease with an increasing number of cases. The average diameter of the CBD was 6.4 ± 0.8 mm. Of a total of ten animals, eight were sacrificed after the procedure. In two animals, a survival model was evaluated. Both pigs recovered completely and survived for two weeks, after which both animals were sacrificed. None of the animals exhibited any signs of bile leakage or anastomosis site stricture. The porcine training model introduced in this paper is an adequate model for practicing laparoscopic CJ. Human tissue simulation is excellent.

An Alternating Treatment Comparison of Oral and Total Communication Training Programs with Echolalic Autistic Children.

ERIC Educational Resources Information Center

Barrera, Richardo D.; Sulzer-Azaroff, Beth

1983-01-01

Comparison of the relative effectiveness of oral and total communication training models for teaching expressive labeling skills to three echolalic autistic children (six-nine years old) demonstrated that total communication was the most successful approach with each of the Ss. (Author/CL)

General surgery resident rotations in surgical critical care, trauma, and burns: what is optimal for residency training?

PubMed

Napolitano, Lena M; Biester, Thomas W; Jurkovich, Gregory J; Buyske, Jo; Malangoni, Mark A; Lewis, Frank R

2016-10-01

There are no specific Accreditation Council for Graduate Medical Education General Surgery Residency Program Requirements for rotations in surgical critical care (SCC), trauma, and burn. We sought to determine the experience of general surgery residents in SCC, trauma, and burn rotations. Data analysis of surgical rotations of American Board of Surgery general surgery resident applicants (n = 7,299) for the last 8 years (2006 to 2013, inclusive) was performed through electronic applications to the American Board of Surgery Qualifying Examination. Duration (months) spent in SCC, trauma, and burn rotations, and postgraduate year (PGY) level were examined. The total months in SCC, trauma and burn rotations was mean 10.2 and median 10.0 (SD 3.9 months), representing approximately 16.7% (10 of 60 months) of a general surgery resident's training. However, there was great variability (range 0 to 29 months). SCC rotation duration was mean 3.1 and median 3.0 months (SD 2, min to max: 0 to 15), trauma rotation duration was mean 6.3 and median 6.0 months (SD 3.5, min to max: 0 to 24), and burn rotation duration was mean 0.8 and median 1.0 months (SD 1.0, min to max: 0 to 6). Of the total mean 10.2 months duration, the longest exposure was 2 months as PGY-1, 3.4 months as PGY-2, 1.9 months as PGY-3, 2.2 months as PGY-4 and 1.1 months as PGY-5. PGY-5 residents spent a mean of 1 month in SCC, trauma, and burn rotations. PGY-4/5 residents spent the majority of this total time in trauma rotations, whereas junior residents (PGY-1 to 3) in SCC and trauma rotations. There is significant variability in total duration of SCC, trauma, and burn rotations and PGY level in US general surgery residency programs, which may result in significant variability in the fund of knowledge and clinical experience of the trainee completing general surgery residency training. As acute care surgery programs have begun to integrate emergency general surgery with SCC, trauma, and burn rotations, it is an ideal time to determine the optimal curriculum and duration of these important rotations for general surgery residency training. Copyright © 2016 Elsevier Inc. All rights reserved.

Calcium and vitamin D supplementation maintains parathyroid hormone and improves bone density during initial military training: a randomized, double-blind, placebo controlled trial.

PubMed

Gaffney-Stomberg, Erin; Lutz, Laura J; Rood, Jennifer C; Cable, Sonya J; Pasiakos, Stefan M; Young, Andrew J; McClung, James P

2014-11-01

Calcium and vitamin D are essential nutrients for bone health. Periods of activity with repetitive mechanical loading, such as military training, may result in increases in parathyroid hormone (PTH), a key regulator of Ca metabolism, and may be linked to the development of stress fractures. Previous studies indicate that consumption of a Ca and vitamin D supplement may reduce stress fracture risk in female military personnel during initial military training, but circulating markers of Ca and bone metabolism and measures of bone density and strength have not been determined. This randomized, double-blind, placebo-controlled trial sought to determine the effects of providing supplemental Ca and vitamin D (Ca+Vit D, 2000mg and 1000IU/d, respectively), delivered as 2 snack bars per day throughout 9weeks of Army initial military training (or basic combat training, BCT) on PTH, vitamin D status, and measures of bone density and strength in personnel undergoing BCT, as well as independent effects of BCT on bone parameters. A total of 156 men and 87 women enrolled in Army BCT (Fort Sill, OK; 34.7°N latitude) volunteered for this study. Anthropometric, biochemical, and dietary intake data were collected pre- and post-BCT. In addition, peripheral quantitative computed tomography was utilized to assess tibia bone density and strength in a subset of volunteers (n=46). Consumption of supplemental Ca+Vit D increased circulating ionized Ca (group-by-time, P=0.022), maintained PTH (group-by-time, P=0.032), and increased the osteoprotegerin:RANKL ratio (group-by-time, P=0.006). Consistent with the biochemical markers, Ca+Vit D improved vBMD (group-by-time, P=0.024) at the 4% site and cortical BMC (group-by-time, P=0.028) and thickness (group-by-time, P=0.013) at the 14% site compared to placebo. These data demonstrate the benefit of supplemental Ca and vitamin D for maintaining bone health during periods of elevated bone turnover, such as initial military training. This trial was registered with ClincialTrials.gov, NCT01617109. Published by Elsevier Inc.

The effect of differential training-based occupational therapy on hand and arm function in patients after stroke: Results of the pilot study.

PubMed

Repšaitė, Viktorija; Vainoras, Alfonsas; Berškienė, Kristina; Baltaduonienė, Daiva; Daunoravičienė, Algė; Sendžikaitė, Ernesta

2015-01-01

The aim of this study was to evaluate the effect of differential training-based occupational therapy on the recovery of arm function and to compare these data with the results obtained after conventional occupational therapy. A total of 27 patients who had suffered a cerebral infarction in the left brain hemisphere were recruited for the study. There were 9 men (33.33%) and 18 women (66.67%). All the patients had paresis of the right arm. The patients were divided into 2 groups: the control group comprised 15 patients who were given conventional occupational therapy (5 times per week) and the study group consisted of 12 patients who underwent conventional occupational therapy (3 times per week) along with occupational therapy based on differential training (2 times per week). In the control group, the mean performance time of only 2 tasks, i.e., flip cards and fold towel, improved significantly (P<0.05), while significant deterioration in the mean performance time of the task "lift can" was observed (P<0.05). In the study group, the mean performance time of all the tasks except for forearm to box (side), hand to box (front), and lift paperclip improved significantly (P<0.05), and no deterioration in arm function was observed. Both patients' groups improved arm function after occupational therapy sessions, but the patients who underwent conventional occupational therapy along with differential training-based occupational therapy recovered their arm function more effectively than their counterparts after conventional occupational therapy. Copyright © 2015 Polish Neurological Society. Published by Elsevier Urban & Partner Sp. z o.o. All rights reserved.

Does Practice Make Perfect? A Randomized Control Trial of Behavioral Rehearsal on Suicide Prevention Gatekeeper Skills

PubMed Central

Seaburn, David; Gibbs, Danette; Schmeelk-Cone, Karen; White, Ann Marie; Caine, Eric D.

2011-01-01

Suicide is the third leading cause of death among 10–24-year-olds and the target of school-based prevention efforts. Gatekeeper training, a broadly disseminated prevention strategy, has been found to enhance participant knowledge and attitudes about intervening with distressed youth. Although the goal of training is the development of gatekeeper skills to intervene with at-risk youth, the impact on skills and use of training is less known. Brief gatekeeper training programs are largely educational and do not employ active learning strategies such as behavioral rehearsal through role play practice to assist skill development. In this study, we compare gatekeeper training as usual with training plus brief behavioral rehearsal (i.e., role play practice) on a variety of learning outcomes after training and at follow-up for 91 school staff and 56 parents in a school community. We found few differences between school staff and parent participants. Both training conditions resulted in enhanced knowledge and attitudes, and almost all participants spread gatekeeper training information to others in their network. Rigorous standardized patient and observational methods showed behavioral rehearsal with role play practice resulted in higher total gatekeeper skill scores immediately after training and at follow-up. Both conditions, however, showed decrements at follow-up. Strategies to strengthen and maintain gatekeeper skills over time are discussed. PMID:21814869

Does practice make perfect? A randomized control trial of behavioral rehearsal on suicide prevention gatekeeper skills.

PubMed

Cross, Wendi F; Seaburn, David; Gibbs, Danette; Schmeelk-Cone, Karen; White, Ann Marie; Caine, Eric D

2011-08-01

Suicide is the third leading cause of death among 10-24-year-olds and the target of school-based prevention efforts. Gatekeeper training, a broadly disseminated prevention strategy, has been found to enhance participant knowledge and attitudes about intervening with distressed youth. Although the goal of training is the development of gatekeeper skills to intervene with at-risk youth, the impact on skills and use of training is less known. Brief gatekeeper training programs are largely educational and do not employ active learning strategies such as behavioral rehearsal through role play practice to assist skill development. In this study, we compare gatekeeper training as usual with training plus brief behavioral rehearsal (i.e., role play practice) on a variety of learning outcomes after training and at follow-up for 91 school staff and 56 parents in a school community. We found few differences between school staff and parent participants. Both training conditions resulted in enhanced knowledge and attitudes, and almost all participants spread gatekeeper training information to others in their network. Rigorous standardized patient and observational methods showed behavioral rehearsal with role play practice resulted in higher total gatekeeper skill scores immediately after training and at follow-up. Both conditions, however, showed decrements at follow-up. Strategies to strengthen and maintain gatekeeper skills over time are discussed.

The effect of a simulation training package on skill acquisition for duplex arterial stenosis detection.

PubMed

Jaffer, Usman; Normahani, Pasha; Singh, Prashant; Aslam, Mohammed; Standfield, Nigel J

2015-01-01

In vascular surgery, duplex ultrasonography is a valuable diagnostic tool in patients with peripheral vascular disease, and there is increasing demand for vascular surgeons to be able to perform duplex scanning. This study evaluates the role of a novel simulation training package on vascular ultrasound (US) skill acquisition. A total of 19 novices measured predefined stenosis in a simulated pulsatile vessel using both peak systolic velocity ratio (PSVR) and diameter reduction (DR) methods before and after a short period of training using a simulated training package. The training package consisted of a simulated pulsatile vessel phantom, a set of instructional videos, duplex ultrasound objective structured assessment of technical skills (DUOSATS) tool, and a portable US scanner. Quantitative metrics (procedure time, percentage error using PSVR and DR methods, DUOSAT scores, and global rating scores) before and after training were compared. Subjects spent a median time of 144 mins (IQR: 60-195) training using the simulation package. Subjects exhibited statistically significant improvements when comparing pretraining and posttraining DUOSAT scores (pretraining = 17 [16-19.3] vs posttraining = 30 [27.8-31.8]; p < 0.01), global rating score (pretraining = 1 [1-2] vs posttraining = 4 [3.8-4]; p < 0.01), percentage error using both the DR (pretraining = 12.6% [9-29.6] vs posttraining = 10.3% [8.9-11.1]; p = 0.03) and PSVR (pretraining = 60% [40-60] vs posttraining = 20% [6.7-20]; p < 0.01) methods. In this study, subjects with no previous practical US experience developed the ability to both acquire and interpret arterial duplex images in a pulsatile simulated phantom following a short period of goal direct training using a simulation training package. A simulation training package may be a valuable tool for integration into a vascular training program. However, further work is needed to explore whether these newly attained skills are translated into clinical assessment. Crown Copyright © 2014. Published by Elsevier Inc. All rights reserved.

[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).

Implementing Adolescent Screening, Brief Intervention, and Referral to Treatment (SBIRT) Education in a Pediatric Residency Curriculum.

PubMed

Schram, Patricia; Harris, Sion K; Van Hook, Shari; Forman, Sara; Mezzacappa, Enrico; Pavlyuk, Roman; Levy, Sharon

2015-01-01

Screening, brief intervention, and referral to treatment (SBIRT) is recommended as part of routine health care for adolescents as well as adults. In an effort to promote universal SBIRT, the Substance Abuse and Mental Health Services Administration awarded funding to residency programs to develop and implement SBIRT education and training. Our project focused on creating scientifically based, developmentally appropriate strategies and teaching materials for the adolescent age range. This paper describes curriculum development and implementation and presents evaluation data. Pediatric and child psychiatry residents were trained. The training consisted of 4 activities: (1) case-based teaching modules, (2) role-play of motivational interviewing and brief interventions, (3) mock interviews with trained adolescents, and (4) supervised "hands-on" screening and brief interventions. Main outcome measures included trainee satisfaction, and SBIRT knowledge, perceived self-efficacy, and self- and observer report of use of the SBIRT algorithm. Among 150 total participants completing the SBIRT training modules, nearly all (92.3%) were satisfied/very satisfied with the training modules. Knowledge accuracy immediately post training was high, but declined significantly by the end of the first residency year, with little change across subsequent years of residency. Confidence ratings also declined over time. Use of the SBIRT algorithm during the Adolescent Medicine rotation was high according to trainee self- and faculty observer report. We found evidence of training satisfaction, increased confidence in talking to adolescents about substance use, and widespread use of recommended practices immediately following training. Use of a highly structured algorithm to guide practice, and simple, highly structured brief interventions was a successful training approach, as residents self-reported accurate use of the SBIRT algorithm immediately after training. Knowledge and self-confidence declined over time. It is possible that "booster" sessions and ongoing opportunities to review materials could help residents retain knowledge and skills.

Effects of Whole-body Vibration Training on Sprint Running Kinematics and Explosive Strength Performance

PubMed Central

Giorgos, Paradisis; Elias, Zacharogiannis

2007-01-01

The aim of this study was to investigate the effect of 6 wk of whole body vibration (WBV) training on sprint running kinematics and explosive strength performance. Twenty-four volunteers (12 women and 12 men) participated in the study and were randomised (n = 12) into the experimental and control groups. The WBV group performed a 6-wk program (16-30 min·d-1, 3 times a week) on a vibration platform. The amplitude of the vibration platform was 2.5 mm and the acceleration was 2.28 g. The control group did not participate in any training. Tests were performed Pre and post the training period. Sprint running performance was measured during a 60 m sprint where running time, running speed, step length and step rate were calculated. Explosive strength performance was measured during a counter movement jump (CMJ) test, where jump height and total number of jumps performed in a period of 30 s (30CVJT). Performance in 10 m, 20 m, 40 m, 50 m and 60 m improved significantly after 6 wk of WBV training with an overall improvement of 2.7%. The step length and running speed improved by 5.1% and 3.6%, and the step rate decreased by 3.4%. The countermovement jump height increased by 3.3%, and the explosive strength endurance improved overall by 7.8%. The WBV training period of 6 wk produced significant changes in sprint running kinematics and explosive strength performance. Key pointsWBV training.Sprint running kinematics.Explosive strength performance PMID:24149223

Effects of Progressive Body Weight Support Treadmill Forward and Backward Walking Training on Stroke Patients' Affected Side Lower Extremity's Walking Ability.

PubMed

Kim, Kyunghoon; Lee, Sukmin; Lee, Kyoungbo

2014-12-01

[Purpose] The purpose of the present study was to examine the effects of progressive body weight supported treadmill forward and backward walking training (PBWSTFBWT), progressive body weight supported treadmill forward walking training (PBWSTFWT), progressive body weight supported treadmill backward walking training (PBWSTBWT), on stroke patients' affected side lower extremity's walking ability. [Subjects and Methods] A total of 36 chronic stroke patients were divided into three groups with 12 subjects in each group. Each of the groups performed one of the progressive body weight supported treadmill training methods for 30 minute, six times per week for three weeks, and then received general physical therapy without any other intervention until the follow-up tests. For the assessment of the affected side lower extremity's walking ability, step length of the affected side, stance phase of the affected side, swing phase of the affected side, single support of the affected side, and step time of the affected side were measured using optogait and the symmetry index. [Results] In the within group comparisons, all the three groups showed significant differences between before and after the intervention and in the comparison of the three groups, the PBWSTFBWT group showed more significant differences in all of the assessed items than the other two groups. [Conclusion] In the present study progressive body weight supported treadmill training was performed in an environment in which the subjects were actually walked, and PBWSTFBWT was more effective at efficiently training stroke patients' affected side lower extremity's walking ability.

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.

Blood Pressure and Hemodynamic Adaptations after a Training Program in Young Individuals with Down Syndrome

PubMed Central

Seron, Bruna Barboza; Goessler, Karla Fabiana; Modesto, Everaldo Lambert; Almeida, Eloise Werle; Greguol, Márcia

2015-01-01

Background Cardiovascular diseases affect people worldwide. Individuals with Down Syndrome (DS) have an up to sixteen-time greater risk of mortality from cardiovascular diseases. Objective To evaluate the effects of aerobic and resistance exercises on blood pressure and hemodynamic variables of young individuals with DS. Methods A total of 29 young individuals with DS participated in the study. They were divided into two groups: aerobic training (AT) (n = 14), and resistance training (TR) (n = 15). Their mean age was 15.7 ± 2.82 years. The training program lasted 12 weeks, and had a frequency of three times a week for AT and twice a week for RT. AT was performed in treadmill/ bicycle ergometer, at an intensity between 50%-70% of the HR reserve. RT comprised nine exercises with three sets of 12 repetition-maximum. Systolic blood pressure (SBP), diastolic blood pressure (DBP), mean blood pressure (MBP) and hemodynamic variables were assessed beat-to-beat using the Finometer device before/after the training program. Descriptive analysis, the Shapiro-Wilk test to check the normality of data, and the two-way ANOVA for repeated measures were used to compare pre- and post-training variables. The Pearson’s correlation coefficient was calculated to correlate hemodynamic variables. The SPSS version 18.0 was used with the significance level set at p < 0.05. Results After twelve weeks of aerobic and/or resistance training, significant reductions in variables SBP, DBP and MBP were observed. Conclusion This study suggests a chronic hypotensive effect of moderate aerobic and resistance exercises on young individuals with DS. PMID:26131704

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

PubMed

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

2016-07-01

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

Optimal training for emergency needle thoracostomy placement by prehospital personnel: didactic teaching versus a cadaver-based training program.

PubMed

Grabo, Daniel; Inaba, Kenji; Hammer, Peter; Karamanos, Efstathios; Skiada, Dimitra; Martin, Matthew; Sullivan, Maura; Demetriades, Demetrios

2014-09-01

Tension pneumothorax can rapidly progress to cardiac arrest and death if not promptly recognized and appropriately treated. We sought to evaluate the effectiveness of traditional didactic slide-based lectures (SBLs) as compared with fresh tissue cadaver-based training (CBT) for placement of needle thoracostomy (NT). Forty randomly selected US Navy corpsmen were recruited to participate from incoming classes of the Navy Trauma Training Center at the LAC + USC Medical Center and were then randomized to one of two NT teaching methods. The following outcomes were compared between the two study arms: (1) time required to perform the procedure, (2) correct placement of the needle, and (3) magnitude of deviation from the correct position. During the study period, a total of 40 corpsmen were enrolled, 20 randomized to SBL and 20 to CBT arms. When outcomes were analyzed, time required to NT placement was not different between the two arms. Examination of the location of needle placement revealed marked differences between the two study groups. Only a minority of the SBL group (35%) placed the NT correctly in the second intercostal space. In comparison, the majority of corpsmen assigned to the CBT group demonstrated accurate placement in the second intercostal space (75%). In a CBT module, US Navy corpsmen were better trained to place NT accurately than their traditional didactic SBL counterparts. Further studies are indicated to identify the optimal components of effective simulation training for NT and other emergent interventions.

Factors associated with residents' satisfaction with their training as specialists.

PubMed

Ayala-Morillas, L E; Fuentes-Ferrer, M E; Sánchez-Díaz, J; Rumayor-Zarzuelo, M; Fernández-Pérez, C; Marco-Martínez, F

2014-05-01

We do not know what factors influence residents' perceived satisfaction during their training. The aim of this study was to analyze the satisfaction of specialists with their training and its associated factors. This was a cross-sectional study using self-completion surveys of residents in training at the Clinic Hospital San Carlos for the courses conducted in 2006, 2009, 2010 and 2012. The study's dependent variable was overall satisfaction with the training; the independent factors were demographic and occupational characteristics, variables related to healthcare, teaching and research activity. The total participation percentage was 83.7% (1,424/1,701), and the mean age was 28.4 years (SD, 3.2 years). The overall satisfaction percentage was 75.2%. The factors statistically associated with overall satisfaction in the multivariate analysis were the involvement of the teaching staff (tutors and assistants) in the training, greater satisfaction in medical versus surgical specialties, the year of residence, the facilities for completing the thesis, working less than 40 h a week, adequate time to perform daily tasks, appropriate number of department meetings and not having a previous specialty. the activities related to research and teaching are associated with the overall satisfaction of residents. The routine activity factors most closely associated with satisfaction were the time available and the work hours. More studies are necessary to understand the impact of resident satisfaction on care quality and in their activity as future specialists. Copyright © 2013 Elsevier España, S.L. All rights reserved.

Personal protective equipment for the Ebola virus disease: A comparison of 2 training programs.

PubMed

Casalino, Enrique; Astocondor, Eugenio; Sanchez, Juan Carlos; Díaz-Santana, David Enrique; Del Aguila, Carlos; Carrillo, Juan Pablo

2015-12-01

Personal protective equipment (PPE) for preventing Ebola virus disease (EVD) includes basic PPE (B-PPE) and enhanced PPE (E-PPE). Our aim was to compare conventional training programs (CTPs) and reinforced training programs (RTPs) on the use of B-PPE and E-PPE. Four groups were created, designated CTP-B, CTP-E, RTP-B, and RTP-E. All groups received the same theoretical training, followed by 3 practical training sessions. A total of 120 students were included (30 per group). In all 4 groups, the frequency and number of total errors and critical errors decreased significantly over the course of the training sessions (P < .01). The RTP was associated with a greater reduction in the number of total errors and critical errors (P < .0001). During the third training session, we noted an error frequency of 7%-43%, a critical error frequency of 3%-40%, 0.3-1.5 total errors, and 0.1-0.8 critical errors per student. The B-PPE groups had the fewest errors and critical errors (P < .0001). Our results indicate that both training methods improved the student's proficiency, that B-PPE appears to be easier to use than E-PPE, that the RTP achieved better proficiency for both PPE types, and that a number of students are still potentially at risk for EVD contamination despite the improvements observed during the training. Copyright © 2015 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

Interval training attenuates the metabolic disturbances in type 1 diabetes rat model.

PubMed

Rocha, Ricelli Endrigo Ruppel; Coelho, Isabela; Pequito, Daniela Cristina T; Yamagushi, Adriana; Borghetti, Gina; Yamazaki, Ricardo Key; Brito, Gleisson Alisson Pereira de; Machado, Juliano; Kryczyk, Marcelo; Nunes, Everson Araújo; Venera, Graciela; Fernandes, Luiz Claudio

2013-11-01

This study investigated the effect of interval training on blood biochemistry and immune parameters in type 1 diabetic rats. Male Wistar rats were divided into four groups: sedentary (SE, n = 15), interval training (IT, n = 17), diabetic sedentary (DSE, n = 17), diabetic interval training (DIT, n = 17). Diabetes was induced by i.v. injection of streptozotocin (60 mg/kg). Swimming Interval Training consisted of 30-s exercise with 30-s rest, for 30 minutes, during 6 weeks, four times a week, with an overload of 15% of body mass. Plasma glucose, lactate, triacylglycerol and total cholesterol concentrations, phagocytic capacity, cationic vesicle content, and superoxide anion and hydrogen peroxide production by blood neutrophils and peritoneal macrophages were evaluated. Proliferation of mesenteric lymphocytes was also estimated. Interval training resulted in attenuation of the resting hyperglycemic state and decreased blood lipids in the DIT group. Diabetes increased the functionality of blood neutrophils and peritoneal macrophages in the DSE group. Interval training increased all functionality parameters of peritoneal macrophages in the IT group. Interval training also led to a twofold increase in the proliferation of mesenteric lymphocytes after 6 weeks of exercise in the DIT group. Low-volume high-intensity physical exercise attenuates hyperglycemia and dislipidemia induced by type 1 diabetes, and induces changes in the functionality of innate and acquired immunity.

Comparison of focused cognitive training and portable "brain-games" on functional outcomes for vocational rehabilitation participants.

PubMed

Bell, Morris D; Laws, Holly; Pittman, Brian; Johannesen, Jason K

2018-01-29

Cognitive remediation performed in a cognitive laboratory was compared with a sham control using portable brain games to study effects on vocational, neurocognitive, and functional outcomes for participants with psychotic disorders in vocational rehabilitation (VR). Seventy-seven participants (61% schizophrenia, 39% other psychosis) in transitional (45.5%) or supported employment (54.5%) were randomly assigned to 6 months of portable cognitive-games (CG) or cognitive remediation (CR) plus a weekly goal-setting group, and evaluated during training, post-training and at 12 months. Overall rates of employment did not differ significantly at 12-month follow-up; however, VR + CG attained employment more rapidly during training. A significant time by condition interaction favored VR + CR on Quality of Life Total Score and Instrumental Functioning over 12 months. Neurocognitive outcomes favored VR + CR, particularly on attention. Training hours related significantly to neurocognitive improvement regardless of condition. No differences were found in training adherence despite portability for VR + CG. Results indicate that VR + CR had significantly greater effect than VR + CG on neurocognition and community functioning, but not on employment outcome. Job attainment rates during the training period revealed a potential advantage for portable training raising new questions concerning how cognitive remediation can be most effectively integrated with VR.

Effects of exercise training in patients with idiopathic pulmonary arterial hypertension.

PubMed

de Man, F S; Handoko, M L; Groepenhoff, H; van 't Hul, A J; Abbink, J; Koppers, R J H; Grotjohan, H P; Twisk, J W R; Bogaard, H-J; Boonstra, A; Postmus, P E; Westerhof, N; van der Laarse, W J; Vonk-Noordegraaf, A

2009-09-01

We determined the physiological effects of exercise training on exercise capacity and quadriceps muscle function in patients with idiopathic pulmonary arterial hypertension (iPAH). In total, 19 clinically stable iPAH patients (New York Heart Association II-III) underwent a supervised exercise training programme for the duration of 12 weeks. Maximal capacity, endurance capacity and quadriceps function were assessed at baseline and after 12 weeks. In 12 patients, serial quadriceps muscle biopsies were obtained. 6-min walk distance and peak exercise capacity did not change after training. However, endurance capacity improved significantly after training, demonstrated by a shift of the anaerobic threshold to a higher workload (from 32+/-5 to 46+/-6 W; p = 0.003) together with an increase in exercise endurance time (p<0.001). Moreover, exercise training increased quadriceps strength by 13% (p = 0.005) and quadriceps endurance by 34% (p = 0.001). Training enhanced aerobic capacity of the quadriceps, by increasing capillarisation (1.36+/-0.10 to 1.78+/-0.13 capillaries per muscle fibre; p<0.001) and oxidative enzyme activity, especially of the type-I (slow) muscle fibres. No changes were found in cross-sectional area and fibre type distribution. Exercise training in iPAH improves exercise endurance and quadriceps muscle function, which is also reflected by structural changes of the quadriceps.

Global health training in US obstetrics and gynaecology residency programmes: perspectives of students, residents and programme directors.

PubMed

Nathan, Lisa M; Banks, Erika H; Conroy, Erin M; McGinn, Aileen P; Ghartey, Jeny P; Wagner, Sarah A; Merkatz, Irwin R

2015-12-01

Benefits of exposure to global health training during medical education are well documented and residents' demand for this training is increasing. Despite this, it is offered by few US obstetrics and gynaecology (OBGYN) residency training programmes. To evaluate interest, perceived importance, predictors of global health interest and barriers to offering global health training among prospective OBGYN residents, current OBGYN residents and US OGBYN residency directors. We designed two questionnaires using Likert scale questions to assess perceived importance of global health training. The first was distributed to current and prospective OBGYN residents interviewing at a US residency programme during 2012-2013. The second questionnaire distributed to US OBGYN programme directors assessed for existing global health programmes and global health training barriers. A composite Global Health Interest/Importance score was tabulated from the Likert scores. Multivariable linear regression was performed to assess for predictors of Global Health Interest/Importance. A total of 159 trainees (77%; 129 prospective OBGYN residents and 30 residents) and 69 (28%) programme directors completed the questionnaires. Median Global Health Interest/Importance score was 7 (IQR 4-9). Prior volunteer experience was predictive of a 5-point increase in Global Health Interest/Importance score (95% CI -0.19 to 9.85; p=0.02). The most commonly cited barriers were cost and time. Interest and perceived importance of global health training in US OBGYN residency programmes is evident among trainees and programme directors; however, significant financial and time barriers prevent many programmes from offering opportunities to their trainees. Prior volunteer experience predicts global health interest. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Surface electromyography and plantar pressure changes with novel gait training device in participants with chronic ankle instability.

PubMed

Feger, Mark A; Hertel, Jay

2016-08-01

Rehabilitation is ineffective at restoring normal gait in chronic ankle instability patients. Our purpose was to determine if a novel gait-training device could decrease plantar pressure on the lateral column of the foot in chronic ankle instability patients. Ten chronic ankle instability patients completed 30s trials of baseline and gait-training walking at a self-selected pace while in-shoe plantar pressure and surface electromyography were recorded from their anterior tibialis, peroneus longus, medial gastrocnemius, and gluteus medius. The gait-training device applied a medially-directed force to the lower leg via elastic bands during the entire gait cycle. Plantar pressure measures of the entire foot and 9 specific regions of the foot as well as surface electromyography root mean square areas were compared between the baseline and gait-training conditions using paired t-tests with a priori level of significance of p≤0.05. The gait-training device decreased pressure time integrals and peak pressures in the lateral midfoot (p=0.003 and p=0.003) and lateral forefoot (p=0.023 and p=0.005), and increased pressure time integrals and peak pressures for the total foot (p=0.030 and p=0.017) and hallux (p=0.005 and p=0.002). The center of pressure was shifted medially during the entire stance phase (p<0.003 for all comparisons) due to increased peroneus longus activity prior to (p=0.002) and following initial contact (p=0.002). The gait-training device decreased pressure on the lateral column of the foot and increased peroneus longus muscle activity. Future research should analyze the efficacy of the gait-training device during gait retraining for chronic ankle instability. Copyright © 2016 Elsevier Ltd. All rights reserved.

Prevention of Hamstring Injuries in Collegiate Sprinters

PubMed Central

Sugiura, Yusaku; Sakuma, Kazuhiko; Sakuraba, Keishoku; Sato, Yamato

2017-01-01

Background: No studies have been reported on how strength, agility, and flexibility training reduce the occurrence of hamstring injuries in sprinters. Therefore, a program for preventing hamstring injury in these athletes has not been established. Purpose: To document the incidence of hamstring injuries during times when different prevention strategies were employed to see whether a particular prevention program reduced their occurrence. Study Design: Descriptive epidemiology study. Methods: The study subjects were a total of 613 collegiate male sprinters trained by the same coach over 24 seasons. Tow training was used throughout the research period as a normal sprint training method. The hamstring injury prevention program evolved over time. From 1988 to 1991 (period 1), prevention focused on strength training alone; from 1992 to 1999 (period 2), a combination of strength and agility training was used; and from 2000 to 2011 (period 3), the program incorporated strength, agility, and flexibility training. The incidence of hamstring injuries was compared for each of the 3 prevention strategies. Results: The incidence of hamstring injuries per athlete-seasons was 137.9 for period 1, 60.6 for period 2, and 6.7 for period 3. A significant difference was observed in the incidence of hamstring injury according to the different prevention programs (χ2(2) = 31.78, P < .001, effect size: Cramer V = 0.23, 1 − β = 0.999). Residual analysis showed that the number of hamstring injuries for period 1 was significantly greater than the expected value (P < .01), whereas that for period 3 was significantly lower than the expected value (P < .01). Conclusion: The incidence of hamstring injuries in sprinters decreased as agility and flexibility were added to strength training. PMID:28210652

Effect of concurrent resistance and sprint training on body composition and cardiometabolic health indicators in masters cyclists

PubMed Central

Delvecchio, Luke; Reaburn, Peter; Trapp, Gail; Korhonen, Marko T.

2016-01-01

In older previously sedentary individuals endurance training imposes a more effective stimulus to enhance cardiometabolic health compared with resistance or sprint training. We examined the effect of replacing a portion of endurance training with combined resistance and/or sprint training and how this influences cardiometabolic health indicators in masters endurance cyclists. Twenty-seven well-trained male road cyclists (53.7±8.2 years) were allocated to a resistance and track sprint-cycling training group (RTC, n=10), an endurance and track sprint-cycling group (ETC, n=7) or a control endurance group (CTRL, n=10). Both the RTC and ETC groups completed a 12-week intervention of specific training while the CTRL group maintained their endurance training load. Lower limb lean mass (LLM), trunk fat mass (TFM), fasting blood glucose (FBG), total cholesterol (TC), triglycerides (TG), systolic blood pressure (SBP), and diastolic blood pressure (DBP) were measured before and after the intervention period. TFM decreased for all groups (P<0.05) while LLM significantly increased for RTC and ETC groups (P<0.05). No significant between group or time effects were observed for FBG, TC, TG, SBP, or DBP. The results suggest that replacing a portion of endurance training with 12 weeks of ETC or RTC training favourably affects body composition by lowering TFM and increasing LLM without negatively affecting cardiometabolic health indicators in well-trained masters endurance cyclists. PMID:27807523

Task-Based Neurofeedback Training: A Novel Approach Toward Training Executive Functions

PubMed Central

Hosseini, SM Hadi; Pritchard-Berman, Mika; Sosa, Natasha; Ceja, Angelica; Kesler, Shelli R.

2016-01-01

Cognitive training is an emergent approach to improve cognitive functions in various neurodevelopmental and neurodegenerative diseases. However, current training programs can be relatively lengthy, making adherence potentially difficult for patients with cognitive difficulties. Previous studies suggest that providing individuals with real-time feedback about the level of brain activity (neurofeedback) can potentially help them learn to control the activation of specific brain regions. In the present study, we developed a novel task-based neurofeedback training paradigm that benefits from the effects of neurofeedback in parallel with computerized training. We focused on executive function training given its core involvement in various developmental and neurodegenerative diseases. Near-infrared spectroscopy (NIRS) was employed for providing neurofeedback by measuring changes in oxygenated hemoglobin in the prefrontal cortex. Of the twenty healthy adult participants, ten received real neurofeedback (NFB) on prefrontal activity during cognitive training, and ten were presented with sham feedback (SHAM). Compared with SHAM, the NFB group showed significantly improved executive function performance including measures of working memory after four sessions of training (100 minutes total). The NFB group also showed significantly reduced training-related brain activity in the executive function network including right middle frontal and inferior frontal regions compared with SHAM. Our data suggest that providing neurofeedback along with cognitive training can enhance executive function after a relatively short period of training. Similar designs could potentially be used for patient populations with known neuropathology, potentially helping them to boost/recover the activity in the affected brain regions. PMID:27015711

Using Patient Demographics and Statistical Modeling to Predict Knee Tibia Component Sizing in Total Knee Arthroplasty.

PubMed

Ren, Anna N; Neher, Robert E; Bell, Tyler; Grimm, James

2018-06-01

Preoperative planning is important to achieve successful implantation in primary total knee arthroplasty (TKA). However, traditional TKA templating techniques are not accurate enough to predict the component size to a very close range. With the goal of developing a general predictive statistical model using patient demographic information, ordinal logistic regression was applied to build a proportional odds model to predict the tibia component size. The study retrospectively collected the data of 1992 primary Persona Knee System TKA procedures. Of them, 199 procedures were randomly selected as testing data and the rest of the data were randomly partitioned between model training data and model evaluation data with a ratio of 7:3. Different models were trained and evaluated on the training and validation data sets after data exploration. The final model had patient gender, age, weight, and height as independent variables and predicted the tibia size within 1 size difference 96% of the time on the validation data, 94% of the time on the testing data, and 92% on a prospective cadaver data set. The study results indicated the statistical model built by ordinal logistic regression can increase the accuracy of tibia sizing information for Persona Knee preoperative templating. This research shows statistical modeling may be used with radiographs to dramatically enhance the templating accuracy, efficiency, and quality. In general, this methodology can be applied to other TKA products when the data are applicable. Copyright © 2018 Elsevier Inc. All rights reserved.

Didactic training vs. computer-based self-learning in the prediction of diminutive colon polyp histology by trainees: a randomized controlled study.

PubMed

Khan, Taimur; Cinnor, Birtukan; Gupta, Neil; Hosford, Lindsay; Bansal, Ajay; Olyaee, Mojtaba S; Wani, Sachin; Rastogi, Amit

2017-12-01

Background and study aim  Experts can accurately predict diminutive polyp histology, but the ideal method to train nonexperts is not known. The aim of the study was to compare accuracy in diminutive polyp histology characterization using narrow-band imaging (NBI) between participants undergoing classroom didactic training vs. computer-based self-learning. Participants and methods  Trainees at two institutions were randomized to classroom didactic training or computer-based self-learning. In didactic training, experienced endoscopists reviewed a presentation on NBI patterns for adenomatous and hyperplastic polyps and 40 NBI videos, along with interactive discussion. The self-learning group reviewed the same presentation of 40 teaching videos independently, without interactive discussion. A total of 40 testing videos of diminutive polyps under NBI were then evaluated by both groups. Performance characteristics were calculated by comparing predicted and actual histology. Fisher's exact test was used and P  < 0.05 was considered significant. Results  A total of 17 trainees participated (8 didactic training and 9 self-learning). A larger proportion of polyps were diagnosed with high confidence in the classroom group (66.5 % vs. 50.8 %; P  < 0.01), although sensitivity (86.9 % vs. 95.0 %) and accuracy (85.7 % vs. 93.9 %) of high-confidence predictions were higher in the self-learning group. However, there was no difference in overall accuracy of histology characterization (83.4 % vs. 87.2 %; P  = 0.19). Similar results were noted when comparing sensitivity and specificity between the groups. Conclusion  The self-learning group showed results on a par with or, for high-confidence predictions, even slightly superior to classroom didactic training for predicting diminutive polyp histology. This approach can help in widespread training and clinical implementation of real-time polyp histology characterization. © Georg Thieme Verlag KG Stuttgart · New York.

High-intensity preoperative training improves physical and functional recovery in the early post-operative periods after total knee arthroplasty: a randomized controlled trial.

PubMed

Calatayud, Joaquin; Casaña, Jose; Ezzatvar, Yasmin; Jakobsen, Markus D; Sundstrup, Emil; Andersen, Lars L

2017-09-01

The benefits of preoperative training programmes compared with alternative treatment are unclear. The purpose of this study was to evaluate the effectiveness of a high-intensity preoperative resistance training programme in patients waiting for total knee arthroplasty (TKA). Forty-four subjects (7 men, 37 women) scheduled for unilateral TKA for osteoarthritis (OA) during 2014 participated in this randomized controlled trial. Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), the Physical Functioning Scale of the Short Form-36 questionnaire (SF-36), a 10-cm visual analogue scale (VAS), isometric knee flexion, isometric knee extension, isometric hip abduction, active knee range of motion and functional tasks (Timed Up and Go test and Stair ascent-descent test) were assessed at 8 weeks before surgery (T1), after 8 weeks of training (T2), 1 month after TKA (T3) and finally 3 months after TKA (T4). The intervention group completed an 8-week training programme 3 days per week prior to surgery. Isometric knee flexion, isometric hip abduction, VAS, WOMAC, ROM extension and flexion and all the functional assessments were greater for the intervention group at T2, T3 and T4, whereas isometric knee extension was greater for this group at T2 and T4 compared with control. The present study supports the use of preoperative training in end-stage OA patients to improve early postoperative outcomes. High-intensity strength training during the preoperative period reduces pain and improves lower limb muscle strength, ROM and functional task performance before surgery, resulting in a reduced length of stay at the hospital and a faster physical and functional recovery after TKA. The present training programme can be used by specialists to speed up recovery after TKA. I.

Does training frequency and supervision affect compliance, performance and muscular health? A cluster randomized controlled trial.

PubMed

Dalager, Tina; Bredahl, Thomas G V; Pedersen, Mogens T; Boyle, Eleanor; Andersen, Lars L; Sjøgaard, Gisela

2015-10-01

The aim was to determine the effect of one weekly hour of specific strength training within working hours, performed with the same total training volume but with different training frequencies and durations, or with different levels of supervision, on compliance, muscle health and performance, behavior and work performance. In total, 573 office workers were cluster-randomized to: 1 WS: one 60-min supervised session/week, 3 WS: three 20-min supervised sessions/week, 9 WS: nine 7-min supervised sessions/week, 3 MS: three 20-min sessions/week with minimal supervision, or REF: a reference group without training. Outcomes were diary-based compliance, total training volume, muscle performance and questionnaire-based health, behavior and work performance. Comparisons were made among the WS training groups and between 3 WS and 3 MS. If no difference, training groups were collapsed (TG) and compared with REF. Results demonstrated similar degrees of compliance, mean(range) of 39(33-44)%, and total training volume, 13.266(11.977-15.096)kg. Musculoskeletal pain in neck and shoulders were reduced with approx. 50% in TG, which was significant compared with REF. Only the training groups improved significantly their muscle strength 8(4-13)% and endurance 27(12-37)%, both being significant compared with REF. No change in workability, productivity or self-rated health was demonstrated. Secondary analysis showed exercise self-efficacy to be a significant predictor of compliance. Regardless of training schedule and supervision, similar degrees of compliance were shown together with reduced musculoskeletal pain and improved muscle performance. These findings provide evidence that a great degree of flexibility is legitimate for companies in planning future implementation of physical exercise programs at the workplace. ClinicalTrials.gov, number NCT01027390. Copyright © 2015 Elsevier Ltd. All rights reserved.

49 CFR 232.111 - Train handling information.

Code of Federal Regulations, 2010 CFR

2010-10-01

... train crew taking charge of a train be informed of: (1) The total weight and length of the train, based... 49 Transportation 4 2010-10-01 2010-10-01 false Train handling information. 232.111 Section 232... TRAINS AND EQUIPMENT; END-OF-TRAIN DEVICES General Requirements § 232.111 Train handling information. (a...

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

PubMed Central

Barrera, R D; Sulzer-Azaroff, B

1983-01-01

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

No Additional Benefits of Block- Over Evenly-Distributed High-Intensity Interval Training within a Polarized Microcycle

PubMed Central

McGawley, Kerry; Juudas, Elisabeth; Kazior, Zuzanna; Ström, Kristoffer; Blomstrand, Eva; Hansson, Ola; Holmberg, Hans-Christer

2017-01-01

Introduction: The current study aimed to investigate the responses to block- versus evenly-distributed high-intensity interval training (HIT) within a polarized microcycle. Methods: Twenty well-trained junior cross-country skiers (10 males, age 17.6 ± 1.5 and 10 females, age 17.3 ± 1.5) completed two, 3-week periods of training (EVEN and BLOCK) in a randomized, crossover-design study. In EVEN, 3 HIT sessions (5 × 4-min of diagonal-stride roller-skiing) were completed at a maximal sustainable intensity each week while low-intensity training (LIT) was distributed evenly around the HIT. In BLOCK, the same 9 HIT sessions were completed in the second week while only LIT was completed in the first and third weeks. Heart rate (HR), session ratings of perceived exertion (sRPE), and perceived recovery (pREC) were recorded for all HIT and LIT sessions, while distance covered was recorded for each HIT interval. The recovery-stress questionnaire for athletes (RESTQ-Sport) was completed weekly. Before and after EVEN and BLOCK, resting saliva and muscle samples were collected and an incremental test and 600-m time-trial (TT) were completed. Results: Pre- to post-testing revealed no significant differences between EVEN and BLOCK for changes in resting salivary cortisol, testosterone, or IgA, or for changes in muscle capillary density, fiber area, fiber composition, enzyme activity (CS, HAD, and PFK) or the protein content of VEGF or PGC-1α. Neither were any differences observed in the changes in skiing economy, V˙O2max or 600-m time-trial performance between interventions. These findings were coupled with no significant differences between EVEN and BLOCK for distance covered during HIT, summated HR zone scores, total sRPE training load, overall pREC or overall recovery-stress state. However, 600-m TT performance improved from pre- to post-training, irrespective of intervention (P = 0.003), and a number of hormonal and muscle biopsy markers were also significantly altered post-training (P < 0.05). Discussion: The current study shows that well-trained junior cross-country skiers are able to complete 9 HIT sessions within 1 week without compromising total work done and without experiencing greater stress or reduced recovery over a 3-week polarized microcycle. However, the findings do not support block-distributed HIT as a superior method to a more even distribution of HIT in terms of enhancing physiological or performance adaptions. PMID:28659826

No Additional Benefits of Block- Over Evenly-Distributed High-Intensity Interval Training within a Polarized Microcycle.

PubMed

McGawley, Kerry; Juudas, Elisabeth; Kazior, Zuzanna; Ström, Kristoffer; Blomstrand, Eva; Hansson, Ola; Holmberg, Hans-Christer

2017-01-01

Introduction: The current study aimed to investigate the responses to block- versus evenly-distributed high-intensity interval training (HIT) within a polarized microcycle. Methods: Twenty well-trained junior cross-country skiers (10 males, age 17.6 ± 1.5 and 10 females, age 17.3 ± 1.5) completed two, 3-week periods of training (EVEN and BLOCK) in a randomized, crossover-design study. In EVEN, 3 HIT sessions (5 × 4-min of diagonal-stride roller-skiing) were completed at a maximal sustainable intensity each week while low-intensity training (LIT) was distributed evenly around the HIT. In BLOCK, the same 9 HIT sessions were completed in the second week while only LIT was completed in the first and third weeks. Heart rate (HR), session ratings of perceived exertion (sRPE), and perceived recovery (pREC) were recorded for all HIT and LIT sessions, while distance covered was recorded for each HIT interval. The recovery-stress questionnaire for athletes (RESTQ-Sport) was completed weekly. Before and after EVEN and BLOCK, resting saliva and muscle samples were collected and an incremental test and 600-m time-trial (TT) were completed. Results: Pre- to post-testing revealed no significant differences between EVEN and BLOCK for changes in resting salivary cortisol, testosterone, or IgA, or for changes in muscle capillary density, fiber area, fiber composition, enzyme activity (CS, HAD, and PFK) or the protein content of VEGF or PGC-1α. Neither were any differences observed in the changes in skiing economy, [Formula: see text] or 600-m time-trial performance between interventions. These findings were coupled with no significant differences between EVEN and BLOCK for distance covered during HIT, summated HR zone scores, total sRPE training load, overall pREC or overall recovery-stress state. However, 600-m TT performance improved from pre- to post-training, irrespective of intervention ( P = 0.003), and a number of hormonal and muscle biopsy markers were also significantly altered post-training ( P < 0.05). Discussion: The current study shows that well-trained junior cross-country skiers are able to complete 9 HIT sessions within 1 week without compromising total work done and without experiencing greater stress or reduced recovery over a 3-week polarized microcycle. However, the findings do not support block-distributed HIT as a superior method to a more even distribution of HIT in terms of enhancing physiological or performance adaptions.

Trauma team leaders' non-verbal communication: video registration during trauma team training.

PubMed

Härgestam, Maria; Hultin, Magnus; Brulin, Christine; Jacobsson, Maritha

2016-03-25

There is widespread consensus on the importance of safe and secure communication in healthcare, especially in trauma care where time is a limiting factor. Although non-verbal communication has an impact on communication between individuals, there is only limited knowledge of how trauma team leaders communicate. The purpose of this study was to investigate how trauma team members are positioned in the emergency room, and how leaders communicate in terms of gaze direction, vocal nuances, and gestures during trauma team training. Eighteen trauma teams were audio and video recorded during trauma team training in the emergency department of a hospital in northern Sweden. Quantitative content analysis was used to categorize the team members' positions and the leaders' non-verbal communication: gaze direction, vocal nuances, and gestures. The quantitative data were interpreted in relation to the specific context. Time sequences of the leaders' gaze direction, speech time, and gestures were identified separately and registered as time (seconds) and proportions (%) of the total training time. The team leaders who gained control over the most important area in the emergency room, the "inner circle", positioned themselves as heads over the team, using gaze direction, gestures, vocal nuances, and verbal commands that solidified their verbal message. Changes in position required both attention and collaboration. Leaders who spoke in a hesitant voice, or were silent, expressed ambiguity in their non-verbal communication: and other team members took over the leader's tasks. In teams where the leader had control over the inner circle, the members seemed to have an awareness of each other's roles and tasks, knowing when in time and where in space these tasks needed to be executed. Deviations in the leaders' communication increased the ambiguity in the communication, which had consequences for the teamwork. Communication cannot be taken for granted; it needs to be practiced regularly just as technical skills need to be trained. Simulation training provides healthcare professionals the opportunity to put both verbal and non-verbal communication in focus, in order to improve patient safety. Non-verbal communication plays a decisive role in the interaction between the trauma team members, and so both verbal and non-verbal communication should be in focus in trauma team training. This is even more important for inexperienced leaders, since vague non-verbal communication reinforces ambiguity and can lead to errors.

Alteration of functional connectivity during real-time fMRI regulation of PCC

NASA Astrophysics Data System (ADS)

Zhang, Gaoyan; Yao, Li; Long, Zhiying

2012-03-01

Real-time functional magnetic resonance imaging (rtfMRI) can be used to train the subjects to selectively control activity of specific brain area so as to affect the activation in the target region and even to improve cognition and behavior. So far, whether brain activity in posterior cingulate cortex (PCC) can be regulated by rtfMRI has not been reported. In the present study, we aimed at investigating whether real-time regulation of activity in PCC can change the functional connectivity between PCC and other brain regions. A total of 12 subjects underwent two training runs, each lasts 782s. During the training, subjects were instructed to down regulate activity in PCC by imagining right hand finger movement with the sequence of 4-2-3-1-3-4-2 during task and relax as possible as they can during rest. To control for any effects induced by repeated practice, another 12 subjects in the control group received the same experiment procedure and instruction except with no feedback during training. Experiment results show that increased functional connectivity of PCC with medial frontal cortex (MFC) was observed in both groups during the two training runs. However, PCC of the experimental group is correlated with larger areas in MFC than the control group. Because the positive correlation between task performance and MFC to PCC connectivity has been demonstrated previously, we infer that the stronger connectivity between PCC and MFC in the experimental group may suggest that the experimental group with neurofeedback can more efficiently regulate PCC than the control group without neurofeedback.

Ear pain and its treatment in hypobaric chamber training in the Japan Air Self-Defense Force.

PubMed

Ohrui, Nobuhiro; Takeuchi, Akihiko; Tong, Andrew; Iwata, Masashi

2008-06-01

We have documented that ear pain is the most prevalent physiologic incident during hypobaric chamber training in the Japan Air Self-Defense Force. Ear pain may increase also in flight in the future because it is closely related to allergic rhinitis. Therefore, it is very important to know the characteristic of ear pain and the efficacy of its treatment. The incidence of ear pain was calculated in each training profile from 1990 to 1998. Type III chamber flight records were further analyzed for the characteristics of ear pain: relationship with a trainee occupational category, time of occurrence of ear pain, and efficacy of treatment. Of 17,935 exposures, 740 trainees (4.1%) had ear pain. Of 7,047 trainees, 429 (6.1%) complained of ear pain especially in Type III, totaling 625 times. Fighter pilots and cargo pilots complained of ear pain one twelfth and one third the number of times, respectively, compared with passengers. Of the 625 episodes, 616 (98.6%) occurred during descent. Three kinds of treatment were administered until the pain was relieved in the following order: Valsalva maneuver, Politzer bag, and decompression. The efficacy rates were 35.8, 92.3, and 83.9%, respectively. Only 5 trainees (0.07%) could not complete training due to ear pain despite treatment. The combination treatment of Valsalva maneuver, Politzer bag, and decompression is very effective for relieving ear pain encountered during hypobaric chamber training. A health specialist needs to understand ear pain and its treatment in hypobaric environment such as aircraft.

Effectiveness of balance training programme in reducing the frequency of falling in established osteoporotic women: a randomized controlled trial.

PubMed

Mikó, Ibolya; Szerb, Imre; Szerb, Anna; Poor, Gyula

2017-02-01

To investigate the effect of a 12-month sensomotor balance exercise programme on postural control and the frequency of falling in women with established osteoporosis. Randomized controlled trial where the intervention group was assigned the 12-month Balance Training Programme and the control group did not undertake any intervention beyond regular osteoporosis treatment. A total of 100 osteoporotic women - at least with one osteoporotic fracture - aged 65 years old and above. Balance was assessed in static and dynamic posture both with performance-based measures of balance, such as the Berg Balance Scale and the Timed Up and Go Test, and with a stabilometric computerized platform. Patients in the intervention group completed the 12-month sensomotor Balance Training Programme in an outpatient setting, guided by physical therapists, three times a week, for 30 minutes. The Berg Balance Scale and the Timed Up and Go Test showed a statistically significant improvement of balance in the intervention group ( p = 0.001 and p = 0.005, respectively). Balance tests using the stabilometer also showed a statistically significant improvement in static and dynamic postural balance for osteoporotic women after the completion of the Balance Training Programme. As a consequence, the one-year exercise programme significantly decreased the number of falls in the exercise group compared with the control group. The Balance Training Programme significantly improved the balance parameters and reduced the number of falls in postmenopausal women who have already had at least one fracture in the past.

Physiological adaptations to low-volume, high-intensity interval training in health and disease.

PubMed

Gibala, Martin J; Little, Jonathan P; Macdonald, Maureen J; Hawley, John A

2012-03-01

Exercise training is a clinically proven, cost-effective, primary intervention that delays and in many cases prevents the health burdens associated with many chronic diseases. However, the precise type and dose of exercise needed to accrue health benefits is a contentious issue with no clear consensus recommendations for the prevention of inactivity-related disorders and chronic diseases. A growing body of evidence demonstrates that high-intensity interval training (HIT) can serve as an effective alternate to traditional endurance-based training, inducing similar or even superior physiological adaptations in healthy individuals and diseased populations, at least when compared on a matched-work basis. While less well studied, low-volume HIT can also stimulate physiological remodelling comparable to moderate-intensity continuous training despite a substantially lower time commitment and reduced total exercise volume. Such findings are important given that 'lack of time' remains the most commonly cited barrier to regular exercise participation. Here we review some of the mechanisms responsible for improved skeletal muscle metabolic control and changes in cardiovascular function in response to low-volume HIT. We also consider the limited evidence regarding the potential application of HIT to people with, or at risk for, cardiometabolic disorders including type 2 diabetes. Finally, we provide insight on the utility of low-volume HIT for improving performance in athletes and highlight suggestions for future research.

Health Benefits of an Innovative Exercise Program for Mitochondrial Disorders.

PubMed

Fiuza-Luces, Carmen; Díez-Bermejo, Jorge; Fernández-DE LA Torre, Miguel; Rodríguez-Romo, Gabriel; Sanz-Ayán, Paz; Delmiro, Aitor; Munguía-Izquierdo, Diego; Rodríguez-Gómez, Irene; Ara, Ignacio; Domínguez-González, Cristina; Arenas, Joaquín; Martín, Miguel A; Lucia, Alejandro; Morán, María

2018-06-01

We determined the effects of an innovative 8-wk exercise intervention (aerobic, resistance, and inspiratory muscle training) for patients with mitochondrial disease. Several end points were assessed in 12 patients (19-59 yr, 4 women) at pretraining, posttraining, and after 4-wk detraining: aerobic power, muscle strength/power and maximal inspiratory pressure (main end points), ability to perform activities of daily living, body composition, quality of life, and blood myokines (secondary end points). The program was safe, with patients' adherence being 94% ± 5%. A significant time effect was found for virtually all main end points (P ≤ 0.004), indicating a training improvement. Similar findings (P ≤ 0.003) were found for activities of daily living tests, total/trunk/leg lean mass, total fat mass, femoral fracture risk, and general health perception. No differences were found for blood myokines, except for an acute exertional increase in interleukin 8 at posttraining/detraining (P = 0.002) and in fatty acid binding protein 3 at detraining (P = 0.002). An intervention including novel exercises for mitochondrial disease patients (e.g., inspiratory muscle training) produced benefits in numerous indicators of physical capacity and induced a previously unreported shift toward a healthier body composition phenotype.

Right ventricle best predicts the race performance in amateur ironman athletes.

PubMed

Bernheim, Alain Marcel; Attenhofer Jost, Christine Helena; Zuber, Michel; Pfyffer, Monica; Seifert, Burkhardt; De Pasquale, Gabriella; Linka, Andre; Faeh-Gunz, Anja; Medeiros-Domingo, Argelia; Knechtle, Beat

2013-08-01

The ironman (IM) triathlon is a popular ultraendurance competition, consisting of 3.8 km of swimming, 180.2 km of cycling, and 42.2 km of running. The aim of this study was to investigate the predictors of IM race time, comparing echocardiographic findings, anthropometric measures, and training characteristics. Amateur IM athletes (ATHL) participating in the Zurich IM race in 2010 were included. Participants were examined the day before the race by a comprehensive echocardiographic examination. Moreover, anthropometric measurements were obtained the same day. During the 3 months before the race, each IM-ATHL maintained a detailed training diary. Recorded data were related to total IM race time. Thirty-eight IM finishers (mean ± SD age = 38 ± 9 yr, 32 men [84%]) were evaluated. Total race time was 684 ± 89 min (mean ± SD). For right ventricular fractional area change (45% ± 7%, Spearman ρ = -0.33, P = 0.05), a weak correlation with race time was observed. Race performance exhibited stronger associations with percent body fat (15.2 ± 5.6%, ρ = 0.56, P = 0.001), speed in running training (11.7 ± 1.2 km · h(-1), ρ = -0.52, P = 0.002), and left ventricular myocardial mass index (98 ± 24 g · m(-2), ρ = -0.42, P = 0.009). The strongest association was found between race time and right ventricular end-diastolic area (22 ± 4 cm2, ρ = -0.64, P < 0.0001). In multivariate analysis, right ventricular end-diastolic area (β = -16.7, 95% confidence interval = -27.3 to -6.1, P = 0.003) and percent body fat (β = 6.8, 95% confidence interval = 1.1-12.6, P = 0.02) were independently predictive of IM race time. In amateur IM-ATHL, RV end-diastolic area and percent body fat were independently related to race performance. RV end-diastolic area was the strongest predictor of race time. The role of the RV in endurance exercise may thus be more important than previously thought and needs to be further studied.

Career Counseling Information

DTIC Science & Technology

1989-01-01

heart disease as described by the National Institutes of Health Conference on Obesity. Fat is clearly the culprit, not total body weight. Overweight is...requiring high-level security clearance, long lead time and specialized training, or overseas screening. This expanded window will allow most personnel with ...replaced with a comprehensive Career Leader Development Program (CLDP). CLDP will include Petty officer Indoctrination Course (POIC); Chief Petty officer

Barroom Aggression in Hoboken, New Jersey: Don't Blame the Bouncers!

ERIC Educational Resources Information Center

Roberts, James C.

2007-01-01

Relying on a structured observation guide listing a large number of variables shown to be good predictors of aggression in bars by past researchers, trained observers spent a total of 444 hours collecting data in 25 licensed drinking establishments in Hoboken, New Jersey. Observations took place at two separate time periods, 7:30pm-10:30pm and…

Online colour training system for dental students: a comprehensive assessment of different training protocols.

PubMed

Liu, M; Chen, L; Liu, X; Yang, Y; Zheng, M; Tan, J

2015-04-01

The purpose of this study was to evaluate the training effect and to determine the optimal training protocol for a recently developed online colour training system. Seventy students participated in the evaluation. They first completed a baseline test with shade guides (SGT) and the training system (TST), and then trained with one of the three system training methods (Basic colour training for group E1, Vitapan Classical for E2, and Vitapan 3D-Master for E3) or shade guides (group C1) for 4 days. The control group (C2) received no training. The same test was performed after training and they finally completed a questionnaire. The correct matches after training increased in three experimental groups and group C1. Among experimental groups, the greatest improvement of correct matching number was achieved by group E3 (4·00 ± 1·88 in SGT, 4·29 ± 2·73 in TST), followed by E2 (2·29 ± 2·73 in SGT, 3·50 ± 3·03 in TST) and E1 (2·00 ± 2·60 in SGT, 1·93 ± 2·96 in TST). The difference between E3 and E1 was statistically significant (P = 0·036 in SGT, 0·026 in TST). The total average training time was shorter in group E2 (15·39 ± 4·22 min) and E3 (17·63 ± 5·22 min), with no significant difference between them. Subjective evaluations revealed that self-confidence in colour matching were improved greater in group C1 and E3. In conclusion, all tested sections of the system effectively improved students' colour-matching ability. Among system training methods, Vitapan 3D-Master showed the best performance; it enabled greater shade-matching improvement, it saved time and was superior in subjective evaluations. © 2014 John Wiley & Sons Ltd.

Changing the Learning Curve in Novice Laparoscopists: Incorporating Direct Visualization into the Simulation Training Program.

PubMed

Dawidek, Mark T; Roach, Victoria A; Ott, Michael C; Wilson, Timothy D

A major challenge in laparoscopic surgery is the lack of depth perception. With the development and continued improvement of 3D video technology, the potential benefit of restoring 3D vision to laparoscopy has received substantial attention from the surgical community. Despite this, procedures conducted under 2D vision remain the standard of care, and trainees must become proficient in 2D laparoscopy. This study aims to determine whether incorporating 3D vision into a 2D laparoscopic simulation curriculum accelerates skill acquisition in novices. Postgraduate year-1 surgical specialty residents (n = 15) at the Schulich School of Medicine and Dentistry, at Western University were randomized into 1 of 2 groups. The control group practiced the Fundamentals of Laparoscopic Surgery peg-transfer task to proficiency exclusively under standard 2D laparoscopy conditions. The experimental group first practiced peg transfer under 3D direct visualization, with direct visualization of the working field. Upon reaching proficiency, this group underwent a perceptual switch, changing to standard 2D laparoscopy conditions, and once again trained to proficiency. Incorporating 3D direct visualization before training under standard 2D conditions significantly (p < 0.0.5) reduced the total training time to proficiency by 10.9 minutes or 32.4%. There was no difference in total number of repetitions to proficiency. Data were also used to generate learning curves for each respective training protocol. An adaptive learning approach, which incorporates 3D direct visualization into a 2D laparoscopic simulation curriculum, accelerates skill acquisition. This is in contrast to previous work, possibly owing to the proficiency-based methodology employed, and has implications for resource savings in surgical training. Crown Copyright © 2016. Published by Elsevier Inc. All rights reserved.

Active learning of neuron morphology for accurate automated tracing of neurites

PubMed Central

Gala, Rohan; Chapeton, Julio; Jitesh, Jayant; Bhavsar, Chintan; Stepanyants, Armen

2014-01-01

Automating the process of neurite tracing from light microscopy stacks of images is essential for large-scale or high-throughput quantitative studies of neural circuits. While the general layout of labeled neurites can be captured by many automated tracing algorithms, it is often not possible to differentiate reliably between the processes belonging to different cells. The reason is that some neurites in the stack may appear broken due to imperfect labeling, while others may appear fused due to the limited resolution of optical microscopy. Trained neuroanatomists routinely resolve such topological ambiguities during manual tracing tasks by combining information about distances between branches, branch orientations, intensities, calibers, tortuosities, colors, as well as the presence of spines or boutons. Likewise, to evaluate different topological scenarios automatically, we developed a machine learning approach that combines many of the above mentioned features. A specifically designed confidence measure was used to actively train the algorithm during user-assisted tracing procedure. Active learning significantly reduces the training time and makes it possible to obtain less than 1% generalization error rates by providing few training examples. To evaluate the overall performance of the algorithm a number of image stacks were reconstructed automatically, as well as manually by several trained users, making it possible to compare the automated traces to the baseline inter-user variability. Several geometrical and topological features of the traces were selected for the comparisons. These features include the total trace length, the total numbers of branch and terminal points, the affinity of corresponding traces, and the distances between corresponding branch and terminal points. Our results show that when the density of labeled neurites is sufficiently low, automated traces are not significantly different from manual reconstructions obtained by trained users. PMID:24904306

Alternative approaches to ambulatory training: internal medicine residents' and program directors' perspectives.

PubMed

Thomas, Kris G; West, Colin P; Popkave, Carol; Bellini, Lisa M; Weinberger, Steven E; Kolars, Joseph C; Kogan, Jennifer R

2009-08-01

Internal medicine ambulatory training redesign, including recommendations to increase ambulatory training, is a focus of national discussion. Residents' and program directors' perceptions about ambulatory training models are unknown. To describe internal medicine residents' and program directors' perceptions regarding ambulatory training duration, alternative ambulatory training models, and factors important for ambulatory education. National cohort study. Internal medicine residents (N = 14,941) and program directors (N = 222) who completed the 2007 Internal Medicine In-Training Examination (IM-ITE) Residents Questionnaire or Program Directors Survey, representing 389 US residency programs. A total of 58.4% of program directors and 43.7% of residents preferred one-third or more training time in outpatient settings. Resident preferences for one-third or more outpatient training increased with higher levels of training (48.3% PGY3), female sex (52.7%), primary care program enrollment (64.8%), and anticipated outpatient-focused career, such as geriatrics. Most program directors (77.3%) and residents (58.4%) preferred training models containing weekly clinic. Although residents and program directors reported problems with competing inpatient-outpatient responsibilities (74.9% and 88.1%, respectively) and felt that absence of conflict with inpatient responsibilities is important for good outpatient training (69.4% and 74.2%, respectively), only 41.6% of residents and 22.7% of program directors supported models eliminating ambulatory sessions during inpatient rotations. Residents' and program directors' preferences for outpatient training differ from recommendations for increased ambulatory training. Discordance was observed between reported problems with conflicting inpatient-outpatient responsibilities and preferences for models maintaining longitudinal clinic during inpatient rotations. Further study regarding benefits and barriers of ambulatory redesign is needed.

Does Warm-Up Training in a Virtual Reality Simulator Improve Surgical Performance? A Prospective Randomized Analysis.

PubMed

da Cruz, José Arnaldo Shiomi; Dos Reis, Sabrina Thalita; Cunha Frati, Rodrigo Marcus; Duarte, Ricardo Jordão; Nguyen, Hiep; Srougi, Miguel; Passerotti, Carlo Camargo

Virtual reality surgical simulators (VRSS) have been showing themselves as a valuable tool in laparoscopy training and education. Taking in consideration the effectiveness of the VRSS, new uses for this tool have been purposed. In sports, warming up before exercise clearly shows benefit in performance. It is hypothesized that warming up in the VRSS before going to the operating room may show benefit in surgical performance. Verify whether there is benefit in surgical performance with preoperatory warm-up using a VRSS. A total of 20 medical students with basic knowledge in laparoscopy were divided in 2 groups (I and II). Group I performed a laparoscopic cholecystectomy in a porcine model. Group II performed preoperative warm-up in a VRSS and then performed a laparoscopic cholecystectomy in a porcine model. The performance between both groups was compared regarding quantitative parameters (time for dissection of the gallbladder pedicle, time for clipping the pedicle, time for cutting the pedicle, time for gallbladder removal, total operative time, and aspirated blood loss) and qualitative parameters (depth perception, bimanual dexterity, efficiency, tissue handling, and autonomy) based on a previously validated score system, in which the higher the score, the better the result. Data were analyzed with level of significance of 5%. The group that underwent preoperative warm-up (group II) showed significantly superior results as to the time for dissection of the gallbladder pedicle (11.91 ± 9.85 vs. 4.52 ± 2.89min, p = 0.012), time for clipping the pedicle (5.51 ± 2.36 vs. 2.89 ± 2.76min, p = 0.004), time for cutting the pedicle (1.84 ± 0.7 vs. 1.13 ± 0.51, p = 0.019), aspirated blood loss (171 ± 112 vs. 57 ± 27.8ml, p = 0.006), depth perception (4.5 ± 0.7 vs. 3.3 ± 0.67, p = 0.004), bianual dexterity (4.2 ± 0.78 vs. 3.3 ± 0.67, p = 0.004), tissue handling (4.2 ± 0.91 vs. 3.6 ± 0.66, p = 0.012), and autonomy (4.9 ± 0.31 vs. 3.6 ± 0.96, p = 0.028). There was no difference in time for gallbladder removal (11.58 ± 4.31 vs. 15.08 ± 4.51min, p = 0.096), total operative time (30.8 ± 11.07 vs. 25.60 ± 5.10min, p = 0.188), and efficiency (4 ± 0.66 vs. 3.6 ± 0.69, p = 0.320). The practice of preoperative warm-up training seems to benefit surgical performance even in subject with mild laparoscopic experience. Copyright © 2016 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Evaluation of a novel tablet application for improvement in colonoscopy training and mentoring (with video).

PubMed

Laborde, Cregan J; Bell, Charreau S; Slaughter, James Chris; Valdastri, Pietro; Obstein, Keith L

2017-03-01

Endoscopic training can be challenging for the trainee and preceptor. Frustration can result from ineffective communication regarding areas of interest. Our team developed a novel tablet application for real-time mirroring of the colonoscopy examination that allows preceptors to make annotations directly on the viewing monitor. The potential for improvement in team proficiency and satisfaction is unknown. The on-screen endoscopic image is mirrored to an Android tablet and permits real-time annotation directly on the in-room endoscopic image display. Preceptors can also "freeze-frame" an image and provide visual on-screen instruction (telestration). Trainees, precepted by a GI attending, were 1:1 randomized to perform colonoscopy on a training phantom using the application with traditional precepting or traditional precepting alone. Magnetized polyps (size < 5 mm) were placed in 1 of 5 preset location scenarios. Each trainee performed a total of 10 colonoscopies and completed each location scenario twice. During withdrawal, the trainee and the attending identified polyps. Outcome measures included number of polyps missed and participant satisfaction after each trial. Fifteen trainees (6 novice and 9 GI fellows) performed a total of 150 colonoscopies where 330 polyps in total were placed. Fellows missed fewer polyps using the tablet versus traditional precepting alone (4.2% vs 12.5%; P = .04). There was no significant difference in missed polyps for novices (12.5% vs 18.8%; P = .66). Overall, fellows missed fewer polyps when compared with novices regardless of the precepting method (P = .01). The attending and all trainees reported reduced stress with improved communication using the tablet. Fellows missed fewer polyps using the tablet when compared with traditional endoscopy precepting. All trainees reported reduced stress, quicker identification of polyps, and improved educational satisfaction using the tablet. Our application has the potential to improve trainee plus attending team lesion detection and to enhance the endoscopy training experience for both the trainee and attending preceptor. Copyright © 2017 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.